Rheumatoid Arthritis: A Food Sensitivity Related Problem?

Myron Yau, HK BioTek Nutritionist

Arthritis is a collective term used to describe the condition of joint pain, swelling and destruction. The two commonly heard types of arthritis in Hong Kong are Gout and Rheumatoid Arthritis (RA). The former one is associated with excessive ingestion of purine or compromised excretion of uric acid into urine while the latter one is of unknown reason causing attack to the joints by own immune system.

The current main stream treatment of RA relies on medication and/or diet rich in omega-3 fatty acid and possibly some other nutrients. In some earlier studies, subgroups of RA patients have been found to have elevated levels of IgG antibodies against wheat ingredients compared with control. Increased antibody levels to several dietary antigens have also been demonstrated by Kjeldsen-Kragh et al in RA patients who subsequently responded favorably to a vegetarian diet. All these provide a light into new direction in treating RA.

In a more recent study, more details in the story are revealed. A group of patients are randomized into two groups, a vegan diet and non-vegan diet group for a year. Turnout, 40.5% patients in vegan diet group have significant improvements according to ACR20 criteria while it was only 4% in non-vegan diet group. The IgG levels against gluten and milk before and after the treatment are measured. It is found that IgG levels of the vegan diet group have significant dropped after the treatment, as compared to the non-vegan diet group. When the data of vegan diet group are subdivided, the decrease of IgG levels mainly come from the positively responder group, but not from other subgroups. The researchers emphasized that this decrease did not always occur as a result of a lack of exposure to the antigens. It rather suggests that a positive effect of a vegan diet in a subgroup of RA patients may indeed be due to diminished immune response tot exogenous food antigens. Taken together other supporting studies, these studies thus provide additional support to the concept that changes in the gut immune system can influence the course of joint inflammation in RA.

This above story gives a clear view of a new way to treat or manage RA with elimination diet based on food-specific IgG levels in blood, beside medication.