Rheumatoid Arthritis research
Diet & Lifestyle

• Vegetarian Diet
• Exercise
• Ginger

Vegetarian Diet & Rheumatoid Arthritis

Rheumatoid arthritis (RA) sufferers could find significant relief by following a vegetarian diet according two studies (1) (2) conducted at the Institute of Immunology and Rheumatology, National Hospital, Oslo, Norway.

The researchers had previously observed that a significant improvement can be obtained in rheumatoid arthritis patients by a short period of fasting followed by an individually adjusted vegetarian diet for one year and so they continued their line of research by monitoring the patients for a period of two years to see whether any benefits could be sustained over a longer period.

The researchers compared the change in the 124 patients’ conditions (53 who ate a strict vegetarian diet, 71 who ate an omnivorous diet) from baseline (i.e. the commencement of the study ) to the time of the follow-up examination. The following variables favoured diet responders: pain score, duration of morning stiffness, Stanford Health Assessment Questionnaire index, number of tender joints, Ritchie's articular index, number of swollen joints, ESR, platelet count and white blood cell count. The differences between patients who responded to dietary therapy was significant for all the clinical variables, except for grip strength. All of the patients were assessed for personality or psychological factors which could influence their responses. The patients who participated in the clinical trial differed significantly from other RA patients. Firstly, they had a higher belief or expectation in the effectiveness of 'alternative', unconventional forms of treatment was higher. But, of the patients who were assigned to a vegetarian diet, there was no significant difference between those who responded and those who didn’t with regard to the personality or character scores although one factor that was noticeable was that those who responded to the diet had a significantly lower belief in the effect of ordinary medical treatment compared with diet non-responders.

The researchers concluded that their findings clearly indicate that large proportion of patients with rheumatoid arthritis can benefit from dietary manipulations and that the improvement can be sustained through a two-year period and that these changes could not be explained by psychological characteristics of the patients.

Encouraged by their results the researchers set out to identify the precise biochemical and immunological factors that were affected through a vegetarian diet. No changes were noted in samples taken from those patients who ate meat but 14 of the 15 measured variables responded positively in the vegetarians and the differences were statistically significant for leukocyte count, IgM rheumatoid factor RF, and the complement components C3 and C4 after only one month of treat ment. Most of the laboratory variables declined considerably in the vegetarians who improved according to clinical variables (symptoms), indicating a substantial reduction in inflammatory activity.

(1) Kjeldsen-Kragh J.; Haugen M.; Borchgrevink C.F.; Forre O. Vegetarian diet for patients with rheumatoid arthritis - Status: Two years after introduction of the diet. Clinical Rheumatology (Belgium) , 1994, 13/3 (475-482)
(2) Kjeldsen-Kragh J.; Mellbye O.J.; Haugen M.; Mollnes T.E.; Hammer H.B.; Sioud M.; Forre O. Changes in laboratory variables in rheumatoid arthritis patients during atrial of fasting and one-year vegetarian diet Institute Immunology/Rheumatology, Fredrikke Qvams Gate 1, N-0172 Olso Norway. Scandinavian Journal of Rheumatology (Norway) , 1995, 24/2 (85-93)

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Exercise & Rheumatoid Arthritis

Why should people with arthritis exercise?: - People who are physically active are healthier and live longer than people who are inactive. This is true for everyone but especially for people with arthritis. In addition to the general benefits of regular exercise, certain kinds of exercise have shown important benefits for people with arthritis.

Arthritis is one of the most common reasons people give for limiting physical activity. Being inactive may increase arthritis problems. Many people who have arthritis are less fit, weaker and less flexible and have more pain than necessary due to the complications of inactivity. Pain, stiffness, fatigue and the fear of doing harm can make it difficult to be physically active with arthritis. For the person with arthritis, however, an appropriate exercise program is very important.

What kind of exercise are helpful and safe?: - Research shows that many people with arthritis can safely participate in appropriate, regular exercise programs and achieve better aerobic fitness. Low impact exercises, such as swimming and water aerobics, may be particularly well-tolerated by people with arthritis. Improved strength, endurance and flexibility, and better ability to walk or perform daily tasks are all benefits of exercise.

There are three major types of exercise. Each plays a role in maintaining or improving health and fitness, and reducing arthritis-related disability and pain.

• Flexibility or stretching: Gentle, low intensity exercises performed daily to maintain or improve range of motion are the foundation of most therapeutic exercise programs and also are important in recreational or fitness exercise. Adequate flexibility improves function and reduces the chance for injuries.

• Muscle conditioning (strength and endurance): These are more vigorous than flexibility exercises and are usually done every other day. They are designed to ask the muscle to work a bit harder than usual. This extra workload may come from lifting the weight of the arm, leg or trunk against gravity, or using weights, elastic bands or weight machines for more resistance. Muscles adapt to the new demands by getting stronger and/or becoming capable of working longer.

• Cardiorespiratory or aerobic conditioning:

The most effective and safest intensity for aerobic exercise is moderate exertion. Moderate exertion means the exerciser can speak normally, doesn’t get out of breath or over-heated and can carry on the activity at a comfortable pace.

Current recommendations for regular aerobic activity are for 30 minutes of moderate aerobic activity on most days of the week. Important news for persons with arthritis is that this 30 minutes can be accumulated in three 10 minutes periods of activity over the course of the day for the same health benefits as one continuous 30-minute session.

How to choose the best exercise program: - A comprehensive exercise program for a person with arthritis includes flexibility, strengthening and aerobic activities. The content and progression of the program depends upon individual needs and capabilities. Persons with long-standing or severe disease or multiple joint involvement should undertake exercise in collaboration with the health care team.

The most successful exercise programs begin with the knowledge and support of people like rheumatologists who are experienced with both arthritis and exercise. Your local Arthritis Foundation is an additional source of information on local exercise programs for arthritis patients.

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