Tratamiento artritis reumatoide con dietas vegetarianas
Existe una línea de investigación centrada en dietas vegetarianas y ayunos, que demuestran la reducción en signos y síntomas de la artritis reumatoidea y potencialmente de otras enfermedades por auto aunticuerpos, las cuales involucran a muchas de las principales enfermedades no infectocontagiosas a nivel mundial.
Rheumatoid arthritis treated with vegetarian diets
Jens Kjeldsen-Kragh
1 From the Department of Immunology and Transfusion Medicine, Ullevaal University Hospital, Oslo.
2 Reprints not available. Address correspondence to J Kjeldsen-Kragh, Department of Immunology and Transfusion Medicine, Ullevaal University Hospital, N-0407 Oslo, Norway. E-mail: jens.kjeldsen-kragh@ioks.uio.no .
Abstract
The notion that dietary factors may influence rheumatoid arthritis (RA) has been a part of the folklore of the disease, but scientific support for this has been sparse. In a controlled, single-blind trial we tested the effect of fasting for 7–10 d, then consuming an individually adjusted, gluten-free, vegan diet for 3.5 mo, and then consuming an individually adjusted lactovegetarian diet for 9 mo on patients with RA. For all clinical variables and most laboratory variables measured, the 27 patients in the fasting and vegetarian diet groups improved significantly compared with the 26 patients in the control group who followed their usual omnivorous diet throughout the study period. One year after the patients completed the trial, they were reexamined. Compared with baseline, the improvements measured were significantly greater in the vegetarians who previously benefited from the diet (diet responders) than in diet nonresponders and omnivores. The beneficial effect could not be explained by patients' psychologic characteristics, antibody activity against food antigens, or changes in concentrations of prostaglandin and leukotriene precursors. However, the fecal flora differed significantly between samples collected at time points at which there was substantial clinical improvement and time points at which there were no or only minor improvements. In summary, the results show that some patients with RA can benefit from a fasting period followed by a vegetarian diet. Thus, dietary treatment may be a valuable adjunct to the ordinary therapeutic armamentarium for RA.
A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens.
I. Hafström, B. Ringertz1, A. Spångberg1, L. von Zweigbergk2, S. Brannemark1, I. Nylander, J. Rönnelid1, L. Laasonen3 and L. Klareskog1
Department of Rheumatology, Karolinska Institutet at Huddinge University Hospital, Stockholm,
1 Department of Rheumatology, Karolinska Institutet at Karolinska Hospital, Stockholm,
2 The Unit for Preventive Nutrition, Karolinska Institutet at Novum, Huddinge, Sweden and
3 Department of Radiology, Surgical Hospital, Helsinki University Central Hospital, Helsinki, Finland
Abstract
Objective. Whether food intake can modify the course of rheumatoid arthritis (RA) is an issue of continued scientific and public interest. However, data from controlled clinical trials are sparse. We thus decided to study the clinical effects of a vegan diet free of gluten in RA and to quantify the levels of antibodies to key food antigens not present in the vegan diet.
Methods. Sixty-six patients with active RA were randomized to either a vegan diet free of gluten (38 patients) or a well-balanced non-vegan diet (28 patients) for 1 yr. All patients were instructed and followed-up in the same manner. They were analysed at baseline and after 3, 6 and 12 months, according to the response criteria of the American College of Rheumatology (ACR). Furthermore, levels of antibodies against gliadin and ß-lactoglobulin were assessed and radiographs of the hands and feet were performed.
Results. Twenty-two patients in the vegan group and 25 patients in the non-vegan diet group completed 9 months or more on the diet regimens. Of these diet completers, 40.5% (nine patients) in the vegan group fulfilled the ACR20 improvement criteria compared with 4% (one patient) in the non-vegan group. Corresponding figures for the intention to treat populations were 34.3 and 3.8%, respectively. The immunoglobulin G (IgG) antibody levels against gliadin and ß-lactoglobulin decreased in the responder subgroup in the vegan diet-treated patients, but not in the other analysed groups. No retardation of radiological destruction was apparent in any of the groups.
Conclusion. The data provide evidence that dietary modification may be of clinical benefit for certain RA patients, and that this benefit may be related to a reduction in immunoreactivity to food antigens eliminated by the change in diet.
--------------------------------------------------------------------------------
