This article was published on Oct 5, 2018, in the peer-reviewed Orthopedics and Rheumatology Open Access Journal.
Abstract
Rheumatoid arthritis has no cure, so long term treatment is indicated. An individual’s dietary choices greatly influence the progression of chronic autoimmune rheumatic diseases. This review shows that the plant-based diet has good scientific evidence of safety and efficacy for both prevention and treatment of rheumatoid arthritis. Studies have shown significant improvements in specific symptoms, such as number of tender joints, Ritchie’s articular index, number of swollen joints, pain score, duration of morning stiffness, grip strength, and improved laboratory values such as sed rate (ESR), C-reactive protein, and rheumatic factor. Patients placed on a plant-based diet also have a beneficial shift in intestinal microbiota, which correlates with clinical improvement. With respect to prevention, those following a plant-based diet experience a reduction in risk of rheumatoid arthritis by about 50%.
RA patients should be advised that a plant-based diet that includes appropriate amounts of carbohydrate, especially dietary fiber, is important for maintaining the symbiosis of intestinal flora, which could be beneficial for preventing autoimmunity. As disease severity worsens, individuals with RA may experience functional decline that can impact dietary intake. New healthy plant-based convenience foods are a good choice for such patients.
 Treatment with a plant-based diet is affordable for the patient, has no adverse reactions and no contraindications, and it can be combined with any of the standard treatments. For mild cases it may suffice as a monotherapy. For moderate and severe cases, it may serve as an adjunct, allowing dosage reductions thus lessening the costs and side effects.
