Open Letter To the Editor-in-Chief, Journal of the American College of Cardiology
October 27, 2017
Dear Dr. Fuster,
In your recent update to the Expert Consensus Decision Pathway, (1) no specific mention was made of a safe and efficacious non-statin therapy, the plant-based diet.
Vegetarian and vegan diets can be very efficacious in reducing serum cholesterol and, importantly, LDL. Studies have shown that those following a plant-based diet have significantly lower total cholesterol and LDL levels. (2)
This article was published on Oct 5, 2018, in the peer-reviewed Orthopedics and Rheumatology Open Access Journal.
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.
See Dr Chan Hwang, Physical Medicine and Rehab, talk about the treatment of Crohn’s Disease and Rheumatoid Arthritis with a plant-based diet:
A printable (pdf) version of this article is available: hypercholesterolemia-and-atherosclerosis
Hypercholesterolemia and atherosclerosis are the subject of intensive research the world over. Epidemiological studies investigating different diets, laboratory studies aimed at elucidating the different etiologic factors and their pathogenic mechanisms, as well as a number of clinical and interventional studies, are all active fields of investigation.
As is well known, hypercholesterolemia raises the risk and is a prime etiologic factor of atherosclerosis, which in turn is an etiologic factor in a number of diseases such as essential hypertension, coronary artery disease, and ischemic stroke, just to name a few.
There has been increasing interest in the role played by the gastrointestinal flora in the etiology of a variety disease processes. It had been known that long term changes in diet influenced the human gut microbiome. Recent research has focused on how the flora of those following a vegetarian diet differ from those on other diets, and what advantages that may convey.