Arthritis and Red Meat

** Originally posted by evanscyoc **

I'm going to see a homeopathic doc next week, but had some questions first. Has anyone ever heard about red meat and how it relates to arthritis, in my case PA? I was reading that things like red meat and red wine can cause/increase arthritis pain.

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** Originally posted by chaimFL **

Here is some interesting abstracts that talk about diet and rheumatic diseases:

Rheumatology Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.

PURPOSE OF REVIEW: Recent scientific data illuminate the dietary link to rheumatic disorders. This review summarizes recently published articles on the dietary link to rheumatoid arthritis, gout, and osteoarthritis. RECENT FINDINGS: A prospective study suggests that higher intakes of meat and total protein as well as lower intakes of fruit, vegetables, and vitamin C are associated with an increased risk of inflammatory polyarthritis or rheumatoid arthritis. Several studies suggest that the Mediterranean-type diet or its main components may have protective effects on the development or severity of rheumatoid arthritis. A recent prospective study investigated several purported dietary factors for gout and confirmed some of the long-standing suspicions (red meats, seafood, beer, and liquor), exonerated others (total protein, wine, and purine-rich vegetables), and also identified potentially new protective factors (dairy products). Recent double-blind, randomized, placebo-controlled studies suggest that antioxidant vitamins (vitamin E, vitamin C, beta-carotene, and retinol) do not halt the progression of symptomatic knee osteoarthritis, as was previously suggested. SUMMARY: Because diet is an unavoidable universal exposure for people, even a small effect that can be achieved by dietary manipulation may produce a large impact on the population's health. As the evidence on the role of dietary factors in rheumatic disorders grows it becomes increasingly important for clinicians and investigators in the field of rheumatology to familiarize themselves with the relevant data and appropriately apply them to clinical and public health practice.

The above abstract only mentions gout as Karen said, but the same principles can be played with to see if you have a positive reaction to similar diet alterations.

Diet therapy for rheumatoid arthritis.

Panush RS, Carter RL, Katz P, Kowsari B, Longley S, Finnie S.

Although diet therapy for arthritis has received considerable publicity, there is little objective information about its efficacy. We undertook a 10-week, controlled, double-blind, randomized trial of patients with active rheumatoid arthritis (RA). Twenty-six patients completed the study; 11 were on an experimental diet (a specific popular diet free of additives, preservatives, fruit, red meat, herbs, and dairy products) and 15 were on a "placebo" diet. Of 183 variables analyzed, there were no clinically important differences among rheumatologic, laboratory, immunologic, radiologic, or nutritional findings between patients on experimental and placebo diets. Six RA patients on the placebo and 5 on the experimental diet improved by objective criteria. Improvement averaged 29% for patients on placebo and 32% for patients on experimental diets. Two patients on the experimental diet improved notably, elected to remain on the experimental diet following the study period, have continued to improve, and noted exacerbations of disease upon consuming nonexperimental diet foods. Our study failed to provide evidence of objective overall clinical benefit of this diet as followed by a group of patients with longstanding, progressive, active RA. However, our data are not inconsistent with the possibility that individualized dietary manipulations might be beneficial for selected patients with rheumatic disease.

This one is inconclusive since the results of those tested were the same as those on placebo. This doesn't mean that it's 100% ineffective, but there was no "clinical bombshell" here to indicate diet plays any major role.

Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption.

Pattison DJ, Symmons DP, Lunt M, Welch A, Luben R, Bingham SA, Khaw KT, Day NE, Silman AJ.

University of Manchester, Manchester, UK.

OBJECTIVE: To investigate the association of red meat and other specific dietary components in predicting the development of inflammatory polyarthritis. METHODS: This nested case-control study was conducted within a prospective population-based study of cancer incidence (European Prospective Investigation of Cancer in Norfolk [EPIC-Norfolk]). EPIC-Norfolk recruited 25,630 subjects ages 45-75 years between 1993 and 1997. Dietary intake was assessed at baseline using a 7-day food diary, and the information was analyzed using dietary analysis software. Patients with new cases of inflammatory polyarthritis were identified by linkage with the Norfolk Arthritis Register, a primary care-based inception study of inflammatory polyarthritis, and were matched for age and sex to 2 controls from EPIC-Norfolk. The risk for development of inflammatory polyarthritis was compared between subjects in the highest and lowest tertiles of dietary intake using conditional logistic regression and was expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). RESULTS: Between 1993 and 2002, 88 new patients with inflammatory polyarthritis were identified and matched with 176 controls. Among patients, the level of red meat intake was higher (P = 0.04) and that of vitamin C was lower (P = 0.03) compared with intake among controls, but no difference in total energy intake was observed. Patients were more likely to be smokers. After adjusting for total energy intake, smoking, and other possible dietary confounders, subjects with the highest level of consumption of red meat (OR 1.9, 95% CI 0.9-4.0), meat and meat products combined (OR 2.3, 95% CI 1.1-4.9), and total protein (OR 2.9, 95% CI 1.1-7.5) were at an increased risk for inflammatory polyarthritis. CONCLUSION: A high level of red meat consumption may represent a novel risk factor for inflammatory arthritis or may act as a marker for a group of persons with an increased risk from other lifestyle causes.

There are some implications here, but it seems that those who had the highest red meat intake also had other factors that may have been involved with the increased inflammation.

All in all, it seems that wine is fine if not good, but red meat is neither here nor there. If it happens that you are a major red meat consumer (true carnivor) then maybe try altering that some to see if you notice a difference.

I'll add that it's important to keep in mind that psoriatic arthritis is a disease that can and most likely will continue to progress. Being under the care of a rheumatologist is first and foremost important. If diet is something you want to pursue then perhaps seeking the advise of a qualified dietician would be helpful.

Good luck and let us know how things work out.

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** Originally posted by evanscyoc **

Thanks for the responses.... I have already been to a rheummy, and that has provided SOME relief, but turns out that the DayPro she gave me to take while waiting on tests to see if I'm able to take things like Humira, I can't take. I have some kidney issues and apparently, the DayPro is not safe in my circumstances.... so it will probably be a very painful next two weeks while I wait to have my next appointment with her.

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** Originally posted by floridian **

The above abstract only mentions gout as Karen said, but the same principles can be played with to see if you have a positive reaction to similar diet alterations.

You must have been tired, bud ... the abstract you referenced said the following:

Several studies suggest that the Mediterranean-type diet or its main components may have protective effects on the development or severity of rheumatoid arthritis.
As the evidence on the role of dietary factors in rheumatic disorders grows it becomes increasingly important for clinicians and investigators in the field of rheumatology to familiarize themselves with the relevant data and appropriately apply them to clinical and public health practice.

And there are plenty of other studies linking meat with arthritis, for example:

Rheumatol Int. 2003 Jan;23(1):27-36. Epub 2002 Sep 6.

Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis.

Adam O, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M, Adam P, Klimmek R, Forth W.

Medizinische Klinik Innenstadt der LMU, Ziemssenstrasse 1, 80336 Munich, Germany.

BACKGROUND: Patients with rheumatoid arthritis (RA) improve on a vegetarian diet or supplementation with fish oil. We investigated the effects of both dietary measures, alone and in combination, on inflammation, fatty acid composition of erythrocyte lipids, eicosanoids, and cytokine biosynthesis in patients with RA. METHODS: Sixty-eight patients with definitive RA were matched into two groups of 34 subjects each. One group was observed for 8 months on a normal western diet (WD) and the other on an anti-inflammatory diet (AID) providing an arachidonic acid intake of less than 90 mg/day. Patients in both groups were allocated to receive placebo or fish oil capsules (30 mg/kg body weight) for 3 months in a double-blind crossover study with a 2-month washout period between treatments. Clinical examination and routine laboratory findings were evaluated every month, and erythrocyte fatty acids, eicosanoids, and cytokines were evaluated before and after each 3-month experimental period. RESULTS: Sixty patients completed the study. In AID patients, but not in WD patients, the numbers of tender and swollen joints decreased by 14% during placebo treatment. In AID patients, as compared to WD patients, fish oil led to a significant reduction in the numbers of tender (28% vs 11%) and swollen (34% vs 22%) joints (P<0.01). Compared to baseline levels, higher enrichment of eicosapentaenoic acid in erythrocyte lipids (244% vs 217%) and lower formation of leukotriene B(4) (34% vs 8%, P>0.01), 11-dehydro-thromboxane B(2) (15% vs 10%, P<0.05), and prostaglandin metabolites (21% vs 16%, P<0.003) were found in AID patients, especially when fish oil was given during months 6-8 of the experiment. CONCLUSION: A diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation.

and there are plenty of other articles like this:

J Altern Complement Med. 2002 Feb;8(1):71-5.

Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis.

McDougall J, Bruce B, Spiller G, Westerdahl J, McDougall M.

St Helena Hospital, Deer Park, CA, USA.

OBJECTIVE: To demonstrate the effects of a very low-fat, vegan diet on patients with rheumatoid arthritis (RA). DESIGN: Single-blind dietary intervention study. SUBJECTS AND STUDY INTERVENTIONS: This study evaluated the influence of a 4-week, very low-fat (approximately 10%), vegan diet on 24 free-living subjects with RA, average age, 56 +/- 11 years old. Outcome measurements: Prestudy and poststudy assessment of RA symptomatology was performed by a rheumatologist blind to the study design. Biochemical measures and 4-day diet data were also collected. Subjects met weekly for diet instruction, compliance monitoring, and progress assessments. RESULTS: There were significant (p < 0.001) decreases in fat (69%), protein (24%), and energy (22%), and a significant increase in carbohydrate (55%) intake. All measures of RA symptomatology decreased significantly (p < 0.05), except for duration of morning stiffness (p > 0.05). Weight also decreased significantly (p < 0.001). At 4 weeks, C-reactive protein decreased 16% (ns, p > 0.05), RA factor decreased 10% (ns, p > 0.05), while erythrocyte sedimentation rate was unchanged (p > 0.05). CONCLUSION: This study showed that patients with moderate-to-severe RA, who switch to a very low-fat, vegan diet can experience significant reductions in RA symptoms.

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** Originally posted by floridian **

After seeing the practioner, you might want to inquire with your rheumatologist to see what his thoughts are regarding diet etc.

That's great if your rheumy has bothered to research the literature, but chances are good that they haven't. My wife has autoimmune thyroiditis, and she specifically asked her rheumatologist if there was any dietary therapies. He said no. We got off our duffs and found a whole body of research that suggested that 30-50% of people with her condition have a reaction to gluten/gliaden in wheat and barley and improve when that is removed from the diet. She cut out the wheat and within a week felt much better. Since then, her lab tests for thyroid hormone (T3, T4) have returned to normal and her antithyroid antibody is close to normal. But even a small amount of wheat brings the symptoms back. Had she listened to the doctor, she would have continued to suffer from coldness, fatigue, muscle aches and moods swings, and they would have waited until end-stage to use steroids or methotrexate, then remove the thyroid.

IT'S YOUR HEALTH PEOPLE!!! There are some good doctors out there, but there are also many who can't be bothered to keep up with the myraid of conditions and glut of research, or who have simply decided (against the evidence) that diet cannot really make a difference.

The "intriguing new evidence" about fish oil and arthritis goes back to the 1950s and beyond ! !

BRUSCH CA, JOHNSON ET. A new dietary regimen for arthritis: value of cod liver oil on a fasting stomach. J Natl Med Assoc. 1959 Jul;51(4):266-70. PMID: 13665344

The article at written by Dr. Michael E. Weinblatt, MD and referenced above flies in the face of a large body of evidence. There are 220 articles on fish oil and arthritis that are indexed in PubMed! "Intriguing new evidence"? "No evidence that diet can influence any arthritis but gout"? That is ill-informed opinion masquerading as science. While there are plenty of controversies related to diet, an honest answer would have addressed the uncertainties and disagreements, not pretended that there is a consensus that diet cannot affect arthritis.

Is diet a magic bullet against all psoriasis? No. Nor is diet a magic bullet against all heart disease. But there would be a lot less suffering from psoriasis and heart disease if the research on diet was put into practice.

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** Originally posted by Dulane **

You got my vote Floridian,

All I know about PA is that I hurt when I eat certain foods. I do eat them on occassion, but I really keep it to a minimum.

I can't cheat for more that 3 days without feeling one joint or another act up. My diet works well for me; I'm just glad I found it before I got more involved.


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** Originally posted by floridian **

" No evidence that diet can influence any arthritis but gout"? That is ill-informed opinion masquerading as science"

Actually its FACT as known to science right now. Like it or not, that IS the consensus.

Not a fact nor scientific. Science is a human process that is quite fallible in the short to medium term; science is not a being that 'knows' anything. That statement on the relation between diet and disease may be the consensus of one organization of doctors, but it is not the consensus of the research community. 220 articles on fish oil and arthritis going back to the 1950s have opened an issue in the scientific community, and anyone that speaks of fish oil and arthritis as a new potential development in the year 2000 is mischaracterizing the research. Thousands of other research articles which show that various diets or dietary modifications can favorably influence arthritis does not support that OPINION in any way.

Floridian, Floridian, there are heart healthy father in law was put on one in the 80's. Have you ever visited the Amercian heart foundations website? YIKES ..if you haven't then you really should...they are all over diet.

Yes, and have you studied the history of the medical industry's opinion on diet and heart disease? Through the 1950s, 1960s and 1970s, they ignored the mounting evidence on diet and smoking on the heart. The American Medical Association, which owned a large amount of stock in tobacco companies up until the 1980s, was of the opinion that people should live the lives they want to, eat, drink and smoke "in moderation" - and if they get a heart attack, the doctors would do their best to fix things. The role of diet was systematically minimized until the 1980s. Then the community of doctors flipped and embraced the research that was too massive to ignore any more.

"The data demonstrating the concept that the risk of coronary heart disease is a function of serum lipids at any level is no longer valid are reviewed. The data of the National Cooperative Pooling Project of the American Heart Association are used to show that up to 250 mg/dl there is no relationship between serum cholesterol concentration and risk."
Am J Clin Nutr. 1978 May;31(5):865-75. Oversimplification of diet: coronary heart disease relationships and exaggerated diet recommendations. Reiser R.

Oops. Most doctors now admit that cholesterol levels under 250 (even under 200 in people with other conditions) can be a risk factor for heart disease.

Circulation. 1972 May;45(5):8-20.
Has knowledge of atherosclerosis advanced sufficiently to warrant its application to a practical prevention program? The 1970 G. Lyman Duff Memorial Lecture, Council on Arteriosclerosis, American Heart Association. Katz LN.

Had knowledge of atherosclerosis advanced sufficiently to warrant its application to a practical prevention program in 1970? Yes, but it took another decade to turn the ship.

Medical associations are by nature sceptical and conservative (ie, reluctant to change, even in the face of overwhelming research). The same story is repeated over and over. Take the case of folic acid and birth defects. They ignored the evidence for decades. First it was animal studies that showed that folic acid levels were a strong predictor of neural tube defects. The medical associations dismissed that data - after all, humans are not rats. Then came the epidemiological studies, which consistently showed that populations with higher folate consumption had fewer birth defects. "Interesting," the medical community said," but epidemiological studies have so many variables, we can't reccommend that people take an innexpensive supplement of a safe vitamin which hasn't been 'proven' to our satisfaction to reduce birth defects." At some point, the medical community again flipped, and they reccommended that folic acid be added to processed foods. Now they are patting themselves on the back because the number of neural tube birth defects is going down, never mind the fact that many of the organizations that now champion the supplement program dragged their feet or actively opposed it for decades, allowing thousands of birth defects to occur.

Most doctors are not scientists - they are practioners. They are influenced by the culture of the medical community to a larger degree than most people will admit. While a good doctor uses scientific information, the average doctor is busy seeing patients for 8 - 20 hours a day, which doesn't leave much time for science. Flip over to the thread started by Brad (misales - "complete about face") where his doctor told him his high triglycerides (800-yikes!) were genetic. Isn't it strange that he 'defeated genetics' and brought it down under 100 with exercise and a change in diet? Or maybe the statement that high triglycerides is usually genetic is wrong, even though the drug industry and many doctors are pushing that view today. A friend of mine at work got the same spiel - triglycerides over 500, its genetic, take this pill. That wasn't a pure, objective scientific statement, and neither is the statement that gout is the only arthritis that responds to diet.

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** Originally posted by skrome **

Hi Erik
My own experience has been that I feel better when I eat a lot of red meat. I came down with severe pa when I was a vegetarian for 15 years. It wasn't until I went on the D'adamo type O blood type diet that I started feeling better. I haven't had an arthritic flare up for about 4 years now. Unfortunately, this diet doesn't seem to help my skin. If you're not blood type O then eliminating red meat might make a difference. In any case, why don't you try giving up all wheat and other gluten grains (bread, bagels, pasta, etc. and read labels) for a month and see if it helps.

PS--Floidian, I'm with you. This is the alternative board. I'm here because I want to read about alternatives whether they're scientific, mystical, folklore or whatever. Many people are helped by alternatives that aren't approved or prooven. If I wanted to hear about the standard ama, fda, or quackwatch line I'd hang out at the other boards.

Everyone have a great itch free new year


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** Originally posted by Dulane **

Altho I noticed a big PA pain reduction after 1 month of going on an elimination diet where I stopped using wheat, corn, sugar, nightshades, dairy, etc, it was still 3 months to where I was pain free.

I have not taken any pain pills for PA. But I still use turmeric and other anti-inflammatory supplements.

I think that it takes quite a while to relieve the inflammation and stop the 'attack cells' from being on guard.

And the fact that just a few days of cheating can bring aches back makes me realize that I still have the disease...I just control it pretty well.

I am not a big fan of the holiday season when these foods are so prevelant and it is our culture to pig out.

I do not seem to have trouble with red meat. But I eat half of what I used to. I don't have any troubles with getting enough protein in my diet. If people really bothered to see what a dietary portion of meat really was, they'd see that most of us get too much.

I'm glad I found out about diet before all the drugs out there. Keep it simple. If it'll probably last longer.

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