to affect up to 1% of the entire population.

It is painful and often debilitating

talking inflammation in the joints,

the likes of which unless you have it,

sometimes you just can't believe.

And the flare ups with aura seem to come out of nowhere.

What triggers them?

Oftentimes it's a mystery, and that is what researchers

at the Physicians Committee wanted to figure out.

And today,

we're joined

by one of the lead

researchers of a brand new groundbreaking study

that analyzes the effect of diet on rheumatoid arthritis.

We welcome the director of clinical research

for the Physicians Committee, Dr.

Hana Kahleova.

Dr. Kahleova, thanks for being back here.

Thanks for having me, Chuck.

So good to see you again.

So good to be here.

Oftentimes

when you're on the show, we talk about diabetes,

but today we're talking about R.A.

And the thing that I know about R.A.

is that when I said it was painful, just a minute ago,

I've seen people just literally crippled over, crippled over

and have their days just ruined by it.

So when we're talking about pain

and R.A., I mean, how painful is this condition?

Yeah, that's exactly right.

Like, it affects the small joints in

the hands in the wrists,

the knees, but also other joints in the body.

And they're not only painful, but also swollen

and eventually over the course of many years

of the disease, there may be a permanent damage.

So it may be disability and disease also

you know, a big cause of disability. So

this is no fun.

We know that there's genetic factors

but also environmental factors.

And, you know, among the factors that we can influence,

diet seems to be one of them.

It's an autoimmune condition, which means that

it may be triggered by certain proteins.

And that's why we were trying to figure out,

you know, if we modified the diet, could we

could we help these people

with their pain and with their swollen joints?

And that's exactly why we conducted a clinical trial.

And let me share my screen with you and just tell you

a little bit about the study.

Yeah, by all means.

And we see the screen up on there right now.

Wonderful.

So we were looking into the effects

of a plant-based diet for rheumatoid arthritis.

And the findings have just been published

in the American Journal of Lifestyle Medicine.

And, you know, when

when people come in with their joint pain,

I need to say not all joint

pain is due to rheumatoid arthritis.

So in our study, we had a rheumatologist

who verified the diagnosis of rheumatoid arthritis, and

he was also making sure

to do the count of the joints

and all of the assessments that rheumatologists do

without knowing which group the participants were

in, both at baseline and then and then at midpoint.

And then at the end of the study,

we recruited 44 people with rheumatoid arthritis

and they were randomly assigned to either

the diet phase

or the supplement phase.

For sixteen weeks.

And then after the sixteen weeks were over,

we re-assessed their joint pain

and we were using questionnaires

and also the rheumatologist met with them and

we drew their labs.

And after a four week washout

period, four, four week of a break,

they switched over to the opposite intervention.

So those who were on the diet previously went on a supplement

and those who were on

a supplement went on the diet for another six weeks.

And then we did all the final assessments again.

Now, let me describe the diet.

What what exactly was the diet about

for the first four weeks?

It was a low fat vegan diet.

That means no animal product, no meat, no dairy,

no cheese, no eggs for four weeks.

Then for another three weeks

on the top of eliminating all the animal foods,

we also eliminated certain plant foods,

for example, gluten containing grains.

So foods and certain vegetables and fruits.

And for the

last nine weeks, we were reintroducing

the eliminated foods one by one back into the diet.

And if the introduced foods didn't cause any problems,

the participants just kept them in the diet

and kept adding new and new foods.

However, if, let's say

introducing potatoes back to the diet

caused a lot of joint pain and so,

you know, the joints were swollen again,

then the potato was just out of the diet again.

And we were testing other foods which provided each participant

with individualized food triggers that would cause

the joint pain and and swelling.

Here's the list of all the eliminated foods

on the elimination diet.

So in addition to eliminating all the animal foods

during the after four weeks,

during the subsequent three weeks week, we excluded

all the gluten containing grains.

Some vegetables such as potatoes and sweet potatoes,

and onions and tomatoes and eggplants and celery.

Only a couple

of fruits such as apples and bananas and citrus fruit,

nuts and peanuts,

soy foods and chickpea and also chocolate,

coffee, sugar, alcohol and nutritional yeast.

So these foods were eliminated for three weeks,

and then they were introduced one by one every two days.

The participants added another food from this

from this elimination diet list.

Now, the disease activity

measured by the DAS 28 score,

which is one of the the major

rheumatologist assessments

didn't change significantly

on the supplement or which was a placebo

but was reduced substantially during the diet

by 2.1 points.

And I need to say that we also did another analysis

looking at people who increased their medications

during the study.

When we excluded them, we we got similarly results.

And also when we took participants with no medication

changes whatsoever during the study and left

only them then and the results were comparable as well.

And another significant

finding from the study was the number of swollen joints

which was reduced by 3.7 during the diet phase

and did not change significantly on the placebo

So in conclusion, it looks like the elimination

plant based diet really work for rheumatoid arthritis

and can be definitely tried out if you have

rheumatoid arthritis.

I'd like to encourage you to give it a try

and we will post the whole

the whole paper with the list of the foods

that that were eliminated on the elimination diet

so that you can you can do it yourself.

Those are really fascinating results. Dr.

Kahleova.

What was your hypothesis going into this?

I mean, we know that plant-based

diets, by and large are anti-inflammatory.

So was it your suspicion that this

probably would be helpful to a lot of these study participants?

Yeah, exactly.

Our thought was let

let's try out how a plant-based diet can help these people.

We know that plant-based diets in general are

anti-inflammatory.

But then

also we realize that there are certain triggers

beyond the animal foods that are excluded from from

the plant, plant-based diet.

That's why we also included the elimination phase.

Unfortunately, the individual foods

that need to be eliminated in

in each single person,

they are completely different from one person to another.

So there is no way how to predict whether a person

will be reacting to a potato or a tomato

or an apple or onion.

Every person just needs to try these foods out.

So one part one part is eliminating

all the animal products.

And most participants reported significant improvement

of their joint pain even after the first four weeks.

But there was still some remaining pain

in some of the participants, and that's

where the elimination diet came into play.

Interesting.

I find it really interesting how wide of a variation

there was as far as the trigger foods.

So what you're saying is

you can't exactly say that while, you know,

fruits are more likely to be triggers or potatoes,

as you said, or onions or whatever

the case may be, you can't say

any of that is more likely to be a trigger than another food.

Do we have any sort of understanding as to why

it varies so widely from person to person?

Our body, it's an autoimmune condition

and it's triggered by certain proteins.

And it also depends on your genetic

background and also your early, early life exposures.

So let's say people who were not breastfed

and where cows and milk was introduced early, early in life,

they may react to dairy much stronger

than a person who was breastfed, for example.

You know, there's different

there's different foods that are being introduced

into the diet in the early life.

And some of them just turn out to be to be triggers.

It's it's also the case

with meat and

with eggs.

You know, the earlier the exposure in life,

the higher the probability that the body will be reacting

to these foods later in life.

So that's also

stressing a

point for all our mothers

who have small babies to be really careful

about the diet of their babies.

You know, make sure they breastfeed them long enough

and also that they introduce foods that are not

not any of these triggers too early in life.

And I'm looking at the list of foods

that were part of the elimination diet.

There were three in particular that stood out to me

that I'm like, hmm, I wonder if some people had a hard time

eliminating these completely I'm talking about coffee

and I'm talking about sugar and I'm talking about chocolate.

Weren't did any of the participants say, hey, look, Dr.

Kahelova, this is like so hard to take out of my life?

Absolutely.

There were a few people who were like,

How am I going to survive without my coffee?

But they did it.

You know, you can you can do everything

if you put your mind to it, like

going through the elimination diet.

Gave the study

participants unique information for the rest of their life.

Let's say,

you know, you're

you're experiencing some pain in your joints, Chuck,

and you don't know where the pain is coming from.

And someone will tell you, you know, let's let's figure it out.

Over the next six weeks, we will know exactly

what triggers your pain.

Then you might be up for that.

You know

what? You might be willing to eliminate

all your sugar in coffee.