Research from Amsterdam UMC researchers, Dirkjan van Schaardenburg, Wendy Walrabenstein and Carlijn Wagenaar indicates that a plant-based diet may be just as effective as painkillers and anti-inflammatories in alleviating symptoms for patients suffering from rheumatoid arthritis (RA) or osteoarthritis.

Rheumatic conditions encompass gout, osteoporosis (bone loss), and osteoarthritis (joint degeneration), totaling over 2 million affected individuals in the Netherlands. Symptoms like pain, stiffness, and joint swelling typically manifest in women around menopause, though some experience them much earlier.

Rheumatoid arthritis (RA) is an autoimmune condition where the body's immune system mistakenly targets its own cells, resulting in painful joint inflammation. In 2021, nearly 170,000 women and over 100,000 men in the Netherlands were diagnosed with rheumatism, with the condition affecting more women than men.

X-rays often reveal signs of wear and tear well in advance, and smoking significantly increases the risk of developing rheumatoid arthritis. Both rheumatoid arthritis and osteoarthritis are associated with being overweight, not solely due to added pressure on joints but also because excess fat, particularly in the abdominal region, exacerbates chronic mild inflammation, intensifying inflammatory processes in the joints.

Plants for Joints

Rheumatologist Prof. dr. van Schaardenburg had long contemplated investigating the potential connection between rheumatic symptoms and a healthy lifestyle. Collaborating with dietitian and researcher Wendy Walrabenstein and physician Carlijn Wagenaar, they conducted research on the impact of a different lifestyle for individuals with rheumatic symptoms. Participants received guidance on adopting a lifestyle that emphasized sleep, relaxation, exercise, and nutrition. To assess its efficacy, participants were split into two groups: one adhered to a vegan diet and received guidance on increased physical activity, improved relaxation, and enhanced sleep. The other group maintained their usual dietary habits and treatment as usual from the physician. Both groups included individuals with rheumatoid arthritis and osteoarthritis. The study, named "Plants for Joints," was carried out at Reade, an expert center for rehabilitation and rheumatology in Amsterdam.

The Key Ingredient: Fiber

Dietitian and researcher Wendy Walrabenstein highlights the long-established link between nutrition and rheumatism. She references a 1991 study published in The Lancet, revealing that rheumatic symptoms abated after a week of fasting followed by a switch to a plant-based diet. Recognizing that fasting is an unrealistic solution, the researchers explored an effective alternative—a plant-based diet.

The program Plants for Joints demonstrates promising results, potentially rivaling medication for rheumatism and significantly reducing pain, stiffness, and improved physical functioning in osteoarthritis.

Chronic inflammation can also be exacerbated by factors like inactivity and extreme stress. Hence, Walrabenstein developed a holistic program that addresses not only dietary improvements but also increased physical activity, stress reduction, and better sleep. This comprehensive approach has shown potential in mitigating rheumatism and significantly alleviating pain and stiffness in osteoarthritis.

The secret to the diet's effectiveness lies in the abundant fiber content. A diet rich in fiber alters the composition of intestinal bacteria in favor of those producing protective anti-inflammatory compounds. Conversely, a diet heavy in meat promotes inflammation-inducing gut bacteria. Saturated fat also adversely affects the microbiome, the gut flora.

Managing this dietary shift requires some consideration. Individuals transitioning to a plant-based diet may need to supplement their intake with vitamin B12, vitamin D, and algae oil (or fish oil). Adequate protein intake can be a challenge for those new to plant-based nutrition, but this can be addressed by incorporating legumes, which are also fiber-rich, into their diets, as suggested by Walrabenstein.

Every Step Counts

Walrabenstein has observed that individuals whom adhere to the program's recommendations about 80% of the time, experiencing substantial benefits. Some people exhibit stronger reactions to factors like animal products, stress, or physical inactivity, motivating them to strictly adhere to the lifestyle. Others may have more flexibility, allowing them to indulge occasionally, albeit mindfully.

Nutrition for Healthy Joints:

  • Consume a variety of fruits and vegetables in large quantities.
  • Base your diet on legumes (beans, chickpeas, lentils) and whole grains (oats, pasta, bread) for energy, fiber, and protein.
  • Enjoy nuts in moderation, preferably in salads to avoid excessive calorie intake.
  • Avoid highly processed foods such as cookies, snacks, pre-packaged and pre-processed foods with Nutri-Score B to D.
  • Limit dairy and meat consumption to a minimum.
  • Include fatty fish like sardines, herring, or mackerel in your diet once or twice a week. The fatty acids in these fish have anti-inflammatory properties. Alternatively, take a fish or algae oil supplement.
  • Minimize added sugars and alcohol consumption. Both significantly contribute to inflammation in the body.

Read the scientific publication by Prof. dr. Schaardenburg, Walrabenstein and Wagenaar here.

Source: Read the original article (in Dutch) by Hanny Roskam in BrabantsDagblad.nl here.

Learn more about our Amsterdam institute for Infection and Immunity research into rheumatic disorders:

Altered gene signatures are detectable in synovial biopsies of individuals at risk of rheumatoid arthritis, which are associated with development of disease months to years later (December 2022)

Interview with Lisa van Baarsen in MedNet's rheumatology newspaper (October 2022)

Accelerated innovation driven by COVID-19 in rheumatoid arthritis research (August 2022)