Plants for Joints is a 4-month multidisciplinary lifestyle intervention program consisting of a whole foods plant based diet, exercise and stress management for patients with (high risk of) rheumatoid arthritis or osteoarthritis with metabolic syndrome, with 2 years follow up.
Lifestyle is associated with rheumatoid arthritis (RA) and osteoarthritis (OA). RA and OA overlap with other chronic diseases with an inflammatory component, such as diabetes and coronary heart disease. The low-grade inflammation present in patients with these diseases associates with the metabolic syndrome (MetS).
To test the (cost-)effectiveness of a multidisciplinary lifestyle program (whole foods plant based diet, exercise and stress management), we perform three randomized controlled trials (RCT), comparing the program with usual care in (1) 80 RA patients with low to moderate disease activity; (2) 16 anti-citrullinated protein antibody (ACPA) positive arthralgia patients (at risk for RA) and (3) 80 patients with OA of hip and/or knee in combination with MetS. After the 4-month RCT, the control group enters the program. All participants are followed for another 2 years.
Primary outcome measures are the difference in change between baseline and 4 months between the intervention and control groups for: the disease activity score of 28 joints (DAS28, RA), the RA-risk score (arthralgia) and the WOMAC Index (OA). Secondary outcome measures include changes in physical, mental and social health, cortisol, body composition and metabolism, mucosa-associated auto-immunity in RA and arthralgia. Changes in oral and intestinal microbiome will be studied, focusing on changes in bacterial diversity and in RA-related species. In OA patients MRI will be used to study changes in visceral and liver fat as well as intramuscular fat.
Plants for joints' is the name of the research Wendy Walrabenstein is conducting, together with Amsterdam rheumatology professor Dirkjan van Schaardenburg about the effect of a plant-based diet, exercise, stress reduction and a better sleeping pattern on rheumatism and arthrosis and on test subjects at increased risk of rheumatism.
It has been suspected since the 1990s that a plant-based diet can reduce the burden of disease in rheumatism, says Wendy Walrabenstein. She is a dietician, a PhD student at Amsterdam University Medical Centre and researcher at Reade, a centre for rehabilitation and rheumatology.