STOCKHOLM, Sweden—Consuming a gluten-free, vegan diet may help rheumatoid arthritis (RA) patients improve their cardiovascular health, according to a new study in the Arthritis Research & Therapy.¹

"A gluten-free, vegan diet in RA induces changes that are potentially atheroprotective and anti-inflammatory, including decreased low density lipoprotein (LDL) and oxidized LDL (OxLDL) levels…raised antiphosphorylcholine (anti-PC) antibodies and IgA levels," conclude researchers led by Johan Frostegard, MD, of the Karolinska University Hospital in Stockholm, Sweden.

The new study comprised 66 RA patients who were randomly assigned to eat either a gluten-free, vegan diet or a well-balanced, nonvegan diet for 1 year. Researchers analyzed the levels of LDL, OxLDL, and anti-PCs at the beginning of the study, at 3 and 12 months.

Those participants who consumed the gluten-free, vegan diet showed reductions in LDL and oxLDL levels as well as increased anti-PC antibodies, the study showed. Triglycerides levels and high density lipoprotein levels were not altered in the gluten-free, vegan group. Both body mass index and weight also decreased among those participants in the vegan group, but not their counterparts in the control group. Moreover, both disease activity score 28 (DAS28) and health assessment questionnaire scores decreased in the vegan group at 3 and 12 months compared with baseline. By contrast, only DAS28 at 3 months dropped among control patients. The vegan group also showed lower levels of C-reactive protein.

The gluten-free vegan diet started with a 1-day low calorie fast of vegetable broth and berry juices. This was followed by a 1-year gluten-free vegan diet in which protein comprised 10% of the total calories, carbohydrates made up 60%, and fat made up the remaining 30%. The vegan diet was replete with vegetables, root vegetables, nuts, and fruits. It also included buckwheat, millet, corn, rice, and sunflower seeds because no gluten was permitted.

The control group’s nonvegan diet comprised 10% to 15% protein, 55% to 60% carbohydrates, and no more than 30% fat. These patients were encouraged to eat ≥5 servings of fruits and vegetables each day.

Translating research into practice

Felicia Busch RD, a nutritionist in St Paul, Minnesota and author of The New Nutrition From Antioxidants to Zucchini, told MSKreport.com that a vegan lifestyle may be a good option for those highly-motivated RA patients. "Mentioning these new study findings may be a good way to encourage RA patients to think more about health and nutrition in general."

A vegan diet is more of a lifestyle, she pointed out. "A true vegan diet is lower in fat; higher in fiber; and richer in antioxidants, vitamins, and minerals. [T]here are nutritional benefits, but with that lifestyle go a lot of other healthy behaviors. Vegans are typically more active, not consuming alcohol and not smoking."

"Vegans also typically have a lower caloric intake which could lead to weight loss and people with arthritis who lose weight see a difference in their symptoms."

Reference

1. Elkan A-C, Sjöberg B, Kolsrud B, et al. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Arthritis Res Ther. 2008;10:R34.