Inside: How Intermittent Fasting can improve Rheumatoid Arthritis symptoms, by decreasing inflammation in the body. 4 different types of fasting and the best combination of fasting diets to help with Rheumatoid Arthritis Pain.

Arthritis especially Rheumatoid Arthritis (RA) is a painful and debilitating condition that affects millions of people worldwide. It is an autoimmune condition where antibodies start attacking your own body joints and ultimately leads to destruction.

The exact cause of this arthritis is unknown, but as with other autoimmune disorders. It has been theorized that it’s an interplay between genetics and environmental factors. RA is characterised by synovial hyperplasia and destruction of cartilage and bone which ultimately leads to multiple joint deformities.

People with RA suffer from various co-morbidities like pain, deformed joints and even their life expectancy is lower as compared to the healthy population. The destruction in RA is because of the complex autoimmune process which involves the activation of T cells and CD4 cells. Patients with RA also show signs of early ageing like telomere shortening, impaired DNA repair etc. 

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Is Current RA Treatment Adequate

With recent advances in treatment strategies, the new line of biologic medications have been introduced to help RA patients.

These medicines block certain inflammatory pathways, but at the same time also suppresses one’s immune system, plus they are really expensive and can come with a host of side effects. Another problem is that some patients don’t see improvement in their symptoms especially pain with these medications.

So the recent interest has been there to look for alternative/ comprehensive ways to manage pain and other comorbidities in RA patients. 

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How Fasting Improves Rheumatoid Arthritis

Diet plays a very important factor in autoimmune diseases and that’s the reason different kinds of diets have been studied for RA patients.

One of the diets which has been popular recently is — intermittent fasting or fasting-mimicking diet. Fasting has been shown to decrease inflammatory markers in people and also bring about some changes which decrease the biological rate of ageing.

Fasting can help autoimmune diseases like RA by reducing inflammation and also through immunosenescence which basically means killing old and damaged cells and replacing them with young and functional ones. A study was done in RA patients by comparing the effect of fasting diet with normal diet for the patients.

In this study, patients went through one time fast of 7-10 days followed by a vegetarian diet. The results not only showed improvement in clinical symptoms but also Lab values of ESR and CRP, which are a marker of inflammation in the system and are correlated with disease severity of RA.

Another study showed similar improvement in pain symptoms for patients after a period of fast. A modified fasting diet with low-calorie intake for 7-10 days was studied in RA patients and it showed clinical improvement in these patients. 

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So Rheumatoid Arthritis does get better with Intermittent Fasting; but what exactly is it and how to do intermittent fasting.

Let’s discuss it here —

What is Fasting and How to do it

There are different ways of doing fasting and people sometimes choose the way that best suits their needs and lifestyle. 

1. Prolonged Fasting: In this kind of fasting people will not eat any real food for a long period of time each week. Fasting days can be anywhere from 1 day a week to 3 days a week. People repeat this 1-3 day fast every week on a periodic basis or intermittently. 
2. Intermittent Fasting: This refers to fasting for 16 hours and restricting your food intake window to only 8 hours. So typically people should not eat between 8 pm till 12 pm the next day. And will have 1-2 meals between 12 pm – 8 pm. They can do this every day or sometimes do it for 3-4 days a week. 
3. Fasting mimicking diet: This is another diet which is getting popular these days, and the basis of this is to eat a diet which mimics fasting method. In this diet calories and carb are restricted while there is more good fat which improves insulin response and reduces inflammation. 

Now the question is — which kind of fasting method is best for RA. The answer to this tricky question is that we really don’t know the exact diet which works for because there has not been a head to head trial to compare all these fasting methods. 

My Suggestion to RA patients to find which fasting best diet that works for them —

What I suggest to my patients is the following combination —

• Longer fast for 1 or 2 days, which means complete fasting for a day or two in a week. Only water and broth allowed for these days.
• Then follow it by intermittent fasting and do the 16:8 method (16 hr fasting: 8 hr food window) for the rest of the days in the week and take 1 day off during the week to reboot the system. So 1or 2 day of complete fast, 4 days of intermittent fasting and 1 day off every week. 

Fasting is a good way to keep your health in good check, especially if you have an autoimmune condition it can really make a difference. For Rheumatoid arthritis, there has been research which shows benefit not only in clinical parameters like pain but also saw improvement in the disease process. So fasting can be a part of RA treatment plan. 

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Related Reading:

6 Must have Herbal Supplements for Rheumatoid Arthritis. 

Are you Taking the Right Form and Dosage of Turmeric for Rheumatoid Arthritis?

Research-Based Hashimoto’s Diet

References: 
Shweta Khanna,1 Kumar Sagar Jaiswal,. Managing Rheumatoid Arthritis with Dietary Interventions. Front Nutr. 2017; 4: 52.Published online 2017 Nov 8. doi: 10.3389/fnut.2017.00052

Choi IY1, Lee C2, Longo VD3. Nutrition and fasting mimicking diets in the prevention and treatment of autoimmune diseases and immunosenescence.Mol Cell Endocrinol. 2017 Nov 5;455:4-12. doi: 10.1016/j.mce.2017.01.042. Epub 2017 Jan 28.

Kjeldsen-Kragh J1, Haugen M, Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis.Lancet. 1991 Oct 12;338(8772):899-902.

Sköldstam L. Fasting and vegan diet in rheumatoid arthritis.Scand J Rheumatol. 1986; 15(2):219-21.

Michalsen A1, Riegert M. Mediterranean diet or extended fasting’s influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study.BMC Complement Altern Med. 2005 Dec 22;5:22.