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Posted on Diet, Rheumatoid arthritis

The impact of lifestyle and diet on Rheumatoid Arthritis

Holistic approach to care
Holistic approach to care

The 16-week Plants for Joints trial investigated the effects of a multidisciplinary lifestyle intervention in people with RA compared to usual care. The intervention was based on a whole-food, plant-based diet alongside physical activity and stress management. Previous reports showed this intervention significantly reduced the 28-joint disease activity score (DAS28) compared to usual care alone.2,3 To expand on this, the researchers wanted to determine the long-term effectiveness of the intervention, specifically about disease activity after 2 years.

After the initial 16-week randomised period, the control group also received the intervention, and participants were followed for 2 years with biannual visits and six adherence-promoting webinars annually. People with DAS28 <2.6 also received a protocol as a suggested approach to tapering their antirheumatic medication – under the supervision of their rheumatologist – and any treatment changes were recorded.

62% of the original trial completers also completed the 2-year follow-up. Those who discontinued most often indicated that this was because they were too busy, unreachable, or did not permit for the second year of the extension study.

The long-term results showed that improvement in DAS28 was maintained for 2 years after completing the intervention – and was significantly lower compared to baseline. Tender joint count and general health components of the DAS28 also improved significantly, although there was no significant difference in the erythrocyte sedimentation rate and swollen joint count compared to baseline. Results were similar in people who completed the 2-year extension study versus those who discontinued prematurely.

Of the 39 participants who completed their follow-up and used disease-modifying antirheumatic medication, 44% could decrease or stop, 26% had stable usage, and 31% had increased medication. Of those with stable or decreased medication compared to baseline, 65% had improved DAS28.

After the 2-year follow-up, HDL cholesterol increased, and C-reactive protein (CRP) remained significantly lower compared to baseline values—although there was no longer a significant difference in weight, waist circumference, LDL cholesterol, or HbA1c.

These findings indicate that intensive lifestyle modifications can be effective in the long term for people with RA.

Posted on Diet

Two decades of studies suggest health benefits associated with plant-based diets.

Cardiovascular health and cancer risk associated with plant based diets: An umbrella review

Vegetarian and vegan diets are generally associated with better status on various medical factors linked to cardiovascular health and cancer risk, as well as lower risk of cardiovascular diseases, cancer, and death.

According to a new review of 49 previously published papers, vegetarian and vegan diets are generally associated with better status on various medical factors linked to cardiovascular health and cancer risk and lower risk of cardiovascular diseases, cancer, and death.

Prior studies have linked certain diets with increased risk of cardiovascular disease and cancer. A diet that is poor in plant products and rich in meat, refined grains, sugar, and salt is associated with a higher risk of death. Reducing consumption of animal-based products in favour of plant-based products has been suggested to lower the risk of cardiovascular disease and cancer. However, the overall benefits of such diets remain unclear.

To deepen understanding of the potential benefits of plant-based diets, Capodici and colleagues reviewed 48 papers published between January 2000 and June 2023 that themselves compiled evidence from multiple prior studies. Following an “umbrella” review approach, they extracted and analyzed data from the 48 papers on links between plant-based diets, cardiovascular health, and cancer risk.

Their analysis showed that overall, vegetarian and vegan diets have a robust statistical association with better health status on some risk factors associated with cardiometabolic diseases, cancer, and mortality, such as blood pressure, management of blood sugar, and body mass index. Such diets are associated with reduced risk of ischemic heart disease, gastrointestinal and prostate cancer, and death from cardiovascular disease.

However, among pregnant women specifically, those with vegetarian diets faced no difference in their risk of gestational diabetes and hypertension compared to those on non-plant-based diets.

These findings suggest that plant-based diets are associated with significant health benefits. However, the researchers note that the statistical strength of this association is significantly limited by the many differences between past studies in terms of the specific diet regimens followed, patient demographics, study duration, and other factors. Moreover, some plant-based diets may introduce vitamin and mineral deficiencies in some people. Thus, the researchers caution against large-scale recommendations for plant-based diets until more research is completed.

The authors add: “Our study evaluates the different impacts of animal-free diets for cardiovascular health and cancer risk, showing how a vegetarian diet can be beneficial to human health and be one of the effective preventive strategies for the two most impactful chronic diseases on human health in the 21st century.”

1 Comment Posted on Patient Talk

St John’s Wort! A natural treatment for depression?


Natural antidepressant?

Natural antidepressant?

I first came across St John’s Wort, maybe fifteen years ago during a discussion with an old friend who suffers from chronic depression.  He mentioned that he had tried it some years previously and that, sadly, it had not worked for him.

I would always think about this conversation whenever I spotted St John’s Wort in a shop. This actually was quite often. It was some time later that I found out that St John’s Wort is often prescribed in Germany for depression.  So, in fact, there might be something in it!

The objective of this blog is to find out if any of our readers have used it and how effective it has been for you.

The current research suggests that may work for mild but not moderate or severe depression.  However the jury is out on this one.  But more interestingly it seems that side effects are much lower than with standard anti-depressants.

Okay this is where you guys come in.  It would be great if you could share your experiences with St John’s Wort in the comments box below.  Have you tried it?  How well did it work?  Would you recommend St John’s Wort to others?

IMPORTANT NOTE. If you are considering taking St John’s Wort it is vital that you consult your Doctor before doing so. The reason for this is that there are a number of other commonly used medications which when taken with St John’s Wort can cause serious adverse reactions.

By the way I am intrigued about the provenance of the word “wort”.  According to a fascinating article in the Natchez Naturalist Newsletter by Jim Conrad he explains that ““Wort” derives from the Old English “wyrt,” which simply meant “plant.” The word goes back even further, to the common ancestor of English and German, to the Germanic “wurtiz.” By the way, “wurtiz” evolved into the modern German word “Wurzel,” meaning “root.” “ You can read the full article here http://www.backyardnature.net/n/03/031221.htm.  If any of you know any more about the origin of the word d I’d love to hear more – so again please add anything you know in the comment box below.