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. 1992 Mar;51(3):298–302. doi: 10.1136/ard.51.3.298

Food intolerance in rheumatoid arthritis. I. A double blind, controlled trial of the clinical effects of elimination of milk allergens and azo dyes.

M A van de Laar 1, J K van der Korst 1
PMCID: PMC1004647  PMID: 1575571

Abstract

The hypothetically negative influence of food on the clinical activity of seropositive rheumatoid arthritis was studied using two types of artificial elementary food. One diet was allergen free, the other allergen restricted, containing only lactoproteins and yellow dyes. Ninety four patients entered the study, which lasted 12 weeks. During the second four week period they were randomly assigned to one of the two artificial foods. Comparison between baseline and subsequent periods showed only subjective improvements. No differences were seen between the clinical effects of the two tested diets. Nine patients (three in the allergen restricted group, six in the allergen free group) showed favourable responses, followed by marked disease exacerbation during rechallenge. Dietary manipulation also brought about changes in objective disease activity parameters in these patients. The existence of a subgroup of patients in whom food intolerance influences the activity of rheumatoid factor seropositive rheumatoid arthritis deserves serious consideration.

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Selected References

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  1. Bennett J. C. The infectious etiology of rheumatoid arthritis. New considerations. Arthritis Rheum. 1978 Jun;21(5):531–538. doi: 10.1002/art.1780210507. [DOI] [PubMed] [Google Scholar]
  2. Beri D., Malaviya A. N., Shandilya R., Singh R. R. Effect of dietary restrictions on disease activity in rheumatoid arthritis. Ann Rheum Dis. 1988 Jan;47(1):69–72. doi: 10.1136/ard.47.1.69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bjarnason I., Williams P., So A., Zanelli G. D., Levi A. J., Gumpel J. M., Peters T. J., Ansell B. Intestinal permeability and inflammation in rheumatoid arthritis: effects of non-steroidal anti-inflammatory drugs. Lancet. 1984 Nov 24;2(8413):1171–1174. doi: 10.1016/s0140-6736(84)92739-9. [DOI] [PubMed] [Google Scholar]
  4. Darlington L. G. Does food intolerance have any role in the aetiology and management of rheumatoid disease? Ann Rheum Dis. 1985 Nov;44(11):801–804. doi: 10.1136/ard.44.11.801. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Felder M., De Blecourt A. C., Wüthrich B. Food allergy in patients with rheumatoid arthritis. Clin Rheumatol. 1987 Jun;6(2):181–184. doi: 10.1007/BF02201021. [DOI] [PubMed] [Google Scholar]
  6. Gregersen P. K., Silver J., Winchester R. J. The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum. 1987 Nov;30(11):1205–1213. doi: 10.1002/art.1780301102. [DOI] [PubMed] [Google Scholar]
  7. Gullberg R. Possible role of alterations of the intestinal flora in rheumatoid arthritis. Rheumatol Rehabil. 1978;Suppl:5–10. doi: 10.1093/rheumatology/xvii.suppl.5. [DOI] [PubMed] [Google Scholar]
  8. Henriksson K., Uvnäs-Moberg K., Nord C. E., Johansson C., Gullberg R. Gastrin, gastric acid secretion, and gastric microflora in patients with rheumatoid arthritis. Ann Rheum Dis. 1986 Jun;45(6):475–483. doi: 10.1136/ard.45.6.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Homsy J., Morrow W. J., Levy J. A. Nutrition and autoimmunity: a review. Clin Exp Immunol. 1986 Sep;65(3):473–488. [PMC free article] [PubMed] [Google Scholar]
  10. Jenkins R. T., Rooney P. J., Jones D. B., Bienenstock J., Goodacre R. L. Increased intestinal permeability in patients with rheumatoid arthritis: a side-effect of oral nonsteroidal anti-inflammatory drug therapy? Br J Rheumatol. 1987 Apr;26(2):103–107. doi: 10.1093/rheumatology/26.2.103. [DOI] [PubMed] [Google Scholar]
  11. Job C., Menkes C. J., Delbarre F. Zinc sulfate in the treatment of rheumatoid arthritis. Arthritis Rheum. 1980 Dec;23(12):1408–1409. doi: 10.1002/art.1780231221. [DOI] [PubMed] [Google Scholar]
  12. Kremer J. M., Bigauoette J., Michalek A. V., Timchalk M. A., Lininger L., Rynes R. I., Huyck C., Zieminski J., Bartholomew L. E. Effects of manipulation of dietary fatty acids on clinical manifestations of rheumatoid arthritis. Lancet. 1985 Jan 26;1(8422):184–187. doi: 10.1016/s0140-6736(85)92024-0. [DOI] [PubMed] [Google Scholar]
  13. Kremer J. M., Jubiz W., Michalek A., Rynes R. I., Bartholomew L. E., Bigaouette J., Timchalk M., Beeler D., Lininger L. Fish-oil fatty acid supplementation in active rheumatoid arthritis. A double-blinded, controlled, crossover study. Ann Intern Med. 1987 Apr;106(4):497–503. doi: 10.7326/0003-4819-106-4-497. [DOI] [PubMed] [Google Scholar]
  14. Lunardi C., Bambara L. M., Biasi D., Venturini G., Nicolis F., Pachor M. L., De Sandre G. Food allergy and rheumatoid arthritis. Clin Exp Rheumatol. 1988 Oct-Dec;6(4):423–424. [PubMed] [Google Scholar]
  15. Morrow W. J., Ohashi Y., Hall J., Pribnow J., Hirose S., Shirai T., Levy J. A. Dietary fat and immune function. I. Antibody responses, lymphocyte and accessory cell function in (NZB x NZW)F1 mice. J Immunol. 1985 Dec;135(6):3857–3863. [PubMed] [Google Scholar]
  16. Nepom G. T., Byers P., Seyfried C., Healey L. A., Wilske K. R., Stage D., Nepom B. S. HLA genes associated with rheumatoid arthritis. Identification of susceptibility alleles using specific oligonucleotide probes. Arthritis Rheum. 1989 Jan;32(1):15–21. doi: 10.1002/anr.1780320104. [DOI] [PubMed] [Google Scholar]
  17. Olhagen B., Månsson I. Intestinal Clostridium perfringens in rheumatoid arthritis and other collagen diseases. Acta Med Scand. 1968 Nov;184(5):395–402. doi: 10.1111/j.0954-6820.1968.tb02478.x. [DOI] [PubMed] [Google Scholar]
  18. Panush R. S., Carter R. L., Katz P., Kowsari B., Longley S., Finnie S. Diet therapy for rheumatoid arthritis. Arthritis Rheum. 1983 Apr;26(4):462–471. doi: 10.1002/art.1780260403. [DOI] [PubMed] [Google Scholar]
  19. Panush R. S., Stroud R. M., Webster E. M. Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk. Arthritis Rheum. 1986 Feb;29(2):220–226. doi: 10.1002/art.1780290210. [DOI] [PubMed] [Google Scholar]
  20. Parke A. L., Hughes G. R. Rheumatoid arthritis and food: a case study. Br Med J (Clin Res Ed) 1981 Jun 20;282(6281):2027–2029. doi: 10.1136/bmj.282.6281.2027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. ROPES M. W., BENNETT G. A., COBB S., JACOX R., JESSAR R. A. 1958 Revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis. 1958 Dec;9(4):175–176. [PubMed] [Google Scholar]
  22. Ratner D., Eshel E., Vigder K. Juvenile rheumatoid arthritis and milk allergy. J R Soc Med. 1985 May;78(5):410–413. doi: 10.1177/014107688507800515. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sampson H. A., Buckley R. H., Metcalfe D. D. Food allergy. JAMA. 1987 Nov 27;258(20):2886–2890. [PubMed] [Google Scholar]
  24. Shinebaum R., Neumann V. C., Cooke E. M., Wright V. Comparison of faecal florae in patients with rheumatoid arthritis and controls. Br J Rheumatol. 1987 Oct;26(5):329–333. doi: 10.1093/rheumatology/26.5.329. [DOI] [PubMed] [Google Scholar]
  25. Sköldstam L. Fasting and vegan diet in rheumatoid arthritis. Scand J Rheumatol. 1986;15(2):219–221. doi: 10.3109/03009748609102091. [DOI] [PubMed] [Google Scholar]
  26. Sköldstam L., Larsson L., Lindström F. D. Effect of fasting and lactovegetarian diet on rheumatoid arthritis. Scand J Rheumatol. 1979;8(4):249–255. doi: 10.3109/03009747909114631. [DOI] [PubMed] [Google Scholar]
  27. Stevenson D. D., Simon R. A., Lumry W. R., Mathison D. A. Adverse reactions to tartrazine. J Allergy Clin Immunol. 1986 Jul;78(1 Pt 2):182–191. doi: 10.1016/0091-6749(86)90011-4. [DOI] [PubMed] [Google Scholar]
  28. Walker W. A., Isselbacher K. J. Uptake and transport of macromolecules by the intestine. Possible role in clinical disorders. Gastroenterology. 1974 Sep;67(3):531–550. [PubMed] [Google Scholar]
  29. Williams R. Rheumatoid arthritis and food: a case study. Br Med J (Clin Res Ed) 1981 Aug 22;283(6290):563–563. doi: 10.1136/bmj.283.6290.563. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Zaphiropoulos G. C. Rheumatoid arthritis and the gut. Br J Rheumatol. 1986 May;25(2):138–140. doi: 10.1093/rheumatology/25.2.138. [DOI] [PubMed] [Google Scholar]
  31. Ziff M. Diet in the treatment of rheumatoid arthritis. Arthritis Rheum. 1983 Apr;26(4):457–461. doi: 10.1002/art.1780260402. [DOI] [PubMed] [Google Scholar]
  32. van de Laar M. A., Aalbers M., Bruins F. G., van Dinther-Janssen A. C., van der Korst J. K., Meijer C. J. Food intolerance in rheumatoid arthritis. II. Clinical and histological aspects. Ann Rheum Dis. 1992 Mar;51(3):303–306. doi: 10.1136/ard.51.3.303. [DOI] [PMC free article] [PubMed] [Google Scholar]

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