Could Diet Cure Arthritis?
Gut and autoimmunity expert Dr. Steven Gundry, author of The Plant Paradox, has been making waves with his research on lectins—a type of protein found in some plants that he believes to be at the root of most diseases. (See why in this goop piece.) Gundry’s diet recommendations have proved particularly effective for patients struggling with arthritis—a condition he not surprisingly has an unconventional stance on, and one that he connects to a breakdown in the gut. We interviewed him about the causes of osteoarthritis (the most common form of arthritis) and the autoimmune disease rheumatoid arthritis, and what he sees as the potential cure:
A Q&A with Dr. Steven Gundry
Q
What causes chronic inflammation to manifest as arthritis?
A
Rheumatoid arthritis (RA) is an autoimmune disease that is different from osteoarthritis (OA), the most common form of arthritis. As a general rule, both result in inflammation in joints, but in the case of rheumatoid arthritis, the individual’s immune system is activated to attack the synovial surface lining the joints, resulting in pain, swelling, and eventually joint destruction. In osteoarthritis, the immune attack is against the cartilage that lines the surface of the joints—also causing pain, swelling and eventual joint destruction. But, that’s not all that is affected. Surprisingly, the effect of osteoarthritis doesn’t stop at the joints. The same damage that happens in the joints happens on the inside of blood vessels and the brain.
People with rheumatoid arthritis also have much higher rates of heart disease and stroke, as certain proteins on the linings of blood vessels are attacked as well. Something that surprised me initially: Half of my patients with biomarkers of rheumatoid arthritis (rheumatoid factor, or RF, and anti-CCP3 antibodies) have no joint symptoms, but present with fatigue, brain fog, generalized aches, or have been told that they have fibromyalgia. Why? Arthritis is a systemic disease that just happens to manifest in many with joint pain. (Also, I’ve been shocked to find that half of my patients whose lab tests show they have RA have been told by a rheumatologist that they don’t have it because they were not tested for anti-CCP3 antibodies.)
Q
Can you talk about the relationship you see between the diet and arthritis?
A
My research [see more in Gundry’s book The Plant Paradox] has shown that both RA and osteoarthritis can be caused by proteins in plants and some milk products, called lectins, which break the gut’s barrier (i.e. leaky gut), releasing these proteins into our blood circulation. In the case of RA, lectins confuse the immune system (called molecular mimicry), and cause it to attack the synovial surface of joints and the lining of blood vessels.
In the case of osteoarthritis, lectins have been shown to attach to the sugar molecule in cartilage called sialic acid, prompting a direct immune attack on the cartilage itself. This can lead people to have their hip or knee replaced—because there is no cartilage left in their hip/knee joint (often referred to as “bone on bone”).
Of interest, societies that typically eat very low lectin diets—like the Kitavans and Okinawans—have extremely low incidence of arthritis or autoimmune diseases of any kind.
Moreover, human studies that used a novel lectin (seeds from the Maackia amurensis tree) that actually prevents other lectins from binding to receptors in cartilage was shown to prevent cartilage breakdown, which could make it an effective treatment to RA and OA.
Q
What’s your treatment plan for patients with arthritis?
A
In either form of arthritis (RA or OA), I ask people to remove the major lectin-containing foods from their diet: These include all grains and pseudograins like quinoa, all beans unless pressure cooked, all nightshade vegetables (such as potatoes, eggplant, tomatoes, peppers, and goji berries), as well as squashes and cucumbers. American nuts and seeds—cashews, peanuts, sunflower, pumpkin, and chia—are also removed. Finally, I ask people to avoid all Casein A1 milk products. Cheese and milk products from goat, sheep, and Southern European cows, which make Casein A2, a safe protein, are okay and increasingly available in the US.
I show how to repopulate the normal gut microbiome using specific probiotics like BC30.
Importantly, I stress the need for the prebiotics that feed friendly bugs in our gut. These include inulin-containing (fiber) foods like jicama, artichokes, radicchio, endive, and Jerusalem artichokes.
I encourage patients to eat resistant starches as well, like sweet potatoes, taro root, sorghum, and cassava because because they feed friendly bacteria that guard the wall of your gut, creating a barrier against lectins.
I urge people to get polyphenols—like grape seed extract or pycnogenol—in their diet because polyphenols cause our gut to make anti-inflammatory compounds. (Many patients get their daily dose of polyphenols from my Vital Reds supplement.)
It is important to realize that you do not have to “live” with arthritis. It should not be managed, it should be cured!
Q
Is rheumatoid arthritis usually accompanied by other autoimmune conditions?
A
If we were to start all over and name autoimmune diseases based on the sophisticated blood tests now available versus just the signs and symptoms that people present with, we probably would have far less specific conditions with names like RA or MS or lupus or psoriasis. Instead, we’d focus on the underlying breach of the gut wall and disturbance of the microbiome. In other words, my research and that of others has shown that all of these autoimmune conditions have a single source and overarching treatment goal: namely, repairing the gut wall and reestablishing the microbiome’s communication with the immune cells called Tregs.
Q
At what age does arthritis normally become an issue? Is it at all a normal part of aging?
A
I have seen arthritis in teenagers and young adults as well as older adults.
Juvenile RA is the same as adult RA. With teens and preteens, there is usually a very strong family history of RA or other autoimmune conditions, and almost always there is a history of multiple rounds of antibiotics early in childhood. Often, but not always, the child was delivered by cesarean section and never developed a healthy microbiome.
Likewise, with RA in general, there is often a family history of RA or other autoimmune diseases like thyroid issues, irritable bowel syndrome (IBS), lymphomas. In addition to antibiotics, many people will have a history of eczema, rashes, asthma, and will have had their tonsils/appendix taken out (can be a sign of lectin intolerance).
Osteoarthritis is just like rheumatoid arthritis except that currently we have no biomarkers that define it on a blood test specifically like we have for RA. When you look at other inflammatory biomarkers in people with osteoarthritis, those with elevated markers have similar histories as the RA patients. The so-called wear-and-tear theory of arthritis doesn’t hold up—it’s not a “normal” part of aging.
Note: If you have painful nodules on the last joint of one or more of your fingers, you likely have leaky gut and an altered microbiome: I’ve seen these painful nodules disappear when patients cut lectins out of the diet and work to repair their gut.
Q
In what instances can arthritis be reversed, and/or at what point do you need to solely focus on minimizing symptoms?
A
I have seen even bone on bone arthritis reversed by applying the principles of The Plant Paradox outlined above. It is actually often much easier to stop and reverse the disease process rather than treat the symptoms with painkillers or biologic drugs that alter the normal immune response.
In the fall of 2016, I presented a study at the World Congress of Targeting the Microbiota at the Insitut Pasteur in Paris that showed that 78 patients with biomarker positive autoimmune diseases (including many with RA) became biomarker- and symptom-free within a year of following the Plant Paradox Program.
Just today, I saw a patient, who was a great sculptor and painter who had to quit his art in his early 70’s because he could not hold a paint brush or chisel due to severe arthritis. He was scheduled for a knee replacement and could not walk without a walker. That was three years ago. Now, in his late 70’s, he paints, sculpts, and walks without assistance. He never had the knee replacement. All he did was remove the foods that were causing his arthritis and he healed himself!
Dr. Gundry is the director of the International Heart & Lung Institute in Palm Springs, California, and the founder/director of the Center for Restorative Medicine in Palm Springs and Santa Barbara. He is the author of Dr. Gundry’s Diet Evolution: Turn Off the Genes That Are Killing You and Your Waistline and Drop the Weight for Good and the forthcoming The Plant Paradox: The Hidden Dangers in “Healthy” Foods That Cause Disease and Weight Gain.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
