Monday, 21 September 2015

Can following the Paleo diet help arthritis?

The 'Paleo' diet (short for paleolithic) is in the headlines a lot at the moment but it's not entirely new; there have been various similar diets around since the 1970s with names like the 'caveman' diet (always makes me think of Fred Flintstone) and the stone-age diet. Followers of the Paleo diet believe that we should stick to the diet of our ancestors pre-agriculture so plenty of meat, vegetables and fruit but no grains, legumes or dairy. They argue that the diet of our distant ancestors is the one that we are genetically optimised for.

I've lost count of the number of Paleo auto-immune protocols that I have read on the internet purporting to cure arthritis. Usually I try to be fairly open-minded about different dietary approaches but I think a lot of the information available about the Paleo diet is entirely misleading and irresponsible. For a start, the whole premise of the diet is that diseases like rheumatoid arthritis didn't exist in the Paleolithic era because they are diseases of affluence and linked to the consumption of grains, legumes and dairy. However, it is more likely that conditions like arthritis didn't exist simply because life expectancy was so short that acute infections, other humans, accidents or predators got to you before any chronic diseases had the chance to develop. Secondly, there if a lot of mixed evidence on what was actually eaten during the paleolithic period by our ancestors. Hunter gatherers were likely to be a lot more nutritionally flexible than the Paleo diet implies - when you exist hand-to-mouth you eat what is available. Your average cave man wouldn't have had the luxury of turning down available food sources in order to pop to WholeFoods. Equally, our ancestors diet would have evolved and varied over the 3.4 million years of the paleolithic period. It wouldn't have been set in stone (if you will excuse the terrible pun). In fact, recent research suggests that grains may well have been consumed by them. Moreover, if the consumption of grains and dairy is so unhealthy it is unlikely that we would have successfully evolved to consume them in our diets. Humans are endlessly adaptable and a wide range of different dietary patterns are followed successfully by different populations around the world.

For people with arthritis, foods like wholegrains, beans and dairy are an extremely important and useful part of the diet. They provide essential nutrients that help mitigate and protect against some of the effects of the disease. Although there is little robust research on the effects of diet on arthritis, most studies that have been conducted have concluded that a vegetarian diet or a Mediterranean diet may be most beneficial and several longitudinal studies have suggested that high consumption of red meat (as on the Paleo diet) may increase a person's risk of rheumatoid arthritis. A Cochrane Review (the gold standard of evidence in health interventions) suggested that any dietary intervention that involves cutting out food groups (like the Paleo diet) should be approached with caution by people with rheumatoid arthritis due to the risk of deficiencies and malnutrition.

Having said all that,  there are some positive aspects to the Paleo diet. the Paleo diet's insistence that we avoid all processed food and increase our consumption of vegetables and fish is a healthy habit for anyone, including those of us with arthritis. But, if you are looking for a great healthy diet for your arthritis, you don't need to look to the Stone Age to find it!

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