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Authors: Joel Fuhrman; Neal D. Barnard

Tags: #Fasting, #Health & Fitness, #Nutrition, #Diets, #Medical, #Diet Therapy, #Therapeutic Use

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Even young people who have not yet narrowed the major blood vessels supplying the heart and major organs may have impairment of circulation to the microscopic vasculature around the joints. Decreased oxygen causes inflammation, which attracts antigen—antibody complexes to be deposited.

Decreased oxygenation also can prevent repair of the microscopic fractures that occur in the joint area from normal activity. Additionally, because the area around the joint capsule is poorly supplied with blood, it is less effective at removing metabolic wastes and toxins that may accumulate in this area.

When the marginal blood supply to a joint is further compromised by narrowing of the small blood vessels from atherosclerotic plaque or by the sludging of blood (stickiness of the red blood cells) that occurs after a fatty meal, the joint tissues become more prone to arthritic damage. This is one reason why the joints are a common site for the manifestation of autoimmune disease.

Drug Treatment of Autoimmune Disease Poses Serious Risks
Autoimmune diseases destroy the body by similar mechanisms, and they are treated by similar drugs. When we look at the use of drugs to treat rheumatologic or autoimmune illnesses, we see serious side effects as well as damaging and dangerous long-term effects. What follows is only a partial list of drug-related side effects.

114

NSAIDs (nonsteroidal anti-inflammatory drugs)
such as salicylates (aspirin and related compounds) have retained their preeminent position in the treatment of rheumatic disease for almost a hundred years. Motrin, Naprosyn, Feldene, and Ansaid are newer NSAIDs. Drugs in this category are generally considered the safest of the medications used for autoimmune illnesses. They are well known for the side effects of irritation of the stomach lining, ulcer disease, and gastrointestinal bleeding. They can also cause diarrhea, nausea, constipation, dry mouth, headache, dizziness, ringing in the ears, liver or kidney disease, nervousness, swelling, and septic meningitis.5

Several studies have shown that NSAIDs actually accelerate the progression of arthritis by further damaging the mucosal lining of the digestive tract.6 This causes more intestinal permeability and more passage of incompletely digested food and bacterial toxins that worsen the underlying autoimmune disease.

Steroids,
such as prednisone, are effective medications for autoimmune illnesses because they quickly suppress the inflammatory response. Side effects include electrolyte disturbances, diabetes, increased susceptibility to infection including tuberculosis, peptic ulcers (which may bleed or perforate), osteoporosis, cataracts, obesity, moon face (the face becomes swollen and round), buffalo hump (characterized by a lump of fatty tissue that grows in the back between the shoulder blades), acne, nervousness, insomnia, depression, schizophrenia, and suicide.

Withdrawal of prednisone can cause muscle and joint pain, as well as weakness. These symptoms from the drug may be extremely difficult to distinguish from the disease (such as rheumatoid arthritis) itself.7

Chemotherapeutic agents
(also used to treat cancer and leukemia) such as methotrexate and Imuran can be effective in controlling symptoms but have dangerous long-term effects such as causing cancer. They work by attacking the immune system, which also is the basis of their toxic side effects. Other side effects include bone marrow destruction, platelet destruction with massive bleeding, bleeding from the digestive tract, death due to gastrointestinal perforation, hair loss, liver and kidney impairment, potentially fatal infections, and both solid tumor cancers and leukemia.8,9

Gold, typically used for rheumatoid arthritis, can cause intestinal bleeding, gold lung, severe skin rashes, life-threatening bone marrow disease (including severe anemia), decreased platelets, kidney and liver damage, and hair loss.10

The use of gold compounds has been shown to be among the most common drug-induced causes of death.11

Plaquenil, most often used for lupus or arthritis, can cause the following: irreversible visual loss from retinal damage, anxiety, nightmares, psychosis, hair loss, hearing loss, and skin eruptions such as psoriasis.12

Thousands of patients die each year or become seriously ill from the side effects of the above medications. Obviously, it makes sense to try a safe, conservative approach to getting well before spending a lifetime on these toxic, 115

dangerous drugs.

Diet Is Critical in Rheumatoid Arthritis

Arthritis sufferers spend more than $1 billion annually on drug treatment. One million new cases are diagnosed every year, and the number is growing. Five percent of America's elderly population suffer from this disease. It is called the

"nation's primary crippler."13 Recent studies have refuted the previously held notion that rheumatoid arthritis has a favorable outcome. Patients experience progressive decline in joint mobility and generally get steadily worse in spite of today's toxic treatments. Such patients generally have a four-to ten-year decrease in life expectancy.

More significantly, the prognosis is very poor for persons who have progressed to multiple joint involvement. The five-year survival rate for severely arthritic individuals with multiple joint involvement is about 45

percent.14 Similar low survival rates are observed in patients with other very serious illnesses, such as Hodgkin's disease and three-vessel coronary artery disease.

Traditionally, when less toxic medications are unable to control symptoms or when the side effects became intolerable, the physician will consider using more powerful and more toxic chemotherapeutic agents, which have even more dangerous side effects, including cancer.

In recent years, rheumatologists have been starting patients on the more toxic chemotherapeutic agents earlier, or even as a primary approach, in a purely theoretical attempt to slow down the progression of the disease. This practice is prevalent even though there is little evidence to prove that it holds long-term benefit for the patient. Although medications can reduce inflammation and pain, the evidence collected so far indicates these drugs have little or no effect on long-term outcome.15,16

Another recent study of arthritis patients reported that after 20 years of treatments with the typical drugs including prednisone, methotrexate, penicillamine, and oral gold, half the patients were either dead or disabled.17

The idea that drugs induce remissions was described as "fallacious." The unfortunate reality is that drug therapy often contributes to the suffering and early death of the arthritis patient.

How can anyone argue that safe and potentially curative modalities such as fasting and natural diet should not be tried first? In spite of numerous and repeated proclamations by the American Arthritis Association and rheumatologists to the contrary, rheumatoid arthritis is preventable and reversible. Fasting and vegetarian diet have proven to be the only effective way to achieve consistent remission in such patients.

The Arthritis Foundation boldly declares in their literature that there is no special diet for arthritis, and that food has nothing to do with causing it.

Fortunately, there is solid evidence to refute this ill-informed and irresponsible 116

opinion.

First there is the epidemiologic evidence. In populations that consume natural diets of mostly unprocessed fruits, vegetables, and grains, autoimmune diseases are almost nonexistent. Rheumatoid arthritis, ankylosing spondylitis, psoriasis, and psoriatic arthritis are exceptionally rare in China, Indonesia, and Africa, where the populations consume vegetarian or near-vegetarian diets.18,19

The same is found with lupus. Whereas African blacks rarely develop this disease, it has a high prevalence in the United States, especially among black women.20

This cannot be because of heredity or racial differences. When people migrate from China, Indonesia, Japan, and Africa to the United States and begin to consume a rich western diet, arthritis and other autoimmune diseases become common.

When these diseases do crop up in such populations, they are not severe.

The people generally have a milder form of the disease, without the joint deformities and the significant reduction of life span that we see in this country.21

So will placing people with rheumatoid arthritis on natural-food, plant-based diets help our autoimmune-disease-ridden population? The results of studies done on dairy-free, plant-based diets have been impressive. In a study at Wayne University Medical School, fat-free diets were fed to volunteers, and resulted incomplete remission of arthritis in the majority of participants. All the participants relapsed when either vegetable oils or animal food was reintroduced into their diets. The investigators concluded that the high-fat, high-protein American diet causes rheumatoid arthritis.22

Fasting Can Be Effective in Treating Autoimmune Illnesses
Fasting is a remarkable anti-inflammatory intervention, more powerful than the strongest and most toxic drugs at reducing inflammation. It is a crucial management tool for the person suffering from autoimmunal disease, and, when combined with appropriate dietary modifications, can induce a remission of symptoms.

A supervised fast is the most effective way the individual with rheumatoid arthritis can quickly eliminate pain and stop the degeneration of the body and joints caused by the attack of the immune system.

A definite benefit is obtained when all dietary antigens derived from foods are removed by fasting. When patients with rheumatoid arthritis are allowed only water on a seven-to ten-day fast, joint pains are substantially reduced and stiffness decreases. Fasting also reduces inflammation by altering excessive activities attributed to the white blood cells and other components of the immune system.

Over time, the markers of inflammation in the blood invariably fall as the fast 117

progresses. For example, the erythrocyte sedimentation rate (ESR) falls to about 5, well within the normal range.

When fasting, the intestinal tract has the opportunity to become quiet, which in turn gives the immune system a much needed rest. Fasting not only stops the input of all potential protein antigens and food-derived toxins, but also allows the digestive tract to rest and heal, restoring its structural integrity.

After the fast, the system will not be as sensitive to potential food allergens because of decreased amounts of potential immune-stimulating peptides crossing the mucosal defenses.

Another positive aspect of the fast is its ability to increase microcirculation to the joints. The negative nutrition associated with fasting mobilizes the fat stores of the entire body, including the pathologic fat stores lining vessels in the macro-and microcirculation, thus supplying the joints with a more adequate oxygen supply. This in turn enables the elimination of retained waste in the joint capsule and allows the inflammation in the joints to subside. In this manner the body is able to catch up on its internal housecleaning, and retained antibody—antigen complexes are eliminated from the joints and connective tissue. Thus the remarkable self-repairing process of the fast begins by removing the triggers to immune hypersensitivity.

Fasting has been shown not only to reduce inflammation, swelling, and pain in arthritis sufferers, but also to enhance the ability of the immune system to fight infection.23 The studies done on fasting for autoimmune diseases have consistently shown multiple benefits to the arthritic, especially when combined with a dairy-free, vegetarian diet.24,25 Some of these studies were carefully done in a crossover manner in which the examiners did not know which patients were in 'the fasted group.

Another important reason fasting is able to ameliorate the clinical manifestations of rheumatoid arthritis is that it alters the fatty acid composition of cellular membranes, taking away important triggers to the autoimmune inflammatory process. This positive effect of fasting has been studied and explained in detail in the scientific literature on fasting.26 It is remarkable to watch the pain, stiffness, and swelling melt away as the fast progresses. The predictability of this response is dramatic. It is exceedingly rare that we do not see dramatic improvement that most often results in complete freedom from pain by the time the fast is completed.

Clearly, when a properly conducted fast is combined with an optimal dietary approach for each individual, the patient has the greatest chance of achieving a total clinical remission.

The results of a study comparing two groups of patients who were tracked for one year were published in the October 12, 1991, issue of
The Lancet,
a respected medical journal. The control group was treated with the conventional medical approach, utilizing drugs. The other group received no medication and was placed on a seven-to ten-day partial fast, followed by a low-fat, dairy-free, plant-based diet. The results, carefully monitored by blood tests and 118

physician examiners, documented the vast superiority of the dietary approach.

All clinical examinations were done by a physician who did not know the group to which the patient had been allocated.

Food was reintroduced after the fast very gradually, which is important in achieving consistent results in such patients. A "new" food item was introduced every second day. If a patient noticed an increase in pain, stiffness, or joint swelling within 48 hours, the item was omitted from the diet for at least seven days. If symptoms were exacerbated on reintroduction of this food, it was excluded from the diet for the rest of the study period.

The patients in the control group treated with drugs ate ordinary food. In the intervention group, in the first three to five months after the fast the patients were asked not to eat food that contained gluten, meat, fish, eggs, dairy products, refined sugar, citrus fruits, salt, strong spices, preservatives, alcohol, tea, and coffee.

After four weeks the intervention group showed a significant improvement in the number of tender joints, pain score, morning stiffness, and grip strength.

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