Avoiding/Managing Rheumatoid Arthritis

Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation). These are mostly, but not all, autoimmune diseases, in which the body’s immune system mistakenly attacks our own joints.

Inflammatory vs Non-Inflammatory Arthritis

Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.

You may be wondering: how does one get non-inflammatory inflammation of the joints?

The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause. So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can, but it’s not as absolutely critical a deal as it is for “inflammatory” forms of arthritis.

We’ll tackle the beast that is osteoarthritis another day, however.

Today we’re going to focus on…

Rheumatoid Arthritis

This is the most common of the autoimmune forms of arthritis. Some quick facts:

• It affects a little under 1% of the global population, but the older we get, the more likely it becomes
• Early onset of rheumatoid arthritis is most likely to show up around the age of 50 (but it can show up at any age)
• However, incidence (not onset) of rheumatoid arthritis peaks in the 70s age bracket
• It is 2–4 times more common in women than in men
• Approximately one third of people stop work within two years of its onset, and this increases thereafter.

Well, that sounds gloomy.

Indeed it’s not fun. There’s a lot of stiffness and aching of joints (often with swelling too), loss of joint function can be common, and then there are knock-on effects like fatigue, weakness, and loss of appetite.

Beyond that it’s an autoimmune disorder, its cause is not known, and there is no known cure.

Is there any good news?

If you don’t have rheumatoid arthritis at the present time, you can reduce your risk factors in several ways:

• Having an anti-inflammatory diet. Get plenty of fiber, greens, and berries. Fatty fish is great too, as are oily nuts. On the other side of things, high consumption of salt, sugar, alcohol, and red meat are associated with a greater risk of developing rheumatoid arthritis.
• Not smoking. Smoking is bad for pretty much everything, including your chances of developing rheumatoid arthritis.
• Not being obese. This one may be more a matter of correlation than causation, because of the dietary factors (if one eats an anti-inflammatory diet, obesity is less likely), but the association is there.

There are other risk factors that are harder to control, such as genetics, age, sex, and having a mother who smoked.

See: Genetic and environmental risk factors for rheumatoid arthritis

What if I already have rheumatoid arthritis?

If you already have rheumatoid arthritis, it becomes a matter of symptom management.

First, reduce inflammation any (reasonable) way you can. We did a main feature on this before, so we’ll just drop that again here:

Keep Inflammation At Bay

Next, consider the available medications. Your doctor may or may not have discussed all of the options with you, so be aware that there are more things available than just pain relief. To talk about them all would require a whole main feature, so instead, here’s a really well-compiled list, along with explanations about each of them, up to date as of this year:

Rheumatoid Arthritis Medication List (And What They Do, And How)

Finally, consider other lifestyle adjustments to manage your symptoms. These include:

• Exercise—gently, though! You do not want to provoke a flare-up, but you do want to maintain your mobility as best you can. There’s a use-it-or-lose-it factor here. Swimming and yoga are great options, as is tai chi. You may want to avoid exercises that involve repetitive impacts to your joints, like running.
• Rest—while keeping mobility going. Get good sleep at night (this is important), but don’t make your bed your new home, or your mobility will quickly deteriorate.
• Hot & cold—both can help, and alternating them can reduce inflammation and stiffness by improving your body’s ability to respond appropriately to these stimuli rather than getting stuck in an inappropriate-response state of inflammation.
• Mobility aids—if it helps, it helps. Maybe you only need something during a flare-up, but when that’s the case, you want to be as gentle on your body as possible while keeping moving, so if crutches, handrails etc help, then by all means get them and use them.
• Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility. Only you can decide where to draw the line when it comes to that trade-off.

You can also check out our previous article:

Managing Chronic Pain (Realistically!)

Take good care of yourself!

Slow Your Aging, One Meal At A Time

This one’s a straightforward one today, and the ““life hack” can be summed up:

Enjoy a vegan diet to enjoy younger biological age.

First, what is biological age?

Biological age is not one number, but a collection of numbers, as per different biomarkers of aging, including:

• Visual markers of aging (e.g. wrinkles, graying hair)
• Performative markers of aging (e.g. mobility tests)
• Internal functional markers of aging (e.g. tests for cognitive decline, eyesight, hearing, etc)
• Cellular markers of aging (e.g. telomere length)

We wrote more about this here:

Age & Aging: What Can (And Can’t) We Do About It?

A vegan diet may well impact multiple of those categories of aging, but today we’re highlighting a study (hot off the press; published only a few days ago!) that looks at its effect on that last category: cellular markers of aging.

There’s an interesting paradox here, because this category is:

• the most easily ignorable; because we all feel it if our knees are giving out or our skin is losing elasticity, but who notices if telomeres’ T/S ratio changed by 0.0407? ← the researchers, that’s who, as this difference is very significant
• the most far-reaching in its impact, because cellular aging in turn has an effect on all the other markers of aging

Second, how much difference does it make, and how do we know?

The study was an eight-week interventional identical twin study. This means several things, to start with:

• Eight weeks is a rather short period of time to accumulate cellular aging, let alone for an intervention to accumulate a significant difference in cellular aging—but it did. So, just imagine what difference it might make in a year or ten!
• Doing an interventional study with identical twin pairs already controlled for a lot of factors, that are usually confounding variables in population / cohort / longitudinal / observational studies.

Factors that weren’t controlled for by default by using identical twins, were controlled for in the experiment design. For example, twin pairs were rejected if one or more twin in a given pair already had medical conditions that could affect the outcome:

❝Inclusion criteria involved participants aged ≥18, part of a willing twin pair, with BMI <40, and LDL-C <190 mg/dL. Exclusions included uncontrolled hypertension, metabolic disease, diabetes, cancer, heart/renal/liver disease, pregnancy, lactation, and medication use affecting body weight or energy.

Eligibility was determined via online screening, followed by an orientation meeting and in-person clinic visit. Randomization occurred only after completing baseline visits, dietary recalls, and questionnaires for both twins❞

~ Dr. Varun Dwaraka et al. ← there’s a lot of “et al.” to this one; the paper had 16 collaborating authors!

As to the difference it made over the course of the 8 weeks…

❝Various measures of epigenetic age acceleration (PC GrimAge, PC PhenoAge, DunedinPACE) were assessed, along with system-specific effects (Inflammation, Heart, Hormone, Liver, and Metabolic).

Distinct responses were observed, with the vegan cohort exhibiting significant decreases in overall epigenetic age acceleration, aligning with anti-aging effects of plant-based diets. Diet-specific shifts were noted in the analysis of methylation surrogates, demonstrating the influence of diet on complex trait prediction through DNA methylation markers.❞

~ Ibid.

You can read the whole paper here (it goes into a lot more detail than we have room to here, and also gives infographics, charts, numbers, the works):

Unveiling the epigenetic impact of vegan vs. omnivorous diets on aging: insights from the Twins Nutrition Study (TwiNS)

Were they just eating more healthily, though?

Well, arguably yes, as the results show, but to be clear:

The omnivorous diet compared to the vegan diet in this study was also controlled; both groups were given a healthy meal plan for their respective diet. So this wasn’t a case of “any omnivorous diet vs healthy vegan diet”, but rather “healthy omnivorous diet vs healthy vegan diet”.

Again, the paper itself has the full details—a short version is that it involved a healthy meal kit delivery service, followed by ongoing dietician involvement in an equal and carefully-controlled fashion.

So, aside from that one group had an omnivorous meal plan and the other vegan, both groups received the same level of “healthy eating” support, guidance, and oversight.

But isn’t [insert your preferred animal product here] healthy?

Quite possibly! For general health, general scientific consensus is that eating at least mostly plants is best, red meat is bad, poultry is neutral in moderation, fish is good in moderation, dairy is good in moderation if fermented, eggs are good in moderation if not fried.

This study looked at the various biomarkers of aging that we listed, and not every possible aspect of health—there’s more science yet to be done, and the researchers themselves are calling for it.

It also bears mentioning that for some (relatively few, but not insignificantly few) people, extant health conditions may make a vegan diet unhealthy or otherwise untenable. Do speak with your own doctor and/or dietician if unsure.

See also: Do We Need Animal Products To Be Healthy?

We would hypothesize, by the way, that the anti-aging benefits of a vegan diet are probably proportional to abstention from animal products—meaning that even if you simply have some “vegan days”, while still consuming animal products other days, you’ll still get benefit for the days you abstained. That’s just our hypothesis though.

Take care!