RHEUMATOID ARTHRITIS BENEFITS FROM FASTING AND PLANT-BASED DIET: AN EXPLORATORY RANDOMIZED CONTROLLED TRIAL (NUTRIFAST)
Authors: A. M. Hartmann et al.
In recent years, intermitting fasting has become fashionable because of its beneficial effects in many chronic diseases. The effects of intermittent fasting in rheumatoid arthritis (RA) are still largely unproven. This exploratory randomized trial has explored the effect of a one week fast followed by an 11 week of plant-based diet, versus a nutritional counselling intervention (=control arm). A population of 53 established RA patients were randomized and analyzed after 12 weeks. While no significant difference existed for the primary outcome after 3 months, a trend of an effect on disease activity was seen after the fasting period (EULAR good of medium response (1wk): ~54% vs 28%). A significant beneficial effect existed on patient reported outcomes (HAQ), in particular after the initial fasting period.
This trial will need to be followed by a larger trial to confirm the exploratory findings. However, these preliminary results suggest that fasting may have a beneficial effect on inflammatory markers, and even more so, on patient reported outcomes. While all the potential anti-inflammatory mechanisms of fasting are not yet fully understood, they probably involve changes in metabolic functions, immune system and intestinal microbiome.