Arthritis is one of the leading causes of disability worldwide [1].

It causes the patient to live with a physical limitation for many years.

Arthritis is a condition that causes inflammation of the bone joints leading to pain, redness, and swelling. It can affect any joint in the body.

It is long known that diet influences arthritis symptoms.

Impact of various diets on arthritis have been studied by researchers and one such diet is called ‘Vegan Diet’.

A vegan diet is completely devoid of all animal products including milk, eggs, and dairy products. It purely consists of plants and plant-based foods.

Intake of a wide variety of plant foods provides all the necessary nutrients required by the body [2].

A vegan diet is adopted by a large number of people as it is known for providing remarkable health benefits. The beneficial effects of this diet are seen in both healthy individuals and in disease conditions [3].

Benefits of a Vegan/Plant-Based Diet in Arthritis

The benefits of a vegan diet in arthritis has been proven by various clinical trials. A vegan diet is found to have an anti-inflammatory action that can reduce disease activity.

It is also known to mitigate joint pain and morning stiffness in arthritis.

Research data also supports that the vegan diet is associated with weight reduction and minimizing the complications arising from long-standing arthritis.

A vegan diet can also play a role in abatement of stress in arthritis.

The benefits of a vegan diet in arthritis patients are discussed in detail below.

1. Anti-inflammatory Benefits of a Vegan Diet

Inflammation is the main underlying cause of the symptoms of arthritis. Therefore, reduction in inflammation can greatly reduce arthritis symptoms.

The process of inflammation in the body is brought about by compounds called as pro-inflammatory mediators and leukotrienes. These biochemical compounds are synthesized by utilizing fatty acids from the diet [4].

In a vegan diet, there is a reduced intake of fatty acids that causes a reduction in biochemical compounds responsible for inflammation leading to a state of reduced inflammation [5].

A clinical trial involving 24 arthritis patients on vegan diet showed a good decrease in C-reactive protein, which is an indicator of inflammation [6].

The gut microbial flora (good bacteria in the gut) has an important role to play in providing immunity to the body.

In case of arthritis, there is a change in these micro-organisms which makes the person more susceptible to joint inflammation [7].

Increased vegetables in the diet can influence the gut microbes in arthritis patients leading to a better immune response by the body by reducing inflammation [8].

What does this mean?

Vegan diet reduce the synthesis of certain bio-chemicals and reduces the inflammation in arthritis. It also promotes the good bacteria in the gut that further contribute to this effect.

2. Alleviation of Arthritis Symptoms by Vegan Diet

A study conducted by Clinton CM et.al., studied the effect of a plant-based diet in arthritis patients. It concluded that the group of patients receiving a plant-based diet had an appreciable improvement in energy and physical functioning [9].

This diet was also responsible for the reduction in pain symptom.

A vegetarian diet has lead to a significant improvement in arthritis patients [10].

The mechanism of pain reduction and increased functionality can be attributed to the following processes:

  • A vegan diet reduces the generation of painful prostaglandins (chemicals causing pain) by decreasing levels of arachidonic acid, which is required for the synthesis of pain chemicals [11]
  • The vegan diet is rich in alpha-linolenic acid which causes reduced inflammation adding on to the pain relief effect [12]
  • The abstinence from animal protein further lowers the inflammation and provides relief from arthritic symptoms [13]
  • A vegan diet is proven to combat pain at rest and after motion [14]. This diet has also demonstrated a reduction in swelling and tenderness of joints [15].

Morning stiffness can be a daunting symptom of arthritis and a vegan diet is known to possess the potential to cut back the duration of this symptom [16].

The vegan diet is rich in carotenoids, vitamin C, vitamin E, lactobacilli and fiber that contributes to this action[17].

Clinical studies have also validated that there are no significant side effects of the vegan diet in arthritis patients when compared to normal diet [18].

What does this mean?

There is a good amount of evidence to suggest that the vegan diet alleviates joint pain and morning symptoms by many mechanisms. These studies also furnish the safety of this diet in arthritis patients.

3. Vegan Diet Can Reduce Weight and Benefit Arthritis Patients

Arthritis and high body mass co-exist in the majority of the patients. There is a considerable number of factors of obesity that can contribute to increased symptoms in arthritis [19].

In obese patients with arthritis, there is increased pressure on the knee and hip joint which adds on to their affliction.

Lowering body weight can reduce pain and disability in such people [20].

A study published in the Journal of General Internal Medicine in the year 2016 performed a review of 12 clinical trials on a vegetarian diet and obesity.

It concluded that a vegetarian diet-induced more weight reduction than non-vegetarian diets [21].

Furthermore, this study conferred the exemplary benefits of a vegan diet in weight reduction when compared with other vegetarian diets.

The weight reduction achieved was maximum in vegan diet subjects [22].

What does this mean?

Vegan diet leads to weight reduction in arthritis patients which can reduce pain. It is proven to be superior to all other vegetarian diets in causing weight loss.

4. Benefits of a Vegan Diet in Reducing Arthritis Complications

Long-standing arthritis can cause certain complications. One such complication is an increased chance of developing a cardiovascular disease like heart attack, stroke, etc.

Consumption of a vegan or plant-based diet is proven to reduce the risk of cardiovascular diseases [23]. This diet can be advantageous in arthritis patients by reducing their complications.

The vegan diet leads to lesser production of Trimethyl-N-oxide (TMNO), which is known risk factor for cardiovascular disease [24].

High levels of TMNO is synthesized in the body with the consumption of animal foods like meat, dairy, and eggs.

What does this mean?

Arthritis complications like increased risk of heart disease can be reduced by adopting a plant based diet. This type of diet reduces the synthesis of chemicals compounds that leads to heart diseases.

5. Vegan Diet Reduces Stress in Arthritis

Psychological stress is known to increase disease activity and cause increased pain symptoms in arthritis [25]  [26].

Stress management can reduce pain and help patients better manage arthritis [27].

Inclusion of fruits and vegetables in the diet has a stress-reducing effect.

A clinical trial by Beezhold B et.al. demonstrated that vegans diet can abate stress to an optimum level by changing the immune response mechanisms [28].

What does this mean?

Vegan diet can help in better stress control in arthritis patients which can help in pain relief.

What to Eat in a Vegan Diet?

The vegan diet allows the consumption of foods other than animal products. The foods included in the diet must meet the normal requirements of the body, therefore, it should be appropriately planned.

The approximate composition of a vegan diet is calories of 1600-2000g and proteins of 65-70g which includes the following [29] :

  • Meat equivalent: Dried beans, peas, lentils, tofu, peanut butter, nuts, etc.
  • Dairy equivalent: Fortified soy milk – 3 cups a dayFruits: All types of fruits can be included; especially fruits rich in Vitamin C
  • Vegetables and sprouts: All types including potato, corn, lima beans, etc.
  • Soups: Made from vegetable stock
  • Bread, Grains, and Cereals: Oatmeal, barley, brown rice, etc.
  • Sugars, syrup, herbs, spices, etc.

What to Avoid in a Vegan Diet?

A vegan diet excludes the following food items:

  • Milk and Dairy Products: Cheese, butter, yogurt, condensed milk, etc.
  • Meat: Beef, pork, lamb, etc.
  • Seafood: Fish, shellfish and fish oils
  • Poultry: chicken, turkey, duck, goose, etc.
  • Animal By-Products: Honey, eggs, gelatine, jellies, etc.

Precautions

No plant sources provide Vitamin B12 but, it is synthesized from certain microbes present in the plants which can provide a small amount of vitamin B12 to the body [30].

Thus, vegan diet adoption may cause Vitamin B12 deficiency [31].

Vitamin B12 deficiency can be prevented by taking an increased amount of cereals that are fortified with Vitamin B12 [32].

Vegans have also been found to have vitamin D deficiency. This can be fixed by taking supplements of vitamin D that are manufactured from plant-based ingredients [33].

A vegan diet may also cause deficiencies of omega-3-fatty acids however, consumption of foods like flaxseeds, soybean oil, walnut, rapeseed oil, etc. can prevent this problem [34].

Vegans are at a higher risk of developing nutrient deficiencies therefore, some extra care must be taken to include a variety of plant-based foods to prevent deficiencies [35].

Some disease conditions might require alteration in calorie or protein intake eg. kidney disease, diabetes, etc. One must consult a physician or a dietician for a structured meal plan to avoid any risks.

Conclusion

The vegan diet is a diet free of all animal products. Adoption of this type of diet has proven to be of various benefits in arthritis.

A variety of clinical studies have proven that the vegan diet has led to reduced inflammation, joint pain, and stiffness.

It is also excellent in causing weight reduction which can further reduce pain in arthritis.

There are certain reports of vegan diet causing nutrient deficiencies which can be taken care of by including a wide variety of plant-based foods or by taking vitamin supplements.

A vegan diet is safe to be used in arthritis patients but, a physician or dietician guidance is necessary to avert any chance of risk and to also develop a carefully assessed meal planning depending on requirements of each individual.

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