Anti-inflammatory Diet for Autoimmune Disease: New Research (AI Protocol)

The AI protocol slides above and below posted with permission of Dr. Monica Guma, MD (principal investigator of this research study. The reference is at the bottom) At the American College of Rheumatology (ACR) meeting NOV 2020, Dr. Monica Guma of UCSD reported results of using an anti-inflammatory diet in the autoimmune disease, rheumatoid arthritis (rheumatoid arthritis). She used the diet posted above.

This is pertinent for lupus patients because lupus is also an autoimmune disease. Eating an anti-inflammatory diet (AI Protocol) is recommended for lupus patients in “The Lupus Secrets.” Note that there are some anti-inflammatory diet studies in lupus mice and lupus humans that show positive effects. However, we need larger, bigger studies. This study is a step in the right direction (even though it is with RA instead of lupus).

She chose motivated RA patients. They stayed on their medications as well. They followed the above diet. They had to have active RA to enter the study. Disease activity was measured 2 weeks before the study, at the start of the study, then 2 weeks later. The bacteria in their stool (microbiome) was also measured!

Below is an example of a typical day of eating:

How did the RA patients do on this anti-inflammatory diet?

After 2 weeks on the diet, there was improved disease activity (overall) with less tender and swollen joints.
Disease activity (measured by a research tool called the CDAI) was significantly decreased.
Below are the results after 2 weeks on the diet.

​For the scientific minded… note the great “p values” for some of these measurements on the right.

What did their gut microbiome do in response to the anti-inflammatory diet?

After 14 days, those RA patients who did better (had lower RA disease inflammation) on the anti-inflammatory diet ended up with a greater diversity of their microbiome. This suggests that the diet influenced their gut bacteria types as well as improved disease activity.

This adds evidence that we may be able to alter our gut bacteria with diet plus improve disease activity in autoimmune diseases! There is hope that diet could also possibly help other autoimmune diseases, such as lupus, in a similar way.

We absolutely need more research. Thanks to Dr. Guma and her team for helping to pave the way for more research on diet and autoimmune disorders.  Below are her results of the microbiome changes in the study.

What should be in an anti-inflammatory diet for lupus and other autoimmune diseases?

This is my commentary:

Some of the recommendations of Dr. Bustamante (first two pics above) have quite a bit of research supporting their use (eating foods high in omega-3, avoiding omega-6, eating prebiotics) in autoimmune diseases such as lupus.

However, others have significantly less evidence (for example, avoiding solanaceae, which is nightshade plants, and eating gluten-free).

I suspect the latter food groups were included since these changes “may possible reduce inflammation.”

We all look forward to more studies in autoimmune disorders, such as lupus.

REFERENCE:

Coras R, Martino C, Gauglitz J, Tripathi A, Jarmusch A, Cedola F, Fernandez Bustamante M, Agustín-Perez M, Alharthi M, Lee S, Singh A, Choi S, Rivera T, Nguyen K, Shekhtman T, Holt T, Golshan S, Knight R, Dorrestein P, Guma M. Rheumatoid Arthritis Improvement After Exposure to an Anti-Inflammatory “ITIS” Diet Is Associated with Changes of Gut Microbiome and Systemic Metabolome [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/rheumatoid-arthritis-improvement-after-exposure-to-an-anti-inflammatory-itis-diet-is-associated-with-changes-of-gut-microbiome-and-systemic-metabolome/. Accessed September 17, 2021.

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What have you found to be helpful in an anti-inflammatory diet?
What do you recommend for a beginner?
Do you recommend any particular books that you found to be most helpful?