To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study)
BackgroundFasting is beneficial in many diseases, including rheumatoid arthritis (RA), with lasting effects for up to 1 year. However, existing data dates back several decades before the introduction of modern therapeutic modalities.ObjectiveThis exploratory RCT compares the effects of a 7-day fast...
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.1030380/full |
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| author | Anika M. Hartmann Anika M. Hartmann Melanie Dell'Oro Michaela Spoo Michaela Spoo Jan Moritz Fischer Nico Steckhan Nico Steckhan Michael Jeitler Michael Jeitler Thomas Häupl Thomas Häupl Farid I. Kandil Farid I. Kandil Andreas Michalsen Andreas Michalsen Daniela A. Koppold-Liebscher Daniela A. Koppold-Liebscher Christian S. Kessler Christian S. Kessler |
| author_facet | Anika M. Hartmann Anika M. Hartmann Melanie Dell'Oro Michaela Spoo Michaela Spoo Jan Moritz Fischer Nico Steckhan Nico Steckhan Michael Jeitler Michael Jeitler Thomas Häupl Thomas Häupl Farid I. Kandil Farid I. Kandil Andreas Michalsen Andreas Michalsen Daniela A. Koppold-Liebscher Daniela A. Koppold-Liebscher Christian S. Kessler Christian S. Kessler |
| author_sort | Anika M. Hartmann |
| collection | DOAJ |
| description | BackgroundFasting is beneficial in many diseases, including rheumatoid arthritis (RA), with lasting effects for up to 1 year. However, existing data dates back several decades before the introduction of modern therapeutic modalities.ObjectiveThis exploratory RCT compares the effects of a 7-day fast followed by a plant-based diet (PBD) to the effects of the dietary recommendations of the German society for nutrition (Deutsche Gesellschaft für Ernährung, DGE) on RA disease activity, cardiovascular (CV) risk factors, and well-being.MethodsIn this RCT we randomly assigned 53 RA patients to either a 7-day fast followed by an 11-week PBD or a 12-week standard DGE diet. The primary endpoint was the group change from baseline to 12 weeks on the Health Assessment Questionnaire Disability Index (HAQ-DI). Further outcomes included other disease activity scores, body composition, and quality of life.ResultsOf 53 RA patients enrolled, 50 participants (25 per group) completed the trial and were included into the per-protocol analysis. The primary endpoint was not statistically significant. However, HAQ-DI improved rapidly in the fasting group by day 7 and remained stable over 12 weeks (Δ-0.29, p = 0.001), while the DGE group improved later at 6 and 12 weeks (Δ-0.23, p = 0.032). DAS28 ameliorated in both groups by week 12 (Δ-0.97, p < 0.001 and Δ-1.14, p < 0.001; respectively), with 9 patients in the fasting but only 3 in the DGE group achieving ACR50 or higher. CV risk factors including weight improved stronger in the fasting group than in the DGE group (Δ-3.9 kg, p < 0.001 and Δ-0.7 kg, p = 0.146).ConclusionsCompared with a guideline-based anti-inflammatory diet, fasting followed by a plant-based diet showed no benefit in terms of function and disability after 12 weeks. Both dietary approaches had a positive effect on RA disease activity and cardiovascular risk factors in patients with RA.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT03856190, identifier: NCT03856190. |
| first_indexed | 2024-04-11T23:30:51Z |
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| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-11T23:30:51Z |
| publishDate | 2022-11-01 |
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| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-0a97174896e5407eaee54e5c3b739c8d2022-12-22T03:57:07ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-11-01910.3389/fnut.2022.10303801030380To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study)Anika M. Hartmann0Anika M. Hartmann1Melanie Dell'Oro2Michaela Spoo3Michaela Spoo4Jan Moritz Fischer5Nico Steckhan6Nico Steckhan7Michael Jeitler8Michael Jeitler9Thomas Häupl10Thomas Häupl11Farid I. Kandil12Farid I. Kandil13Andreas Michalsen14Andreas Michalsen15Daniela A. Koppold-Liebscher16Daniela A. Koppold-Liebscher17Christian S. Kessler18Christian S. Kessler19Department of Dermatology, Venereology and Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyConnected Healthcare, Hasso Plattner Institute, University of Potsdam, Potsdam, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Rheumatology and Clinical Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, GermanyInstitute for Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, GermanyBackgroundFasting is beneficial in many diseases, including rheumatoid arthritis (RA), with lasting effects for up to 1 year. However, existing data dates back several decades before the introduction of modern therapeutic modalities.ObjectiveThis exploratory RCT compares the effects of a 7-day fast followed by a plant-based diet (PBD) to the effects of the dietary recommendations of the German society for nutrition (Deutsche Gesellschaft für Ernährung, DGE) on RA disease activity, cardiovascular (CV) risk factors, and well-being.MethodsIn this RCT we randomly assigned 53 RA patients to either a 7-day fast followed by an 11-week PBD or a 12-week standard DGE diet. The primary endpoint was the group change from baseline to 12 weeks on the Health Assessment Questionnaire Disability Index (HAQ-DI). Further outcomes included other disease activity scores, body composition, and quality of life.ResultsOf 53 RA patients enrolled, 50 participants (25 per group) completed the trial and were included into the per-protocol analysis. The primary endpoint was not statistically significant. However, HAQ-DI improved rapidly in the fasting group by day 7 and remained stable over 12 weeks (Δ-0.29, p = 0.001), while the DGE group improved later at 6 and 12 weeks (Δ-0.23, p = 0.032). DAS28 ameliorated in both groups by week 12 (Δ-0.97, p < 0.001 and Δ-1.14, p < 0.001; respectively), with 9 patients in the fasting but only 3 in the DGE group achieving ACR50 or higher. CV risk factors including weight improved stronger in the fasting group than in the DGE group (Δ-3.9 kg, p < 0.001 and Δ-0.7 kg, p = 0.146).ConclusionsCompared with a guideline-based anti-inflammatory diet, fasting followed by a plant-based diet showed no benefit in terms of function and disability after 12 weeks. Both dietary approaches had a positive effect on RA disease activity and cardiovascular risk factors in patients with RA.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT03856190, identifier: NCT03856190.https://www.frontiersin.org/articles/10.3389/fnut.2022.1030380/fullrheumatoid arthritisfastingcaloric restrictionplant-based dietinflammation |
| spellingShingle | Anika M. Hartmann Anika M. Hartmann Melanie Dell'Oro Michaela Spoo Michaela Spoo Jan Moritz Fischer Nico Steckhan Nico Steckhan Michael Jeitler Michael Jeitler Thomas Häupl Thomas Häupl Farid I. Kandil Farid I. Kandil Andreas Michalsen Andreas Michalsen Daniela A. Koppold-Liebscher Daniela A. Koppold-Liebscher Christian S. Kessler Christian S. Kessler To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study) Frontiers in Nutrition rheumatoid arthritis fasting caloric restriction plant-based diet inflammation |
| title | To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study) |
| title_full | To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study) |
| title_fullStr | To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study) |
| title_full_unstemmed | To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study) |
| title_short | To eat or not to eat—an exploratory randomized controlled trial on fasting and plant-based diet in rheumatoid arthritis (NutriFast-Study) |
| title_sort | to eat or not to eat an exploratory randomized controlled trial on fasting and plant based diet in rheumatoid arthritis nutrifast study |
| topic | rheumatoid arthritis fasting caloric restriction plant-based diet inflammation |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.1030380/full |
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