Foods Cross-Reacting May Contribute to Rheumatoid Arthritis: The Gut-Joint Axis

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Researchers from Norway recently published in the British journal Gut additional new evidence of the link between foods and rheumatoid arthritis. Professor Bradtzaeg and his colleagues at the Institute of Pathology in Oslo measured IgG, IgA, and IgM antibodies to foods in blood and intestinal fluid in people with rheumatoid arthritis compared with healthy people. They performed blood and intestinal fluid antibody tests to the following food antigens: gliadin, oats, cow’s milk proteins (casein, lactalbumin, lactoglobulin), soy, pork, cod fish, and egg (ovalbumin). These foods are in the top 10 of common food allergens as well as food protein intolerances. They found a “particularly striking (incidence) of cross reactive food antibodies in proximal gut secretions” as well as increased IgM antibodies to some of these foods in the blood though the findings were less dramatic in the blood. This is consistent with difficulties finding elevated blood antibodies to foods in people with rheumatoid arthritis and other autoimmune/inflammatory conditions despite a lot of anecdotal and elimination diet experience supporting the role of foods in these conditions.

The results, in their opinion, indicate that measuring blood antibodies to foods in rheumatoid arthritis provides little information about the role of foods in rheumatoid arthritis. However, intestinal antibodies not only show a “striking” pattern of elevation consistent with adverse food immune reactions but also that there appears to be a potential cumulative effect of multiple foods. That is, not only may some foods trigger an abnormal immune response resulting in joint inflammation but combinations of multiple problem foods may be a key component to this link. Their results support the connection of mucosal (gut) immune activation from cross reaction of foods to rheumatoid arthritis in at least some people.

What might this mean? It proposes the idea that elimination of certain problem food combinations may be beneficial in preventing or reducing joint inflammation which is both exciting and intriguing. Multiple commonly eaten foods that are frequently linked to food allergies and sensitivities may be contributing to inflammatory and/or autoimmune conditions. These common problem foods or their lectins are likely contributing to the process of gut inflammation causing injury resulting in the leaky gut. This injury and leaky gut, especially in genetically predisposed people, may in the setting of altered gut bacteria (dysbiosis), predispose to further injury. Injury and a leaky gut may allow the entry of toxic food protein (lectin)-bacteria complexes resulting in inflammatory and/or autoimmune conditions like rheumatoid arthritis.

This gut-joint axis is likely the same mechanism as the gut-brain axis and gut-skin axis that produce the myriad of symptoms and diseases increasingly seen. The associated food protein (lectin)-bacteria immune reactions in the gut are being increasingly explored as contributing to a myriad of diseases and symptoms. Much more needs to learned, but it is interesting that certain foods keep showing up as the usual suspects. These problem foods or lectins include the grains (especially wheat, barley, rye, oats, corn), dairy (casein), nightshades (potato, tomato, peppers) and peanuts, soy and other legumes. Diets eliminating or restricting these foods have been reported as being beneficial for many symptoms and diseases though definitive links are difficult to establish because of limitations of scientific research. The foods implicated are usually limited in some manner in a variety of elimination diets such as the gluten-free/casein free diet, naked diet, paleolithic/hunter-gatherer/caveman diets, arthritis diet, low carbohydrate diet, anti-inflammatory diet, Neopaleo Elimination Diet, six food elimination diet etc. etc..

The Paleolithic or Hunter-Gatherer diet specifically recommends restricting grains, dairy and legumes. Various anti-inflammatory or arthritis diets usually recommend eliminating either wheat or gluten, dairy and the nightshades. The dietary approach to autism commonly advocated is a casein-free, gluten-free diet. Despite lay public reports of great successes with such elimination diets, mainstream medicine continues to be slow to study the dietary treatment of disease. However, especially in the past two to three years more studies are appearing showing links supporting a significant role of food and bacteria in the gut and various autoimmune diseases. I hope you will continue to follow along with me through articles published here, on my blog www.thefooddoc.blogspot.com and my website www.thefooddoc.com as I continue to write and share my insights as a specialist doctor in the field of gastroenterology all the exciting new developments on food related illness and the digestive tract as they occur.

Reference: Hvatum M, Kanerud L, Hallgren, Brandtzaeg P. The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis. Gut 2006; 55:1240-1247.

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Dr. Scot Lewey, a food allergy expert-the food doc, is a medical doctor specializing in diseases of the digestive tract (gastroenterologist). For over two decades he has been practicing medicine, writing articles, and participating in research. As an doctor who diagnoses and treats Celiac disease, food intolerance, food allergies, colitis, Crohn's disease, irritable bowel syndrome, stomach ulcers and acid reflux and personally is gluten and casein sensitive he has unique insights that he shares on his website and weblog at http://www.thefooddoc.com

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