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Juice, Inflammation and Auto-Immune Diseases


When foreign substances enter our bodies, we have powerful defense mechanisms involving our immune systems to prevent those substances from causing damage. Our bodies do this through chemical and cellular mechanisms that result in inflammation. However, the inflammation that results is not without its own drawbacks. Think about a mosquito bite, an asthma attack, or Joe’s urticaria. These are reactions that we can directly observe, but there are many others that occur throughout our bodies that contribute to heart disease, stroke, and autoimmune diseases such as rheumatoid arthritis, multiple sclerosis and lupus, to name a few. These inflammatory processes protect us, but cause disease when the response is profound.

Fasting (in the form of total, subtotal and juice fasting) has been studied for over 40 years in rheumatoid arthritis (RA) patients(1-6). A review of the literature demonstrated that short-duration fasting followed by a vegetarian diet can result in clinically significant long-term improvements in patients with RA(7). In general, the patients that responded the best were those with the least advanced disease. An increase in symptoms was most notably observed with reintroduction of high-fat meats, dairy, and gluten.

The foods we eat play a role in the amount of inflammation in our bodies. Eating a high-fat meal, for example, causes fat, muscle, and white blood cells to release strong inflammatory chemicals like IL-6 and Tumor Necrosis Factor-α (TNF-α)(8-10). Increased IL-6 is implicated in diabetes, depression, lupus, and rheumatoid arthritis amongst other autoimmune conditions(11-14). TNF-α is involved with many autoimmune diseases as well and in fact there is a whole class of powerful drugs that inhibit TNF-α to treat these diseases(15,16). IL-17 is another of these powerful chemicals that increases inflammation by causing cells to release more pro-inflammatory substances. It also has been shown to play a role in autoimmune diseases and cardiovascular disease and it increases in the bloodstream after eating a high-fat meal(17,18). A recent study done in Italy showed that drinking a fruit juice drink (water, 40% pineapple, 18% blackcurrant, 5% plum, and sugar) although processed, but rich in phytochemicals, reduced the high levels of IL-6, TNF-α, and IL-17 after eating a high-fat meal(19). Two other studies demonstrated that drinking orange juice or a strawberry beverage decreased the pro-inflammatory effects of a high-fat, high-carbohydrate meal(20,21). Although none of these studies were done with fresh expressed juice, they all showed a decrease in these inflammatory chemicals after eating high-fat meals. I would love to see the same studies done with freshly expressed juice, which has even higher levels of phytochemicals than processed juices.

These studies demonstrate how the addition of juices rich in phytochemicals can decrease the inflammatory responses that result from eating certain foods. While we do not know for certain that these are the mechanisms that can improve disease, this probably comes as no surprise to anyone who has experienced significant improvements in their health during and following a juice fast. We frequently hear people say that their joint pain was significantly improved during a juice fast. It is also not surprising why symptoms can return so quickly after a juice fast if we return to eating a substantial amount of high-fat, processed foods. While these diseases involve complex mechanisms that we do not yet fully understand, this is some early research to suggest how diet can play a role in increasing or decreasing the symptoms from these diseases. The good news is, unless you have a hard to control autoimmune disease, you can decrease the inflammation following a less-than-perfect meal by including freshly expressed juice as part of your diet. Even better, as Joe experienced, juicing and eating greater amounts of fresh fruits and vegetables can have a positive impact on many autoimmune conditions.

Do you suffer from rheumatoid arthritis, lupus or multiple sclerosis? Has a Reboot helped your symptoms? We would love to hear from you.

This information is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

References:
1. Pirlet K, et al. Physikalisch-diatetische Behandlung der progressiven chronischen Polyarthritis. Archiv fur physikalische Therapie. 1968;20:487-91.

2. Skoldstam L et al. Effect of fasting an lactovegetarian diet on rheumatoid arthritis. Scan J Rheumatol 1979;8:249-55.

3. Sundqvist T, et al. Influence of fasting on intestinal permeability and disease activity in patients with rheumatoid arthritis. Scand J Rheumatol 1982;11:33-8

4. Skoldstam L et al. Specific plasma proteins as indices of inflammation during a modified fast in patients with rheumatoid arthritis. Scand J Rheumatol 1983;12:369-73.

5. Kjeldsen-Kragh J, et al. Changes in laboratory variables in rheumatoid arthritis patients treated with fasting and a one-year vegetarian diet. Clin Exp Rheumatol 1995;13:167-72

6. Skoldstam L et al. Fasting, intestinal permeability, and rheumatoid arthritis.

7. Muller H, et al. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systemic review. Scan J Rheumatol 2001;30:1-10.

8. Jimenez-Gomez Y, et al. Olive oil and walnut breakfasts reduce the postprandial inflammatory response in mononuclear cells compared with a butter breakfast in healthy men. Atherosclerosis 2009; 204:e70-6.

9. Mohamed-Ali V, et al. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab 1997;82:4196-200.

10. Corpeleijn E, et al. Postprandial interleukin-6 release from skeletal muscle in men with impaired glucose tolerance can be reduced by weight loss. J Clin Endocrinol Metab 2005; 90:5819-24.

11. Kristiansen OP, Mandrup-Poulsen T. Interleukin-6 and diabetes: the good, the bad, or the indifferent?” Diabetes 2005;54 Suppl 2:S114-24

12. Dowlati Y, et al. A meta-analysis of cytokines in Alzheimer’s disease. Biol Psych 2010;68(10):930-41.

13. Tackey E, et al. Rationale for interleukin-6 blockade in systemic lupus erythematosus. Lupus 2004;13(5):339-43.

14. Nishimoto N. Interleukin-6 in rheumatoid arthritis. Curr Opin Rheumatol 2006;15(3):277-81.

15. Dayer JM, et al. Cachectin/tumor necrosis factor stimulates collagenase and prostaglandin E2 production by human synovial cells and dermal fibroblasts. J Exp Med 1985;162(6):2163-8

16. Feldermann M, Maini RN. Lasker Clinical Medical Research Award. TNF defined as a therapeutic target for rheumatoid arthritis and other autoimmune diseases. Nat Med 2003;9(10):1245-50.

17. Liang J, et al. Myeloperoxidase (MPO) and interleukin-17 (IL-17) plasma levels are increased in patients with acute coronary syndromes. J Int Med Res 2009;37:862-6

18. Yamada H. Current perspectives on the role of IL-17 in autoimmune disease. J Inflamm Res 2010;3:33-44

19. Peluso I, et al. High fat meal increase of IL-17 is prevented by ingestion of fruit juice drink in healthy overweight subjects. Curr Pharm Des 2012;18:85-90.

20. Ghanim H, et al. Orange juice neutralizes the pro-inflammatory effects of a high-fat, high-carbohydrate meal and prevents endotoxin increase and Toll-like receptor expression. Am J Clin Nutr. 2010;91:940-9.

21. Ellis, CL et al. Attenuation of Meal-Induced Inflammatory and Thrombotic Responses in Overweight Men and Women after 6-week daily strawberry (Fragaria) intake. J Atheroscler Thromb. 2011;18:318-327.

Dr. Carrie Diulus M.D.

Dr. Carrie Diulus M.D.

Dr. Carrie Diulus is an orthopaedic spine surgeon for the Cleveland Clinic. She treats a range of degenerative and sports related spine conditions. She has a special interest in the role of nutrition in orthopaedics and chronic pain. As a result of struggling with her own weight she now includes freshly expressed juice into her daily routine and incorporates juicing and high micronutrient diets into the treatment of her patients. Dr. Diulus has co-authored textbook chapters and her research in orthopaedics, pathology and biomaterials has been published and presented at both national and international meetings.

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