Dr. Randolph has known for many years that arthritis and arthralgia can be caused by certain foods and chemicals in particular individuals. He and others have written extensively on the subject.¹ The relationship of food to arthritis is beginning to be recognized. In February 1986, two articles describing this relationship appeared. First, "Food-Induced (Allergic) Arthritis" came out in Arthritis and Rheumatism,² the recognized journal on the subject in the United States. A patient was tested double blind with foods placed in opaque capsules. She has significant reactions to milk and possibly to other foods. The authors conclude, "We have provided compelling evidence relating symptomatic deterioration of inflammatory, rheumatoid-like arthritis with immunologic hypersensitivity to milk in a single patient.

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A patient was tested double blind with foods placed in opaque capsules. She has significant reactions to milk and possibly to other foods. The authors conclude, "We have provided compelling evidence relating symptomatic deterioration of inflammatory, rheumatoid-like arthritis with immunologic hypersensitivity to milk . . .

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In the same month, in the prestigious British medical journal, The Lancet, another article, "Placebo-Controlled, Blind Study of Dietary Manipulation Therapy in Rheumatoid Arthritis,"³ appeared. The patients were tested with actual foods so the study was not double blind. However, it was single blind in the sense that "assessments were undertaken by a trained observer unaware of the patients’ stage of treatment. . . . After challenge, any foods producing symptoms were excluded from the diet." Overall they got statistically significant changes during dietary elimination compared to the baseline, and of the 45 patients who completed the study, 33 said they were "better" or "much better." Analyzing the results for these "good responders," researchers found that "the beneficial effect of the dietary manipulation was even more pronounced." We note that these researchers were very careful to note the individual food reactions in their patients.

People like Sharon Feldman, who spoke for NOHA in January on conquering rheumatoid arthritis, are delighted to see a dawning recognition of how foods affect the many kinds of arthritis. For some time it has been acknowledged that fasting reduces symptoms, which will flare again when patients return to their regular diet or even to a special one that is given to all patients and that is not particularly tailored to the reactions of each individual. In The Lancet article mentioned above, the authors cite a Scandinavian study in which the patients fasted and then were put on "a lacovegetarian diet for 9 weeks" after which "there were no differences between diet patients and controls." Dr. Panush, the senior author of the first article, had conducted an earlier randomized, double blind study⁴ of "patients with longstanding, progressive, active RA." They got some improvements on placebo and some on the experimental diet with no overall objective difference. However, two of their patients improved markedly on the experimental diet and decided to stay on it because they noticed increased joint symptoms when eating other foods. The authors conclude that "our data are not inconsistent with the possibility that individualized dietary manipulations might be beneficial for selected patients with rheumatic disease." We in NOHA can confirm the excellence of this individualized approach.

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¹Randolph, T.G., "Ecologically Orientated Rheumatoid Arthritis" and "Ecologically Orientated Myalgia and Related Musculoskeletal Painful Syndromes" in Dickey, L.D., editor, Clinical Ecology, Thomas, 1976, pp. 201-223.