Over the past several decades Americans have lost much of the diversity in their diet, impacting the gut microbiome and contributing to the epidemic of autoimmune disorders. We are seeing that the vast majority of people in the US have less-than-perfect diets, often high in calories, short on nutrients, and low on fiber. In fact, only about 10 percent of Americans meet their daily fiber requirements.

A significant environmental trigger in autoimmune disease is the diet. Dietary approaches provide the most effective means to returning balance and dysfunction with the gastrointestinal system. According to a new study published Monday in Nutrients, researchers demonstrated the role of dietary fiber in rheumatoid arthritis.

This study included 36 patients with rheumatoid arthritis (RA) in clinical remission. All of the patients continued their current medication throughout the study. They consumed either a high-fiber bar or cereal for a 28-day period. Laboratory assessment included biomarkers of intestinal inflammation, intestinal permeability, and adaptive T cell-related immunity taken at baseline and at the end of the study. In addition, measurements of disease activity, physical function, and quality of life were assessed. As a result, researchers noted an increase in T regulatory cell numbers, a positive Th1/TH17 ratio, and decreased bone erosion demonstrated by a significant reduction in serum collagen fragments (CTX-1). In addition, IgM rheumatoid factor and IgG anti-citrullinated protein antibodies slightly decreased and the anti-citrullinated vimentin p18 peptide antibody levels significantly decreased after the high-fiber supplementation. Also, serum calprotectin and zonulin were significantly reduced after treatment.

The gut plays an essential role in immune function as well as digesting and absorbing one’s food. The intestinal barrier provides an effective barrier from pathogenic bacteria as well a healthy environment for beneficial bacteria. A high fiber diet leads to the production of short chain fatty acids (SCFAs) in the gastrointestinal tract. These play an essential role in T regulatory cell activation, which regulates the intestinal immune system. If there is dysregulation in the immune system, there can be increased inflammation, amplifying disease severity.

In addition to increasing fiber and following a strict gluten-free diet, other nutrients to consider include vitamin D, fish oil, resveratrol, curcumin, and probiotics for autoimmune conditions. The level of nutrient intake, lifestyle choices and environmental exposures filtered through genetic predisposition are major factors in the expression of disease, and a successful treatment approach must investigate these factors.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Hager J, Bang H, et al. The Role of Dietary Fiber in Rheumatoid Arthritis Patients: A Feasibility Study. Nutrients. 2019. Oct 7;11(10).