Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are complex autoimmune conditions characterized by chronic inflammation that affects joints and overall health. As a result, many individuals explore various dietary strategies to manage their symptoms. The carnivore diet, an extreme elimination diet, has garnered attention as a potential approach to reduce inflammation and alleviate symptoms of autoimmune conditions like RA and PsA.
What is the Carnivore Diet?
The carnivore diet is an all-animal-product diet that includes meat, fish, eggs, and sometimes dairy, while excluding all plant-based foods like fruits, vegetables, grains, and legumes. It’s often described as an extreme elimination diet, aiming to reduce potential dietary triggers of inflammation. Some people on this diet only eat one type of meat. Others eat all kinds of meat and other animal products. Some people cut out food groups so strictly that they don’t season their food. There are many variations of the carnivore diet, but they’re all based on the same claim: Eating only meat is the best thing for your health.
How the Carnivore Diet May Help Rheumatic Diseases
Rheumatic diseases are often driven by chronic inflammation and autoimmune responses, leading to joint pain, stiffness, and fatigue. The carnivore diet may offer some benefits in managing these conditions through several mechanisms:
Reducing Inflammation
By eliminating plant-based foods that may contain anti-nutrients (e.g., lectins, oxalates), the diet may lower inflammation for some individuals. Some individuals, like Mikhaila Peterson, Dr. Shawn Baker and Dr. Paul Saladino have reported significant symptom relief from autoimmune condition after adopting the carnivore diet, though these are anecdotal and not supported by large-scale clinical trials. While eliminating carbohydrates can temporarily reduce inflammatory triggers by starving harmful gut microbes, the carnivore diet lacks phytonutrients and fiber essential for long-term gut and immune health.
Addressing Food Sensitivities
Many RA and PsA patients develop sensitivities to complex proteins. Restrictive diets can inadvertently increase sensitivity to the few foods you’re eating. Using mediator-release assays, IgG/IgG4 panels, or elimination/reintroduction trials helps pinpoint triggers.
Read also: The Carnivore Diet: An Autoimmune Solution?
Potential Benefits and Drawbacks
Short-Term Relief vs. Long-Term Sustainability
While the carnivore diet might offer a flare-up solution by temporarily reducing inflammation through carbohydrate elimination, it is not a sustainable long-term strategy for most RA patients. Many who adopt the carnivore diet report a return of symptoms once carbohydrates are reintroduced.
Macronutrient Considerations
A balanced intake of macronutrients (carbohydrates, fats, and proteins) is essential. The carnivore diet meets protein and fat requirements, but its heavy reliance on saturated fats and animal cholesterol may increase levels of arachidonic acid-a precursor to inflammatory cytokines.
Tip: Favor lean animal proteins and, when possible, choose sources with a better fat profile.
Gut Microbiome Implications
The gut microbiome is central to immune function; about 70-80% of your immune system resides in your gut. A healthy gut microbiome requires diversity, which is best supported by a varied diet including plant-based foods. Up to 80% of immune regulation occurs in the gut. A diverse microbiome-fostered by a wide spectrum of fibers and resistant starches-promotes anti-inflammatory bacterial strains that help calibrate immune responses.
Phytonutrient Deficiency
Phytonutrients-antioxidants and anti-inflammatory compounds found in plants-play a crucial role in reducing inflammation. Diets rich in phytonutrients help modulate immune responses and support gut health. Phytonutrients-such as flavonoids, polyphenols, and terpenes-scavenge free radicals and modulate immune signalling pathways. Diets rich in colorful fruits, vegetables, herbs, and spices help down-regulate pro-inflammatory cytokines and support gut barrier integrity.
Read also: The Carnivore Diet's Impact on Sleep
Research and Evidence
Studies on Psoriasis and Psoriatic Arthritis
The effect of different diet patterns on psoriasis (PSO) and psoriatic arthritis (PSA) is unknown. A study evaluated the effectiveness of a Mediterranean diet (MD) and Ketogenic diet (KD) in patients with PSO and PSA. Twenty-six patients were randomly assigned to start either with MD or KD for a period of 8 weeks. After a 6-week washout interval, the two groups were crossed over to the other type of diet for 8 weeks.
At the end of this study, MD and KD resulted in significant reduction in weight, in BMI, in waist circumference (WC), in total fat mass, and in visceral fat, in comparison with baseline. After KD, patients displayed a significant reduction in the Psoriasis Area and Severity Index (PASI), Disease Activity Index of Psoriatic Arthritis (DAPSA), interleukin (IL)-6, IL-17, and IL-23, whereas no significant differences were observed in these markers after MD, compared to baseline.
Limitations and Controversies
There have been anecdotal reports of people who claim their health issues have benefited from this diet. But many of these claims about the carnivore diet are unscientific and should be approached with caution. Some supporters of the carnivore diet claim that plant-based food is toxic and causes inflammation, but there’s little evidence to support this. For example, lectins (natural proteins found in many plant-based foods) and gluten are cited as toxins. Lectin is common in beans and rice and may cause stomach upset when too much is eaten. However, it’s not usually necessary to avoid it completely. Gluten is harmful to people with celiac disease and nonceliac gluten sensitivity, but eating a gluten-free diet is not necessary for most people.
Specific Considerations for Psoriasis and Psoriatic Arthritis
Red Meat and Inflammation
Red meat and psoriasis don’t mix well. In particular, beef and pork are high in saturated fatty acids. Foods with high levels of saturated fats may trigger inflammation, which can worsen psoriasis symptoms. So, eating lots of red meat isn’t the best choice for people with psoriasis. But there are some kinds of meat that are good for psoriasis. Lean proteins, such as poultry and fish, are great meal options for people living with psoriasis.
Heart Health
People with psoriasis are at a higher risk of heart disease compared to the general population. The carnivore diet can make this worse because an all-meat diet can lead to high cholesterol, which can increase the risk of heart problems. Eating large amounts of high-sodium, processed meats can also increase the risk of hypertension (high blood pressure) - another condition associated with psoriasis. Hypertension can raise the risk of other types of heart disease and stroke.
Read also: Troubleshooting Carnivore Diet Diarrhea
Other Potential Health Concerns
In addition to possibly affecting heart health, cutting out all grains, legumes, fruits, and vegetables can create other health problems. Some other potential health issues that may be associated with a carnivore diet include:
- Deficiency in minerals and vitamins
- Constipation from lack of fiber
- Kidney disease (related to high sodium from eating large amounts of processed meats)
- Colorectal cancer (associated with high meat consumption)
Alternative Dietary Approaches
Mediterranean Diet
In general, a healthy diet focused on fruits, vegetables, grains, legumes, lean protein, and healthy fats is recommended. This is especially true for people with psoriasis and heart disease. This type of diet is often called the Mediterranean diet. A Mediterranean-style diet also includes low-fat dairy products and nuts and seeds. This type of diet is thought to have anti-inflammatory effects on the body, which may help improve psoriasis symptoms.
An anti-inflammatory diet, such as the Mediterranean diet, is one of the most popular choices among members of MyPsoriasisTeam. Anti-inflammatory diets include some of the best foods for PsA. They are high in fresh fruits, vegetables, nuts, whole grains, and extra-virgin olive oil. They eliminate foods that may trigger a flare or worsen disease activity. Foods to limit or avoid include saturated fats, refined sugars, and refined carbs, such as white bread.
Essentials of anti-inflammatory diets include:
- Fresh fruits and vegetables - Blueberries, cherries, collard greens, spinach, kale, Swiss chard, and beet greens all contain antioxidants (plant nutrients that protect cells) that can help decrease inflammation.
- Olive oil - The cornerstone of the Mediterranean diet, olive oil is loaded with heart-healthy and anti-inflammatory fats.
- Fish and omega 3s - Fatty fish, such as salmon and mackerel, are high in omega-3s, a healthy type of fat with anti-inflammatory properties that may help protect people with PsA against heart disease. Good plant-based sources of omega 3s include flaxseed, chia seeds, and walnuts.
- Whole grains - Brown rice, whole grain bread, quinoa, barley, and wheat berries contain fiber, which helps regulate blood sugar and may also decrease inflammation.
- Nuts - Peanuts, almonds, walnuts, cashews, pistachios, and pecans have healthy fats and fiber that may lower levels of inflammation in the body.
- Beans - High in dietary fiber and protein, beans have significant antioxidant and anti-inflammatory compounds.
Weight-Loss Diets
According to the National Psoriasis Foundation (NPF), the best diet for managing PsA symptoms is one that helps people attain a healthy weight and takes pressure off the joints. A small 2019 study found that obesity is associated with higher disease activity, poorer treatment response, and a higher risk of other inflammatory conditions. When participants in the study lost weight, their joint pain and swelling decreased.
Ask your doctor about the best nutrition plan if you’re looking to lose weight.
Gluten-Free Diet
The NPF recommends a gluten-free diet only for people with specific gluten sensitivities, such as celiac disease. That’s because going gluten-free can sometimes mean missing out on certain nutrients. Studies from the Journal of the American Academy of Dermatology show that celiac disease is more common in people with psoriasis or PsA, and testing can help you find out if gluten sensitivity is a factor for you.
Marcel's Experience with the Carnivore Diet and Psoriasis
Marcel’s Journey with Psoriasis and Other Health Issues: Having suffered from psoriasis for 17 years, Marcel’s condition had gotten worse as it gradually spread to almost completely cover his hands and torso. Due to the fact that psoriasis is an autoimmune disorder, it can cause the joints and other tissues to be attacked. Marcel developed psoriatic arthritis five years ago. Things got more complicated when Marcel began to experience sleep apnea, a vitamin B12 deficiency, problems with lactic acid buildup in his muscles, and other health issues, which sped up the progression of his ailments.
The Effect of Medication on Marcel’s Health: Four years ago, Marcel began taking medications for psoriasis. The drug was an immune system blocker, known as a TNF blocker. This resulted in some control of his psoriasis and eliminated the inflammation in his joints. However, it left Marcel “Always tired, with muscle cramps. Just struggling with the symptoms of an autoimmune disease.”
The Carnivore Diet as a Solution to Marcel’s Health Problems: Sometimes bad things can force us to make good changes, and Marcel was about to experience this paradox. His son became ill, and Marcel had to work from home so that he could take care of him. “That week, I felt just fine, and that week I took my psoriatic arthritis medication.” One of the problems with immune-system-blocking medication is that it can leave you very vulnerable to other infections that the immune system would normally protect you from.
Marcel’s Discovery of the Carnivore Diet and Its Benefits: The result was quite severe for Marcel: “The next day, I became ill; I got a fever and a sore throat. I got a throat infection and, as a result, a huge psoriasis flare-up. I was covered from my scalp to the bottom of my feet. Feeling utterly hopeless and tired of being sick, I just went searching for possible solutions. Being an Advanced Nurse Practitioner in Training, being sick does not compute with the way I want to live.”
As many of us have, Marcel began a desperate search for answers online. He found the now-famous Joe Rogan podcast, where he was interviewing Dr. Shawn Baker. He wondered if the carnivore diet could be the solution. Marcel talked it over with his girlfriend, and they decided he should commit to trying Carnivore for one month, staying very strict.
Marcel’s Success with the Carnivore Diet: The results were very promising, and his psoriasis began to vanish! Marcel’s joint pain eased as well, and for the first time, he began to have hope. He continued on the diet. Experiencing some inflammatory flare-ups because of two “cheat days” around Christmas, Marcel found his body was not forgiving about his diet. Nine weeks after starting his carnivore journey, his psoriasis is completely gone! He still has some scarring from the lesions, but perhaps these will fade over time.
Psoriasis Diet Recommendations
In general, a healthy diet focused on fruits, vegetables, grains, legumes, lean protein, and healthy fats is recommended. This is especially true for people with psoriasis and heart disease. This type of diet is often called the Mediterranean diet. A Mediterranean-style diet also includes low-fat dairy products and nuts and seeds. This type of diet is thought to have anti-inflammatory effects on the body, which may help improve psoriasis symptoms.
People with psoriasis may also find they benefit from limiting other foods and beverages that trigger their particular symptoms. These may include alcohol, dairy, red meat, refined carbohydrates like white bread, and fried foods.