The carnivore diet, an extreme elimination diet consisting exclusively of animal products, has garnered attention for its potential to alleviate symptoms of rheumatic diseases like rheumatoid arthritis (RA). This article delves into the scientific evidence, anecdotal reports, and expert opinions surrounding the carnivore diet and its impact on arthritis, providing a comprehensive overview for individuals considering this dietary approach.
Understanding the Carnivore Diet
The carnivore diet is an all-animal-product diet. It includes meat, fish, eggs, and sometimes dairy, while excluding all plant-based foods like fruits, vegetables, grains, and legumes. The carnivore diet is often described as an extreme elimination diet, aiming to reduce potential dietary triggers of inflammation. Some Arctic populations have survived for generations on almost entirely animal-based diets. The carnivore diet seeks to replicate this way of eating.
The carnivore diet is a highly restrictive dietary regimen that eliminates all plant-based foods, relying exclusively on animal products such as meat, fish, eggs, and dairy. The carnivore diet claims to provide several health benefits. Some supporters of the carnivore diet suggest that eliminating plant-based foods may benefit individuals with autoimmune conditions by reducing exposure to potential dietary triggers, such as lectins and oxalates.
Rheumatic Diseases and Inflammation
Rheumatic diseases are often driven by chronic inflammation and autoimmune responses, leading to joint pain, stiffness, and fatigue. Rheumatoid arthritis (RA) is a complex autoimmune condition where chronic inflammation wreaks havoc on joints and overall health.
Potential Benefits of the Carnivore Diet for Rheumatic Diseases
The carnivore diet focuses exclusively on animal-based foods-meat, fish, eggs, and animal fats-while completely eliminating carbohydrates, fiber, and plant-based components. For some individuals with RA, this approach can offer temporary relief. By eliminating plant-based foods that may contain anti-nutrients (e.g., lectins, oxalates), the diet may lower inflammation for some individuals.
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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.
The Gut Microbiome and Immune Function
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.
Potential Drawbacks and Risks
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. Phytonutrients-such as flavonoids, polyphenols, and terpenes-scavenge free radicals and modulate immune signaling pathways. Diets rich in colorful fruits, vegetables, herbs, and spices help down-regulate pro-inflammatory cytokines and support gut barrier integrity.
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. 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.
Potential nutritional imbalances due to the carnivore diet could also present challenges to long-term adherence. Given the limited long-term research, individuals considering this diet should exercise caution and consult healthcare professionals to ensure adequate nutrient intake.
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Expert Opinions and Research Findings
As a surgeon and gut microbiome specialist, I’ve seen firsthand how dietary choices can influence RA symptoms. 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.
A recent prospective study showed that higher consumption of red meat and total protein was associated with increased risk for inflammatory polyarthritis. However, a study prospectively examined the relationship between diet (in particular, protein, iron, and corresponding food sources) and incident rheumatoid arthritis (RA) among 82,063 women in the Nurses' Health Study. From 1980 to 2002, 546 incident cases of RA were confirmed by a connective tissue disease screening questionnaire and medical record review for American College of Rheumatology criteria for RA. The multivariate models revealed no association between RA and any measure of protein or iron intake. Red meat, poultry, and fish were also not associated with RA risk. The study were unable to confirm that there is an association between protein or meat and risk for RA in this large female cohort.
The Ketogenic Diet as an Alternative
The principle of ketogenic diet (KD) is restriction of carbohydrates to a maximum of 5-10% of the total daily caloric intake, aiming at shifting body metabolism toward ketone bodies. Literature about the anti-inflammatory properties of KD in rheumatic diseases is still limited. The clinical effect of KD may be primarily attributed to improvement of insulin sensitivity. In rheumatoid arthritis, fasting was shown to be effective in reducing disease symptoms, possibly through the production of β-hydroxybutyrate (BHB), the main ketone body. BHB may exert inhibitory effects also on IL-17 and intermittent fasting improved the clinical manifestations of psoriatic arthritis. The mean time for achieving nutritional ketosis is generally 3 days, although longer periods up to 10 days have been documented. During the first 3 days, the ketosis induction phase, the patient may experience adverse effects including headache, nausea, asthenia, fatigue, constipation. These effects tend to disappear at the end of the induction phase. Insulin reduction and improvement of insulin sensitivity contribute to the clinical effects of KD.
Dietary Fiber and Gut Health
Dietary Fiber Intake and Gut Microbiota in Human Health. The gut microbiome: linking dietary fiber to inflammatory diseases. Interplay between diet and gut microbiome, and circulating concentrations of trimethylamine N-oxide: findings from a longitudinal cohort of US men.
The Role of Fasting
During Ramadan, Muslims refrain from eating and drinking from dawn to sunset. It results in a month of intermittent fasting. Studying the effects of fasting during Ramadan, Su et al. observed non-significantly higher DAS-28 scores before than during Ramadan and significant improvement in morning stiffness and functional disability.
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