Unlock the Truth: How the Carnivore Diet Could Transform Autoimmune Disease Management

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory, and debilitating autoimmune illness that affects about 1% of the world’s population. The carnivore diet, a highly restrictive dietary regimen that eliminates all plant-based foods and relies exclusively on animal products, has gained attention as a potential intervention for autoimmune diseases. 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. This article explores the current research and evidence surrounding the carnivore diet and its effects on autoimmune diseases, with a focus on rheumatoid arthritis.

Understanding 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. Proponents of the carnivore diet argue that early humans thrived primarily on animal-based diets, and that eliminating plant-based foods can lead to weight loss, reduced inflammation, improved mental clarity, and simplified eating habits.

The Western Diet and Autoimmune Diseases

The prevalence of autoimmune diseases is higher in Western countries, which can, at least partly, be attributed to, or influenced by, dietary habits. The dietary habits characterized by the consumption of foods high in fats, trans fatty acids, cholesterol, proteins, simple sugars, salt, as well as the frequent consumption of processed and “fast food”, has been termed the “Western diet” (WD). The Western diet, which is typically high in saturated and trans fats, refined carbohydrates, sugar-sweetened drinks, and a low ratio of omega-3: omega-6 fatty acids, increases inflammation and the risk of RA. In fact, the Western diet increases inflammation and the risk of RA. The main feature of the Western diet is the high consumption of animal proteins and red meat, which, in a nested case-control study, was reported to increase the risk of inflammatory polyarthritis.

The Mediterranean Diet and Autoimmune Diseases

Conversely, a protective role of certain diets has also been hypothesized. The Mediterranean diet (MD) was first described by Ancel Keys in the early 1960s as the dietary pattern found in the Mediterranean region. According to its most recent definition, published by UNESCO in 2010, the MD is much more than a diet: rather, it is as a set of cultural traditions and values that interpret food as a means of sharing, of conviviality, aimed at making proper nutrition the pillar of a healthy lifestyle from all standpoints. The MD is characterized by the frequent consumption of olive oil, whole grains, seasonally-available fruits and vegetables, a moderate amount of fish, dairy products, and meat, and many condiments and spices, all accompanied by water, infusions, and wine in moderate amounts. The high intake of fruits, vegetables, and whole grains, typical of the MD, is primarily beneficial, owing to the high content of fiber, which can support the gut microbiome. A greater adherence to the Mediterranean diet (MD) in the Mediterranean region has been reported more in elderly people than in younger age groups. Nutritional interventions have the potential to prevent and/or support the treatment of ADs. The ability of microbiota-derived SCFAs in promoting the expansion and differentiation of regulatory T cells (Tregs), which are crucial in maintaining immune homeostasis, has been established, and is a form of chemical-mediated communication between commensal microbiota and the immune system, closely dependent on the diet.

Animal Flesh Foods Consumption and Rheumatoid Arthritis: A Case-Control Study

A case-control study was conducted to evaluate the relationship between animal flesh foods consumption and rheumatoid arthritis. Meat consumption was assessed by using a semi-quantitative Food Frequency Questionnaire (168 items) in a case-control study of 297 subjects (100 newly diagnosed cases and 197 healthy controls). Multivariate logistic regression, adjusted for lifestyle and nutritional confounders, was used to evaluate the relationship between dairy consumption and rheumatoid arthritis.

The results of this study indicate an inverse association between fish consumption and RA. On the contrary, a higher amount of processed meat intake was associated with increased odds of RA. However, no significant association was found between red meats and poultry consumption and the risk of RA in the fully adjusted model.

Fish and Seafood Consumption

Participants with greater consumption of fish and seafood were less likely to have RA (OR 0.52; 95% CI 0.27-0.98). Concordant with these results, the association between fish consumption and a reduced risk of RA has been shown in many empirical studies. Indeed, evidence suggests that consumption of individual foods, including fish, might reduce the risk of RA. In a case-control study conducted by Rusell et al. on 1889 patients and 2146 controls, the results showed that consumption of oily fish reduced the risk of RA while intake of fish oil supplements did not show a beneficial result. In another study of 32,000 women in 1987 and 1997 from the Swedish Mammography prospective Cohort, Giuseppe et al. found that intake of 1-3 servings of fish per week reduced the risk of RA. The association between fish intake and the risk of RA found in the present study might be attributed to the anti-inflammatory properties of fish oil.

Processed Meat Intake

A higher processed meat intake was associated with increased odds of RA (OR 3.45; 95% CI 1.78-6.68). Several studies have shown that processed meat can increase inflammatory mediators, including CRP. Processed meat refers to products that are usually made from red meat and cured, salted, or smoked to improve the taste, color, and shelf life. Processed meats, such as sausages, have a high amount of fat (Often 50% by weight of sausage or more), SFA, and cholesterol. In general, processed foods maybe increase the intake of saturated fats, cholesterol, salt, nitrite, heme iron, and polycyclic aromatic hydrocarbons, depending on methods used for food preparation. Thus, the result might be due to these various components, knowing that they play an important role in oxidative stress.

Red Meat and Poultry Consumption

No significant association was found between red meats and poultry consumption and the risk of RA in the fully adjusted model. Similar to these findings, the results of a cohort study in the United States showed no association between red meat and poultry and the incidence of RA. Another prospective cohort (Nurses’ Health Study) conducted on 82,063 women, which followed participants for more than 20 years, could not find a significant association between red meat intake and RA incidence.

Case Series: Ketogenic and Carnivore Diets for Inflammatory Bowel Disease

A case series reported on 10 patients who successfully treated IBD with a KD or carnivore diet. Final inclusion required a histologically confirmed diagnosis of ulcerative colitis (UC) or Crohn’s disease that was responsive to treatment with a ketogenic or carnivore diet without medication or with successful medication cessation on the diet.

Clinical presentations were diverse, including six cases of UC and four of Crohn’s disease. Clinical improvements were universal, with clinical improvement scores ranging between 72 and 165 points on the IBDQ. Patients’ diets comprised mostly meat, eggs, and animal fats.

These cases suggest that ketogenic and carnivore diets hold promise for the treatment of IBD, including UC and Crohn’s disease.

Potential Health Benefits of the Carnivore Diet

Some people report positive outcomes from following the carnivore diet, including:

Weight loss: By eliminating carbohydrates, the body enters a state of ketosis, which burns fat for fuel.
Reduced inflammation: Some people with autoimmune diseases claim symptom relief after cutting out plant-based foods that may cause gut irritation.
Improved mental clarity: Stable blood sugar levels from a high-protein, high-fat diet may help some people avoid energy crashes.
Simplified eating habits: With no need to count calories or worry about food variety, some find the diet easier to follow.

The Risks and Drawbacks

While the diet may offer short-term benefits, nutrition specialists and other medical professionals express concerns about potential health risks, including:

Heart health concerns: Diets high in saturated fat and cholesterol from red meat have been linked to increased heart disease risk.
Nutrient deficiencies: A meat-only diet lacks essential vitamins and minerals found in plant-based foods, such as fiber, vitamin C and antioxidants, which are crucial for gut and immune health.
Digestive issues: The lack of fiber can lead to constipation and disruptions in gut microbiome diversity, essential for digestion and overall well-being.
Long-term sustainability: Cutting out entire food groups can make it difficult to maintain balanced eating habits over time, potentially leading to disordered eating patterns.

Carnivore Diet and Gut Microbiota Homeostasis and Intestinal Integrity

Impaired intestinal barrier functions can lead to the activation of an (auto)immune response, which may be induced through different mechanisms, such as molecular mimicry between food ingredients and self-antigens, or the reaction of certain chemical products with self-molecules, generating novel antigenic molecules. Furthermore, tight junction dysfunction is a common feature in ADs, and the central role played in AD pathogenesis by altered intestinal permeability has been extensively described. In addition to increasing inflammation, the condition of a leaky gut has a second adverse effect: the risk of malabsorption of essential macro- and micronutrients; this is important, since vitamin deficiencies (e.g., vitamin D deficiency) have been named as risk factors for some autoimmune diseases, such as rheumatoid arthritis (RA) and MS.

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