My PhD research overview – Diet and rheumatoid arthritis

It’s high time for an update on my nutrition research.

I’m currently 2 years into my Ph.D. and this post is a little background on how I got here, what I’m researching and where the research is at to date.

A little background. While working at a CrossFit gym in 2009, I was introduced to the paleo diet and the work of Prof Loren Cordain. He suggested cereal grains, especially gluten may be detrimental to those with autoimmune disease. When I eliminated grains and gluten my joint inflammation stopped. A little while later during my PGDip, I heard of 2 women with rheumatoid arthritis who has a big decrease in their symptoms using paleo. This led to my first study in 2015, where I interviewed 10 people with RA who all experienced a reduction in RA symptoms on either paleo or the autoimmune protocol (AIP)

As a result of learning that these people had such success using this diet, I was intent on carrying out an intervention testing AIP in people with RA. Anecdotes of those who are successful are not clinical trials. To properly evaluate what the response rate is to an eating plan, a clinical intervention study is needed.

I talked to potential supervisors in different Auckland Universities and found supervisors at Auckland University of Technology to support me. Their ideas gelled with what I believed would be a good direction for the study. I also have the support of a Professor of Rheumatology in Otago University who is an advisor.

I started as an MPhil student at AUT Millenium in 2021 and conducted a mixed method 2-phase pilot with 9 participants. For the first 4 weeks, participants ate their normal diet without change, following that they ate along the guidelines of the autoimmune protocol diet. Weekly online questionnaires evaluated their quality of life and RA symptoms. Weight and waist were tracked as was their discretionary pain relief. 3-day diet diaries were collected 4 times during the 12 weeks. At the end of the study each person was interviewed for an hour on their experience of using the protocol.

In late 2021, I sought approval to expand my research and upgrade to a Ph.D., and my Ph.D. proposal and candidature were approved in 2022.

My research expanded to conducting 1-year mixed methods post-study follow-up with any participant who agreed to take part. Fortunately, all have agreed. Repeat data was collected, RA questionnaires, 3-day diet diaries, and weight and waist. I also carried out in-depth interviews with all on how they have fared since the end of 2021 when they were left on their own following intense support on the AIP diet.

Another part of my research is carrying out a scoping review (a type of systematic review) looking at all types of diet studies in RA with an elimination and food challenge. I’m particularly interested in what the studies show about food sensitivity being a trigger for RA symptoms.

Now that all the data has been collected, this year is devoted to analysis and writing & publishing.

Now that I have researched and collected multiple (hundreds!) diet studies on people with RA, I will endeavor to do posts on some of the more useful and interesting ones over the course of the year.

Here is an early abstract publication from the end of 2021

A pilot study to test the effect of the autoimmune protocol diet in people with rheumatoid arthritis

Julianne McNeill Auckland University of Technology

 

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