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Arthritis is a kind of disease in which joints and connective tissues are chiefly affected causing inflammation, pain and stiffness. However, other parts of the body too are affected in several cases. Although there are more than 100 different types of Arthritis amongst which Osteoarthritis, Rheumatoid Arthritis and Fibromyalgia are the most common ones.

Osteoarthritis, also called Degenerative joint disease, is a type of Arthritis that mostly affects the large weight-bearing joints of the hips, knees and spine, and is caused when bone start rubbing against bone upon the withering away of the joint surface. The disease starts affecting the people between the ages of 18 and 79.

Rheumatoid Arthritis is another common type of Arthritis that most commonly affects the joints of the fingers, wrists, arms and legs involving the same joints on both sides of the body. Besides, in some of the patients Rheumatoid Arthritis sometimes also affect the hearts, lungs and eyes. Its symptoms also include a general feeling of sickness and fatigue in addition to weight loss and fever. People between the ages of 25 and 50 are mostly affected by this disease, although children and people above 50 years may become afflicted.

Fibromyalgia is the third common type of Arthritis in which muscles, ligaments, tendons or soft tissues are generally affected thus causing constant fatigue, deep muscle pain, sleeplessness and depression. This is a chronic disease.

According to studies conducted by medical professionals, certain foods have been strongly linked to Arthritis. The foods include products with refined (white) sugar or flour, red meat, citrus fruits (including oranges), dairy foods, tomatoes, potatoes, aubergines, tea, coffee, alcohol, or ‘instant’ meals containing large amounts of artificial preservatives, colorings or flavorings.

As early as 1917, medical practitioners began reporting the cases of food allergy or adverse reaction of foods in Arthritic patients. During the study, they were able to identify the difference between immediate and delayed exacerbation of arthritic symptoms after the food was ingested. They also ascertained the fact that what was so far being perceived as normally a delayed reaction could be turned into an immediate one provided the diet did not include the concerned food for at least a period of five days. It was also found out that upon the reintroduction of the said food, excluding slowly absorbed foods such as cereals, the reaction occurred within 4-6 hours. However, Dr. Michael Zeller proved to be the first physician to notably point out in his paper published in 1948 entitled ‘Rheumatoid Arthritis: Food Allergy as a Factor’ in the Annals of Allergy that symptoms for Rheumatoid Arthritis partially owed their existence to food allergies caused by subsequent re-ingestion of certain foods, which could, however, be remedied by appropriate food exclusion diets. Even, Dr. Zeller observed in his findings that constant reintroductions of identified food allergens after an interval of at least five day reportedly resulted in the exacerbation of pain, joint swelling and general inflammation.

Medical practitioners have also pointed out that Rheumatoid Arthritis condition shows signs of worsening due to excess intake of Omega-6 fatty acids. It has been reported that excessive consumption of feedlot beef, refined cooking oils and margarines result in the increase of inflammation, which can be minimized or eliminated after the limiting of their consumption. Besides, the production of pro-inflammatory substances in the body also increases due to most saturated fats, which are prominently found in whole dairy products including whole milk and cheese, and in animal products such as red meats and poultry. In some of the Arthritic patients, antibodies against gluten (a protein found in many grains) are found, while some Rheumatoid Arthritis patients have antibodies against milk proteins. According to medical practitioners, joint problems can also be aggravated due to constipation, which is because of the intake of rich, fatty foods.

As such, it can be stated that apart from the above mentioned foods, it has been found by some Rheumatoid Arthritis patients that their condition deteriorates after the consumption of certain foods. In effect, different people can have problems with completely different foods. The adverse food reactions in Arthritic patients therefore can only be determined with the help of a proper food and symptom diary or allergy elimination diet.

In their studies, researchers have linked food allergies, adverse food reactions, intestinal inflammation, certain eating habits, and harmful bacteria in the digestive tract with Rheumatoid Arthritis. Those diets that are high in saturated fats, meat, dairy, and omega-6 fatty acids (found in animal products), refined vegetable oils such as corn oil, safflower oil, and margarine, are believed to cause Rheumatoid Arthritis. Also, in some cases certain food additives such as yellow dye #5 (tartrazine) also cause Rheumatoid Arthritis. Apart from these, diets considered low in fruits, vegetables, and other good sources of fiber that encourages the growth of harmful bacteria, results in causing Rheumatoid Arthritis.

Nightshade foods such as potatoes, tomatoes, eggplant, pepper (all kinds, including green, red chilli, paprika, cayenne, hot, sweet, etc., except for black and white pepper) also cause Arthritis since their consumption leads to the removal of calcium from the bones and getting it deposited in joints, kidneys, arteries, and other areas of the body, proving to be harmful.

Gluten-containing foods such as bread, pasta, cakes and cookies also cause Rheumatoid Arthritis in those people who have been suffering with celiac or abdominal disease and have been consuming such food. According to researchers, about 20% of patients with regional enteritis and 10% with ulcerative colitis are reported to have developed inflammatory arthritis.

In 1953, Kaufman pointed out that in some cases of arthritis, food allergy was a causative factor. O’Banion, who conducted research on three patients afflicted with Rheumatoid Arthritis, reported in his findings that when the patients were barred from taking allergenic foods from their diet arthritis pain was completely eliminated. In another instance, Hicklin et al while conducting researches on 22 patients suffering from Rheumatoid Arthritis pointed out that 20 patients (or 91%) registered significant improvement in their symptoms with at least 19 of them finding that exacerbations were repeatedly caused by certain foods.

Further, researches were carried out on 15 women and eight men with Rheumatoid or Psoriatic arthritis by Ratner et al. In this case the patients were asked not to take dairy products and beef at all in their diet. As a result within 3-4 weeks after the start of the diet seven patients showed improvements in their symptoms, but later on again reported exacerbation of symptoms when the dairy products were again reintroduced into their diet. However, the other 16 patients did not show signs of improvement, and even those seven patients who showed improvements were all women, being seronegative, and lactase-deficient, thus proving that refraining from a diet free of dairy products and beef is beneficial for lactase-deficient women with seronegative Rheumatoid Arthritis or Psoriatic arthritis.

In order to substantiate that certain foods were linked with Rheumatoid Arthritis, trial on 27 patients suffering with the disease were conducted. The patients were made to undertake a partial fast, followed by individual food challenges under which foods including animal foods, refined sugar, citrus fruits, preservatives, coffee, tea, alcohol, salt, and strong spices, which provoked symptoms, were avoided. Consequently, 26 patients partook of an ordinary diet, and reported marked improvement in the number of tender joints, number of swollen joints, pain score, and duration of morning stiffness, grip strength, sedimentation rate, and C-reactive protein, after four weeks. The said diet group also did not complain about the recurrence in symptoms even after one year thus proving the fact that a partial fast, followed by a lactovegetarian diet helps in the treatment of Rheumatoid Arthritis.

In another instance, Beri et al conducted researches on 27 patients suffering with Rheumatoid Arthritis by prescribing them an elimination-and-rechallenge diet. The diet programme was completed by 14 patients amongst whom 10 patients or 71% reported significant improvement. Prominent researcher Darlington also conducted trials on 70 patients suffering with Rheumatoid Arthritis by identifying and eliminating symptom-provoking foods, and found out that at least 19% of the patients neither reported any complaints nor required any medications during follow-up periods that ranged from 1.5 to 5 years. During the process, Darlington also identified foods such as corn, wheat, bacon/pork, oranges, milk, oats, rye, egg, beef, coffee, malt, cheese, grapefruit, tomato, peanuts, cane sugar, butter, lamb, lemon and soy, which were the causative factors in developing symptoms.

According to a study published in the January 2004 issue of ‘Arthritis and Rheumatism’, foods rich in vitamin D such as salmon, tuna, shrimp, sunflower seeds, eggs and vitamin-D fortified milk products prevents Rheumatoid Arthritis from taking place. The study is based on the research on 29,368 women in the age from 55 to 69 that began in 1986 and conducted over a period of 11 years. The research concluded that there was a 27% lower risk of Rheumatoid Arthritis being developed in the women who consumed the most foods naturally rich in vitamin D, whereas there was a 34% lower risk of Rheumatoid Arthritis being developed in those women who consumed the most foods fortified with vitamin D, i.e., milk products.

Though, for quite sometime both the patients and physicians have been struggling to ascertain whether certain foods are in any way linked with the developing of symptoms causing Arthritis. However, the abovementioned researches on Arthritis patients conducted over the years conclude that a variety of food items in effect have adverse effects in some Arthritis patients. As such, several studies conclusively prove that in some cases diet therapy may improve symptoms and likely to prevent Arthritis from exacerbating or taking place.

Darlington and Ramsey have suggested in their study that recourse to diet therapy be undertaken for Arthritic patients that should begin with elimination of all foods believed to be causing symptoms, followed by single food reintroductions to ascertain which foods reproduce symptoms. They also pointed out that foods such as corn, wheat, cow’s milk, pork, oranges, oats, rye, eggs, beef, coffee, malt, cheese, grapefruit, lemon, tomato, peanuts and soya may quite likely be the causes for Arthritis.

Children with autism are sensitive. Of the thousands of children I have known in thirty years as a doctor, the few hundred with problems in the spectrum related to autism stand out as the most distinctively sensitive of them all. Touching, tasting, hearing, smelling, and seeing involve an enterprise that is not only characterized by difficulties in processing and organization but is also involves a heightened, often painful, sensitivity.

We all know what it feels like to have sunburned skin or a reaction to a certain sound of chalk on the black board and we can empathize with children who are involved in a more global sensitivity, but we scientists still do not understand what happens at the cellular or molecular level to change a person’s reactivity from normal to sensitive. Even the words we use: “hypersensitive”, “allergic”, “intolerant”, “hyper-reactive” do not have precise definitions. Many physicians, however, would quibble if we were to say that “autistic children are allergic” as opposed to “allergic children are sensitive”.

How Doctor Baker discovered the behavioral allergy connection...
I was such a physician. Twenty five years ago when a child psychiatrist sent me Martin Zelson for evaluation of his seasonal behavioral deterioration. Martin was on the verge of being thrown out of his school program where he was in a group of other school aged children with severe developmental and behavioral problems, mostly in the autistic spectrum. Martin was aggressive, hyperactive, and destructive.

...I was skeptical, proficient in allergy evaluation, and was a former school boy New England wrestling champ. Evaluation and treatment of Martin’s inhalant and food sensitivities resulted in a major improvement so that he was able to benefit more from his school program and participate in family activities that would have previously been impossible. His allergic responses were cognitive and behavioral in the absence of the kinds of symptoms we usually consider to be allergic (stuffiness, eczema, wheezing, itching).

3 decades in practice revealed how common allergies are with children...
As it turns out, I have learned in the past three decades that Martin was not an exception. Most children with his kinds of problems - and including children with all sorts of attention problems - have hypersensitivity to foods, and inhalants. Those of us physicians who have taken a close look not just at their histories and allergy test results but at their biochemistry and immune systems now recognized that they tend to be in a state of inappropriate immune activation.

Autism is not caused by allergy, and yet...
Don’t get me wrong. I am not saying that “autism is caused by allergy”. I am saying that children who have problems in the autistic spectrum (as well as children who have significant attention problems) are sensitive not just in the area of their senses, but also in their immune system’s reaction to the environment. This association is a lot easier for me to understand if I look at the central nervous system (CNS) and immune systems from a functional, as opposed to an anatomical, point of view.

Anatomically the CNS and immune systems are quite distinct and different. One is made up of stationary long branching permanent cells with a compact headquarters between ones ears. The other is made up of a disseminated population of short-lived mobile cells with no specific organ to call home. Pick up any textbook of anatomy, physiology, or pathology. The CNS and immune system chapters are widely separated as are the experts who wrote the chapters. From the way I see it, however, they are a functional unit.

An important hidden link between the CNS and immune system...
Look at it this way: The cells of both systems arise from the same origin in the neural crest of the embryo. Both systems contain the only cells of our bodies that exist as permanent, undividing cells from infancy to old age. (Such long-lived cells are a subset of the otherwise ephemeral cells, lymphocytes, of the immune system.) Both systems have the job of perceiving the environment. The CNS takes in the big world of our senses, our every day cognitive experience. The immune system takes in the microscopic or molecular world of that has to do with “sensing” the constant presence of friendly or unfriendly (such as cancer) cells, germs, food molecules, and toxins.

The chemistry of the immune system perceiving its tiny environment is not very different from our nose smelling the bread baking in the oven. However we have a direct experience of the bread while our immune system only makes us aware of its activities when something seems to be quite wrong, and the message that something is wrong may be quite delayed or obscure. The memory of your fifth birthday party when your friend Jeffrey spilled purple juice all over your new sneakers is in your CNS. That same week, when the doctor gave you your shot against tetanus, diphtheria, and whooping cough, the enduring memory of the “taste” of those germs was evoked in your immune system where it remains today. The birthday and the immunization are stored differently in you body, but functionally they are come under the same heading: perception and memory.

Another important link between the CNS and immune system...
Perception and memory are the basis for “recognition”. Recognition is a term we use interchangeably to describe the day to day activities of both our CNS and our immune systems. Finally, both of these two systems share the capacity for this mysterious process called sensitization, which is, in a way, an inconvenient or painful alteration of the memory and recognition process. Viewed from this perspective, it is not surprising that children who have problems with taking in and processing the world express that problem on both the cognitive and immune levels. They are really just different aspects of the same underlying mysterious disorder.

We try to help our children organize and integrate their cognitive world by imposing certain simplified order. Such order may take the form of repetitive behavioral and linguistic exercises or efforts to modify responses (desensitize) to sensory input. On the immune level we try to impose a simplified order by avoidance of, or desensitization to, offending foods and inhalants. This applies whether the mechanism of the reaction to foods, for example, is “allergic” within the academic definition of the word or “intolerant” within a notion that covers a variety of mechanisms, including the mischief caused by certain peptides derived from gluten and casein.

Helping a picky, hypersensitive child...
So you have a picky kid. Your job is to help him or her learn better picking. If he or she chooses to limit his or her activities to monotonous behavior, you try to broaden his or her cognitive experience by picking and presenting other, more useful, kinds of stimuli. If he or she is sensitive to tastes, touch, smells, sights or sounds, you take steps to help him or her integrate and become less painfully sensitive to these stimuli. If your kid’s immune system is picky, your job is to find the stimuli that are bothersome, and present ones that are not mischievous.

How important is the food allergy link to children?
...When you have lots of other things to think about, should you change the diet of a child who has decided to live on French fries, smooshed bagels, chocolate milk, pretzels, Twinkies and diet coke, rejecting all alternatives with an iron will? Yup! And when you get over the hump, you are likely to be rewarded with changes in sleep, behavior, attention and “sensitivity” that make the struggle worth it. There are several ways of checking for food allergy. Trial and error changes in diet are tedious but inexpensive. I have found IgG ELISA blood testing as done at Immuno Laboratories to be a reliable measure both in term of my experience with individuals as well as in research studies done to validate the test.

Dr. Baker practices, writes, and does research in Connecticut. He is a graduate of Yale School of Medicine and former Director of the Gesell Institute of Human Development in New Haven.

The Autism File is a unique magazine covering all aspects of autism ­edited and published by parents of autistic children. The Autism File reports on the latest findings, therapies, tests and treatments from leading researchers, doctors and professionals to help parents find the right treatment protocol for their autistic child. Visit them online at www.autismfile.com