4

votes

Arthritis and meat consumption

Answered on August 19, 2014
Created February 16, 2012 at 2:21 PM

My question is this:

Is eating a more "primal" diet, following Mark Sisson's model, associated with arthritis? And how would Mark Sisson know, if he's never compared his diet with a vegetarian one?

I ask this question for the following reasons:

  • Since adopting this diet, I have found my joint pains are getting much worse, enough that it is affecting my ability to function.

  • It is repeatedly recommended that people eat offal, yet those are often high in purines and can aggravate gout. Fructose is a popular scapegoat. People with gout trouble will then aggressively cut carbohydrates even more, and are then surprised when their uric acid levels skyrocket. (It is also telling that, in this case, he had his first gout attack after going paleo.) So the recommendation to eat lots of offal makes me pretty suspicious, as does blaming everything on fructose (particularly when it comes from fruit). It just sounds too much like massaging the information to fit an ideology, which makes it little better than what some vegetarian activists are accused of doing.

  • Recently I tried a vegetarian, aggressively fat-reduced diet (in part just to see what it would do to my blood lipids), and found that my joint pain was dramatically improved.

  • I have yet to see this question addressed here to my satisfaction. To be honest, I get the real impression that this is a bit of an "elephant in the room", something nobody likes to talk about because it is a real problem with the diet.

This isn't a troll, and no, I don't have a hidden agenda. It's a legitimate question, and I'd be grateful for some thoughtful answers. Even better if they are supported by some science and good references!

Thanks :)

7c379a865738d2b373a362dc0f1d9459

(357)

on October 02, 2012
at 12:33 PM

I was wondering the same thing! I have felt like my RA has gotten worse since doing paleo.

3aea514b680d01bfd7573d74517946a7

(11996)

on February 18, 2012
at 03:14 PM

...keto-adaptation can take up to six weeks, according to Phinney and Volek (ketogenic diet researchers). Me, I never experienced the dreaded "low-carb flu", but this board is littered with tales of people who suffered through this period, and many who quit low-carbing because of it. I guess I was one of the lucky ones.

3aea514b680d01bfd7573d74517946a7

(11996)

on February 18, 2012
at 03:12 PM

Well, since I had already been at <30 or so grams of carbs a day, I'd been in ketosis for a couple years already when I started zero-carbing. The strips didn't get any darker, lol -- in fact, the last time I checked, I didn't seem to be spilling ketones in the urine at all (which experts say happens when you're keto-adapted). I can only assume that I'm in deep ketosis since I eat no dietary carbohydrate at all, except the trace amounts in eggs, shellfish and organ meats, and muscle meat glycogen. Regarding setting-in time, most of us go into ketosis while sleeping, regardless of diet, but...

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 18, 2012
at 02:27 AM

Thanks Rose, I appreciate the input. I'm looking at the papers you suggested, and I'm also intrigued by the deep ketosis, even though it goes in the direction of more protein consumption. When you started out, how long did it take to set in? Was it detectable with ketone strips?

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 18, 2012
at 02:17 AM

Thanks for this. I am thinking of some things to try, and I will definitely give an update!

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 17, 2012
at 02:36 AM

I am working on a few approaches and will definitely report my experience!

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 17, 2012
at 02:29 AM

Gout and other forms of arthritis have traditionally been distinguished from each other, but there's some evidence that there is a role for uric acid in garden-variety osteoarthritis. Because a definitive cause for OA hasn't yet been found, it makes sense to seek out the inflammatory mechanisms that might cause it.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 17, 2012
at 02:23 AM

Gout and other forms of arthritis have traditionally been distinguished from each other, but there's some evidence that there is a role of uric acid in garden-variety osteoarthritis. Because a definitive cause for OA hasn't yet been found, it's makes sense to seek out the inflammatory mechanisms that might cause it.

3aea514b680d01bfd7573d74517946a7

(11996)

on February 16, 2012
at 06:54 PM

Sounds like your joints are doing it for you. Interesting that you have the same experience I do -- any cheat, no matter how small, brings the pain back. I really wonder WTF is going on.

9b4208ea76a3eaf64f94317fad5a34e4

(50)

on February 16, 2012
at 03:16 PM

My N=1 is very similar, except I typically eat even fewer carbs. I had both gout (immobilizing, excruciating pain) as well as generalized joint pains that I referred to as TBA - Total Body Ache. Those conditions are now both gone.

C79a5b43dfc5749200bd9dcaa6bb0858

on February 16, 2012
at 02:50 PM

Stephen, you talk about arthritis and then gout. Are you having trouble with both and what type of arthritis is it? Also, what type of vegetarian diet were you on? Just curious.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on February 16, 2012
at 02:31 PM

Are we talking gout or some other variety of arthritis?

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10 Answers

4
Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on February 16, 2012
at 07:39 PM

Recently I tried a vegetarian, aggressively fat-reduced diet (in part just to see what it would do to my blood lipids), and found that my joint pain was dramatically improved.

This makes me think that you might have been consuming too much Omega 6. Focusing on grass-fed ruminants, avoiding too much poultry, pork & nuts and adding in some krill oil may be what you need.

Alternatively, you may have a dairy or nightshade intolerance.

I've been Primal for over 15 months. When I added in krill oil, all my joint pain disappeared. I could have added in more fish, of course! I'm 49, FWIW.

No "elephant in the room". :-)

You just need to do some tweaking.

Also make sure your Vitamin D level is sufficient and you are supplementing Magnesium 200-600 mg.

4
3aea514b680d01bfd7573d74517946a7

(11996)

on February 16, 2012
at 02:52 PM

I suffered from terrible hip and shoulder pain, enough to have seen a rheumatologist ten years ago and get preliminary testing for autoimmunity. All the preliminary tests looked positive for some sort of autoimmune problem. Because I was still able to control the pain with OTC meds, we didn't move forward with a diagnosis and prescription (he is of the old school, which treats conservatively as opposed to aggressively).

I continued to suffer (sometimes more, sometimes less) over the years, and just before I started zero-carbing in September 2009, I was ready to go back to him and tell him to resume the testing and prescribe the liver crushers. I'd already been eating VLC for a couple of years, but had stalled and was trying every tweak I could find to get below 190; I finally tried ZC (even though I thought it was a crazy idea, lol). Within a week or so of dropping salads and vegetables (my only remaining plants on VLC), my joint pain had completely gone.

I have no idea why dropping plants had this effect -- if it's the carbs, or if it's some kind of toxins in the plants, or even allergies (Paul Jaminet has suggested that an infection might be involved). But any time I try to add greens or veggies back for more than one meal, the pain comes roaring back.

I'm sorry you're hurting -- arthritis is really nasty. I'm not suggesting zero-carb for you (especially since you improved on a vegetarian diet); the best I can suggest is to keep tweaking and see if you can find a culprit or culprits. But to answer your main question, it may be that the reason people aren't talking about this is because it's not happening to a lot of folks. At least, it's the opposite of what happened for me.

ETA: You might take a look through some of the papers here. They're specific to RA, my particular concern, but as I recall, they showed benefits from vegetarian eating, but even greater benefits from fasting (which my deep ketosis simulates). So something interesting for both of us, lol.

3aea514b680d01bfd7573d74517946a7

(11996)

on February 18, 2012
at 03:12 PM

Well, since I had already been at <30 or so grams of carbs a day, I'd been in ketosis for a couple years already when I started zero-carbing. The strips didn't get any darker, lol -- in fact, the last time I checked, I didn't seem to be spilling ketones in the urine at all (which experts say happens when you're keto-adapted). I can only assume that I'm in deep ketosis since I eat no dietary carbohydrate at all, except the trace amounts in eggs, shellfish and organ meats, and muscle meat glycogen. Regarding setting-in time, most of us go into ketosis while sleeping, regardless of diet, but...

3aea514b680d01bfd7573d74517946a7

(11996)

on February 18, 2012
at 03:14 PM

...keto-adaptation can take up to six weeks, according to Phinney and Volek (ketogenic diet researchers). Me, I never experienced the dreaded "low-carb flu", but this board is littered with tales of people who suffered through this period, and many who quit low-carbing because of it. I guess I was one of the lucky ones.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 18, 2012
at 02:27 AM

Thanks Rose, I appreciate the input. I'm looking at the papers you suggested, and I'm also intrigued by the deep ketosis, even though it goes in the direction of more protein consumption. When you started out, how long did it take to set in? Was it detectable with ketone strips?

3
9d43f6873107e17ca4d1a5055aa7a2ad

on February 16, 2012
at 06:27 PM

Dan Roddy posted his uric lab results after chugging lots of orange juice on a Peat-type diet and they were dramatically reduced.

There are also one or two studies that show a raw vegan diet improves idiopathic joint pain associated with fibromyalgia, which is what I thought I had.

Raw vegan worked quite well for that, but it hasn't come back on paleo either. It's only come back a few times since I've been hacking my diet and that's when I've been sick with infections, which makes me suspect that I have chronic reactive arthritis from a really bad salmonella infection I once had. So I guess offal or whatnot hasn't bothered that condition, but maybe you have something else and diet might affect your condition totally differently. I eat offal only a few days a month though and I eat fructose as much as I want.

3
0df0b1c6ae16bbb75b4a5efa3d876765

(2240)

on February 16, 2012
at 05:16 PM

Above all, eat what feels right to your body. Switching to paleo doesn't mean you automatically become a bloodthirsty organ-chomping carnivore overnight. It's okay to not be hungry like the wolf.

I noticed a lot of what you are describing in my first month, but now not so much if at all. I also only had liver once at the time, but now I eat it once a week so far with no issues. I was eating a good bit of steak and pork though. At first I think I was actually ignoring signals from my brain saying "that steak is too big, man!" or things along those lines, so I eventually took my overall protein consumption down a bit.

I had also started bare-footing in the beginning and now attribute a lot of the stiffness in my legs upon waking to my adjustment to the new way of walking. Still though, the overriding feeling most often was that I was eating too much meat. So I ate less.

I agree with AG's suggestion to find a more balanced approach and eat what feels right. I started eating liver again after it sat in my freezer for a couple months because I actually began craving it.

I also recently began using CRON-o-meter (the software version, downloadable here) which lets you dial in a basic macronutrient ratio along with tracking your food intake. I currently have my ratio set to 60% fat, 20% carb, 20% protein, and it adjusts my daily intakes according to those numbers. At my height/weight with 'sendentary' activity level selected, it has me at 131g of protein for the day.

Yesterday I had 2041 calories out of 2615, 109g protein out of 131, 135g of fat out of 174, and 97g of carbs out of 179. At a glance I can see these on the main bar graph and it just makes it easy for me to see the balance of what I'm getting so I know if something is way off. I just thought I'd mention it if you haven't tried tracking your intakes yet (couldn't hurt?). I was using FitDay online in the beginning but didn't like logging in all the time and also don't like the interface near as much.

Anyhow, good luck figuring it out! Report back with any updates on your progress if you can.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 17, 2012
at 02:36 AM

I am working on a few approaches and will definitely report my experience!

121a16aded2bed8dca492d3c9662ef4c

(1327)

on February 18, 2012
at 02:17 AM

Thanks for this. I am thinking of some things to try, and I will definitely give an update!

2
3846a3b61bc9051e4baebdef62e58c52

(18635)

on February 16, 2012
at 03:02 PM

No its not associated with arthritis. If anything the overwhelming historical/ancestoral and anecdotal evidence shows just the opposite.

And fructose is not a scapegoat.....it's a very important consideration for those with gout or any metabolic/liver/health concerns. I might suggest that you change your question to ask about a specific type of arthritis if you are having an issue yourself. There are some tweaks that people may be able to offer you.

BTW I think we got more than a couple "vegetarians" who still eat primal. Sisson's wife is one (think she is like pesco-vegetarian or something).

2
Fd8cf1696bb79f053b2e02037c1be724

(100)

on February 16, 2012
at 02:42 PM

I have no idea, but my n=1 experience is that I had just purchased my first set of knee braces because the arthritis in my knees had gotten so bad over the past few years and I was finding it hard to exercise without knee support. I was also starting to have some stiffness in my hands and neck.

Then I switched to "mostly" paleo (I still eat cultured dairy products and a small amount of grains, but no modern wheat). Within about 6 months, all my joint pains were gone. Now, a little over a year later, the pains are still gone, and so is all my excess weight.

I eat tons of meat and some offal (liver, heart, etc) every week. My fat intake is usually between 50 and 60%, and my carb intake is around 25-30%.

9b4208ea76a3eaf64f94317fad5a34e4

(50)

on February 16, 2012
at 03:16 PM

My N=1 is very similar, except I typically eat even fewer carbs. I had both gout (immobilizing, excruciating pain) as well as generalized joint pains that I referred to as TBA - Total Body Ache. Those conditions are now both gone.

2
Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on February 16, 2012
at 02:35 PM

I don't have any references, just my own experience. I have had pain in my hip joints, diagnosed as osteoarthritis, for about 12 years. At times it was quite bad, back when I was eating a whole grain, low fat diet. In a bid to control another health problem, migraines, I made a radical diet departure and starting eating low carb high fat. This improved headaches a lot, and joint pain a little. A year ago, I started following the Perfect Health Diet, including all the recommended supplements and safe starches (mainly white rice). After about six months it dawned on me that my joints DONT HURT ANYMORE.

1
93ae9f2d376e5426e891a9b58d8302fa

(2936)

on February 16, 2012
at 05:57 PM

My minor joint pains seem to come back when I cheat on my diet. My diet is all carnivore, close to zero carb, more and more influenced by the Owsley Stanley teachings. But I think I've eaten three Bartlett pears this week and I regret it. Uf! Somebody give me a spanking!

3aea514b680d01bfd7573d74517946a7

(11996)

on February 16, 2012
at 06:54 PM

Sounds like your joints are doing it for you. Interesting that you have the same experience I do -- any cheat, no matter how small, brings the pain back. I really wonder WTF is going on.

0
A3ff262a2686d79789e09a26013901b3

on February 16, 2012
at 04:46 PM

Oddly, I was going to ask a similar question, but I have been finding lately that the stiff knee that i get after sitting for awhile seems to be better when I eat more carbs. This of course is my N=1 observation and seem to contradict everyone else, but I plan on adding more safe starches as my weight loss has stalled on a VLC primal diet anyway.

0
F524eaa9d58e5cd2d2368ff7bfffda9c

(480)

on February 16, 2012
at 04:44 PM

You may want to consider not 'following' any 'diet' and instead go with what you feel is most logical based on the information you have and your own personal experience.

Stop eating offal. Find a more balanced or conservative approach to the 'diet'

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