Patients following the ITIS diet are encouraged to avoid gluten and dairy, but can have fermented dairy products, such as yogurt.
Although vegetables are considered healthy, potatoes and tomatoes are pro-inflammatory for some patients with arthritis and not encouraged on the diet.
Spices, such as turmeric, and anti-inflammatory oils, such as olive oil, are encouraged in the diet, as well as seeds and nuts. The ITIS diet discourages patients from eating fried foods. If a patient is going to fry their food, they should do it for a shorter amount of time and use olive oil.
Another goal of the diet is to encourage the consumption of more omega 3 fatty acids and less omega 6 fatty acids.
In a pilot study published by Dr. Guma and co-authors, 22 patients with RA followed the ITIS diet for two weeks while also using their prescribed medications.2 Fifty percent of the patients cut their pain and swelling in half. They also improved their fatigue. The remaining patients felt better but did not have a measurable difference in their pain and swelling. This finding may be due to changes in the way people respond to the diet, or these patients may have needed more time to respond to it, she says.
At the time of the podcast, a trial was underway to track results over three months.
During the pilot trial with this diet, researchers provided many of the necessary ingredients. In the longer-term trial, the dietitian is meeting with study participants to help them find healthy options at their economical level.
Dr. Guma acknowledged that some of the healthy choices can get more expensive than normal diets.
Practical Implications
Dr. Hausmann asked for nutritional guidance rheumatologists can share with patients with RA.
The Arthritis Foundation has reliable information on food and nutrition, including background on ITIS, Dr. Guma says.3
“If a patient tries a diet like this and physically notices a difference, whether it’s less stiffness, pain or swelling, it’s going to be a huge motivator to keep going,” she says.
Dr. Hausmann emphasized that the diet changes some people may want to try should be done in conjunction with medications and traditional treatments for rheumatic disease.
“We are not telling people to replace their TNF inhibitors with a better diet,” he says.
Vanessa Caceres is a medical writer in Bradenton, Fla.
