Can diet prevent the aches and pains of arthritis?
The answer is "yes," for some people.
Three years ago I was plagued by severe arthritic pain in my hands and other joints, particularly my hips. Getting up from a sitting position was so difficult that my wife preferred to bring me whatever I might need rather than watch me go through the contortions of moving from sitting to standing. I routinely took up to a dozen or more aspirin each day to dull the pain.
Then, in the fall of 1992, while browsing the shelves in our local library to learn more about arthritis, I ran across a thin volume titled "The Arthritic's Cookbook," by Dr. Collin H. Dong. I quickly read the fewer than 40 pages of text preceding the recipe section. Although some of the food restrictions seemed a bit harsh, trying them certainly could do no harm.
After a month or two of half-hearted attention to the diet, I began to follow it rigidly on New Year's Day 1993.
The results were astonishing. Within a month the constant pain was gone and I had quit taking aspirin. Within six weeks I was able to stand up quickly and easily. When I asked my wife to get me something she was able to say, with a clear conscience, "Get up and get it yourself."
What you can eat
The Dong diet allows all the rice, vegetables and fish you want to eat. Because it was developed in the days before the ill effects of fat and cholesterol became well-known, it also permits unlimited use of vegetable oils (corn, safflower, olive), non-dairy margarine and non-dry-roasted nuts as well as egg whites, honey, sunflower seeds, soybean products, tea and coffee. By inference the diet allows products made from wheat, like bread and pasta, so long as they are free of egg yolks. Permissible taste enhancers include parsley, onions, garlic, bay leaves, salt and sugar.
In his book Dong is specific about avocado being a permissible vegetable, but he advises those with gout or gouty arthritis to avoid mushrooms, asparagus, spinach, artichokes, peas and beans. He emphasizes that each person is different and must determine individually what can be tolerated.
What you eat is the easy part. Now consider the hard part.
What you can't eat
Forbidden by Dong are meat in any form (including broth), fruit of any kind (including tomatoes), dairy products (except for egg whites), vinegar or other acid items, pepper, chocolate, dry-roasted nuts, alcoholic beverages and soft drinks (except for plain soda), and all additives and chemicals, especially monosodium glutamate.
Dong's list of "do's and don'ts" specifies that "perhaps occasionally" you can have breast of chicken and chicken broth, a small amount of wine in cooking, a small drink of bourbon, or a small pinch of spicy seasoning.
This list of what you can't eat isn't very long - but it turns out to be devastating to many people, especially the prohibition on dairy products (cheese) and fruit.
Some practical advice
In practice, there turns out to be a lot of variation in what individuals can tolerate. My advice to those who want to experiment with the diet is to follow it rigorously for six weeks. That's ample time to find out if it works. If it doesn't work, forget it. But if it does work, then begin to add individual food items for a week or two, one at a time and see what effect they have.
In my case, I've found that citrus fruits or wine will bring back the arthritic symptoms within a day or two. But I am able to eat bananas or melons without ill effect. I avoid wine, but choose to follow the medical advice that one or two alcoholic drinks each day can substantially reduce the risk of heart attack. Since "alcoholic drinks" include scotch, bourbon, gin, vodka and beer, I'm really not depriving myself of very much.
My wife and I happen to like pasta, and we've found or invented recipes for many pasta sauces that require neither tomatoes nor cream. Rice milk (or soy milk) works well with cereal. I probably eat more chicken breast and turkey breast than Dong recommends, but without noticeable ill effects. A little ingenuity with stir-fried vegetables, shrimp, scallops and rice also tends to add variety to our diet. We've learned to make an extensive array of omelets with egg whites or egg substitutes. For most people fish can be a dietary staple.
I tend to ignore the prohibition on vinegar, at least in salad dressings. I've learned, though that the monosodium glutamate (MSG) used in many Chinese restaurants can bring back the arthritic symptoms very quickly. Fortunately, many Chinese chefs are willing to leave out the MSG on request.
Although most sources indicate that a vegetable, rice and fish diet provides an ample variety of necessary nutrients, we do take a variety of vitamin and mineral supplements just to be sure.
It should be obvious that I'm sold on the Dong diet. I've described it to many others, some of whom have tried it with good results. Others have balked when they find they have to give up their morning orange juice or their noontime cheese sandwiches. It's really just a matter of deciding how bad you hurt, and how much of a compromise you want to make between eating what you like and giving up activities you want to do.
One of my neighbors went on the diet after she heard me talking about it. Both she and her family say it's changed her life (and theirs). They've also passed on information about the diet to many others who've seen the effect it had on her.
How the diet originated
Collin Dong was born in Salinas, Calif., early in this century. He graduated from Stanford Medical School, then in San Francisco, in 1931, and established a practice there. Seven years later he was crippled with arthritis. After years of using the standard remedies prescribed by the rheumatology experts, Dong decided to experiment with diet. Over a period of time he abandoned his standard American diet rich in meat, dairy products and fruit. Instead, he limited himself to the food of the Chinese peasant - rice, vegetables and fish. As he refined his diet and quit taking his medicines, his arthritic symptoms disappeared and he was able to resume a normal life.
For the next 30 years Dong had a thriving medical practice, including thousands of arthritis patients for whom his special diet provided welcome relief from their aches and pains.
In 1973 Dong and one of his patients, Jane Banks, published "The Arthritic's Cookbook," which describes in detail his empirical dietary theories, gives many case histories of patients helped by the diet and includes numerous recipes to show how tasty and nutritious meals can be made without using meat, dairy products, sharp spices or fruit.
The first book was followed a few years later by "New Hope for the Arthritic," a volume that provides more information on arthritis and its various forms, plus more of Jane Banks' recipes.
Will the diet work for you?
The Dong diet doesn't work for every arthritis sufferer. In the one controlled study I've found in the medical literature, about 20 percent of the participants benefited from the diet and remained on it after the experiment ended (the doctors who conducted this study concluded that the diet did not work).
If the Dong diet seems too restrictive, there are others that also help some arthritics. For example, in his book "The McDougall Program," Dr. John A. McDougall devotes several pages to arthritis and how his low-fat, vegetarian diet plan helps relieve the aches and pains of arthritis.
In recent months there has been a continuing discussion of diet in the Internet news group alt.support.arthritis. A number of people reported there that they have been helped by various diets. One that was mentioned repeatedly eliminates the five nightshades: potatoes, tomatoes, peppers, eggplant and tobacco.
Perhaps the most important lesson I've learned from my experiences with the Dong diet, and my limited research into other diets, is that one should be open to alternate forms of treatment, so long as they do not have potential ill effects. If they work for you, that's great. If they don't work, you've lost nothing by trying. My own doctors have expressed neither approval nor disapproval, although one of them expressed considerable interest.
I no longer follow the diet as rigorously as I did the first year. When I'm traveling, or eating in the homes of friends, I eat what's available or what's served. One result of this is that I do take Tylenol more frequently than I would like to. But I reconcile this by pointing out that I am 69 years old, did a 205-mile bike ride in Alaska last summer, and am continuing to ride to remain in shape for a planned 300-mile ride across Italy this year.
------------------------------------------------------------------ Harry Lewenstein lives in Palo Alto, Calif. ------------------------------------------------------------------
-------------------- Additional resources --------------------
Here are some additional sources of information on arthritis diets and more.
-- "The Arthritic's Cookbook," Collin H. Dong, M.D., and Jane Banks, first published 1973 by Bantam Books, reprinted March 1992 by Pinnacle Books.
-- "New Hope for the Arthritic," Collin H. Dong, M.D., and Jane Banks, Thomas Y. Crowell Co., New York, 1975.
-- "The McDougall Program," John A. McDougall, M.D., Plume (the Penguin Group), 1991.
-- Diet in the Treatment of Rheumatoid Arthritis and Rheumatism, Vol. 26, No. 4, April 1983, Morris Ziff.
-- "The PDR Family Guide to Nutrition and Health," Medical Economics Company, 1995, contains a chapter called "Arthritis Diet Remedies: Fact or Folklore?" A discussion of the Dong diet is included.
-- The Arthritis Foundation, Washington State Chapter, has numerous informational resources as well as details on exercise programs. Call 622-1378 or (800) 542-0295. Online information is available via the Internet at http://weber.u.washington.edu/bonejnt/Arthritis/Arthritis.html