Research

Plants for Health is an effective and sustainable lifestyle program for people with various conditions. The foundation for the program was laid with the scientific study Plants for Joints for people with rheumatoid arthritis and osteoarthritis.

Rheumatoid arthritis

Rheumatoid arthritis is a disease that is treatable but not yet curable.

In the past, people with rheumatoid arthritis often had fused joints due to joint inflammation which occurs because the immune system attacks its own body.

With an increase in effective medications, inflammation can be inhibited or suppressed. This results in less pain and less damage to the joints. Yet these medications do not solve everything. Many people with rheumatoid arthritis continue to suffer from pain and fatigue.

Osteoarthritis

Osteoarthritis is the largest chronic conditions worldwide.

For example, in the Netherlands 10% of the population has osteoarthritis, a number which is predicted to increase in the coming decades. Osteoarthritis is not simply wear and tear, but a condition often associated with other complaints, such as obesity, high blood pressure, and high cholesterol and blood sugar.

Currently, treatment options are limited: pain medication, some exercise therapy and, in the worst case scenario, joint replacement surgery.

In the Plants for Joints study, 77 people with rheumatoid arthritis and 64 people with osteoarthritis were randomly divided into the Plants for Joints group, which started the lifestyle program immediately, and the control group, which received standard care.

During the 4-month program, participants attended 10 meetings with their group of 6-12 people for a cooking workshop, and meetings covering topics like healthy, plant-based and unprocessed nutrition, exercise, relaxation, and sleep. Behavioral change was stimulated through theoretical education, practical exercises, and group support.

At the start, halfway, and end of the study, disease activity, symptoms, blood results, body composition, eating and exercise behavior were measured. A process evaluation was also conducted to identify effective elements, experiences, and areas for improvement.

Our study showed that the program resulted in a significantly lower disease activity in people with rheumatoid arthritis. This result is similar to what is usually achieved in drug trials. In people with osteoarthritis, we found that the program resulted in a statistically significant and clinically relevant decrease in pain, stiffness, and improvement in physical function. The figures below show the results. Other studies with similar programs have shown that this approach is also effective for treating cardiovascular disease, type 2 diabetes, and obesity.

Rheumatoid arthritis: disease activity (DAS 28)

Infographic Rheumatoid arthritis

Osteoarthritis: pain, function, stiffness

Infographic Osteoarthritis

What is a randomized controlled trial?

A randomized controlled trial (RCT) is a scientific study in which you randomly (i.e., based on chance) divide people into either an intervention group or a control group. The participants are able to join the study if they meet certain criteria, such as adults with rheumatoid arthritis.

In an RCT, you test a hypothesis that often has to do with the effectiveness of a treatment. The scientific value of an RCT is greater than that of a study without a control group.

Whole-food plantbased diet

Physical activity

Stress management

Sleep

What did we measure?

During our study, we did a lot of measurements. However, the most important ones were ‘disease activity’ in rheumatoid arthritis and ‘pain, stiffness and physical function’ in osteoarthritis.

We measured disease activity in rheumatoid arthritis using the Disease Activity Score based on 28 joints, the so-called DAS28. This score is used worldwide by rheumatologists to measure rheumatoid arthritis activity. The goal is to permanently get the score below 2.6. Then you are “in remission:” the disease is still there, but it is not active. The score is made up of 4 measurements: inflammation in the blood (erythrocyte sedimentation rate), number of painful joints, number of swollen joints, and participant’s self-reported global health score.

For osteoarthritis, we used the WOMAC questionnaires which are questionnaires used worldwide to measure osteoarthritis. Various questions are used to assess the extent to which people have pain, suffer from stiffness, and they can do everyday things (physical function). A lower score means less pain, less stiffness, and better physical function.

In addition to these disease-specific measurements, other things measured included: various blood values (inflammation, cholesterol, blood sugar, kidney function, and liver values, etc), body composition with a DEXA and also MRI scans, various questionnaires, blood pressure, etc. All participants also submitted saliva and stool samples.

The study showed that people’s metabolic health – think weight, fat mass, cholesterol, blood sugar – also improved. A nice side effect of this “treatment”!

Positive side effects:

  • On average 5 kg of weight loss
  • Improved blood sugar and cholesterol levels
  • After one year maintenance of effects with less medication

     

Satisfaction

We scored a 9.2 on a scale of 1 to 10.
The question was: how likely are you to recommend this program to someone you know with your condition?

Researchers

The researchers speak out

We are happy with the results and participant’s satisfaction with the program.