rheumatoid arthritis
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Rheumatoid arthritis can be prevented and treated by fasting and caloric restriction. Clinical evidence:

Clinical study of the efficacy of ambulant fasting in patients with osteoarthritis.
Forsch Komplementmed. 2010 Apr;17(2):87-94. doi: 10.1159/000285479. Epub 2010 Mar 12.
Schmidt S1, Stange R, Lischka E, Kiehntopf M, Deufel T, Loth D, Uhlemann C.
OBJECTIVE:
To study the efficacy of fasting therapy according to Buchinger on pain, state of health, and articular function in patients with osteoarthritis.
PATIENTS AND METHODS:
Uncontrolled pilot study in which 30 patients (22 women, 8 men) with osteoarthritis (Kellgren stages I-III) of the hand (N = 10), hip (N = 8) and knee (N = 12) underwent ambulant fasting therapy according to Buchinger for 2 weeks with 3 pre-fast days, 8 fast days (300 kcal) and 4 re-feed days as well as follow-up 4 and 12 weeks afterwards. ASSESSMENT CRITERIA: Global intensity of pain (visual analogue scale, VAS); joint pain with activity, with start of walking, at rest (VAS); pressure pain threshold; articular function; health-related quality of life (SF-36 including Physical Component Score and Mental Component Score); Western Ontario and McMasters Universities Arthrose Index (WOMAC); painDETECT-questionnaire (Pfizer); analgesics; weight; body mass index (BMI); waist circumference; blood pressure; pulse and a variety of serological parameters.
RESULTS:
Pain, state of health, and articular function improved significantly; significant reduction in weight, BMI, and waist circumference during fasting and over the complete course of the study; analgesics could be reduced. No abnormalities in autonomous, metabolic, or blood parameters were observed.
CONCLUSION:
Medically supervised fasting can have a positive impact on the symptoms of patients with moderate osteoarthritis. This finding must be consolidated by controlled studies that include higher numbers of patients.

Prolonged fasting as a method of mood enhancement in chronic pain syndromes: a review of clinical evidence and mechanisms.
Curr Pain Headache Rep. 2010 Apr;14(2):80-7.
Michalsen A.
Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre, Germany. 
Periods of deliberate fasting with restriction to intake of solid food are practiced worldwide, mostly based on a traditional, cultural, or religious background. Recent evidence from clinical trials shows that medically supervised modified fasting (200-500 kcal nutritional intake/day) with periods from 7 to 21 days is efficacious in the treatment of rheumatic diseases and chronic pain syndromes. Here, fasting is frequently accompanied by increased alertness and mood enhancement. The beneficial claims of fasting are supported by experimental research, which has found fasting to be associated with increased brain availability of serotonin, endogenous opioids, and endocannabinoids. Fasting-induced neuroendocrine activation and mild cellular stress response with increased production of neurotrophic factors may also contribute to the mood enhancement of fasting. Fasting treatments may be useful as an adjunctive therapeutic approach in chronic pain patients. The mood-enhancing and pain-relieving effect of therapeutic fasting should be further evaluated in randomized clinical trials.

Clinical study of the efficacy of ambulant fasting in patients with osteoarthritis.
Forsch Komplementmed. 2010 Apr;17(2):87-94. doi: 10.1159/000285479. Epub 2010 Mar 12. Schmidt S1, Stange R, Lischka E, Kiehntopf M, Deufel T, Loth D, Uhlemann C.
OBJECTIVE:
To study the efficacy of fasting therapy according to Buchinger on pain, state of health, and articular function in patients with osteoarthritis.
PATIENTS AND METHODS:
Uncontrolled pilot study in which 30 patients (22 women, 8 men) with osteoarthritis (Kellgren stages I-III) of the hand (N = 10), hip (N = 8) and knee (N = 12) underwent ambulant fasting therapy according to Buchinger for 2 weeks with 3 pre-fast days, 8 fast days (300 kcal) and 4 re-feed days as well as follow-up 4 and 12 weeks afterwards. ASSESSMENT CRITERIA: Global intensity of pain (visual analogue scale, VAS); joint pain with activity, with start of walking, at rest (VAS); pressure pain threshold; articular function; health-related quality of life (SF-36 including Physical Component Score and Mental Component Score); Western Ontario and McMasters Universities Arthrose Index (WOMAC); painDETECT-questionnaire (Pfizer); analgesics; weight; body mass index (BMI); waist circumference; blood pressure; pulse and a variety of serological parameters.
RESULTS:
Pain, state of health, and articular function improved significantly; significant reduction in weight, BMI, and waist circumference during fasting and over the complete course of the study; analgesics could be reduced. No abnormalities in autonomous, metabolic, or blood parameters were observed.
CONCLUSION:
Medically supervised fasting can have a positive impact on the symptoms of patients with moderate osteoarthritis. This finding must be consolidated by controlled studies that include higher numbers of patients.

Clinical study of the efficacy of ambulant fasting in patients with osteoarthritis. 
Forsch Komplementmed. 2010 Apr;17(2):87-94. doi: 10.1159/000285479. Epub 2010 Mar 12. Schmidt S1, Stange R, Lischka E, Kiehntopf M, Deufel T, Loth D, Uhlemann C.
OBJECTIVE:
To study the efficacy of fasting therapy according to Buchinger on pain, state of health, and articular function in patients with osteoarthritis.
PATIENTS AND METHODS:
Uncontrolled pilot study in which 30 patients (22 women, 8 men) with osteoarthritis (Kellgren stages I-III) of the hand (N = 10), hip (N = 8) and knee (N = 12) underwent ambulant fasting therapy according to Buchinger for 2 weeks with 3 pre-fast days, 8 fast days (300 kcal) and 4 re-feed days as well as follow-up 4 and 12 weeks afterwards. ASSESSMENT CRITERIA: Global intensity of pain (visual analogue scale, VAS); joint pain with activity, with start of walking, at rest (VAS); pressure pain threshold; articular function; health-related quality of life (SF-36 including Physical Component Score and Mental Component Score); Western Ontario and McMasters Universities Arthrose Index (WOMAC); painDETECT-questionnaire (Pfizer); analgesics; weight; body mass index (BMI); waist circumference; blood pressure; pulse and a variety of serological parameters.
R
ESULTS:
Pain, state of health, and articular function improved significantly; significant reduction in weight, BMI, and waist circumference during fasting and over the complete course of the study; analgesics could be reduced. No abnormalities in autonomous, metabolic, or blood parameters were observed.
CONCLUSION:
Medically supervised fasting can have a positive impact on the symptoms of patients with moderate osteoarthritis. This finding must be consolidated by controlled studies that include higher numbers of patients.

Short-term therapeutic fasting in the treatment of chronic pain and fatigue syndromes--well-being and side effects with and without mineral supplements [Article in German]. 
Forsch Komplementarmed Klass Naturheilkd 2002 Aug;9(4):221-7.
Michalsen A, Weidenhammer W, Melchart D, Langhorst J, Saha J, Dobos G. 
Abteilung fur Innere Medizin V, Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Essen. 
Fasting followed by vegetarian diet has shown to be an effective treatment for rheumatoid arthritis, moreover fasting is frequently used as an adjunctive treatment in chronic pain and stress/exhaustion syndromes. Data on well-being and the frequency of side effects during fasting are mostly retrospective. Mineral supplements are frequently used in order to compensate for fasting-induced tissue acidosis and to reduce side effects. There are only limited data that support this practice. OBJECTIVE: To study the effects of oral mineral supplements on common side effects and well-being during short-term fasting. PATIENTS AND METHODS: 209 consecutive inpatients with chronic pain/exhaustion syndromes were recruited. In a controlled non-randomised study design all patients underwent fasting (250 kcal; 3 l fluid intake/day) over 7 days, in study phase 1 without (n = 103) and in study phase 2 with (n = 106) concomitant prescription of standardised oral mineral supplements (3 x 2 to 3 x 3 Bullrich's Vital). Weight, blood pressure and urinary pH were recorded daily. Well-being and mood as well as common side effects (i.e. fatigue, hunger, heart burn, headache) were assessed with standardised self-reports. RESULTS: Baseline characteristics of the 209 patients (mean age 54.7 +/- 10.5 years; 83.3% female) were balanced. Both groups showed a fasting-induced decrease of blood pressure, a slight decrease in mood and well-being on days 3 and 4 with consecutive increase and moderate hunger, i.e. in the evening. Side effects and general tolerability of fasting as well as well-being and mood were not different between the groups. There were no serious side effects in both groups. CONCLUSIONS: Short-term fasting in inpatients with pain and stress syndromes is safe and well tolerated, concomitant mineral supplements have no additive benefit. 

Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. 
Scand J Rheumatol 2001;30(1):1-10. 
Muller H, de Toledo FW, Resch KL. 
Balneology and Rehabilitation Sciences Research Institute (FBK), Bad Elster, Germany. 
Clinical experience suggests that fasting followed by vegetarian diet may help patients with rheumatoid arthritis (RA). We reviewed the available scientific evidence, because patients frequently ask for dietary advice, and exclusive pharmacological treatment of RA is often not satisfying. Fasting studies in RA were searched in MEDLINE and by checking references in relevant reports. The results of the controlled studies which reported follow-up data for at least three months after fasting were quantitatively pooled. Thirty-one reports of fasting studies in patients with RA were found. Only four controlled studies investigated the effects of fasting and subsequent diets for at least three months. The pooling of these studies showed a statistically and clinically significant beneficial long-term effect. Thus, available evidence suggests that fasting followed by vegetarian diets might be useful in the treatment of RA. More randomised long-term studies are needed to confirm this view by methodologically convincing data. 

Effects of a low calorie vegan diet on disease activity and general conditions in patients with rheumatoid arthritis [Article in Japanese]. 
Rinsho Byori 1999 Jun;47(6):554-60. 
Fujita A, Hashimoto Y, Nakahara K, Tanaka T, Okuda T, Koda M. 
Clinical Research Laboratory, Sunstar Co. Ltd., Takatsuki. 
There is little objective information about diet therapy for rheumatoid arthritis (RA) in Japan. We studied 14 patients with RA who stayed in the Koda hospital for 55 days. They basically took a 1200 kcal vegan diet consisting of unpolished rice gruel, juice of raw vegetables, soya bean curd and sesame seeds, and undertook a 3-5-day fast three times. During the 55-day stay, average body weight decreased by 5.1kg. Lansbury index and ESR decreased whereas CRP did not change. WBC decreased and the differential cell counts showed a decrease of neutrophils, eosinophils and monocytes without a change in lymphocytes or basophils. RBC, hemoglobin and MCV increased. LDL-C decreased, while HDL-C increased. There was no change in total protein or albumin. These data suggest that this combination of a low calorie vegan diet and fasting may contribute to improve RA with little undesirable effects on the patient's general conditions.

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