2004
Rheumatology (Oxford). 2004 Nov;43(11):1429-33.
The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis.
Karatay S, Erdem T, Yildirim K, Melikoglu MA, Ugur M, Cakir E, Akcay F, Senel K.
Department of Physical Medicine and Rehabilitation, Ataturk University, Erzurum, Turkey.

OBJECTIVE: To investigate the effect of individualized diet challenges consisting of allergenic foods, defined by the skin prick test (SPT), on tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) levels in patients with rheumatoid arthritis (RA). METHODS: Twenty patients with a positive SPT response for food extracts and 20 with a negative SPT response were enrolled. None of the patients had active disease. All patients were fasted for the most common allergenic foods for 12 days and then allocated to two groups according to SPT results. Food challenges were performed with allergenic foods in the prick-positive group (PPG) and with corn and rice in the prick-negative group (PNG) for a period of 12 days. Then, allergenic foods were excluded from the PPG patients' diet and corn and rice were removed from the PNG patients' diet. Clinical examinations were performed after fasting (baseline), at the end of the challenge phase and at the end of the re-elimination phase. Stiffness, pain, tender and swollen joint counts, health assessment questionnaire (HAQ), Ritchie's articular index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum TNF-alpha and IL-1beta levels were measured. RESULTS: TNF-alpha (P < 0.01), IL-1beta (P < 0.05), ESR (P < 0.05) and CRP (P = 0.001) levels and all of the clinical variables, except HAQ, were increased with food challenges in the PPG. These increases were also recorded after the re-elimination phase. In the PNG, no significant change was seen in any of the variables, except pain (P < 0.05). During the study, important differences were observed for most of the variables between the two groups. Thirteen (72%) patients in the PPG and three (18%) in the PNG experienced disease exacerbation with challenges. This aggravation continued after elimination. CONCLUSIONS: Our results suggest that individualized dietary revisions may regulate TNF-alpha and IL-1beta levels in selected patients with RA.

2003
J Am Coll Nutr. 2003 Apr;22(2):174-82.
Immunological effects of low-fat diets with and without weight loss.
Santos MS, Lichtenstein AH, Leka LS, Goldin B, Schaefer EJ, Meydani SN.
Nutritional Immunology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA.

OBJECTIVE: The immunologic effects of isocaloric reduced- and low-fat diets and a voluntary calorie-restricted low-fat diet resulting in weight loss were compared to the immunologic effects of an average American diet in hyperlipidemic individuals. METHODS: Ten hyperlipidemic subjects were studied during three six-week weight maintenance phases: baseline (BL) [35% fat [14% saturated fat (SFA), 13% monounsaturated fat (MUFA), 8% polyunsaturated fat (PUFA)] and 147 mg cholesterol (C)/1000 kcal], reduced-fat (RF) [26% fat (4% SFA, 11% MUFA, 11% PUFA) and 45 mg C/1000 kcal], and low-fat (LF) [15% fat (5% SFA, 5% MUFA, 3% PUFA) and 35 mg C/1000 kcal] diets followed by 12-week, low-fat calorie reduced phase (LFCR). RESULTS: During the last phase, the subjects' weight significantly decreased (p = 0.005). Cholesterol levels were significantly reduced during all phases, compared to BL diet (p < 0.05). Delayed-type hypersensitivity (DTH) was assessed using Multi-test CMI. Maximum induration diameters were 22.7, 25.4, 30.5, 34.5 mm for BL, RF, LF and LFCR diets, respectively. Subjects on the LFCR diets had significantly higher DTH compared to the BL diet (p = 0.005). No significant effect of diet was observed on lymphocyte proliferation or interleukin (IL)-1, IL-2 and prostaglandin (PG) E(2) production. CONCLUSIONS: These data suggest that low-fat diets (15% energy), under conditions which result in weight loss, do not compromise and may enhance the immune response of middle-aged and elderly hyperlipidemic subjects. The results of this study provide support for the hypothesis that moderate caloric restriction in humans may have a beneficial effect on cell-mediated immunity such as those reported in calorie-restricted rodents.

2001
Toxicol Pathol. 2001 Mar-Apr;29(2):200-7
Suppressive effects on allergic contact dermatitis by short-term fasting.
Nakamura H, Kouda K, Fan W, Watanabe T, Takeuchi H.
Department of Public Health, Hamamatsu University School of Medicine, Shizuoka, Japan.

Fasting alters various hormonal and immune conditions. It has been reported that delayed type immune response to the injection of keyhole limpet hemocyanin was depressed by short-term fasting. In this study, we adopted the computer-assisted image analyzer for histopathological analysis and evaluated the influence of short-term fasting on allergic contact dermatitis induced by 2,4-dinitrofluorobenzene (DNFB). Mice were sensitized by painting of DNFB to the abdomen. After the sensitization, mice were challenged by DNFB painting to the ear. Fasting started 24 hour before (48-hour fasted group) or immediately after (24-hour fasted group) the challenging. Fasting without DNFB treatment did not induce remarkable change of ear thickness, ear tissue, serum albumin, serum total protein, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase. or serum creatine phosphokinase. In contrast, lasting suppressed the increment of ear thickness in the DNFB-treated group in this study. We could also demonstrate, using the computerized image analyzer, that both lymphocyte infiltration and the edema in the dermis were suppressed in fasted mice treated with DNFB. Further, edema in the dermis was inhibited more strongly in 48-hour fasted mice than in 24-hour lasted mice. These findings indicate that short-term fasting induce histopathological changes in the state of contact dermatitis.