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The effects of a strict uncooked vegan diet on serum lipid and sterol concentrations were studied in patients with rheumatoid arthritis. The subjects were randomized into a vegan diet group (n 16), who consumed a vegan diet for 2-3 months, or into a control group (n 13), who continued their usual omnivorous diets. Serum total and LDL-cholesterol and -phospholipid concentrations were significantly decreased by the vegan diet. The levels of serum cholestanol and lathosterol also decreased, but serum cholestanol:total cholesterol and lathosterol:total cholesterol did not change. The effect of a vegan diet on serum plant sterols was divergent as the concentration of campesterol decreased while that of sitosterol increased. This effect resulted in a significantly greater sitosterol:campesterol value in the vegan diet group than in the control group (1.48 (SD 0.39) v. 0.72 (SD 0.14); P < 0.001). A higher concentration of campesterol compared with sitosterol is normal in omnivorous subjects and can be explained by lower absorption and esterification rates of sitosterol. Our results suggest that a strict uncooked vegan diet changes the relative absorption rates of these sterols and/or their biliary clearance.

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We tested the effects of an uncooked vegan diet, rich in lactobacilli, in rheumatoid patients randomized into diet and control groups. The intervention group experienced subjective relief of rheumatic symptoms during intervention. A return to an omnivorous diet aggravated symptoms. Half of the patients experienced adverse effects (nausea, diarrhoea) during the diet and stopped the experiment prematurely. Indicators of rheumatic disease activity did not differ statistically between groups. The positive subjective effect experienced by the patients was not discernible in the more objective measures of disease activity (Health Assessment Questionnaire, duration of morning stiffness, pain at rest and pain on movement). However, a composite index showed a higher number of patients with 3-5 improved disease activity measures in the intervention group. Stepwise regression analysis associated a decrease in the disease activity (measured as change in the Disease Activity Score, DAS) with lactobacilli-rich and chlorophyll-rich drinks, increase in fibre intake, and no need for gold, methotrexate or steroid medication (R2=0.48, P=0.02). The results showed that an uncooked vegan diet, rich in lactobacilli, decreased subjective symptoms of rheumatoid arthritis. Large amounts of living lactobacilli consumed daily may also have positive effects on objective measures of rheumatoid arthritis.

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The fatty acid composition of erythrocytes, platelets, and serum lipids was compared between subjects who had been eating a strict uncooked vegan diet ("living food") for years and omnivore controls. The vegan diet contains equal amounts of fat but more monounsaturated and polyunsaturated and less saturated fatty acids than the mixed diet of the control group. In vegans, the proportion of linoleic acid was greater in all lipid fractions studied. Also, the levels of other n-6 fatty acids were greater, with the exception of arachidonic acid levels, which were similar in most fractions. In erythrocytes, platelets and serum phospholipid fractions, this increase was mainly at the expense of the n-3 fatty acids. The proportions of eicosapentaenoic and docosahexaenoic acid were only 29-36% and 49-52% of those in controls, respectively. In vegans the ratio of n-3 to n-6 fatty acids was only about half that in omnivores. In addition to the lower levels of n-3 fatty acids, the proportions of palmitic and stearic acids were lower in serum cholesteryl esters, triglycerides and free fatty acids of vegans. The proportion of oleic acid was slightly lower only in serum cholesteryl esters and erythrocyte phosphatidylserine. The results show that, in the long term, the vegan diet has little effect on the proportions of oleic and arachidonic acids, whereas the levels of n-3 fatty acids are depressed to very low levels with prolonged consumption of the high linoleic and oleic acid components of this diet.

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BACKGROUND: High salt intake is a risk factor for essential hypertension in man. There is evidence that, in hypertension, intracellular sodium content and univalent cation transport across erythrocyte membranes are changed. It has been proposed that a low-sodium diet has an antihypertensive effect; this may be related to changes in cation fluxes across plasma membranes. METHODS: Sodium and potassium fluxes and the composition of fatty acids were studied in the erythrocytes of people who had eaten a low-sodium vegan diet for many years (n = 9) and in those of controls who had consumed a mixed diet (n = 11) to investigate the dependence of these variables on dietary factors. Both systolic and diastolic blood pressures were lower in vegans than in controls. RESULTS: The passive permeability to sodium (P < 0.05) ,Na+,K+ cotransport (P < .001) and the intracellular content of exchangeable sodium (P = 0.076) were decreased in the erythrocytes of those who had consumed the low-sodium diet compared with the controls. The activity of the Na+-K+ pump, Na+-H+ exchange and the passive permeability to potassium were unaltered. Swelling-induced K+,C1- cotransport was increased in the erythrocytes of those who had eaten the low-sodium vegan diet compared with controls (P < 0.01). The proportion of linoleic acid was increased (P < 0.01) at the expense of eicosapentaenoic and docosahexaenoic acids (P < 0.001) in the erythrocyte membranes of the vegans. CONCLUSION: Our results show that levels of intracellular sodium and Na+,K+ cotransport activity, which increase in patients with hypertension, decreased in those consuming a low-sodium vegan diet. This suggests that the risk of essential hypertension was diminished in the vegan participants, confirming our observation that systolic and diastolic blood pressures were lower in the strict vegans than in the controls.

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