The bottom line
The Paddison Program may be worth a try if you have rheumatoid arthritis. Diet is underused as a treatment strategy for autoimmune disease, with three dietary approaches in particular that seem to have decent success rates (the Autoimmune Paleo Diet, a whole-foods based vegan diet, and funny enough, also a Carnivore Diet), likely due to certain foods they eliminate.
This particular diet will be much harder to maintain than other diets, due to the extremely low calorie intake in the beginning stage, and limited food choice. However, the Paddison Program does have a good deal of credible-seeming success stories. And it targets gut health, which is surely involved in many cases of RA. Overall, if you have extremely painful rheumatoid arthritis, you’re likely down to try anything to help.
What is the Paddison Program?
The Paddison program is highly specialized vegan diet: extremely low fat, with distinct phases, and also non-diet components.
An Australian bloke named Clint Paddison developed a severe case of rheumatoid arthritis, and used a specifically-formulated vegan diet to reduce then eliminate the symptoms.
He went from essentially disabling pain to no pain, making for a compelling story. This story is backed up by testimonials from those who bought his book. How strongly should you consider these testimonials? We’ll cover that in a following section.
Paddison’s diet is similar to the so-called “80:10:10” vegan diet, except that it includes some cooked starches. His diet also has distinct phases, with the first phase intended to give your digestive system a break through juicing and very few calories, then later phases ratcheting up the amount of calories through eating a few types of staple starchy carbs. He also heavily recommends Bikram yoga, and having a positive mindset.
Does evidence support the Paddison Program?
While this specific diet hasn’t been tested in randomized controlled trials, evidence does support the central thesis of the program. That being said, some of the evidence presented to support the diet appears to be overstated.
Paddison cites many studies in his book, which is refreshing. His central thesis is that you have to heal the gut in order to prevent proteins and bacterial toxins from leaking into the bloodstream and causing autoimmune reactions. Bingo! While autoimmune disease can have many different triggers, research suggests that this is likely to be the most common one. So overall, this book does a great job formulating a thesis.
Some of the evidence in the book may be overstated, though. For example, while large amounts of saturated fat are implicated in bacterial translocation (and thus, possibly, more susceptibility to autoimmune disease), the book cites a retrospective case study of six patients on a fat-free diet to illustrate the harms of fat. However, evidence doesn’t seem to implicate moderate fat intake in development of autoimmune disease, with potential benefit from intake of omega-3 and monounsaturated fats. Specifically, olive oil supplementation may even improve autoimmune disease, when combined with fish oil.
The book also touts the power of enzymes contained within live foods, especially if one is low in digestive enzymes. This does not appear to be backed up by trial evidence or other strong evidence, and doesn’t make as much sense conceptually: raw foods are often harder to break down, even if they contain enzymes, since those enzymes aren’t necessarily working within our guts to break down the highly structured food matrix. His diet is low protein on purpose: to lower the chances of protein fragments leaking through the gut. But what if someone doesn’t handle tons of raw plants well? Would fragments of those plant proteins then escape ileal digestion (the last part of the small intestine) and possibly leak? Plant protain is, after all, categorically lower on the latest protein digestibility scale used the World Health Organization (DIAAS).
What are potential downsides of the Paddison Program?
The diet is very low calorie in the beginning stages, and low protein throughout. If you try it, do it under the care of a physician. Some with gut issues may react poorly to the large amount of raw plant matter.
The Paddison Program should be fairly safe, as long as its done under the care of a physician. If it’s not, you should be careful, as the first part of the program is extremely low in calories. Large trials on rheumatoid arthritis patients eating such low calories have not been done, so side effects can’t be accurately ascertained, although small studies suggest that fasting in rheumatoid arthritis patients is fairly safe (when under the care of a clinician).
It’s hard to find downsides of this diet on the web, because a Google search brings up nearly unanimous positive reviews. What explains the relative lack of negative reviews? Well, it could be because the program has a high success rate, or it could be that people who don’t succeed don’t post about it. It’s probably a bit of both.
The potential downsides of the diet depend on who you are. If your gut doesn’t do well with high amounts of raw veggies, you may experience tummy upset. Some of the recommended veggies are high in FODMAPs, such as cooked sweet potato and celery juice. You may need to use other options such as white rice if you react strongly to FODMAPs. Also, if you require high energy levels for your job or your life, be careful in the beginning stages of the diet. And the diet is also very low protein (on purpose), so muscle loss is possible.