Inflammatory bowel diseases, such as colitis and Crohn's disease, are disorders that cause chronic inflammation in the digestive tract. The signs and symptoms that are common to both IBDs include diarrhea, fever and fatigue, abdominal pain and cramping, blood in the stool, loss of appetite, and sudden weight loss. In 2015, approximately three million adults in the U.S. reported being diagnosed with an inflammatory bowel disease, either Crohn's disease or ulcerative colitis.
Speaking at the Nutrition in Medicine Conference in London, Dr. Alan Desmond, a gastroenterologist at South Devon Healthcare NHS Foundation Trust, suggested that Crohn’s disease can be reversed by adhering to a Whole Food, Plant-Based Diet (WFPBD). This type of diet restricts the consumption of animal protein, animal fat, omega-6 polyunsaturated fatty acids, dairy, emulsifiers, and food additives, but provides dietary fiber.
He mentioned two trials that demonstrated that diets like the WFPBD, which offers dietary fiber, can improve Crohn’s disease within six weeks. Some of the participants in the trials were given enteral formula, an artificial complete nutrition product, to account for 50 percent of their caloric intake, while the other 50 percent of their caloric intake came from a WFPBD. However, 18 other participants refused to take the enteral formula and solely adopted a WFPBD diet.
Results showed that individuals with newly diagnosed Crohn’s disease and people with an established and "difficult-to-treat" condition had complete remission rates of 62 percent and 71 percent. Meanwhile, significant clinical improvements of 90 percent and 79 percent were observed.
On the other hand, 14 out of the 18 participants who adopted a WFPBD alone achieved complete remission. Evidence also suggested that the remission of Crohn’s disease can be retained for a longer period even if only a semi-vegetarian diet is followed.
Soluble fiber and Crohn's
Turns out, contrary to what you may have heard in the past, fiber is not actually bad for people with Crohn's disease. One of the standard diet tips for patients of Crohn’s disease is a low-fiber diet to avoid flare-ups. However, many studies showed that this type of diet did not provide any benefit and often has harmful effects.
In fact, some studies, although limited in size, showed that soluble fiber could bring about improvements in Crohn’s, according to Desmond. He cited that a small trial of Crohn's disease patients fed with a breakfast rich in soluble fiber reported improvements in many symptoms and improved quality of life.
“We know that soluble fibre reduces inflammation of the gut. We know that fibre actually helps maintain the integrity of the epithelial barrier,” explained Desmond.
Animal fats and protein consumption
Desmond also said that observational data showed that people who consume the greatest amounts of animal protein have the highest risk of developing IBD. He also cited another study that showed the other risk factors for IBD include a higher ratio of animal: vegetable protein intake, higher omega-6: omega-3 ratio and higher iron intake.
Dairy consumption was also found to cause bowel disorders. For example, a high milk-fat diet can cause Crohn’s disease or colitis through multiple mechanisms, such as reduced mucus layer, higher gut permeability, increased production of inflammatory molecules, greater bacterial penetration of the gut wall, and unfavorable changes to the gut bacteria composition.
Desmond also recommended foods to include in diets. These include soluble fiber from oats, psyllium, and pulses; insoluble fiber obtained from whole grains and nuts; and fruits and vegetables as sources of omega-3 fatty acids. On the other hand, foods to be avoided include meat, dairy fats, cheese, large amounts of fruit juice and juices with high-fructose content, food emulsifiers, and maltodextrin. (Related: Inflammatory bowel disease linked to higher rates of processed meat consumption.)
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