To help IBD symptoms, target your microbiome with these foods
Based on medical research, there’s no single plan that definitively offers relief.
A recent study on a new diet called the IBD-AID diet has shown that it may help.
The diet focuses on correcting gut bacteria balance with probiotic and prebiotic foods.
“Diet has a huge impact for IBD,” said Dr. David L. Suskind, a gastroenterologist with Seattle Children’s Hospital. He wasn’t involved in the research, but currently studies how diet affects IBD. “The impact of diet isn’t only on patients’ symptoms, but also on the inflammatory process itself.”
In the IBD-AID trial, there were 19 people with mild to severe Crohn’s disease or ulcerative colitis, which are forms of IBD.
Of them, 61.3 percent on the diet for at least 8 weeks reported a significant decrease in symptom severity. When the researchers evaluated their fecal samples, they found those who stayed on the diet had an increase in good bacteria that promote remission and favorable immune system response.
The diet is based on research that shows people with IBD have a gut bacteria imbalance. This is believed to contribute to inflammation. The IBD-AID diet promotes probiotics and prebiotics. People on the diet avoid foods containing wheat, refined sugar, corn, and lactose, and they eliminate trans fats. A variety of fruits and vegetables are encouraged, as well as lean proteins and healthy fats. Saturated fat intake is limited.
When people have severe symptoms, they stick to foods from the diet’s phase I list. That includes yogurt, ground meat, pureed soups, and smoothies. As symptoms improve, they can integrate foods from the phase II list that includes greens, and then later add items on the phase III list that includes whole beans and shellfish.
Diets including IBD-AID are derived from the specific carbohydrate diet, which originally was created to treat celiac disease.
How diet affects IBD
Diet recommendations vary based on whether a person has active IBD or is in remission, and what kind of IBD they have, noted Dr. Matthew A. Ciorba, an associate professor and director of the IBD program at Washington University School of Medicine in St. Louis.
“Many providers agree that diet can be modified to ease some of the symptoms of IBD,” Ciorba said. For instance, limiting insoluble fibers in the diet can ease abdominal discomfort.
Recommendations differ significantly when having an active flare compared to when a patient is in remission, explained Kelly Krikhely, a clinical nutrition supervisor at The Mount Sinai Hospital. When in a flare state, people with IBD should avoid high fiber foods, such as raw vegetables, most raw fruits, whole grains, and nuts and seeds. They also should avoid tough fibrous meats.
“The focus while in flare state should be on soft protein sources, such as fish, chicken, eggs, tofu, nut butters, and Greek yogurt, along with refined grains, peeled and well-cooked vegetables, and certain fruits, such as banana,” Krikhely pointed out.
Common intolerances during flares can include fatty foods, lactose containing foods, concentrated sweets, and caffeine. Large volumes of food are also often poorly tolerated. When active inflammation resolves, people with IBD can slowly reintroduce other foods.
“During remission, there isn’t a standard diet. Instead, it depends on each individual’s personal tolerances,” Krikhely said.
But she doesn’t recommend that people with IBD follow a low fiber diet indefinitely, which is something she hears from them.
“If tolerated, consuming fiber is recommended when in remission. For those with Crohn’s disease, it may even reduce the risk of flares,” she said.
Krikhely likes the IBD-AID plan because it discourages fast food, processed foods, and refined sugar while encouraging people to eat healthier whole foods.
“I also like that the diet takes personal tolerances into account and explains to patients that even when in remission, tolerance needs to be assessed and that specific foods may need to be added or removed depending on individual tolerances,” she said.
Krikhely recommends that people with IBD continue to consume grains, however. “During remission, whole grains can provide lots of vitamins and minerals, such as B vitamins and magnesium. I wouldn’t recommend whole grains during flares, but refined grains, such as white rice, tend to be well tolerated and can even be beneficial for those with diarrhea, since it can have a binding effect,” she said.
Better eating for IBD
While diet is a key factor in treating IBD, Suskind said that the eating plan needs to be personalized to the patient. The success of diet to help with IBD symptoms depends on a patient’s disease state, severity, and how they respond to foods.
Recent research has helped to push forward understanding which diets will be best for individuals.
“I think it’s a very exciting age and time. Researchers are pushing for the question of ‘How does diet impact disease?’ And it does,” Suskind said.
Overall, Ciorba hopes that many of the proposed IBD diets are better tested to look at their impact on inflammation beyond remission.
“Despite the lack of evidence crowning one diet as the gold standard, the IBD-AID and some of the other diets proposed to treat IBD can certainly be attempted safely by interested patients,” he said. People with IBD should consult a dietitian to ensure they eat well. Diet should support a person’s medication, Ciorba said.
“We have good medications for IBD as well, but it doesn’t exclude the need for dietary interventions,” Suskind said.
Read original article by Kristen Fischer here.