Is A Plant-Based Diet A Treatment Option For IBD?

If you don’t trust diets to help relieve your Crohn’s or colitis symptoms after proper medicine couldn’t do it, we completely understand. Sometimes, for some people medication doesn’t lead to enough improvement. And this, among other things, is why clinical trials are continuously searching for a cure but if not a cure, at least a better, more efficient treatment with fewer side effects. However, don’t write out lifestyle changes and supplementing therapies just because you think they’re too mild to make a noticeable difference. 

We at FindMeCure believe that scientific progress is in the core of eradicating some of the most burdensome diseases humanity has faced. Thanks to vaccines, for example, we don’t even know what smallpox even looks like anymore. It would be ignorant, however, to write off the importance of lifestyle when it comes to physical health. 

There has been an ongoing debate on the benefits of different diets for the management of IBD. Here on the blog we already discussed the effects of gluten and fibre – very controversial topics in the research world. Today we’ll look at the recent scientific evidence for the effects of two distinct diets on IBD symptoms. As always, we caution you to be safe and only introduce diet and lifestyle changes under medical supervision and with the explicit OK of your treatment team.  

A recent study from the University of Southern California suggests that a fast-mimicking plant-based diet has the potential to reduce gut inflammation associated with IBD. The study was conducted in mice – one group was only given water for 48 hours (a water-based fast), while the other group of subjects were put on a calorie limiting plant-based diet. The results not only showed improvement of symptoms in the second group but a reversal of some IBD features. The first group showed fewer improvements but enough to lead the researchers to conclude that the nutrients available through the fast-mimicking diet seem to enhance the positive effects of fasting on gut bacteria. 

Prof. Longo of the study team remarks that certain microbes are affected by “both the fasting and the diet”. They observed structural changes in the gut of the mice on the fast-mimicking diet like tissue regeneration, as well as an increase in stem cell activity – a vital part of tissue repair. The team believes that fasting and then replenishing cells with the proper nutrients go hand in hand and work together to prepare and then repair damaged tissue. The researchers behind this study tested the fast-mimicking diet in humans as well and observed a drop in inflammation markers. 

The investigation team, however, did not come up with a step-by-step diet plan ready to be implemented in human IBD patients, so if you’d like to try a combination of fasting and a plant-based diet, do so only under medical supervision. In the meantime, the team behind the study is planning a randomized clinical trial to assess the effectiveness of the diet as an IBD treatment and you can look for upcoming clinical trials if you’d like to enrol in this one. 

A case study (a detailed study of typically a single or a few individual subjects) of a man with Crohn’s disease seems to support the beneficial effects of a plant-based diet on IBD inflammation. The study co-author Dr Hana Kahleova bases her understanding on research in which people who suffer from Crohn’s disease report significant improvement and 62% to 71% remission rates following a Crohn’s Disease Elimination Diet (CDED). The diet is very similar to a whole food plant-based diet – both of them exclude processed food and dairy. 

The research team investigates a man who, after a year on standard treatment, turns to nutrition for answers. He was classified as high-risk due to the severity of his symptoms and inflammation, and the age of his diagnosis – under 30. After giving up animal products and processed food for a period of time due to religious reasons, he reported a complete lack of symptoms. Because of this unexpected improvement, he decided to adopt a plant-based diet for good, limiting his consumption of animal products to once a week. 

Six months after he changed his lifestyle, a colonoscopy of the previously affected region revealed no visible evidence of Crohn’s disease. The affected tissue had healed. The researchers behind the study speculate that a plant-based diet promotes the diversity of gut bacteria and suggest a controlled clinical trial can lead to more well-founded conclusions. 

There is another diet, however, that’s often recommended for IBD, almost as often as the plant-based one. The Low-Residue Diet aims at reducing foods that can increase stool output and not only limits the amount of fibre but also recommends ground meat and fish. It does limit dairy, on the other hand, which seems to be common between the two diets. 

Believers in the low-residue diet point out that insoluble fibre found in leafy greens and nuts adds bulk to the stool and can be particularly irritating during a flare-up. Here we arrive at the familiar conflict between fibre proponents and those who argue that fibre makes food more difficult to digest, thus irritating the already inflamed bowels. Looking for research on the low-residue and other fibre-limiting diets, you’ll find that there is not much of a difference between patients who limit fibre intake and those who are more liberal with their diet. It’s actually 40% less likely for adults with Crohn’s disease who don’t limit fibre to experience a flare-up over a period of 6 months. 

As always, we recommend that you consult a nutritionist who works with IBD patients or at least has some previous experience before you introduce changes into your diet. And if you’re further interested in alternative nutritional treatments, you can look into joining a clinical trial – not only are you going to try a new therapy under medical supervision, but you can also help researchers find better solutions for patients like you.