The educational content of this post, developed in collaboration with Bromatech, was independently developed and approved by the GMFH editorial team and editorial board.
What you eat is important for managing ulcerative colitis and Crohn’s disease. Diet can influence the types and functions of the gut microbiota, as well as the protective lining of the gut. While there are no specific foods or diets that can prevent or cure ulcerative colitis and Crohn’s disease, the diet can help keep your gut healthy and prevent inflammation.
The most extensively studied dietary therapy for IBD is an all-liquid formula meal replacement diet (called exclusive enteral nutrition, or EEN). EEN provides all essential nutrients from the formula, excluding all other foods. EEN has been shown to have several benefits, including inducing remission (children), reducing inflammation, promoting mucosal healing, and improving nutritional status. Ultimately, the EEN must be used for a defined amount of time, and then the food is gradually reintroduced.
While there is no one perfect diet that works for everyone with IBD, Natasha Haskey, PhD, who is a registered and trained dietitian with a focus on IBD, explained to GMFH editors via email that a mediterranean is recommended for people with IBD looking to eat a healthier balanced diet and reduce inflammation.
High levels of consumption of vegetables, fruits, nuts, legumes, olive oil and lean protein sources have been shown to have a protective effect against the development of IBD and contribute to a healthy gut microbiota. Conversely, Western dietary patterns, rich in omega-6 polyunsaturated fatty acids, alcohol, red meat, and food additives (excessive salt, emulsifiers, and artificial sweeteners) promote intestinal inflammation and may worsen symptoms, and thus should be limited.
Fat is an important nutrient to watch out for in IBD. Natasha’s PhD research focused on studying the impact of dietary fat in a rodent model of chronic colitis. According to Natasha: We’ve seen that a diet high in omega-6 polyunsaturated fatty acids (commonly found in corn, soybean, safflower and sunflower oils) promotes inflammation. Conversely, a diet rich in olive oil and containing omega-3 polyunsaturated fatty acids (from fish) and some saturated fat (milk fat) promoted immune homeostasis in ulcerative colitis. Based on these results, in IBD it would be prudent to reduce the content of omega-6 polyunsaturated fatty acids in the diet and to increase omega-3 polyunsaturated fatty acids and olive oil together with a diet rich in fruits, vegetables, whole grains with some consumption of dairy products.
As for when diet can help the most, Haskey acknowledges that diet can help manage symptoms and inflammation in both active disease and remission. However, given that each patient has their own microbial and genetic makeup, the most appropriate diet should be individualized. According to Natasha: Diet needs to be individualized for each individual, considering their disease and what works in their lifestyle. The advice of a dietician experienced in the management of IBD is essential to develop an individualized plan.
As our understanding of the impact of diet on the management of IBD improves, there are more opportunities to use diet as a supplemental therapy to control inflammation and relieve symptoms. Before choosing one of the diets promoted for IBD online, talk to your doctor so they can recommend a personalized meal plan that works for you.
In the meantime, this infographic is a good starting point for considering the dietary components that should be promoted and restricted for better living with IBD:
Additional references on gut microbiota and IBD:
- Palumbo VD, Romeo M et al.(2016), The long-term effects of probiotics in the therapy of ulcerative colitis: a clinical study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Republic; 160(3):372-377 .
- Rodolico V, Tomasello G et al. (2010), Hsp60 and Hsp10 are increased in the colonic mucosa of Crohn’s disease and ulcerative colitis. Cellular stress and chaperones vol. 15, 877884.
- Bellavia M, Tomasello G, Romeo M et al. (2013), Gut microbiota imbalance and accompanying system malfunction are central to the pathogenesis of ulcerative colitis and can be counteracted with specially designed probiotics: a working hypothesis. Medical microbiology and immunology vol. 202, 393406
- Tomasello G, Scium C et al. (2011), immunohistochemical levels of Hsp10, Hsp70 and Hsp90 change in ulcerative colitis after therapy. Eur J Histochem; 55(4):e38.
- Tomasello G, Palumbo VD et al.(2014), Probiotics and conventional therapy: a new frontier in the therapeutic approach in the articular manifestations of IBD. Advances in Nutrition 2014; vol. 16 No. 3: 176-187
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