Current research on the microbiome presents a new approach to managing IBD by using food as medicine. Researchers are investigating the role diet plays in the development of IBD, and the new evidence suggests diet is more important than previously thought, not only in development but in the management of the condition.
Certain dietary changes can even contribute to fewer flare-ups and longer periods of remission, especially Exclusive Enteral Nutrition (EEN), which contributes to mucosal healing. It’s all about working your microbiome.
Diet & the Microbiome
The human gut microbiome is made up of a multitude of bacteria and microorganisms. These gut microbiota make up around 70% of our immune system. They play a vital role in nearly every aspect of our physiology, from our daily mood to the way our body fights disease.
A healthy microbiome has high levels of bacteria diversity and a balance between ‘good’ and ‘bad’ bacteria. Statistically, IBD patients have low bacteria diversity and suffer from extreme microbial imbalance (dysbiosis). The resulting inflammation damages the intestinal barrier, leading to acute IBD symptoms.
Here’s the good news. A change in diet can restore balance to the microbiome, improve gut bacteria diversity, enhance nutrient absorption and help heal intestinal barrier function. Meaning less inflammation, fewer flare-ups, and longer periods of remission.
The Best Anti-inflammatory Diet for Ulcerative Colitis
There are a few diets being promoted for IBD symptom management. The low-FODMAP diet involves limiting carbohydrates that impact the microbiome. It can be effective in improving GI symptoms, but many find it too restrictive and therefore unsustainable.
The Mediterranean diet involves limiting refined sugars and red meat while increasing plant-based, seasonal food, and healthy fats. Although hailed as one of the healthiest diets in the world, it lacks fine-tuning for patients with IBD.
The IBD Anti-inflammatory Diet (IBD-AID) finds the perfect balance. Designed especially for IBD patients, it’s less restrictive, more sustainable, and has been clinically shown to dramatically reduce disease severity of IBD within weeks.
Can the IBD-AID Improve symptoms of IBD?
After 15 years in development, researchers at the University of Massachusetts tested the IBD-AID on patients with Crohn’s disease and ulcerative colitis. The results of their pilot study showed that 100% of the participants experienced a reduction of symptoms after partaking in the regimen.
One study saw 61.3% of participants report a dramatic decrease in disease severity after 8 weeks on the regimen. And, in one case report series, 100% of participants on the diet were able to discontinue at least one of their IBD medications. All patients experienced symptom reduction, including bowel movement frequency.
How the IBD Anti-Inflammatory Diet Works
The IBD-AID was specifically developed to recompose the microbiome to support the growth of helpful bacteria while reducing pro-inflammatory bacteria. The diet emphasizes foods enriched with short-chain fatty acids (SCFAs), which promote the healing of the intestinal barrier system.
The IBD-AID diet is broken up into 3 phases, depending on disease activity:
- Eliminating heavily processed foods to treat flare-ups
- Balancing the microbiome with pre & probiotics to maintain remission
- Boosting nutrient absorption
Phase 1: Starving out pro-inflammatory bacteria
The aim of Phase 1 is to eliminate complex carbohydrates (refined sugar, gluten-based grains, and certain starches), believed to provide a substrate for pro-inflammatory bacteria. This phase is for patients experiencing flare-ups and acute symptoms including diarrhea, bloody stool, urgency, pain, and frequent bowel movements.
The texture of food can impact recovery, so it’s recommended to stick with soft-cooked and pureed food at this stage.
Foods to avoid in Phase 1 of the IBD AID
- Lactose, wheat, refined sugar (sucrose), corn
- Refined or processed carbohydrates
- Trans fats & saturated fats (store-bought baked goods, anything with partially hydrogenated oil, processed foods, and fast food)
- Grains except for oats
- Milk & fresh cheese (aged cheese is fine)
- Beer & Processed meat
Recommended food in Phase 3 of the IBD AID
- Butternut squash, pumpkin, sweet potato
- Soft fruits like banana, papaya, avocado & pawpaw
- All fish, lean grounded meat
- Chicken & eggs
- Yogurt, kefir, miso & tofu
- Olive oil, hemp oil, flax oil
- Ground flax or chia seeds
- Well-cooked oats
- Pureed soups & vegetables
It’s recommended to limit red meat, and drink coffee and tea in moderation. Alcohol is best avoided altogether, but 1 glass of red wine won’t be too harmful.
Phase 2: Restoring balance to the microbiome
The aim of phase 2 is to enhance microbiome health with probiotics and prebiotics once symptoms have improved. This is the time to introduce more fibers, textures, and food variety to the system. Soluble fibers are included to increase short-chain fatty acids, which help enhance stool consistency and slow gut motility. Food should be well-cooked and tender, so it’s recommended to mince or grind certain ingredients, especially proteins.
Probiotics are the microorganisms found in fermented food, mainly bacteria, and yeast. These living microorganisms are the ‘good’ bacteria that help colonize the microbiome.
Prebiotics are fibers found in plants that humans can’t digest. These fibers feed the microorganisms in the digestive system and maintain good intestinal bacteria. Think bananas, berries, garlic, green vegetables & oats to name a few.
Recommended food:
- Yogurt, kefir, kimchi, miso, tempeh
- Fermented vegetables like sauerkraut & pickles
- Oat groats & steel-cut oats
- Garlic, onions, barley
- Chicory root & acacia root
- Artichokes, leeks, asparagus
- Soft greens (butter lettuce, baby spinach without stems)
- Well-cooked lean meats & poultry
- Aged cheese & nut butters
- All vegetables, some fruits (seedless is best, avoid citrus at this phase)
It’s best to steer clear of stems, seeds, hard peels, or skins in phase 2 of the IBD-AID diet.
Phase 3 – Enhancing Nutrient Absorption
Once you’re in remission, it’s time to increase micronutrients, vitamins, minerals, and fiber. Phase 3 includes a wider variety of fruits and vegetables, lean proteins, and healthy fats. At this stage, you can expand food texture and slowly introduce richer foods.
Foods to introduce:
- Broccoli and cauliflower (for those without intestinal strictures)
- Stir-fried vegetables and meats
- Shellfish
- Citrus fruits
- Whole beans
- Cooked apples
- Strawberries, apricots, cherries, kiwi, passionfruit
- Lean cuts of beef, lamb, duck & goose
- Well-cooked lentils & bean purees
- Mint, ginger, chives, mustard
Of course, there’s no one-size-fits-all when it comes to diet. We highly recommend consulting a dietician or nutritionist to find the right plan for your specific condition.
Evinature
