"The Best Diet for Crohn's
Disease Treatment" Important to our understanding
and prevention of the global increase in inflammatory bowel disease, we know
that dietary fiber appears to reduce risk, whereas dietary fat, animal protein,
and sugar may increase risk. "Despite the recognition of the
westernization of lifestyle as a major driver of the growing incidence
of inflammatory bowel disease, no countermeasures against such lifestyle
changes have been recommended, except that patients with Crohn's
disease shouldn't smoke." Look, we know consuming
whole, plant-based foods is synonymous with an
anti-inflammatory diet. Here's a list of foods
with inflammatory effects; here's a list of foods with
anti-inflammatory effects. So how about putting a
plant-based diet to the test? Just cutting down on red and
processed meat didn't work, but what about cutting
down on all meat? A 25-year-old guy diagnosed
with Crohn's disease, but failed to enter clinical remission
despite standard medical therapy. But after switching to a diet based
exclusively on grains, legumes— like beans, split peas, chickpeas,
and lentils—vegetables, and fruits, he entered clinical remission,
without the need for medication and showed no signs of Crohn's
disease on follow-up colonoscopy.
It's worth delving into
some of the details. The conventional treatment they started
him on is infliximab, sold as REMICADE, which can cause a stroke, and may
increase your chances of getting lymphoma and other cancers—but
it's a bargain for only $35,000 a year. And it may not even work
in 35 to 40% of patients, and that seemed to be the case
here, so they upped the dose after 37 weeks, and still suffering
after two years on the drug— until he tried completely eliminating
animal products and processed foods from his diet—finally experiencing
a complete resolution of his symptoms. Prior to this, his diet had
been a typical American diet. But having experienced complete
clinical remission for the first time since his diagnosis, he decided
to switch to a whole-food, plant-based diet permanently, severely
reducing his intake of processed food and limiting animal products
to one serving, or less, per week.
And whenever his diet started to slip,
symptoms started coming back. But he could always wipe
them out by eating healthier. After six months of implementing
these changes in diet and lifestyle, including stress relief and exercise,
a follow-up demonstrated complete mucosal healing of the gut lining with
no visible evidence of Crohn's disease. We know a diet consisting of whole
grains, legumes, fruits, and vegetables has been shown to be helpful in the
prevention and treatment of heart disease, obesity, diabetes,
hypertension, gallbladder disease, rheumatoid arthritis,
and many cancers. Although further research is required,
this case report suggests that Crohn's disease might be
added to this list of conditions.
But that further research
has already been done! About 20 patients with Crohn's disease
were placed on a semi-vegetarian diet, meaning no more than a half-
serving of fish once a week and a half-serving of meat
once every two weeks, and achieved 100% remission rate
at one year, and 90% at two years. Some strayed from the diet though.
Let's see what happened to them. After a year, half had relapsed, and at
year two only 20% remained in remission.
But those that stuck with
it had remarkable success. It was a small study with
no formal control group, but represents the best reported
result in Crohn's relapse prevention published in the medical
literature to date. Nowadays, Crohn's patients are often
treated with so-called biologic drugs, expensive injected antibodies that
suppress your immune system and have effectively induced
and maintained remission in Crohn's disease,
but not in everyone. The current remission rate in Crohn's
with early use of REMICADE: 64%. So 30 to 40% of patients are likely to
experience a disabling disease course even after treatment. So what
about adding a plant-based diet? Remission rates jumped up to 100%
for those who didn't have to drop out due to drug side effects.
Even
if you exclude the milder cases, 100% of those with serious, even severe
fulminant disease achieved remission. But if you look at gold standard
systematic reviews, they conclude that the effects of dietary interventions
on inflammatory bowel diseases, Crohn's disease and ulcerative
colitis, are uncertain. This is because only randomized
controlled trials were considered. Totally understandable, as that's
the most rigorous study design. Nevertheless, people with inflammatory
bowel disease deserve advice based on the 'best available evidence'
rather than no advice at all. And switching to a plant-based diet
has been shown to achieve far better outcomes than those
reported on conventional treatments in both active and quiescent stages
in both Crohn's and ulcerative colitis. For example, here's one-year
remission rates in Crohn's disease: 100% compared to budesonide, an
immunosuppressant corticosteroid drug; a half elemental diet, meaning
like at-home tube feedings; the $35,000 a year drug REMICADE;
or the $75,000 a year drug Humira. Safer, cheaper, and more effective? Maybe we should recommend plant-based
diets for inflammatory bowel disease. It would seem clear that treatment
based on treating the cause of the disease is optimal.
Spreading the word about healthier
diets could help halt the scourge of inflammatory bowel, but how
are people going to hear about this amazing research without some
kind of public education campaign? That's what NutritionFacts.org
is all about..
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