Strict Dietary Changes Help IBD Patients Achieve Clinical Remission in Small Study

Strict Dietary Changes Help IBD Patients Achieve Clinical Remission in Small Study

Researchers have found that eliminating foods known to stimulate intestinal inflammation — a dietary approach known as the autoimmune protocol diet — improves clinical outcomes in inflammatory bowel disease (IBD) patients.

The small study, “Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease,” was published in the journal Inflammatory Bowel Diseases.

IBD is a complex disease where the interplay of both genetic and environmental factors influences disease onset and progression. But while researchers have identified approximately 200 genes as risk factors for IBD, their contribution to the disease is limited, accounting for up to 13 percent of Crohn’s disease (CD) and 7 percent of ulcerative colitis (UC) cases.

Among environmental factors, diet and the gut microbiome — the collection of natural microbes that populate the intestine — are considered the two major factors to influence disease course.

Accumulating evidence suggests that modifications to diet can improve IBD clinical outcomes, but further work is required to identify dietary factors that may be useful in a nutrition-based therapy.

The so-called autoimmune protocol (AIP) diet stems from the Paleolithic diet — characterized by consumption of meats, fish, fruits, vegetables, nuts and seeds, and the avoidance of dairy products, legumes and grains.

As such, “the AIP [autoimmune protocol] diet focuses on an initial elimination phase of food groups including grains, legumes, nightshades, dairy, eggs, coffee, alcohol, nuts and seeds, refined/processed sugars, oils, and food additives,” the authors wrote.

This diet’s main objective is to avoid consuming food (and medications) that may trigger gut inflammation and changes in its microbiome.

Researchers conducted a prospective study to evaluate the potential efficacy of the autoimmune protocol diet in patients with active CD and UC.

Fifteen patients — nine with CD and six with UC — were put an autoimmune protocol diet that ran from Sept. 5 to Nov. 18, 2016. It included a six-week staged elimination of avoided foots, followed by a five-week strict-adherence or maintenance phase. Patients had IBD for a mean period of 19 years and almost half of them reported using biologicals for up to two years before the study.

The elimination phase gradually removed from patients’ diet “grains, legumes, night-shades, dairy, eggs, coffee, alcohol, nuts and seeds, refined/processed sugars, oils, and food additives,” which remained absent throughout the study.

Results showed that after six weeks, 11 of the 15 patients achieved clinical remission — six with CD and five with UC — and maintained remission during the maintenance phase.

Researchers also “identified improvements in FC [fecal calprotectin, a biomarker of intestinal inflammation] along with endoscopic improvements in the mucosal appearance in most patients undergoing follow-up endoscopy,” they wrote.

These results suggest that dietary modification is a potential treatment to use in combination with conventional IBD therapy (50 percent of study participants used biological) in patients with moderate-to-severe disease.

“Our study demonstrates that dietary modification focused on elimination of potentially immunogenic or intolerant food groups has the potential to improve symptoms and endoscopic inflammation in patients with IBD,” the researchers concluded.

These preliminary findings require validation in large randomized studies.

5 comments

  1. Jane Hunter says:

    I have suffered from IBS since my teens and am now in my mid 50’s and have struggled for decades just to feel well. I have always had a healthy diet but it was the wrong kind of healthy. Think high fibre but the fibre coming from brown breads and a lot of wholegrain foods which was always advised by the health profession.
    Over ten years ago it was discovered by a very forward thinking doctor, who put me on an elimination diet, that I was severely gluten intolerant and most probably had been for years. So no more wheat, rye, barley or anything containing gluten. Following on from that, my symptoms started to creep back in so eliminated all dairy.
    Two years ago I was diagnosed with Cronh’s Disease but asked to try managing my condition through diet instead of Pharmaceuticals. It was a hit and miss journey to start.
    By finally eliminating, along with gluten and diary, all sugar, processed foods, legumes and eating mainly a Paleo/AIP style diet, my symptoms have reduced vastly and I couldn’t be feeling any better. I can have a tiny bit of blue cheese on the odd occasion and even a small portion of lentils now and then as my body will cope with them but its mainly vegetables, a bit of fruit and quality protein like fresh fish, chicken, lamb. I have occasionally some rice or potatoes and they are good too but I make sure I consume healthy fats as these are still needed to regulate your hormones – coconut oil and olive oil are top.
    The inflammation has vastly reduced throughout my body including the secondary inflammation in my joints and overall I am functioning much better as a useful human being. My mood has improved, the brain fog has lifted and the spare fat around my tummy is gradually disappearing. All achieved by changing what I eat, but still eating plenty.
    It is definitely worth trying, after all, what you eat has a direct consequence on your body. It makes a lot of sense and I wish more health care professionals could see the sense behind healthy diets before suggesting pharmaceuticals.

  2. Lesley says:

    This is amazing that they achieved clinical remission. I am a big believer in the power of diet in reducing symptoms and have managed to do so with my autoimmune conditions but remission would be amazing. I will definitely be looking more into AIP after reading this. I already eat no grains except rice (occassionally) but I do eat eggs, nuts and seeds. Thanks for reporting this study

  3. Josie says:

    My daughter achieved remission with the AIP protocol. Diagnosed at age 17 with severe UC, she struggled to get her symptoms under control. Initially prednisone and Pentasa were prescribed. When that didn’t work anymore, she was put on Remicade which worked for about two years after which she was again hospitalized and then back on Prednisone and Humira. It took about a year to wean off the prednisone. She continued on Humira and Pentasa, but was never symptom free. Prior to her last hospitalization, we had started to explore dietary options. Going gluten free seemed to help, but only temporarily. Then she tried the SCD diet, which seemed to improve symptoms as well for a while. However she still continued to struggle with flare ups. Eventually we discovered the Auto Immune Protocol which put her on a gradual road to recovery. After about two years on AIP, she was able to start re-introducing some of the foods not allowed on AIP. She can now have nuts, seeds, egg yolk. She continues to avoids egg white and nightshades and dairy as those foods appear problematic still. During the start of the protocol she also started using VSL probiotic. For the past six months she has been symptom free and is not using Humira and Pentasa anymore although she is still using probiotics.

    The AIP diet requires quite a change in life style but the results have been so significant and best of all is not being on any heavy duty pharmaceuticals. It has not been an easy journey and although we understand there is no guarantee , she now is in remission for the first time in 7 years.

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