People living with an inflammatory bowel disease (IBD) such as Crohns disease or ulcerative colitis have a less-diverse microbial community in their gut, and this can contribute to intestinal inflammation. Researchers at the University of Massachusetts Medical School have developed the IBD-Anti Inflammatory Diet (IBD-AID)to help these individuals restore the good bacteria in their guts and reduce IBD symptoms.
The diet, which scientists worked on for 15 years, is made up of three phases to treat flares and maintain remission. In the first phase of the diet, a person increases his or her intake of prebiotic and probiotic foods, while avoiding certain carbohydrates.
Probiotics are fermented foods that have live bacteria in them, such as:
Prebiotics, which support the growth of probiotics in the digestive system, include:
Second, the diet also involves avoiding trans fats, processed foods, fast food, and pro-inflammatory carbohydrates, which includes anything with lactose, wheat, refined sugar, and corn. This, the researchers say, will starve the bad bacteria and help a sensitive gut recover.
And finally, patients were encouraged to eat a variety of fruits and vegetables, lean protein, and healthy fats.
How successful is the diet?
In a small study abstract presented at the Crohns and Colitis Congress January 2325, 2020, in Austin, Texas, Ana Luisa Maldonado-Contreras, PhD, an assistant professor of microbiology at University of Massachusetts (UMass) Medical School and her colleagues found that participants with moderate to severe IBD who were on the IBD-AID diet for eight weeks saw a 61.3 percent decrease in disease severity.
Dr. Maldonado-Contreras says the diet isnt an exclusion but a substitution diet, because its all about sustainability.
The first task was to recognize that this is challenging because its a complete mindset change, but when people consider nutrition as part of their medicine, they can begin to solve their IBD issues, she says. Were advocating for prebiotic foods like bananas, chia seeds, oats, garlic, and onion because we want people to introduce more normal or real foods instead of inulin supplements, she says. Inulin supplements are the common prebiotics found in containers sold at vitamin shops.
Study participants had different stages of disease severity and were on different treatments, so they served as their own control in this study. Using in weekly food-intake surveys and twice-weekly stool samples over the course of 18 weeks, Maldonado-Contreras was able to match up the patients microbiomes with what they ate and assess their symptoms.
Stool samples also showed that the diet resulted in an increase in the abundance of short-chain fatty acids (SCFAs). SCFAs are created by fermentation when microbes break down food that humans can't digest, and they promote the growth of other bacteria that help make nutrients available to the body.
The IBD-AID diet does not diverge too much from the specific carbohydrate diet (SCD) when it comes to cutting out carbohydrates. The main difference is that, while the IBD-AID emphasizes pre- and probiotics, the SCD focuses more on prohibiting certain carbohydrates that may either throw off the balance of the gut bacteria or promote inflammation in the gut. Both effects are especially bad for those with IBD.
I love the focus on pre- and probiotic foods as well as the phased approach that the IBD-AID diet sets forth, says Kelly Kennedy, RD, who manages and oversees nutrition content, meal planning, and diet and nutrition coaching at Everyday Health. Pre- and probiotics are proving to be immensely important to overall human health and especially gut health.
Another common diet for people with IBD is the low-FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet, which encourages low intake of certain carbs that trigger inflammation in the digestive system. It involves strict restriction of any foods high in FODMAPS for three to eight weeks.
While that approach has been shown to be relatively effective for many people, the diet itself is restrictive at first and can be difficult to follow as a result, says Kennedy.
Also, the foods that are allowed or restricted on the low-FODMAP diet are not obvious because they are based on the types of fermentable carbohydrates in each food, so you'd need to keep a list of allowed foods handy especially as you're getting started on that diet, she explains.
The next short-term step for Maldonado-Contreras and her team will be to repeat the study with a larger number of patients so they can work with a larger data set and refine the diet as necessary. In the meantime, people with IBD can try some fun menu ideas, including a pumpkin spice smoothie and a tofu stir-fry with zesty almond sauce(the UMass Medical School is also developing videos to teach people on the IBD-AID diet how to prepare meals).
Were not telling people whats right to do but instead giving them the tools, she says, its complicated and hard, but lets work together and get results.
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Could a New Diet Focused on Restoring the Gut Microbiome Reduce IBD Symptoms? - Everyday Health