Recently, one of the most common questions I’ve been asked is all about the power of plant-based. Specifically: can going vegan can help IBD? Given my recent discussions of the low residue diet and the low FODMAP diet, I thought it was a good idea to tackle veganism head on.
Before we get stuck in, I’d just to make clear that the post isn’t a discussion of ethical issues surrounding a vegan diet. Instead, it’s an overview of the benefits and drawbacks of following a vegan diet with Crohn’s disease and Ulcerative colitis-in relation to your disease and symptoms.
Why might people go vegan with IBD?
Again, moral issues aside, there are many reasons people may explore a vegan diet for Crohn’s disease and UC.
-They notice that they feel worse after eating meat or find it difficult to digest (this is particularly the case with red meat and I brushed upon this topic in my low stomach acid guide).
-They find milk products and eggs difficult to tolerate (you can read a full breakdown into the role of dairy and IBD in this blog post) so are introduced to veganism that way.
-They feel better when centring their meals around a ‘plant-based diet’- which makes sense given this way of eating is often more natural, contains fewer preservatives and might remove other foods the person finds problematic- such as red meat, eggs, grains, cheese etc.
Is there any evidence to show going vegan helps IBD?
As you’ll probably know by now, there isn’t much in the way of evidence when it comes to diet and IBD. The majority of success stories and emerging research centres around the Specific Carbohydrate Diet, which is actually quite meat-heavy. However, there is also some research into going vegan too.
One study suggested meat eating could be linked to IBD at the diagnosis stage. It stated: greater consumption of meat and animal products is associated with the onset of Crohn’s disease and ulcerative colitis, whereas greater consumption of fruits and vegetables is typically associated with a lower incidence of these diseases.
….and went on to argue: patients who consumed more eggs, meat (particularly red and processed meat), and alcohol were more likely to experience a relapse of their disease than patients who consumed low levels of those items. Which was shown in a ‘based on a small study that suggested that patients who followed a semi-vegetarian diet may be more likely to remain in remission
The article is fascinating and I’d recommend reading the full thing once you’ve finished this post.
The study in question turned out to be a Japanese study- which compared remission rates in those on a ‘semi-vegetarian diet’ (having fish weekly and meat every fortnight) and those on Infliximab. The contrast is impressive- with only 8% relapse rate after two years compared to 75% on Infliximab.
However, given its small scale and being based in a different country (in which IBD has a very different profile) it is not a foregone conclusion. To me at least, it may point to a link between meat and IBD – but it appears to be due to processed and red meats; rather than the elimination of poultry and fish.
What are the problems of going vegan with IBD and other digestive issues?
So if you are thinking about switching to a vegan diet, let’s look at potential issues which may arise…
As a nutritional therapist, I will be honest and say that a vegan diet is not something I would personally recommend to those with IBD. It is perfectly possible to be completely healthy and balanced on the diet, but given the additional needs of IBD patients, it might be trickier to navigate. Let’s look at why:
-Anaemia/B12 Deficiency. This is a common issue with IBD and while plants do provide iron, it’s not as efficiently absorbed as in haem (meat) sources. In turn, B12 is also another common deficiency which is rarely found in a vegan diet without supplementing.
–Lack of protein. Protein is crucial to control your blood sugar levels and help with gut repair. Again, protein is found in plants but collagen from meat protein is particularly beneficial in repairing the gut lining (see this blog post on bone broth).
-Sudden Increase in insoluble fibre and raw foods. While some people do absolutely fine with raw foods, a sudden increase in insoluble fibre (from raw vegetables) can cause issues. Insoluble fibre is really good for us but high amounts can also be abrasive on the gut (which is why low residue diets are sometimes recommended by doctors)
What should I do if I still want to go vegan?
This blog post isn’t designed to deter anyone from a vegan diet. There are plenty of vegan bloggers with IBD, such as the Plantiful Chef, Rhian’s Recipes,and Vegan Ostomy . However, should you wish to go vegan, definitely make sure you…
–Speak to your doctor to get your iron levels, vitamin B12 and D levels checked.
–Always make sure you combine a vitamin C source with iron and never take iron supplements with tea or coffee (tea contains tannin which stops iron being absorbed properly)
–Consider things like vegetable broth as an alternative to bone broth.
–Make sure you have a variety of complementary proteins in every meal.
-Read more about soluble and insoluble fibre and make sure you have a balance of the two.
-Be flexible. With IBD, a diet that is suitable for one period of time, might not be for another. So always keep track of your foods and correlating symptoms.