Which is the best diet for Inflammatory Bowel Disease?

Today, I thought I would provide a nutritional overview of the latest diets out there that could help you with your gut health: whether you are looking for a Crohn’s disease diet plan or just a list of suggested foods for IBD/IBS.  If you really believe that nutrition has no place at all in IBD or gut health then this is not the post for you! But as I’ve said before: the aim of this blog to support people with a balanced lifestyle and improve gut health. For me, making the right food choices play a huge role in supporting the gut and managing symptoms but I am always keen to make clear that everyone is different. In turn, the body is hugely complex and one size does fit all. I always recommend that the best approach is to keep a food diary (in fact, you can grab your free one here) and working with a professional (more information on booking a consultation with me here) This blog, however, may give you a starting point on where to begin..

 

GLUTEN AND DAIRY FREE

What is it? Every single diet aimed at improving gut health explores these 2 triggers so I thought this would be a good place to start. It’s important to consider why many diets exclude these two foods. Gluten is a protein found in lots of things mainly bread, pasta, baked goods and sauces. Dairy includes cheese, milk, yoghurt, butter and cream. So basically everything that is good in life.

How can it help?  The theory behind avoiding gluten/dairy is that if a gut is inflamed (due to IBD) or has a poor bacteria balance ( due to antibiotics, IBS, poor diet etc) it becomes more permeable (this means the gut wall is not as strong and contains gaps and food particle can slip through it more easily without being properly broken down). Gluten particles are quite large and if the gut is weak, it can’t break them down and they slip through the net of the gut wall. These undigested particles ( and they’re still pretty tiny; we’re not talking big chunks of donut!) can then cause irritation and even an inflammatory reaction as they make their way into the bloodstream. This is termed leaky gut by many and this infographic explains it really well…

Infographic:www.cornersclinic.com

Dairy causes a similar reaction and is often described as causing lots of mucus and thus irritation. Therefore, if you take nothing else from this article, I’d suggest you monitor the role of these 2 in your diet when keeping your food diary.(And if you need inspiration; check out my ‘free from posts’ for ideas).

You do need to do it carefully: follow food labels to the letter and  do not stockpile gluten free processed products and soy milk as you’re unlikely to find much a difference. Instead, if you are considering removing these foods from your diet: try to seek advice from a dietician or nutritional therapist to get a proper plan in place to make sure you can accurately monitor your symptoms and don’t miss out nutritionally.

Read about the role of gluten on your gut health here and the effect of dairy here. 

So let’s get more specific, what other diets are there?

 

DIET 1: PALEO/AUTOIMMUNE PALEO

What is it? Paleo or as it’s often billed ‘the caveman’s diet’ centres around eating purely natural foods, largely meat, fish, nuts, fruit and veg. There’s also Autoimmune Paleo, designed specifically for those with autoimmune disease (this is more restrictive and cuts out nuts altogether as well as things like beans)

 

 

Can it help? Paleo can definitely help cut all the rubbish out of your diet. Many of the banned foods such as sugary snacks, gluten and most types of dairy can be pro-inflammatory so avoiding these might make a real difference. However, you need to adapt it to your own needs; especially if you find fibre a problem. For example swapping raw nuts for nut butters (to minimise fibre) and high fibre raw green veg for more tummy friendly cooked pumpkin. You may find you can tolerate more fibre as your gut improves. As for AIP, It’s great to see diets popping up specifically focusing on autoimmune disease but this diet is even more restrictive, so you’d need to plan meals carefully. In summary, paleo is positive as a concept but tricky as a diet. Think natural with your foods but be mindful of balancing fibre (more on fibre in this blog post.)

 

DIET 2: FASTING OR 5:2 DIETS.

What is it?

Traditionally in places like India fasting is something that was seen as hugely beneficial- although the focus now has shifted from spiritual wellbeing to weight loss! Nevertheless many still tout the idea of fasting as a way to detox and give the body a break: this range from water fasts, juice fasts, or a 5:2 diet (where fasting is undertaken two days out of 5)

Can it help? It’s no secret that liquid diets (like elemental shakes) have good success with IBD (they’re not usually offered for IBS or other gut issues). This is because it rest the bowels and allows healing. As for undertaking a fast yourself, I would make some suggestions. As you know I am a huge juicing fan so I do feel it can be extremely helpful for the body- since the nutrition uptake can be higher without the need to breakdown fibre. Yet I strongly suggest you do not undergo a juice fast for more than a day or 2 without proper support, since it’s important the body has protein to repair itself; especially if you are underweight or anemic. If you are experiencing lots of diarrhea, you may be better drinking the water of cooked vegetables or bone broth (since some say cold juice can be too irritating; although I’ve never found this).

The best advice I was ever given was the term ‘detox’ can be individual to the user and to do it one step at a time. Do you eat a lot of junk food? Detox by giving it up and only eating natural foods. Are you eating pretty well already? Then try changing breakfast for a morning juice and fasting until lunch? By detoxing one step at a time, the body isn’t tricked into anything too drastic avoiding die off symptoms such as headaches and upset stomach (which often make people feel as if it’s not working).  5:2 in theory can be a good way to introduce gentle fast but I know far too many people that eat rubbish for the other 5 days. You’re much better off having a juice/smoothie for brekkie and then a natural based diet for the rest of the day.

DIET 3: low FODMAP

Low FODMAPS is centred around short-chain carbohydrates that are difficult for the body to digest. These include gluten and dairy but also things like fructose from certain fruits, onion and sugar. 

Can it help? If you are suffering from IBS, it is definitely worth a try but you’ll need to do it with the support of a dietician (or at the very least one of the many FODMAP apps you can buy). After publishing this guide, I actually wrote a more in-depth blog post on the low FODMAP diet– which explains why it needs to be done with proper support or it can cause more harm than good.

DIET 4:SCD

What is it? Although googling it may bring up pictures of Peter Andre in sequins, SCD actually stands for the Specific Carbohydrate Diet. This diet is broadly similar to Paleo but focuses more on the bacteria balance in the gut. Whether foods are allowed are all to do with whether they are single sugar molecules or complex ones. Probiotics is a huge part of the diet with users making homemade natural yoghurt daily.

Can it help? For some, the answer is yes. If you are looking for a diet with many success stories, this is the one. In fact, Stanford University started a study on whether this induces remission in Crohn’s patients so the medical profession is starting to take it seriously. There are many patients who swear by it and since more is being discovered about the link between bacteria and IBD it makes sense. but it can be difficult to follow in the UK since many ingredients (pure gelatine, dry cottage cheese) are difficult to find. It is a diet you need to follow for the long-haul since many find it takes months to work. As dairy is a problem for many, you’ll need to introduce the probiotic yoghurt slowly.

 

DIET 5: GAPS

What is it? GAPS (Gut and Psychology Syndrome) is often billed the British version of SCD and had many similarities. It also focuses on eliminating many foods and probiotics- although it does allow supplementation rather than the yoghurt. I’d suggest trying this over SCD purely because you can find a registered GAP dietician here in the UK and will find it easier to get everything on your shopping list.

 

DIET 6:WEIGHTLOSS DIETS (SLIMMING WORLD, WEIGHTWATCHERS ETC)

What is it? I’ve decided to group these types of diets together since many people comment on a change of gut symptoms when trying Weightwatchers/Slimming World. I do think these diets can be a useful starting point if you are making poor food choices and need encouragement but I don’t really agree with them as a way to approach food (since many ‘free’ or ‘unlimited’ foods are actually pretty bad for us. Unlimited sweeteners? I’m alright thanks!

 

Can it help? Many people find their gut symptoms improve on these kinds of diets and tout them as a miracle! It’s more likely because cutting down on things like alcohol and junk food is going to give your gut an easier time. Others say it actually makes symptoms worse and that’s probably because they go over board on things like salad for lunch which are just too raw and irritating for a sensitive and inflamed colon. Ready meals touted by these companies are usually full of sugar so I would definitely not recommend them! So in answer, these diets won’t really help your gut health alone: but using them as a way to introduce healthier alternatives might help your overall wellbeing.

DIET 7: LOW RESIDUE

What is it? Low residue is a diet when you limit foods high in ‘residue’- namely high fibre wholegrains and tough to digest vegetables. 

 

Can it help? Low residue can be a temporary beneficial measure but can be problematic when followed long-term. This blog post explains why low residue can cause problems with deficiencies and gut bacteria.

 

I hope this overview has helped you somewhat with making a diet decision. It can definitely be a tricky area to navigate and it may take some time to find the right diet for you.  If you are looking for more tailored, personalised support to figure out what is the best diet for you, then head to my nutrition consultation page– which will give you an idea of  how I can work with you to figure out what you can and can’t eat, tackle nutritional deficiencies and manage symptoms. Or keep in touch by the ways listed below!

 

Want more info?
Email me: jfarmer@abalancedbelly.co.uk.
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3 Comments

  1. January 14, 2016 / 9:52 pm

    Thank you! Thank you. This is very helpful.

  2. July 11, 2017 / 9:29 pm

    Great post! I’ll be book marking this – so informative. I was diagnosed almost 2 years ago with Ulcerative Colitis and I’ve drastically changed my diet and I’m seeing that it’s beneficial to get into remission and stay there. Thank you for posting this!

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