Crohn's/IBD Diet Books?

What are your favorite books? I'm looking at this one on Amazon called "What to eat with IBD". It has good reviews. I want to make sure I'm doing everything I can to get all of my nutrients. Unfortunately I'm a TERRIBLE COOK.

I was looking at the Makers Diet book... but the testimonials and the way they claim to have cured people on their death bed sort of turned me off...

You might want to check out "Listen to Your Gut" by Jini Patel Thopmson.

"Breaking the Vicious Cycle" by Gottschall, yes- very good. And I think I am the person being referred to as the one posting about "Life Without Bread."

Both rely upon carbohydrate restriction, similar to Atkins, but for the fact that Life Without Bread has the dieter settling out at 72 grams/carbs per day, versus Atkins which starts at 20-30 grams per day and tapers upwards to 50-60 grams or so. (Note that Atkins claimed- with no apparent data to support his claim other than personal anecdote- that his diet worked for ~85% of his patients with Crohn's. This figure is very similar to that of Dr. Lutz in "Life Without Bread.")

I have it on authority that the author of of the Maker's Diet used the Gottschall diet to achieve stability in his life; she was rather upset later when he came out with his book and claimed her diet did nothing for him. I think he attributed his success to "essential soil organisms" or some other nonsense.

The simple fact is this: carbohydrate restriction is at the root of all these dietary control measures. Atkins is very strict; Lutz is less so, and his book has an excellent explanation as to why it is a healthier dietary choice. Breaking the Vicious Cycle gets right to the root of the problem, which is restriction of oligosaccharides and polysaccharides; whatever has gone wrong with us collectively is grounded in too high a concentration of dietary OS and PS. Gottschall has the dieter restricting these two compounds, and advises reducing the other polymeric carbohydrates (sucrose, lactose, etc.). The Maker's Diet also restricts carbohydrates, perhaps in a little more roundabout way; high concentrations of carbs in the diet is a modern thing- cheap, largely "empty" calories in the form of white wheat, potatoes, corn, and other dietary components that taste sweet to us, but have not been available in large quantities in the diet until modern times- about 100 years.

For anyone who goes on these diets: follow the Gottschall advice. If there will be any positive effect, it should be visible within a few weeks. Follow the diet to the letter- no cheating. Within a few months (yes, it takes time) there will probably be improvement- 70-80% of the time. Within a year, there should be substantial improvement- 80-90% of the time. Don't give up, don't cheat.

I'm now 9 months into carbohydrate restriction, and feeling better than I have in *years*.

meowese =

they are complex long chain sugars. the body does better with monosaccharides (ie glucose). sprouted grains pre-digests the natural sugars in those grains, changing them to monosaccharides. the more complex the sugar, the more the body must work to break it down and the harder it is for the body to do so.



osprey101-

i forget which book, it may be the makers diet, where jordan rubin actually spends a bit of time discussing the scd. he gives it props but not as much as i think it deserves. he does credit the mysterious black powder with his recovery, not the diet. i disagree and view it the other way around. it was the diet that got me well but i am sure the probiotics helped in the initial detox phase allowing me to reseed my gut with the proper flora. i know if i went off the diet and ate like i did before or worse and still took probiotics my symptoms would return. it is so obvious to me that it is the diet, but hey, he's got a product to sell, but he could be genuinely convinced of it too. whatever. i started makers on phase 3 cos phase 1 and 2 were too intimidating with the elimination of bread for a month. i saw results in a few days doing it this way. jordan had me redo it, starting at phase 1 and that is how i totally got even better. so i firmly believe that there is something to restricting grains. that is why i eat grains sparingly and eat sprouted grain, as recommended by the makers diet. however i do go gluten free if i cant get sprouted. i wouldnt be surprised that he got the idea of no grains for phases 1 and 2 from the scd. however there is a lot of good stuff in grains, if you eat the right ones. i agree with jordan that they should be part of your diet, but we should choose better options and some of us should be on tighter restrictions than others. carbs, which are the main thing in grains, supply only energy while protein and fat do oh so much more. a person eating only carbs derived from grains for a year will die while some one eating protein and fat will survive just fine. go figure...

EMom> Yes, I did recommend "Life Without Bread," and I think it is probably the most important book I have read in the past 2-3 years. (Mind you, I was only diagnosed with Crohn's 9 months ago!).

CrazyHarry already expounded upon the carbohydrates, but here's a quick rundown:

Monosaccharides are single (one sugar) carbohydrates; honey is comprised almost entirely of fructose and glucose, for example. These are absorbed "high" in the gut- past the duodenum (where the stomach lets out into the small intestine), but not too far into the small intestine. The body just grabs them out of the gut and stuffs them into the bloodstream.

Disaccharides are two-sugar carbohydrates; table sugar (sucrose) is a combination of one molecule of fructose and one of glucose. From the time you consume it, the body is working on it with enzymes (invertases) that break it up into its component molecules, which are then absorbed as above. Lactose is another disaccharide; many people lack the enzyme to break it down into its component sugars, glucose and galactose. There are other disaccharides, but they are minor in the diet.

Trisaccharides and tetrasaccharides (three- and four-sugar molecule carbohydrates) are found in vegetables and some other foods. The inability of some to do well on asparagus, broccoli, brussels sprouts, cabbage, soybeans, etc. may be due to these complex sugars.

From there, you have oligosaccharides- molecules that are even bigger. I think they are comprised of chains from 5-9 sugar molecules, while polysaccharides are 10 and up. Polysaccharides would consist of big honkin' molecules like inulin, starch, pectin, that sort of thing.

And this model works very nicely to explain why the "gluten free" diet works well for some Crohnies. If you get rid of gluten like a celiac, then you're excluding barley, rye, oats, and wheat- all are seeds that contain huge honkin' quantities of starch. It also explains certain sensitivities to specific vegetables.

In his book, Lutz suspects it's due to the insulin "pulse" from eating carbs; this causes the digestive system to speed up for a bit, which could push carbohydrates that are not sufficiently digested into the large colon. There they feed undesirable organisms, which in turn cause the gut to go haywire.

After a number of weeks or months (I think Gottschall puts it at 3 months) on carbohydrate restriction, there can be a relapse which involves blood, mucus, and pain that may be interpreted by the dieter that it is not working. To the contrary: I suspect this is a die-off of the previous, sugar-fed flora, which is in turn to be replaced by more "normal" flora that can persist on fewer sugars. Interestingly, I have relatives who offer weight-reduction consults through their medical practice; about two weeks into the diet, they report a similar event (minus the blood). The nature of the mucus, etc. was unknown to them and I informed them it's very simple: out with the old flora, in with the new. Cinch.

I would also opine that this mechanism jibes with the theories that MAP plays a role in Crohn's. MAP presumably colonizes the intestine, resulting in portions of the colon that are then susceptible to secondary infection. The ulcers are made worse by organisms- probably fungi- that can attack this raw tissue, resulting in the pain and bleeding, and making the malabsorption worse. The reason I suspect fungi is that they do better on polymeric carbohydrates, while bacteria prefer small sugars. In fact, MAP is a facultative intracellular parasite- it can live off the glucose fed to the body's cells; the polysaccharides should not affect it directly, only indirectly.

This also explains why probiotics tend to help in that recolonizing the gut with more benign flora is imperative once the changeover begins.

Gottschall has it exactly, on-the-nose correct. Lutz takes a less precise approach, but reaches the same conclusions independently.

Meanwhile, your average gastroenterologist will insist that specific dietary measures are unable to control this disease, and if so, certainly not to the degree that it may be interpreted as a "cure." A little tip:

Go to PubMed:

http://www.ncbi.nlm.nih.gov/pubmed/

Search for "diet" and "Crohn's." You will go blind and insane trying to make sense of all the studies, some of which say there is an effect, many of which do not.

Then search for "diet," "Crohn's," and "carbohydrate." You will find the field greatly restricted, and much more open to reading with only 132 hits. Now pore over them, looking for studies in which the authors researched Crohn's management through carbohydrate restriction. They are quite old, but they are there; medicine seemed to give up the study after the mid-1980's, but they're there and (best as I could find) they all showed strong positive results.

Net upshot: no, dietary management of the disease does not look like a valid venue- until one looks only at carbohydrate restriction. At that point, the literature is virtually unanimous: it works. You can verify this yourself through the instructions I give above.