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2 recent Med diet studies (surprised folks could eat all this when flaring, AND improve)

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Ulcerative Colitis
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Posted 4/17/2022 5:20 PM (GMT 0)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737160/

https://www.gastrojournal.org/article/S0016-5085(21)03069-9/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F

The first one is both UC and CD, the second just CD. Neither were large.

Nonetheless—because ilovefood!—it is intriguing to me that docs would give folks, even some who were flaring, diets that included salad, nuts, beans, etc. (and in the second case even desserts!) and they would not only be fine but in many cases improve.

This other study (below) made the case more generally that though many docs and patients alike have long assumed a low fiber, low residue diet is necessary to reduce symptoms, this may lead to poorer health outcomes, that fiber is necessary to prevent dysbiosis:

https://www.gastrojournal.org/article/S0016-5085(21)03069-9/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F

I'm wondering what all you folks think about this. Part of the issue is perhaps that, for me anyway, flaring is accompanied by IBS-type symptoms/sensitivities that I don't, for the most part, have while in remission (except for maybe lactose).

Are we staying away from foods that could heal us because, in a flare, they simply cause more gas (especially if eaten once, leading to stopping altogether, vs. being eaten more regularly)?

Is the whole idea that things like whole nuts scrape your colon a myth? And, if not, why are docs/researchers giving them to these folks and they're improving?

Those of us who own 100+ cookbooks and do not want to eat the same 5 foods every day are very interested in what y'all think about all this.
Posted 4/17/2022 6:30 PM (GMT 0)
Sounds to me like you would find Digestive Enzymes very helpful on your journey?

Here is what I think about Food and IBD. Its role is definitely underestimated. Part of what causes the dysbiosis in the first place is not eating proper and healthful meals.
My strategy is eat whatever I want unless my body is telling me differently. I will know very specifically within 24-48 hours. I don’t think just because a food doesn’t feel right during flaring you should not touch it during remission too. Definitely experiment and incorporate a lot more variety remission. Symptoms from food are not the same during flaring and when you are in remission. To me the MD doesn’t sound too alien at all.

Nuts don’t scrape your colon. You can consume them very safely (provided you have no sensitivity /allergy towards them) in powdered form, as paste or even lightly roasted - all of which make them easier on the gut. Also bear in mind MD or any other anti inflammatory one is not about nuts alone. It is about balance in my opinion and knowing which food groups should be on your plate and to what amount. This may probably not be same for every so experiment with what works for you.
Posted 4/17/2022 6:36 PM (GMT 0)
Seeker, thanks--I've been lucky enough to be mostly in remission for many years, so have always eaten pretty much everything (except maybe milk or much ice cream).

But what interested me about these studies (which contain detailed diet info, even an actual weekly plan in one case) is that these folks ate what I would consider a pretty normal, highly varied Mediterranean diet DURING A FLARE--and the result was more improvement than not.

That's what I tend not to see on this site. And that's what I was curious to ask folks about. I mentioned nuts, salad, beans bc those are examples of Med. diet staples that I had cut out while warding off a very early flare, and that many here seem to avoid as well. But is this perhaps not the most helpful approach? Again, drs. seem to be rethinking the low residue thing.
Posted 4/18/2022 3:29 PM (GMT 0)
I'm really curious about this too! It seems like low residue diet contravenes a lot of the advice about the nutritional contributions to a healthy gut biome. Sometimes this disease feels like such a catch-22, so I'm intrigued by the research and how it aligns (and doesn't) with people's experience.
Posted 4/18/2022 3:57 PM (GMT 0)
I personally eat a high-fiber vegan diet but it has never helped my UC. Wish it did.
Posted 4/20/2022 8:31 PM (GMT 0)
Thanks, Sara! Again, my question is less: Will such a diet help everyone? (because clearly it doesn't—though these diets did include dairy and eggs and some fish). It's more: Would such a diet be harmful? These studies suggest no, and that, in a significant number of cases, it DID help. And yet, again, many of us do seem to avoid many of the foods included when in a flare—perhaps, again, based on ideas about a low residue diet that may be outdated (and more based on symptoms like as than on healing).
Posted 4/20/2022 11:08 PM (GMT 0)
During my last flare I ate whatever I wanted because it made no difference
Posted 4/21/2022 2:37 AM (GMT 0)
Yeah, it never seemed to harm me or help me. I can't imagine doing a low fiber diet myself, at least not long-term. I shared some studies here once about plant-based diets helping some people and I was crucified for it...
Posted 4/21/2022 5:27 AM (GMT 0)
What part are you asking that is perceived as possibly harmful?

q
Posted 4/24/2022 7:52 PM (GMT 0)
Quincy: my normal diet consists of salad every day for lunch with some kind of bean and a protein. I also eat nuts with my breakfast.
Warding off this flare (with help from second enema), I wondered about changing my diet and found that if you search "salad," "beans," "nuts," etc. with UC on this site all you get is folks talking about how, in a flare, they avoid these things. What they do eat, if it's not SCD or whatever, seems to map onto a low-residue diet.
Yet these studies suggest low-residue—again, in a flare—is NOT the way to go, and that diets like the Med. Diet that included all these elements were helpful.
Oh, and Sara: it's clear that both a diet with no grains AND a diet with no animal fat helped folks. So either it's that both diets forced folks to eat more veggies than they normally do, or that combining grains with animal fats was more the problem (which I have sometimes noticed in my own case—I try to have them at separate meals when things are bad).
Posted 4/24/2022 8:53 PM (GMT 0)
I think the low residue/low fibre recommendation is mainly about reducing the amount of "work" your bowel has to do when there's a lot of active inflammation, so that you experience less discomfort, as opposed to being a long term solution.

When I'm flaring, it changes all the time which foods i can tolerate depending on the extent and severity of the inflammation.

Note that fibre can be soluble or insoluble. When flaring i can't tolerate insoluble fibre. In remission i can eat anything i want (I assume, since I still mainly eat healthy options.....)

Mediterranean diet has a lot of olive oil and other anti inflammatory ingredients.

With regards to animal protein - there are some UCers who swear by ketogenic diet to get into remission.
Posted 4/26/2022 7:58 PM (GMT 0)

ilovefood said...

Oh, and Sara: it's clear that both a diet with no grains AND a diet with no animal fat helped folks. So either it's that both diets forced folks to eat more veggies than they normally do, or that combining grains with animal fats was more the problem (which I have sometimes noticed in my own case—I try to have them at separate meals when things are bad).

Yeah, that makes sense. I do eat grains, mostly whole grains, like oatmeal, brown rice, quinoa, and whole grain sprouted bread. Sometimes the quinoa seems a little rough on my gut if I eat a lot of it.
Posted 4/30/2022 7:30 PM (GMT 0)
I've never noticed specific food impacting my condition.
Posted 4/30/2022 10:12 PM (GMT 0)
Ditto nssg.
q
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