Put Crohn’s Disease Into Remission!

It’s Q&A Day at 10almonds!

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In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

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❝What to eat for Crohns Disease? I keep getting Doctors telling me different things❞

Frustrating, isn’t it? Doctors are usually more knowledgeable about drugs than they are about nutrition, of course.

First, it’s important to address the overlap between Crohn’s, ulcerative colitis, and IBS in general. These things can often get diagnosed as each other, and while some advice stays the same for each, some differs. For example, probiotics have been found effective against symptoms of IBS and ulcerative colitis, but not Crohn’s:

• Probiotics for induction of remission in Crohn’s disease
• Probiotics in Irritable Bowel Syndrome: An Up-to-Date Systematic Review
• The role of probiotics in the prevention and treatment of IBS and other related diseases: a systematic review of randomized human clinical trials
• Safety and Potential Role of Lactobacillus rhamnosus GG Administration as Monotherapy in Ulcerative Colitis Patients

Diet-specific matters

You asked about diet more generally though, and probiotics are of course only a small part of diet (one cannot live on kimchi alone), so let’s turn next to a closely related dietary matter, that is: fiber

For most people in most states of health, more fiber is usually better than less. With Crohn’s disease, the amount of fiber often needs to be limited

…and unfortunately, that changes everything, in terms of a whole-foods majority plant-based diet.

What stays the same:

• You still ideally want to eat a lot of plants
• You definitely want to avoid meat and dairy in general
• Eating fish is still usually* fine, same with eggs
• Get plenty of water

What needs to change:

• Consider swapping grains for potatoes or pasta (at least: avoid grains unless you’re really sure you’ll be fine after them)
• Peel vegetables that are peelable; discard the peel or use it to make stock
• Consider steaming fruit and veg for easier digestion
• Skip spicy foods (moderate spices, like ginger, turmeric, and black pepper, are usually fine in moderation)

Much of this latter list is opposite to the advice for people without Crohn’s Disease.

*A good practice, by the way, is to keep a food journal. There are apps that you can get for free, or you can do it the old-fashioned way on paper if prefer.

But the important part is: make a note not just of what you ate, but also of how you felt afterwards. That way, you can start to get a picture of patterns, and what’s working (or not) for you, and build up a more personalized set of guidelines than anyone else could give to you.

Fast-mimicking diet

This is where our headline came from, because in a medium-sized (n=97) study, this dietary approach enabled 64.6% to achieve remission over the course of a 3-month study. As well as symptom-based remission, key inflammatory biomarkers dropped too, including fecal calprotectin, along with reductions in inflammatory lipids and immune signaling.

While that latter item (“immune signaling”) sounds like an almost-empty add-on, it’s actually perhaps the most critical, bearing in mind that macrophages are part of the immune system, specialist white blood cells that “eat” things that need to be removed. There are two kinds, inflammatory and non-inflammatory. The former aggressively “eat” invaders. The latter are more like cellular janitors.

In Crohn’s disease, the balance of these two kinds of macrophage becomes imbalanced, and guess which kind goes on the rampage. If you guessed “not the janitors”, you guessed correctly.

As for why this happens: in a healthy gut, NOD2 gene binds to girdin in non-inflammatory macrophages, helping them suppress inflammation and promote tissue repair. The most common Crohn’s-linked mutation deletes the part of NOD2 that connects to girdin, disrupting this balance and allowing chronic inflammation to take over.

So, correct the signaling, and you correct the rampage!

But how to do that?

What the diet involved: participants ate a very low-calorie (about 700–1,100 kcal/day), plant-based diet for 5 consecutive days each month, then returned to their normal diet for the rest of the month.

The good news is you should know if it’s working quite quickly, because improvements were seen after just one 5-day cycle, looking promising with rather quick-to-appear benefits.

You can find the paper itself, here: A fasting-mimicking diet in patients with mild-to-moderate Crohn’s disease: a randomized controlled trial

Want to learn more?

We did a main feature about this diet (for other reasons) a while back: The Fast-Mimicking Diet

The expert featured in that article, Dr. Valter Longo, is the same “V. D. Longo” that you’ll see in amongst the “et al.” of the paper we linked above, and he’s also written some books you might like:

• The Longevity Diet: Discover The New Science To Slow Aging, Fight Disease, And Manage Your Weight – by Dr. Valter Longo
• Fasting Cancer:How Fasting and Nutritechnology Are Creating a Revolution in Cancer Prevention and Treatment – by Dr. Valter Longo

Take care!