The Latest and greatest treatments for IBD: What to believe
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A study comparing the Mediterranean and Specific Carbohydrate Diets showed both work about 40% of the time to achieve what's known as symptomatic remission (JD Lewis and others, Gastroenterology 2021). What's more, over 30% had improvement in one of the important markers of internal disease activity at 6 weeks into the study. Improvement was seen in pain levels, tiredness (fatigue), and the way participants rated their quality of life. All of this while those in the study didn't change their medicines or anything else—though it's of note that the majority of those in the trial was on a least one medication during the 12-week trial.
The reason for doing the trial comparing the 2 diets is interesting in itself. Earlier studies have shown that those on a traditional Mediterranean Diet, which is loaded with fresh fruits, vegetables, nuts, fish, and whole grains, with olive oil as the main cooking oil and spread) lowers the risk of getting Crohn's disease, while the Specific Carbohydrate Diet (which eliminates most sugars and grains) in small studies seems to improve active Crohn's disease.
So investigators at 33 sites around the US enrolled 194 patients in the trial, providing their meals based on one of the diets for the first 6 weeks. Then they let them follow their assigned diet for another 6 weeks, though that was less successful, with few staying on the foods they were supposed to eat and a number of the participants dropped out of the study along the way.
There are some important lessons here:
Perhaps the bottom line is that healthy nutrition helps those with Crohn's disease and that the focus of that should be increased fresh fruits and vegetables while eliminating processed foods as much as possible.
Similar studies of diets in inflammatory bowel disease, in general, and ulcerative colitis are beginning to show similar results.
This article, as well as all others, was reviewed and edited by a member of our Medical Advisory Board.
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