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A recent study from 2022 looked at the diets of people with Crohn’s disease and ulcerative colitis for clues about which diets were associated with fewer symptoms.
In this article, we go over the types of diets the participants followed, the impact those diets had on the frequency and severity of flares, and what conclusions we can draw from this study.
What was this study about?
Researchers asked 691 people with IBD to recall their diet during the last 3 months that they were in clinical remission (clinical remission, also known as symptom remission, is when you don’t have any symptoms but you may still have inflammation).
When the researchers combined the results from all participants, they found that participants’ diets could be grouped into 5 main categories, which they referred to as diet patterns.
What types of diets did participants follow?
- Western Diet 1 - 168 people followed a diet with low intake of fruits, vegetables, plant protein, and cooked grains, with moderate intake of all other food groups.
- Western Diet 2 - 157 people followed a diet with high intake of animal proteins, red and processed meats, added sugars, and sweetened beverages. This diet pattern also included moderate intake of mixed grains, breads, boxed cereals, added fats, candy, savory snacks, sweet bakery products, other desserts, and dairy products. This group had a low intake of fruits, vegetables, cooked grains, and water.
- Balanced Diet - 163 people followed a diet similar to Western Diet 1 except that this group had higher consumption of water relative to other beverages as well as a moderate intake of cooked grains, fruits, and vegetables.
- Plant-Based Diet 1 - 110 people followed a diet with high intake of fruits, vegetables, plant-based proteins, and cooked grains. This group preferred juices and other beverages over water and had moderate intake of added fats, oils, sugars, seafood, and dairy products. This group also had modest intake of meats, eggs, mixed grains, and breads.
- Plant-Based Diet 2 - 93 people followed a diet with high intake of fruits, vegetables, plant-based proteins, and cooked grains. This diet pattern also included an average intake of seafood and dairy products. This group had low intake of animal proteins (especially red and processed meats), added fats, sweetened beverages, sweet bakery products, other desserts, eggs, and breads. People in this group also preferred water to other beverages.
How were the diets related to symptoms?
Researchers looked at the diets people were following and compared them to the symptoms people were experiencing at the time of the study. They found that:
- 7.6% of people following a westernized diet reported severe symptoms compared to just 1.1% of people following the Plant-Based Diet 2.
- 23% of people following a westernized diet were in symptom (clinical) remission at the time of the study, compared to 48% of people following Plant-Based Diet 2.
How did diet impact Crohn’s disease patients?
Compared to people with Crohn’s disease following a westernized diet, people with Crohn’s who followed the Plant-Based Diet 2 in remission were
- 68% less likely to have a symptomatic flare
How did diet impact ulcerative colitis patients?
Compared to people with UC following a westernized diet, people with UC who followed the Plant-Based Diet 2 in remission were:
- 69% less likely to have a symptomatic flare
Although this is an interesting study with a large number of participants (which is rare for research studies on diet), there are three important limitations to consider:
- Recall bias - People were asked to recall their diet during the last 3 months or during the last time they were symptom-free. It’s hard to recall what you ate yesterday, let alone 3 months ago, so there may be some bias in what people reported eating during the study.
- The study looked at symptoms, not inflammation - The authors looked at the effect each diet had on symptoms, not inflammation. Since symptoms can be poorly correlated with inflammation, we can’t draw any conclusions about the role of these diets on inflammation.
- This was just a single study - Although this was a large study with almost 700 participants, more research is needed to confirm which diet pattern, if any, is best for people with IBD.
People with Crohn’s disease and ulcerative colitis following a plant-based diet while in remission may be less likely to experience a symptomatic flare than those following a westernized diet.
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- Limketkai BN, Hamideh M, Shah R, Sauk JS, Jaffe N. Dietary Patterns and Their Association With Symptoms Activity in Inflammatory Bowel Diseases. Inflamm Bowel Dis. 2022 Nov 2;28(11):1627-1636. doi: 10.1093/ibd/izab335. PMID: 35092268.