Questions Answered By Expert
Kalee Eichelberger, RD,LD/N, CNSC
Specialty Dietitian at the Orlando Health Digestive Health Institute Center for Inflammatory Bowel Disease
A: It has been demonstrated that dietary sugar consumption contributes to increased inflammatory processes in humans. The evidence suggests that eating too much added sugar and too many refined carbohydrates can cause inflammation in the body. Processed sugars trigger the release of inflammatory messengers called cytokines. According to research, it has been shown that dietary sugar intake especially sugar-sweetened beverages may be a key stimulus of subclinical inflammation, as measured by the inflammatory marker C-reactive protein (CRP). Added sugars contribute sweetness and although they add calories, offer minimal nutrition. Make sure to read nutrition facts labels carefully. Many foods now list added sugar separately. You also can find added sugar by reading the ingredients. On an ingredient label, sugar may appear under many names. Some of the most common ones include cane sugar, evaporated cane juice, corn syrup, high-fructose corn syrup, raw sugar, brown sugar, honey, maple syrup and brown rice syrup. Dietary Guidelines for Americans recommends limiting added sugars to no more than 10% of daily calorie needs, which is about 12 teaspoons (48 grams of added sugar) on a 2,000-calorie diet. hide answer
A: If gastrointestinal symptoms are still present after food intake regardless of disease activity, discussing this with your health provider could prove to be beneficial. Some patients with inflammatory bowel disease experience intolerance to food items due to underlying disease related inflammation; however, when IBD is in remission and symptoms are still being experienced after eating, this may be due to a specific intolerance, such as lactose or fructose intolerance, or Irritable Bowel Syndrome in addition to IBD. A low-FODMAP diet may help with IBS and in some cases can help reduce IBD symptoms, but research doesn’t support its use for reducing IBD inflammation. This diet is not typically recommended if you are in a flare, but it can be helpful if you struggle with gas, cramping, and bloating and dietary intolerance. FODMAP is an acronym for Fermentable, Oligo-, Di-, Monosaccharides and Polyols. The language may sound complicated, but it is a diet that cuts back on a group of sugars that can be poorly absorbed by your GI tract. This includes foods containing fructose, lactose, sugar polyols (sorbitol and mannitol), fructans (found in garlic, leeks, artichokes, and wheat), and galacto-oligosaccharides (found in lentils, chickpeas, and black beans). Meeting with a dietitian can help identify which of these food items could be potentially worsening symptoms, and which foods can be reintroduced without exacerbating symptoms. Keeping a food log may also be helpful to help correlate specific symptoms with food items. hide answer
A: Research has shown that dietary changes can have a big impact on inflammatory bowel disease management. Intermittent fasting (IF) is an eating pattern that cycles between periods of fasting and eating, traditionally used for weight loss. To find out whether intermittent calorie restriction or fasting plays a role in reducing inflammation, a University of Southern California preliminary study published in Cell Reports in March of 2019 tested cycles of a low-calorie, low-protein, plant-based diet on mice with inflamed bowels. In the mice given cycles of the fasting-mimicking diet, gut inflammation and other signs of IBD appeared to improve. Additionally, researchers tested three cycles of a fasting-type diet in 100 healthy people. People who started the study with higher levels of certain inflammatory markers had noted improvements in certain serum indicators by the end of the fasting diet, which may point to a role in lowering inflammation. However, any type of fasting or restrictive diet can be difficult to adhere to and may not be suited for IBD patients given their increased risk for malnutrition. More research is needed on this particular diet such as a clinical trial to test the safety and efficacy of these fasting diet cycles in people with IBD. Intermittent fasting is not as of now recommended as a way to help treat IBD and is also generally not recommended for individuals in periods of rapid growth, such as children and adolescents. hide answer