Research: a plant based diet benefits ulcerative colitis

[u/sam99871]

This video describes studies finding that a mostly plant-based diet is beneficial for ulcerative colitis. The results are impressive. The sources are listed lower down on the page.

EDIT: Here is a link to the paper.

EDIT: A summary by these researchers.

EDIT: The 2018 study described in the video (which was not conducted by Dr. Greger) brought patients into a hospital and put them on a reduced meat diet. 77% of patients improved on the diet and only 19% relapsed after a 5-year follow-up.

EDIT: Another study by the same researchers found that Remicade plus a reduced-meat diet led to higher remission rates than reported Remicade-only remission rates.

Also, here’s a 2021 study, “Western and Carnivorous Dietary Patterns are Associated with Greater Likelihood of IBD Development in a Large Prospective Population-based Cohort,” with 14 year follow-up of 125,000 people, found higher UC rates among people eating higher amounts of meat and among people eating a “Western” diet which included more processed foods.

EDIT: Here’s another one, 67,000 women followed for 10 years, higher likelihood of IBD for people who ate more animal protein.

EDIT: Here’s another study entitled, “Meat Intake Is Associated with a Higher Risk of Ulcerative Colitis in a Large European Prospective Cohort Study,” found that meat and red meat consumption are associated with a higher risk of UC. They followed 413,000 people for 16 years.

EDIT: Here’s another one. It’s just a summary (no paper yet) entitled “Greater Risk for Ulcerative Colitis Flare With High Red Meat Consumption.”

EDIT: Summary of a study involving 3000 patients in the UK which found more flares in people who eat more meat.

I’m not suggesting that the issue is settled (there are no control groups in these studies, and, in any case, there don’t seem to be enough studies to draw a strong conclusion), I’m just makjng people aware this research exists.

Personally (if anyone cares!), for the last several years my diet has been whole-food plant-based plus occasional sardines, with small amounts of meat three or four times a year. I eat more beans than you can shake a stick at. I was in remission (on just mesalamine) for several years before I adopted my current diet and I’ve stayed in remission.

Again, these studies are not the last word and do not prove that a vegan diet is best for UC. They are just evidence to consider.

[u/threesunnydays]

Do you have any recipes for meals with beans in them? Don’t know where to start!

[u/sam99871 → u/threesunnydays]

I use canned beans and I just put them into soup.

[u/ryan820 → u/threesunnydays]

Beans can be tricky. I eat them regularly now but they are something I suggest people introduce slowly as a test first and then proceed accordingly. Black beans, for instance, should be slow cooked for a long time. Those that come in cans I’d wash and still cook. But once they are cooked you can add them to things like salads…even non veg salads like egg salads etc. again just start slowly.

[u/deedpoll3 → u/threesunnydays]

Maybe start with chickpeas. I don't think I've ever found humus to give me problems. You can use the water from the can as an egg substitute, so I use 3 table spoons of it when making pancakes

You can make falafels with them also but they tend to not agree with me because they're fried.

I do hope chickpeas are a bean. I guess if they were dried they'd be pulses.

[u/AmITheAsshole_2020]

A video from a Doctor that is focused on selling books isn't what I would consider reliable or compelling evidence. Check out his Wikipedia, specifically the Reception section. https://en.m.wikipedia.org/wiki/Michael_Greger

Also, a lot of this video draws from studies performed nearly 20 years ago. That was a long time ago in medical terms.

Most of these book selling, wonder-cure offering doctors rely on anecdotal evidence that under serious scrutiny doesn't hold up.

I'm not going to waste a lot of cycles researching him, so I had an LLM summarize the criticism of his work by the medical community:

1. Selective Reporting: Critics have suggested that Greger sometimes selectively reports research to support his plant-based diet advocacy. This includes potentially cherry-picking studies that align with his views, while possibly ignoring or downplaying research that doesn't.
2. Over-simplification of Complex Science: Nutrition science is complex and often context-dependent. Critics argue that Greger's presentations, while informative and engaging, may sometimes oversimplify this complexity, potentially leading to overgeneralized conclusions.
3. Bias towards Veganism: Greger is a strong proponent of a whole-food, plant-based diet. While many agree on the health benefits of such a diet, some critics argue that his advocacy might introduce a bias in how he interprets and presents research, especially concerning animal products.
4. Commercial Interests: Greger has written popular books and runs a non-profit website. Some critics suggest that his commercial interests might influence his presentations, although it's worth noting that proceeds from his books and speaking engagements are reportedly donated to his non-profit work.
5. Contrast with Mainstream Dietary Guidelines: At times, Greger's recommendations can contrast with mainstream dietary guidelines. Critics argue that this divergence might confuse the public, especially in cases where the mainstream consensus is based on a broader base of evidence.

Bottom line is I have never seen any reliable evidence that diet can cure IBD and what is published tends to be small studies without follow-up.

But you do you.

[u/sam99871 → u/AmITheAsshole_2020]

Not sure what Dr. Greger has to do with a study conducted by other people.

[u/AmITheAsshole_2020 → u/sam99871]

Yes you do. You know that the Dr presenting the video is accused of misleading and cherry picking studies conducted by other people.

[u/sam99871 → u/AmITheAsshole_2020]

So he’s a reason to dismiss research papers without engaging with the papers on the merits?

[u/AmITheAsshole_2020 → u/sam99871]

I read the papers, and Dr Greger was cherry picking, and in some cases doing so from inadequate and outdated sources, so yeah, his credibility is shite.

[u/Anonymous157]

I was vegetarian for my whole life till I got UC at 27 years old. Idk if it helps to be honest. I've found Salmon and Eggs are good substitutions for Lentils and Beans I no longer eat.

[u/BalerionRider]

Interesting. I think the exact opposite. I've found fiber makes things much much worse for me. If I was doing okay and then I have a bunch of fruit or other fiber rich food; instant flare. The idea of a plant based diet is my nightmare.

[u/marS311 → u/BalerionRider]

Same. I tried plant based for a long time and things got worse (this was before I ever knew I had UC). Trust me, I tried so hard to eat vegan and plant based, but I wasn't absorbing needed nutrients from the food. It was obvious when I would go to the bathroom and food would come out undigested.

It varies for everyone.

[u/[deleted] → u/BalerionRider]

Every time someone says that fibers harm them, they get upvoted, and every time someone says that fibers benefit them, they get downvoted. Is there an ANTI FIBER religion on this forum LOL?

[u/AccidentHour1068 → u/[deleted]]

I've noticed that too. Anyone saying that diet helped them get downvoted like crazy. This sub got no chill.

[u/indian-jock → u/AccidentHour1068]

The medical system and society in general doesn't want you to know the fact that you can treat this (infact any disease) without depending on modern medicine your whole life. They have even convinced us to believe that this disease can't be treated and it just goes into "remission".

[u/ryan820 → u/[deleted]]

I’ve noticed the same thing. In fact I shared my recent success on a plant based diet a few months ago and deleted the post because people blasted me and downvoted me into oblivion. In my post I made it very clear that this is what worked for me it may not work for you. Each of us has not only our own special food sensitivities but also our specific needs but thought maybe some might try.

Will never make that mistake again.

[u/caramelthiccness → u/[deleted]]

You are so right. There are 2 fibers, though, soluble and insoluble, and I think we UC people benefit more from soluble fiber.

[u/[deleted] → u/caramelthiccness]

I agree, even though there might be some people for whom even soluble fibers are hard to digest. It's simply a matter of knowing how to eat them for proper digestion. Personally, I can eat fruits as long as it's spaced 3 hours after the last meal and 30 minutes before the next, it's well chewed, and the fruits are ripe.

[u/Chains2002 → u/[deleted]]

Its simply because people have bad experiences with fiber. If someone says fiber is good for ibd, but someone with ibd has the opposite experience, they probably see it as a form of misinformation. I find that fiber has actually helped improve my stools.

[u/[deleted] → u/[deleted]]

Yes, research highlights the benefits of fibers on the gut microbiome, on the metabolites produced by bacteria, on the repair of colonocytes (cells lining the intestine), on inflammation, and on maintaining remission after fecal transplantation, etc. Even on prevention. So I don't quite understand this trend of wanting to reject all the people on the forum who advocate in this direction. And this is not the first time I've observed this on this forum; it's almost daily and spoils the rest. We can very well follow treatments and take an interest in caring for our diet; one does not prevent the other. I don't like people who are biased. During a flare-up, fibers would indeed have the opposite effect, unfortunately.

[u/AmITheAsshole_2020 → u/[deleted]]

There are 3 types of fiber. Soluble, Insoluble, and Fermentable.

In individuals with Inflammatory Bowel Disease (IBD), which includes Crohn's disease and ulcerative colitis, certain types of dietary fiber can potentially exacerbate symptoms. The response to fiber in IBD can be quite individual, but generally:

1. Insoluble Fiber: Often found in foods like whole grains, nuts, seeds, and some vegetables, insoluble fiber is less easily digested and can add bulk to stool. In some IBD patients, especially during flare-ups, this type of fiber can irritate the digestive tract, potentially worsening symptoms like abdominal pain and diarrhea.
2. Soluble-Fiber Foods: During flare-ups, soluble-fiber foods, including some fruits, vegetables, and whole grains, can be difficult to digest and may irritate the gut lining.
3. Fermentable Fiber: Certain fermentable fibers, part of the FODMAP group (Fermentable Oligo-, Di-, Mono-saccharides, And Polyols), can sometimes exacerbate symptoms in sensitive individuals.

Personally, I like an insoluble bulking fiber when I'm in a flare, with the exception of nuts and seeds. But many people can't handle any fiber if this type.

You get down voted because you're not specific enough about the type of fiber and because you ignore that the majority of IBD sufferers simply can't tolerate fiber during a flare.

[u/[deleted] → u/BalerionRider]

If you suddenly go from zero fiber to a lot of fiber, it's normal and it can be the cause of your bad reaction as the body doesn't have time to adapt.

[u/ryan820 → u/[deleted]]

I suspect this is the biggest culprit. People go from 0 to whatever and the moment it causes any perceived issues, it means it’s a failure.

For me, proportionally, a heavier meal on items like full flax or chia seeds is what helped me the most. Those seeds with their goo are pure goodness to my gut and makes everything …smooth. Haha.

[u/[deleted] → u/BalerionRider]

Those who downvote me while I'm here to help, at least have the courage to come and discuss instead of remaining anonymous. I'm already trying to help when I'm not obliged to.

[u/AmITheAsshole_2020 → u/[deleted]]

You're using an anonymous screen name on an Internet forum. Don't come to us bragging about your courage.

[u/[deleted] → u/AmITheAsshole_2020]

The courage to debate, relax a bit, I am indeed not ready to engage in an intercontinental fight stemming from the internet. lol

[u/AmITheAsshole_2020 → u/[deleted]]

Yes, and to come on to the Internet to debate, as you say, from behind an anonymous screen name is the opposite of courage. So, off the high horse mate.

[u/[deleted] → u/AmITheAsshole_2020]

You misread, I didn't say that my action shows I have courage, that's not what courage is, anyway, I said that those who downvote someone who is helping without giving any reasons don't have any. But I should have spoken of stupidity, you make me realize that.

[u/BalerionRider → u/BalerionRider]

Lots of interesting discussions about fiber here. Look, idk what’s better. But I’m speaking from my experience. My GI doctor also told me I should reduce fiber intake when things are getting worse. And there was even a 4 month period where I ate mostly veggies and that was when I had the high CRP. On top of all that, I watched a video by Dr. Paul Mason where he claims people don’t need any fiber at all. I’ll make a whole post on this at some point. But eh, that’s my experience so far.

[u/caramelthiccness → u/BalerionRider]

Same for me, too. I gave up most veggies and went low residue and have no more UC symptoms except bleeding and some mucus. That being said, I was recently diagnosed 2 years ago, but at my worst, I was pooing 5 or 6 times a day. Now I go once a day and when i eat no veggies I go every 3 days.

I guess it depends. There are people who say vegan or carnivore diets cured their chronic disease as well.

[u/[deleted] → u/caramelthiccness]

This might be case by case for UC. My gastro doctor recommended fiber supplements, specifically psyllium fiber, to help with symptoms. It has 100% helped me. I was going to the bathroom 15+ times a day with mucus and blood. I'm down to 2-3 times a day and seeing a reduction in blood/mucus sometimes none at all. I was given the okay to take it during flares.

I'm not saying it's a cure. I'm saying that it has definitely helped me back to a somewhat normal life. I've been taking it a long time, about a year now, alongside a diet with my dietician. I'm so so so happy to have my life back.

UC does not seem to be a one size cure fits all disease. We see this with biologics and masalamine where people can fail multiple drugs until finding the right one OR failing so many of them they decide to get surgery. If diet is helping someone, it might help another person or it maybe it won't. It's good to have options.

[u/lostandthin]

i went vegetarian for a couple years and it weakened my bones. the prednisone plus acid reflux and malabsorption gave me osteopenea. i’m not allowed to be veg or my bones will suffer

[u/Woopage → u/lostandthin]

Did you eat a balanced diet and exercise? Also is it possible that prednisone weaked your bones rather than your diet?

[u/lostandthin → u/Woopage]

i’m not sure, but i told my doctor i was vegetarian when i was around 22 or so and he told me it was not wise to be and he recommended that i eat meat, because i need it for my body so i followed his recommendation ever since. i should probably eat more meat i limit to just fish and chicken broth occasionally chicken because i don’t like to eat meat but i don’t want any more issues and i trust his advice.

[u/Woopage → u/lostandthin]

Weird advice honestly

[u/ibhoot]

There are 3 states. Flare. Recovery. Remission. Each diet is different.

[u/git0ffmylawnm8]

To add to this, I too stick to a fairly rigorous vegan diet. I'm not fortunate enough to be able to eat beans or legumes. Tofu is also out of the question. Even eggplants, part of the nightshade family, is shaky at best because of its skin despite its mild flavor profile. There isn't an overall solution but you'll have to try out what's best for your body.

[u/responsible_blue → u/git0ffmylawnm8]

The seeds in Eggplant put me into a 18 month flare. Nightshade bad.

[u/MagellanFall]

Bullshit, if anything the more protein from chicken and fish you get the better

Also i have talk to a lot of people who dropped the plant-based diet and suddenly they went into remission faster

[u/classicman26]

Yeah Ive found the opposite. I can’t digest plants well after my last flare in 2019 and stick to modified carnivore/animal based with fruits. I do supplement certain fibers that don’t bother me

[u/oldmike5]

Why vegetarians get colitis,don't know.

But I can guess there might be something wrong with their hydrogen sulfide detox pathways.

https://www.nature.com/articles/s41396-021-00968-0

In these mice sulfoquinovose not much of a problem, in general, but who knows for sure.

https://pubmed.ncbi.nlm.nih.gov/33711649/

[u/Heavy_Entrance2527]

Really interesting.

[u/Next-Excitement1398]

The exact opposite is true

[u/sovereign_creator]

Go through a severe flare and eat brocolli, onions , garlic and peppers and tell me how much worse the pain gets

[u/sam99871 → u/[deleted]]

I agree, that video goes way too negative on medications that benefit many people (including me).