Digestive health was what got me into studying medicine so when new research comes out I get really excited. Its fairly often that I have a patient with irritable bowel disease. Until now the dietary intervention that I see work clinically hasn’t had research to back it. This particular study is therefore a landmark and I definitely suggest glancing over the abstract.
New Research Backing the Autoimmune Paleo Protocol (AIP)
The participants of this study were all in an active flare of either Crohn’s or Ulcerative Colitis. All were symptomatic and need to have received an endoscopy. Labs included tissue biopsies, gut testing to assess the changes in the microbiome and 6 weeks of an autoimmune paleo diet. This was followed by 5 weeks of maintenance and monitoring. Their medications remained unchanged during the study. Quality of life surveys were included. The average age of participants was mid 40’s and most had the disease for roughly 20 years.
The results were incredible: 73% went into clinical remission! This is based on the standard indexes for each disease taken at 3 different intervals during the research.
Average Mayo score (disease activity) in ulcerative colitis patients
- Baseline: 5.8
- Week six: 1.2
- Week eleven: 1.0
Average Harvey-Bradshaw index (disease activity) in Crohn’s disease patients:
- Baseline: 7.0
- Week six: 3.6
- Week eleven: 3.4
These results are encouraging given that most others treatments for IBD come with multiple side effects. An increased risk for infection is common. These drug have mixed results with high variability. But in this study four participants were able to discontinue some or all of their meds.
People who develop one autoimmune disease often develop more. So this kind of dietary intervention is actually saving people’s lives. I see it in my clinic and I hear the same from colleagues in Functional Medicine.
Treatment in conventional medicine usually includes suppressing the immune system with pharmaceuticals and invasive surgery which doesn’t get to the root of the disease.
What causes IBD?
Genetics: 231 single nucleotide polymorphisms (SNPs) within 200 different genes are associated with IBD risk. But genetics only account for a small proportion of the variance in disease. In Celiac Disease only 8.2% can be linked to genetics and 13.1% in Ulcerative Colitis)
Environmental Factors: include gut dysbiosis, environmental toxins, and diet, among others play the biggest role. Increased risks from eating a Standard American Diet (SAD) are well know whereas anti-inflammatory diets like AIP are known to offer relief.
Food Sensitivities: 65% of people with IBD have known food sensitivities. Some patients may not know which foods might be harming them. An elimination diet like AIP is the gold standard for assessing food sensitivities. Alternately testing is available. For my patients I always start with an elimination diet. Once people start feeling better these dietary changes are really not as difficult to make as people think.
Making The Leap and the Commitment
When he was 3 years old, I took my son off of egg whites and gluten after he developed unrelenting eczema on his legs. Both these foods are excluded in AIP. I used both an elimination diet and serum blood testing.
His skin cleared up immediately. Yes he wants to eat gluten sometimes and he has egg whites occasionally in baked goods but I monitor him. Skin and lungs are connected and this is the first winter he hasn’t had a persistant cough. He did have an asthma attack in the fall but so far this is the only one and it wasn’t severe. He doesn’t need to be on steroids. This may be due to the herbs and other interventions I’ve implemented.
Having a limited diet is not always easy socially. We both have to make the commitment for it to work. The pay off is that he is thriving. I’m pretty convinced that if I had followed the doctor’s suggestion to use hydrocortisone on his eczema and make no diet changes he would have multiple more serious concerns to manage instead.
Conventional medicine does a great job monitoring his lungs. We are lucky to have met with an excellent pediatrician who we happen to know personally. He is curious and open about what other treatments we’ve explored. I know its not always like this. Patients tell me every week how they don’t feel this level of respect from their care provider. Functional medicine is holistic meaning it’s inclusive of allied professionals. Its also evidence-based meaning we stay on top of current research and are always looking for more effective ways of treating patients.
Looking to the future I see an integrative model of medicine where lifestyle and diet are primary interventions for chronic conditions. This kind of research is an important step in the right direction.