Is the Paleo Diet a Reliable Treatment for Ulcerative Colitis?

It’s not generally recognized as such, but it seemed to put a New Zealand nutritionist’s case into remission. Julianne Taylor provides the details in a guest post by Jess Fisk.

A search of the Internet will reveal many cases of apparent cure or remission of ulcerative colitis after a great variety of non-obvious interventions. I’m happy for all those folks, whether the intervention was responsible or the disease coincidentally went into “spontaneous” remission when the intervention began.

One of my go-to sources for current disease information is UpToDate.com. Most of the articles there are written by medical school professors. A quick scan of ulcerative colitis treatments reveals an overwhelming focus on surgery and drugs. Little in terms of diet except for this tidbit on elimination diets:

An elimination diet involves removing a food from the diet for a period of time and seeing whether symptoms resolve during that time. In patients receiving enteral nutrition, it involves introducing one new food at a time to identify foods that precipitate [inflammatory bowel disease] symptoms. Many patients can identify foods that they believe may precipitate or worsen their disease and it is reasonable for them to avoid such foods. Using an elimination diet to identify at-risk foods may decrease the possibility of a “flare” of [inflammatory bowel disease].

(Inflammatory bowel disease refers to both ulcerative colitis and Crohn’s disease.)

Foods that precipitate symptoms commonly included cereals, lactose, and yeast products.

Studies were contradictory or inconsistent regarding the benefits of other dietary interventions such as low carbohydrate diets, fiber, fish oil supplements, and antioxidants.

In case you’ve heard of the Specific Carbohydrate Diet, the UpToDate authors say that randomized trials are required before it can be recommended for ulcerative colitis.

I didn’t see anything about the FODMAPs diet.

With regards to dietary causes of inflammatory bowel disease (IBD), I found this at UpToDate:

Food antigens are thought to trigger an immunologic response resulting in the development of IBD. However, specific pathogenic antigens have not been identified. While studies attempting to associate specific diets with the development of IBD have had inconsistent results, the data suggest that a “Western” style diet (processed, fried, and sugary foods) is associated with an increased risk of developing Crohn’s disease, and possibly ulcerative colitis.

The next paragraph talks about implicated dietary risk factors, including hypersensitivity to cow milk protein in infancy, refined sugar, decreased vegetable and fiber intake. Also, “increased dietary intake of total fat, animal fat, polyunsaturated fatty acids, and milk protein has been correlated with an increased incidence of ulcerative colitis and Crohn’s disease and relapse in patients with ulcerative colitis. In addition, a higher intake of omega-3 fatty acids and a lower intake of omega-6 fatty acids have been associated with a lower risk of developing Crohn’s disease.”

Since the paleo diet eliminates several major food groups, it’s entirely possible it could put ulcerative colitis into remission or even cure it.

Academically oriented paleo diet gurus should get together and decide what the paleo diet is, so clinicians can start testing it scientifically.  They’re the guys who can snag the funding for studies.

Steve Parker, M.D.