Barbara Olendzki, RD
Nutritional therapy is essentially adding foods that will help to heal and substituting for foods in the way of healing.
What are Therapeutic Diets
Therapeutic diets are whole-food based, nutritionally balanced dietary plans that improve symptoms, reduce inflammation, and aid in mucosal healing. Like a standard healthy diet, therapeutic diets focus on nutrient-dense whole foods thought to be beneficial like vegetables and fruits. They differ in that they limit components thought to be problematic in Crohn's disease and ulcerative colitis, like processed foods, additives, sugar, gluten, and dairy. To be effective, a therapeutic diet must be followed more strictly than a general healthy diet, and a long-term commitment is required to achieve and sustain results. After a prolonged period of remission with healing, many find they can broaden the diet to incorporate a wider range of healthy foods.
How Does It Work?
Therapeutic diets have a beneficial effect on the microbiome. The gut microbiome is a community of bacteria, viruses, and fungi living within the lining of the gastrointestinal tract. A balanced community of organisms in the microbiome may be essential to good health.
In Inflammatory Bowel Disease (IBD), the composition of the gut microbiome is altered, a condition known as dysbiosis, which is associated with inflammation. Diet influences the gut microbiome and may be the most effective means to modify it in a favorable way. Therapeutic diets provide an opportunity to improve microbial diversity and shift dysbiosis towards a more balanced state.
Therapeutic diets also avoid components thought to be harmful to the gut barrier (the lining of the intestinal tract). Restoring or maintaining the condition of the intestinal lining can prevent the abnormal activation of the immune system, which can result in inflammation.
While nutritional therapy has the potential to reduce inflammation by altering the microbiome, medications target the abnormal activation of the immune system. In combination, these two therapies work to resolve inflammation from different vantage points. This combined approach may have the potential to produce better results than either method alone.
Those interested in learning more about the microbiome can read about it on the NT for IBD website home page and find links to studies on the microbiome and IBD on the NT for IBD website Related Research page.
If you are the caregiver, the following considerations apply to you and to the patient.
When to Consider a Therapeutic Diet:
- When you want to implement a diet that has been specifically designed to target IBD or auto-immune conditions.
- When you have a strong positive desire to improve your diet and include more healthy diversity.
- When you feel empowered by the idea of making your own food and exploring the addition of the healthy variety of fruits and vegetables available to you.
- When you have enough time, support, energy, and financial stability to comfortably make these changes.
When a Therapeutic Diet May not Be Right for You:
- When you (or the patient) has an eating disorder, has a history of an eating disorder, is at high risk of developing an eating disorder, or when there is a history of an eating disorder in the immediate family.
- When it is not something that you (or the patient) is interested in or committed to. Therapeutic diets should only be considered if it is something the patient wants. This is particularly important when the patient is a child. Imposing unwanted dietary change on an unwilling child may further burden a child already carrying a heavy load and may foster an unhealthy relationship with food.
- When implementing a therapeutic diet will cause too much hardship due to lack of time, energy, interest, support, and/or financial stability.
- When your quality of life decreases after implementing a therapeutic diet. Successful implementation of a therapeutic diet should improve quality of life by allowing you to enjoy things that were difficult when your disease was active. When the demands of a therapeutic diet cause more hardship than benefits, a therapeutic diet is not the right fit.
- When you find that you cannot expand the diet to include a healthy diversity of foods.