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The Paleo Diet and Crohns Disease
Paleo diet is a highly restricted diet that includes foods that were available during the paleolithic era. The main justification for paleo diet is that most of the foods included in modern diets are simply unsuitable for human digestion and are, therefore, bad for our health. Since foods included in paleo diet are simple and easily digested, some experts believe that they can help soothe the irritated, damaged mucosa in Crohn’s disease. What are the benefits of paleo diet in Crohn’s disease? Is it really a healthier choice? Can it help relieve the symptoms of inflammatory bowel disease? Read on to find out.
Paleo or paleolithic diet is also known as caveman diet and Stone Age diet. It is a diet meant to mirror, as closely as possible, the diet of man as a hunter-gatherer.
In contrast to the modern diet, paleo diet relies entirely on animal products and food crops readily available prior to the introduction of agriculture and the industrial revolution that made food processing popular.
Therefore, paleo diet closely resembles the kind of diet our human ancestors ate in the paleolithic era. The paleolithic era spanned 2.5 million years and ended as recently as 10,000 years ago.
Of course, some of the foods available in the diet of man in the paleolithic era are near impossible to find especially in cities. However, the modern paleo diet finds contemporary foods to replace these while still staying true to the natural-only tenets of paleolithic diet.
Compared to the average modern diet, paleo diet is higher in protein, lower in carbohydrates and possesses equivalent amount of fats.
Of course, there are variations of the paleo diet. Some advocates exclude high glycemic foods even when they are likely to be found in the paleolithic era. In addition, while cooking foods is accepted among mainstream paleo dieters, there are some that advocate eating only foods that are both raw and paleolithic.
Some studies show that societies that subsist on paleo diet are largely free from chronic diseases when compared to those that have adopted the modern diet of processed and refined foods.
In addition, there is solid evidence to show paleo diet packs more of essential nutrients than the typical modern diet while delivering fewer calories.
There are clear advantages to increasing protein in the diet at the expense of carbohydrate.
For example, the high-protein, low-carb combination in paleo diet is good for the heart in multiple ways. It promotes weight loss, prevents obesity and lowers the risks of atherosclerosis and type 2 diabetes.
To further reduce the risk of heart disease and type 2 diabetes, paleo diet contains more dietary fiber than modern diets. In fact, highly fibrous fruits and vegetables are the mainstay of paleo diet.
In addition, paleo diet contains high levels of unsaturated fats. It is also low in omega-6 fatty acids while containing significantly higher amounts of omega-3 fatty acids. The omega 6 : omega 3 ratio is favorable and in sharp contrast to the typical unhealthy ratio in the average American diet.
Another advantage of paleo diet over most modern diets is its lower energy density. Compared to high energy-density foods, low energy-density foods are more filling.
Therefore, the paleo diet provides a greater feeling of satiety and lower calories.
In contrast, the high energy-density foods in modern diets promote overeating and weight gain. Even critics of the paleo diet agree that high energy-density foods contribute significantly to the rising incidence of chronic diseases in affluent societies.
Besides the omega-6 : omega-3 ratio, paleo diet also provides a better sodium : potassium ratio than the typical modern diet.
Since refined salt and processed foods (in which salt is used as a preservative) are excluded from paleo diet, it contains a lower amount of sodium than the average modern diet. In contrast, it contains a higher amount of potassium because it includes potassium-rich fruits and vegetables.
Increasing the dietary intake of potassium while lowering sodium can improve cardiovascular functions by preventing edema and high blood pressure while keeping the heart muscles healthy.
Lastly, paleo diet does not acidify the body like modern diets do. Therefore, it promotes calcium retention.
By reducing calcium loss, paleo diet improves bone health and reduces the risks of osteoporosis. In addition, reducing the acidity of the body prevents renal stone formation and muscle loss.
Some of the foods excluded from the paleo diet are especially harmful to the gut. They can impair digestion and even cause “leaky gut” syndrome.
Leaky gut syndrome is closely associated with inflammatory bowel syndrome such as Crohn’s disease. It results from the opening of the gaps in the gastrointestinal mucosa.
The gut mucosa absorbs macronutrients and micronutrients broken down from fully digested foods through a mesh of comb-like structures known as microvilli. These structures form a barrier against the entry of harmful substances into blood circulation.
However, when there are wide gaps in these structures, partially digested foods and toxins may pass into systemic circulation.
The entry of these unwanted substances into the blood causes a widespread immune hyperactivity that results in continued inflammation and increased damage to the gut.
Therefore, leaky gut syndrome can prompt and worsen the symptoms of Crohn’s disease.
Foods known to damage the gut mucosa include cereal grains, legumes and milk. Grains contain harmful compounds such as gluten and gliadin; legumes release lectins and saponins; and milk has casein.
Gluten is known as one of the causes of celiac disease in susceptible individuals.
Besides these harmful food compounds, foods excluded from paleo diet are also known to contain significant amounts of antinutrients such as phytates and lectins. These antinutrients block the absorption of important micronutrients in the body and are known to cause vitamin and mineral deficiencies.
Phytates, for example, bind to metal iron and prevent them from being absorbed. The phytate content of the average modern diet is high enough to significantly contribute to mineral deficiencies.
These antinutrients can reduce the absorption of zinc, calcium and iron and may be a prominent factor in the high prevalence of calcium and iron deficiencies among people with Crohn’s disease.
In contrast, all these harmful compounds can be avoided simply by adopting paleo diet. Since paleo diet excludes grains, legumes and dairy product, it can preserve the integrity of the gastrointestinal mucosa. Therefore, paleo diet reduces the risk of Crohn’s disease and can help keep diagnosed cases in remission.
As explained above, the harm done to the gastrointestinal tract by foods excluded from the paleo diet can significantly affect the absorption of essential minerals and vitamins.
Damage to the intestinal mucosa not only interferes with the absorption of these nutrients but the symptoms of Crohn’s disease can also cause nutritional deficiencies. For example, diarrhea, a common symptom of Crohn’s disease will speed up the emptying of the gut and reduce the transit time that foods spend in the gut.
In contrast, the high-fiber content of paleo diet can help stop diarrhea. This gives the body more time to break down foods and absorb micronutrients from them.
Besides the gut, foods such as grains can also damage the gall bladder and reduce the production of bile.
When bile flow to the gut is impaired, the absorption of fat is seriously impacted. This means that all nutrients dependent on fat for absorption cannot be transported into systemic circulation.
Fat-soluble vitamins are mostly affected by fat malabsorption. Therefore, vitamins A, D, E and K are poorly absorbed when grains reduce the production of bile. Unfortunately, all 4 vitamins are needed by people with Crohn’s disease.
In fact, the most common vitamin deficiencies in Crohn’s disease are those of vitamins A, D, E and K.
Therefore, adopting paleo diet can help restore optimal serum levels of fat-soluble vitamins.
There is solid evidence to indicate dairy products can affect the type and number of bacteria growing in the gastrointestinal tract.
In a study undertaken by researchers from the University of Chicago, it was discovered that concentrated milk fats found in dairy products changed the composition of gastrointestinal bacterial flora.
Ideally, there is a delicate balance by which the body controls the population and strain of bacteria in gut. Some bacteria are quite necessary for breaking down foods. However, when the balance is disrupted, harmful bacteria or even virulent strains of resident bacteria may overgrow and damage the gut mucosa.
Such bacterial overgrowth is believed to be one of the triggers of Crohn’s disease.
In the study mentioned above, the researchers impaired the immune system (much like what happens in Crohn’s disease) in 2 groups of mice. They placed one group on a diet rich in polyunsaturated fats (much like paleo diet) and the other group ate a diet high in saturated milk fats for 6 months.
The result of the study showed that the incidence of ulcerative colitis (an inflammatory bowel disease like Crohn’s disease) was 20% in the first group and 60% in the second group.
In addition, the mice who were given saturated milk fats developed colitis more quickly and earlier. They also experienced a more severe form of colitis than the mice given polyunsaturated fats.
This study demonstrates that paleo diet can help prevent the bacterial overgrowth that triggers Crohn’s disease. By doing this, it can also help prevent the misguided immune reaction that perpetuates the inflammatory bowel disease.
The low-carb nature of paleo diet means that it is unlikely to promote inflammation in the body. This is one of the reasons why the diet can help lower the risks of autoimmune diseases with strong inflammatory component.
Carbohydrates with high glycemic indices (and often, high empty calories) such as added sugar have been shown to promote the release of pro-inflammatory compounds in the body.
Therefore, a diet, such as paleo diet, that excludes refined sugars and contains relatively low amounts of carbohydrates, can reduce the likelihood of inflammation and provide relief for inflammatory diseases such as Crohn’s disease.
The same argument goes for the fat content of paleo diet. While it contains similar amount of fats or even more fats than the typical modern diet, paleo diet contains more of the healthier unsaturated fats and less of saturated fats that have been linked with inflammation.
In addition, paleo diet is far richer in omega-3 fatty acids than omega-6 fatty acids.
Omega-3 fatty acids have anti-inflammatory properties that can help reduce the inflammation in the gastrointestinal mucosa. Omega-6 fatty acids, on the other hand, release pro-inflammatory cytokines that can worsen the symptoms of Crohn’s disease.
Overall, paleo diet is an anti-inflammatory diet. It can, therefore, help break the endless cycle of inflammation that keeps Crohn’s disease going.
The final argument that can be made for paleo diet in the treatment of Crohn’s disease involves its effects on nutrition and the eating habits of patients with the inflammatory bowel disease.
Most of such patients usually have difficulty swallowing and experience loss of appetite. They are certainly wary of the foods they eat. Therefore, poor eating habits can contribute to the nutritional deficiencies that worsen Crohn’s disease.
Paleo diet is known for its foods with lesser energy-density than the average modern diet. In addition, it also promotes satiety. This means that patients with Crohn’s disease can get the greatest benefits from foods without the need to eat too much.
In addition, paleo diet is an excellent source of most of the essential vitamins and minerals needed by the body. The only exception is vitamin D which can be raised with dietary supplements.
However, the high-fiber content of paleo diet may be a source of concern for patients with Crohn’s disease.
Although fiber helps stop diarrhea, it can also irritate the stomach lining. Therefore, those who are concerned about this effect of dietary fiber should avoid heavily fibrous fruits and vegetables. They should also take foods with soluble fibers as long as they are taken with lots of water.
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