Image Credit: Dylan Luder / Flickr. This image has been modified.

Treating Crohn’s Disease With Diet

Inflammation has recently emerged as an important player in the development of age-related disability and many of our major chronic diseases including heart disease, cancer, diabetes, and Alzheimer’s disease. Now that laboratory tests such as C-reactive protein have been developed, we can measure the effects different foods and diets have on inflammatory markers.

Most plant-based foods decrease inflammation. Processing destroys the anti-inflammatory effects of some (garlic decreases inflammation but garlic powder does not), but improves these effects in others (tomato juice decreases inflammation but whole tomatoes do not). For a review of which plants have been found to be most anti-inflammatory, check out my 3-min. video Anti-inflammatory Effects of Purple Potatoes.

Do these anti-inflammatory plant foods actually have an impact on inflammatory disease mortality though? In my 2-min. video Fighting Inflammation in a Nut Shell I profile a new study out of Australia, which followed about 2,500 older adults and their diets for 15 years. In that time, about 200 participants died of inflammatory diseases, allowing the scientists to calculate the specific aspect of the survivors’ diets that seemed to help the most. It was nuts! The equivalent of half a walnut a day appeared to cut the risk of dying from inflammatory disease in nearly half. Fish consumption, to their surprise, didn’t seem to help, which may be due to pro-inflammatory industrial pollutants that build up the food chain. This may help explain why most studies done to date on those eating vegetarian or vegan have found lower levels of inflammatory biomarkers in their bodies.

However, just because plant-based diets decrease markers of inflammation doesn’t necessarily mean that plant-based diets can successfully be used to fight inflammatory disease. To find that out, you’ve got to put it to the test. The gold standard for evidence in nutritional science is an interventional trial. You split people into two groups and ask half to go on one diet, half to go on another, and then stand back and see what happens. That’s just what researchers recently did for the  inflammatory bowel condition known as Crohn’s disease, profiled in my 4-min. video Dietary Treatment of Crohn’s Disease.

Crohn’s disease is an autoimmune condition where your immune system attacks your own intestines. There is no cure; all you can do is try to keep it in remission as long as possible between attacks. Sufferers are often put in anti-inflammatory and immunosuppressive drugs and may find themselves in and out of the hospital getting segments of their intestines surgically removed. Since it’s the intestine itself that’s inflamed, it would seem a good condition to test out the anti-inflammatory power of plant-based diets. We’ve known that meat, cheese, fish, and animal protein in general has been found to increase risk of developing inflammatory bowel disease but what about plants to to not just prevent, but treat it?

Japanese researchers took a group of Crohn’s patients in remission, either because they just came out of surgery or because they were able to beat it back with steroids. And for two years asked half of them to eat a semi-vegetarian diet, meaning in this case vegetarian except for half a serving of fish a week, and half a serving of other meat once every two weeks, so less than one serving of meat per week. Now this wasn’t a prison study or anything, these were free-living adults, so the results are not what necessarily happens when Crohn’s sufferers actually go on a plant-based diet, but what happens when people they are just told to eat a more plant based diet and how much they comply is up to them, which makes the results even more astounding.

You can see the graph in the video, but basically 200 days into the study all of the patients told to eat more of a plant-based diet were still in remission, but about 20% of the group not told to eat anything different relapsed. After a year 100% of the semi-veg group still symptom free, but the disease re-emerged in half of the standard diet group. And at the end of two years, 92% of the patients told to eat a more plant-based diet remained without disease, whereas the majority of those not given that advise relapsed back in the cycles of drugs, hospitalizations and surgery.

And that horrible relapse rate is typical on typical diets. Most Crohn’s sufferers relapse within a a year or two–unless, it seems, they start eating healthier. Remission rate, meaning disease-free status, with the semi-vegetarian diet was 100% at 1 year and 92% at 2 years. To the best of the researcher’s knowledge this is the best result in relapse prevention ever reported.

Inflammatory bowel disease risk has been tied to arachidonic acid, which may partially explain the animal protein connection given the levels in chicken and eggs. The anti-inflammatory nature of plant foods may also explain why those eating plant-based diets have less diabetes (Preventing Macular Degeneration With Diet), fewer allergies (Preventing Allergies in Adulthood), less heart disease (China Study on Sudden Cardiac Death), better moods (Improving Mood Through Diet), and fewer chronic diseases in general (Say No to Drugs by Saying Yes to More Plants).

-Michael Greger, M.D.

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


51 responses to “Treating Crohn’s Disease With Diet

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  1. I put my severe Crohn’s disease into remission by following a vegan, high-nutrient diet.  Not only did my symptoms disappear; four of the five blood markers (IBD serology panel) normalized as well!  My gastroenterologist had told me that those blood markers are regularly tested to see whether various medications are effectively treating a person’s IBD; he said it was pointless to test when ‘just’ changing diet, because it would not make a difference.  It feels wonderful to prove him wrong!  I have been in remission for two years now.




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    1. Linda, I’m SO happy for u!  Im struggling immensely with Crohn’s/colitits.  May I ask u to post a typical day’s food log?  I’d love to see exactly what u are eating, for it may help me out in terms of healing my own IBD.

      Are u taking any supplements?  If so, which?

      How is your digestion with certain foods?  Do u avoid any in particular or have any that u just have major difficulty digesting?

      Thanks for the help!  I pray things continue to go so well!




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      1. I followed Dr. Joel Fuhrman’s advice to heal my IBD damage; at his website drfuhrman.com, if you sign up for email alerts you can request a free newsletter (which are all free for members, btw).  The IBD issue is March 2008; that was my basic road map, augmented by advice from Dr. Fuhrman via his Ask the Doctor forum of the website (once again, available to members).  You can also contact me via email or private message at that site, for further dialogue.

        Probiotics are very helpful in normalizing the gut flora, which is important in healing leaky gut syndrome and halting hyper-sensitivity.  Dr. F recommends super-strong probiotics.

        Some foods are not food for me, because they are food for my disease.  I do not eat foods which feed disease; I only eat foods which feed health and life!  NOTHING tastes as great as feeling whole again!

        Individual food intolerances are common; my body cannot digest grains properly, and I had to heal significantly before I could digest starches like sweet potato.  Many other autoimmune patients of Dr. F have no problem with those foods; many people are intolerant of foods which I can easily eat, too.  It’s a very individual realm, food sensitivities.  There’s a great bunch of men & women at the site who encourage each other as we heal our bodies via nutritional excellence.  I apologize if this sounds like a commercial for Dr. F; he has given me back my life, and I’ll be eternally grateful.  I don’t think I’d have been able to stick with it long enough to develop my new, healing habits if I hadn’t had the mutual support from other members at Dr. F’s site.




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      1. Hi, Laura Monique Margosian! I am Christine, a NF volunteer nutrition moderator. I understand how frightened you must be with your recent Crohn’s disease diagnosis. If you haven’t already seen it, this video should provide some encouragment:
        https://nutritionfacts.org/video/achieving-remission-of-crohns-disease/
        You may need to keep a food diary to identify foods that cause issues for you personally. The materials used by Linda above, who has achieved Crohn’s disease remission, may be found here:
        https://www.drfuhrman.com/learn/health-concerns/62/crohns-disease
        Vitamin D status may also play a role in autoimmune conditions such as Crohn’s disease. Good, plant-based vitamin D supplements are available, if you are unable to get enough through exposure of the skin to sunlight.
        I hope that helps!




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  2. Gee, Chrohn’s sounds like a terrible disease :(. How wonderful there is a way to treat it through diet.
    We’ve just gone so extreme in our ways that the simple act of eating is something we have to re-learn. We’re a suicidal bunch!

    I think it’s interesting that foods have different effects based on even the most simple processing, such as drying as with the garlic.




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  3. I love this post, Dr. Greger.  You did such a great job of explaining this story.  These blog posts are very important support for the videos.  The videos are great.  But the way they get put together with the little blog posts makes it all incredibly awesome.




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  4. I got rid of my Crohns completely following a raw vegan diet. Literally no symptoms and no medication anymore. I used to be on 30g prednisolone a day and it was making me miserable.




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  5. You mention arachidonic acid in your article as being implicated in IBD, an inflammatory condition. Arachidonic acid is present in peanuts, does this mean we should avoid eating peanuts and peanut butter?

    Thanks so much for all your amazing videos and blog entries!
    Shanah Tovah!




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    1. Arachadonic acid is processed down from omega 6. Large amounts of pre formed arachadonic acid is found in eggs and chicken. Similarly, flax contains omega 3 which processes down to DHA and EPA. Preformed DHA and EPA can be found in algae oil supplements (although not necessary).

      So the point is we should try to consume the right amount of omega 3 and omega 6. An adequate ration of omega 6 to omega 3 is 4:1.This ratio is an overall ratio for a day. Now peanuts have a ratio of 4400:1 and almonds have a ratio of 1800:1. So we should limit the amounts of these nuts we consume. Omega 3 and omega 6 share the same enzymes for processing and the enzymes go where the higher concentration is. So if you consume too much omega 6, the omega 3 will be left out and you end up with unprocessed omega 3, which is not good. So peanuts do not contain arachadonic acid, but the high omega 6 content can create it in your body.

      The nuts/seeds with the best ratios are flax and chia seeds as well as walnuts.




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      1. Hi Toxins,
        Thanks so much for the explanation.
        I love peanut butter but this is very good incentive to stay out of the stuff.
        I’ll stick with the flaxseed, chia seed and walnuts.




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  6. In answer to ‘Linda’ below: Any doctor (especially a GI doc!) who would state that diet couldn’t affect a disease like Crohn’s is an idiot.  Although I’ve been in remission for years, there’s still foods I wouldn’t dare eat because of the residual damage and strictures. I work as a medical transcriptionist and in over half a million dictations, I have yet to have a doctor state that they questioned a patient about their diet, which could be anything from Twinkies every day to OCD dietary choices like one food and one food only…  when a raw vegan diet can cure diabetes in less than a week, any doc who is ignoring the implications of diet just simply isn’t paying attention to new information, or has been taught to scoff at it, which is even worse. 

    My own addition to this discussion is that I find it useful to have a very high intake of Vitamin C; I use supplements, vitamin C powder in my daily water intake, but a high fruit and vegetable diet would probably also help a lot; I just can’t eat that much fiber myself. I think the high levels of C are necessary anti-inflammatories and for healing. 




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  7. Sorry this question is off topic, but I don’t see a topic about dangers of flax seeds.  I’ve believed, and taught, that ground flax seeds are a great way to get our Omega 3 fatty acids.
        Today I received an email questioning that. Apparently, Wayne Coates, co-author of a book entitled “Chia” is saying that flax contains toxins and shouldn’t be consumed unless it has been detoxified, a process that requires solvents. Another source, U. of Maryland Medical Cetner, says “do not eat raw or unripe flax seeds — they may be poisonous.”
        I’ve never heard anything bad about flax seeds before, and I figured if there were any studies out there with this information, the person to ask is Dr. Michael Gregor!

    Thanks so much for all your research, and for sharing it with us!

    Delisa Renideo




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    1. Many plants contain naturally occurring toxins and while it is true that
      flaxseeds contain tiny amounts of cyanide-containing substances, this
      has not been shown to be a problem. The concern arises from the
      writings in a popular book or two and has not been confirmed in any
      published studies that I know of.

      If you think it is a concern, heating the flaxseeds has been shown to eliminate any detectable amounts of this chemical

      So, while it may be theoretically possible that eating huge amounts
      of raw or unprocessed flaxseeds or flaxseed meal could potentially pose a
      problem, this massive load of flax seed is not probable is normal consumption levels.




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  8. Hey Linda!

    I dont have the money to join his site….$150 is a huge committment. Did he give u personal advice and what did he say?

    What probiotics were u on and are u still on them? Does he recommend fermented foods and if so, which?

    How long have u been healing ur gut?

    Does he recommend digestive enzymes? and do u take them?

    What do u mean by “Some foods are not food for me, because they are food for my disease. I do not eat foods which feed disease; I only eat foods which feed health and life!”?

    How long did it take u to be able to tolerate sweet potatoes? I cannot eat them either….and all grains bother me, except for brown rice tortillas, lol. Are u able to handle greens and veggies? Those are tough on me too. Right now, I do a lot of green smoothies and am trying to incorporate a raw/vegan protein powder at the end of the day to fix my low protein/albumin levels.

    How many are on the site? How active are the doctors in answering questions?

    Thanks for the help!




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      1. I have all his books too, but I am not able to digest legumes, starches, nuts/seeds and most veggies…thus, my diet is primarily fruit-based. How are u able to digest all these foods with IBD? Do u take digestive enzymes, probiotics…??

        How long did it take ur gut to heal? What specifically did u do?

        What is a daily diet log specifically like for u? See how u structure ur meals would really help me out a lot!




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        1. By introducing the foods slowly your gut flora will learn how to diggest them. This is how you will develop a flaura that will be very benefic for your gut. If you go cold turkey you might have issues for a week or so but eventually you will get the right bacterias and then your gut health will improve dramatically!




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  9. Dr. Gregor, I am loving your site. The past two years I’ve cut down drastically on my consumption of animal products (and lost 50 pounds!), but your website has inspired me to go “all the way” and pursue a plant-based diet. For the past two weeks I’ve become a vegan, which really hasn’t been too hard of a stretch for me since I’ve already been eating a lot of plants (it’s as simple as leaving the beef out of the chili or the shrimp out of the stir fry). 

    However, I am concerned because (this past week especially) I feel like my body is deficient in something. I crave the smoked oysters I used to have for lunch, and on a full stomach I look at the McDonald’s hamburger on a street sign and feel like my body NEEDS it. I have been taking B12 and DHA supplements, and I eat whole grains, lots of fruits, veggies, and nuts, and very little sugar.
    I know, you are probably thinking that I am just craving those “forbidden foods,” but I know what that kind of craving feels like – I lost 50 pounds by fighting through those cravings! No, this is a desire for meat that comes with low energy and a yearning for something missing- maybe the higher amounts of protein or iron I used to eat?

    Anyway, with that long introduction, let me get to my question: Do any of these studies you have researched indicate that the people participating in the study had “withdrawal” symptoms from eliminating meat from their diet? Is this a common side effect for folks, or possibly at least for folks like me (where anemia is common in my family)? 

    Thanks.




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  10. Will someone help me to find more details about how to find a way to having an outstanding Flaxseed oil vegetable with omega nutrition dishes ?

    i want to create a awesome “more than reasonable” foods to my gust,
    in most circumstances they not much like natural foods to say the record ,
    so please it require your support
    make me persuade  them that health and fitness food can go with the phrase “wonderfully enchanting fulfill diner”

    flax seed benefits 




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    1. I would keep away from flaxseed oil, or any oil for that matter, as all of these oils lack any vitamins, minerals, fiber and phytonutrients found in the original food. Omega 3 is only one aspect of the health benefits of flaxseed.




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  11.  I’ve also been symptom free since I changed my diet. I’ve been on a whole foods,gluten-free, and lactose-free diet since June 2010. I also only use honey and maple syrup as sweeteners. This means, no processed foods or foods containing artificial and refined ingredients either. It’s been 2 years and 5 months total that I’ve been on this more wholesome diet. I went med free in May 2011, so it’s been a year and a half that I’ve been without symptoms and without the use of medication. The book that changed my life was Breaking the Vicious Cycle by Elaine Gotschall. Please check it out if you have Crohn’s or other digestive problems.




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  12. There is NOTHING in a McDonalds hamburger or smoked oysters that your body “needs”. Read “The Pleasure Trap”. And watch “Earthlings”. vegan is better for you and the planet!




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  13. What recommendations do you have for someone in Crohn’s who was vegan for several years before getting it? I’m already vegan, but it’s hereditary and my dad had it (and Ashkenazi), so what else can I do? I’ve been in remission for 2 years on Remicade but my doctors don’t want me to go off. Let me know. :-( thanks!




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    1. I have been vegan for over 14 years and was diagnosed this week at 29 years old! So I doubt it’s caused by diet, but definitely is affected by it. It seems the best thing to do is to keep a food diary and see a dietician I hope to see one soon.




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    2. Ilana, i was treated with remicade for 6 years, every 8 weeks, now i have developed a melanoma tumor in my eye, as a side affect of that treatment, this is still growing since 2014, so if i were hou, i would ask my doctor about thema risks of this medecin.




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  14. I’m currently suffering with crohn’s. It was in remission for 20+ years, until a doctor prescribed a medication that brought it out of remission.
    My crohn’s doctor says raw vegetables, and beans are hard for me to process. I found out on my own that giving up gluten has helped with my inflammation.
    Recently I began a vegan lifestyle but I feel incapable of doing anything. I’m so weak! Can anyone enlighten my journey in any way?
    I would appreciate any tips or ideas. Nothing can be as bad as I am now.
    Thank you :(




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    1. Sheri: I’m not a doctor, but I know a couple of people who started eating whole food plant based and were really good about sticking to the whole foods. But then they started feeling week. It turns out that they weren’t getting enough calories. They were eating low calorie dense foods and that bulk was filling them up too fast.

      The trick (for them anyway) was not to start eating junk food again, but to start eating some more of the higher calorie density whole foods, such as nuts, seeds and dried fruits. You might also look into tofu and avocados. Adding some of those foods into your diet may do the trick???

      I don’t know your situation, so that idea may not be appropriate for you. But if you try it, let me know how it works. Good luck! I’m so sorry you are going thru this. I hope you find solutions that work.




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  15. I have a question about the remission relapse study discussed above, and on the video. Did the participants following surgery STAY OFF Crohn’s drugs while they went on the plant-based diet, or was the diet in conjunction with drugs? And, if they were off the drugs, how did that occur? Weaned off over time or immediate stop? My daughter-in-law has Crohn’s and says her doctor says that fiber is bad for her condition, so she eats very little fiber….mostly animal based foods therefore. So, how does she approach her doctor about trying this, even if I could persuade her to try it? Thank you for all your help!




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  16. Sometimes the cravings could be an indication of lower calorie intake, specially carbohydrates. Since animal products and specially burgers are calorie dense, in a state of calorie deficit the body carves known sources of dense calorie. Try eating more of the good complex carbohydrate and fruit.




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  17. Sometimes the cravings could be an indication of lower calorie intake, specially carbohydrates. Since animal products and specially burgers are calorie dense, in a state of calorie deficit the body carves known sources of dense calorie. Try eating more of the good complex carbohydrate and fruit.




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  18. I’m no expert, but there appears to be an error in this article. The group of patients in the study in Japan that was referred to achieved remission via infliximab (not steroids).




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  19. I listened to your book on Audible.com and was markedly impressed. I’ve been telling everyone who would listen what a compelling case you make for a whole-food, plant-based diet. I had been a vegetarian for 10 years, a Pescetarian for another 10 and only in the last few had switched to a Paleo style diet at the advice of a Natural doctor and acupuncturist to heal Leaky Gut and my Crohn’s disease. Mind you, although I had been diagnosed with Crohn’s 12 years ago, the worst I ever had was chronic diarrhea. After listening to your book, I was highly motivated to return to a vegetarian diet, filled with whole, plant based foods. I eliminated meat products, downloaded your app, The Daily Dozen, and used it religiously, getting up to 80+% compliance – making salads with lentils and beans, eating hummus and ground flax seeds. Within 2 weeks, I suffered a partial, small bowel obstruction and was hospitalized with a nasal-gastric tube (I don’t recommend that). I am now on a “full liquid”, low fiber diet, gradually transitioning to a “white” diet (all those foods I’ve tried to avoid for years – white potatoes, rice, bread, carbs, etc.). I’ve lost 9 pounds in 3 days (not a bad side effect, but not the healthiest way to do it). Obviously, it isn’t a “cause-effect” situation but I am so disappointed. I have an appointment with a GI specialist but am concerned about the whole western medicine pill and surgery approach. Any advice on how to use your recommendations/research to help me get healthy and out of pain?




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    1. Lauren,
      It sounds like you and I are in similar situations. I was diagnosed as well 12 years ago and have learned a lot about diet since then. I can not digest vegetables properly and that causes inflammation, thus cramps and pain and the works.So, I do not go near vegetables, and I do avoid most complications.
      I have been on the GAPS Diet. And so far, it has been the best thing I’ve done. I do feel the best I have when on it. And when I eat things not okay, I do suffer some.
      Make sure they check your iron and hemoglobin.
      Right now, that is the biggest symptom that is creating havoc on my life.
      Healing…how when you can’t eat vegetables without major symptoms?

      When I was diagnosed, a friend of mine was too. She did medication, I did not. She ended up so sick and in and out of the hospital.

      I will NEVER go the medication way. I have had surgery in 2005. At that time, it saved my life, as I was losing 1 1/2 pounds a day, until I was weeks away from dying. I lost 35% of my body weight and I didn’t need to lose weight. Went from 140 lbs of muscle and health to 103lbs. I looked anorexic at 125.

      So, do your research while you are still healthy and have a choice. I won’t do surgery again. If I knew what I do now, I would have been able to avoid it.

      Good luck.




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  20. Hi so I don’t have any health insurance and I haven’t found any foods that work for me… Is it safe to live on vitamins probiotics water




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  21. My son has IBD. We’ve been told to eat a high protein no grain or starch diet. I personally am a vegan and belive strongly in eating plant based. So will grains and starch hurt my son?




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  22. I am a family doctor from Indiana and have a patient with severe Crohn’s (4 years without remission). She has history of a billroth surgery many years ago where part of her stomach and small bowel were removed due to a gastric ulcer. Because her current treatments have not provided any hopes of remission, I talked with her about this video and the research that shows a plant based diet can help achieve remission. She had a subsequent follow up with her GI specialist and he recommended against a plant based diet but advised her to adhere to a low-residue diet. Does anyone have insight into this recommendation and why low residue would be helpful for her?
    Thank you!
    Kristin




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    1. Hi Kristin
      I was diagnosed with Crohns after going to the ER with a GI bleed. Three days in the hospital and many test later I was able to go home with lots of medicines. I was on some strong antibiotics and steroids for a long time before I was able to start Humira. When I left the hospital I was on a liquid diet. Then I was told a low residue or low fiber diet would be best for me. Too much fiber and I was in the bathroom and cramping with some bad Crohns symptoms. That’s why I ate a low residue diet. It gave my insides a break. They didn’t have to work so hard! Now that I am in remission with Humira I can eat a lot more, but still have a hard time with some fresh fruits and vegetables. I am going to talk to my GI doctor next time I see him about the semi-vegetarian diet. As much as I would love to do it I am fearful that too much of a good thing is a bad thing, for me anyway. As I can only tolerate small amounts of fruits and vegetables. Hope this helps.
      Sue




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    2. Kristin,
      I commend you as a doctor for looking for solutions that may not be main stream.
      Many don’t care enough or have time to do this.

      Plant based, for me, caused great pain. I am unable to digest and break down the cell walls, at the moment. Maybe one day.

      Good luck.




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  23. I was diagnosed with Crohn’s in 2005. I had surgery to save my life, and have been up and down since then. I’m not doing meds. I have done Holistic, natural medicine and it seems to have helped a great deal. Yet, I’m not living fully, and the Anemia is driving me batty.

    I have read and listened to Dr. Greger say a plant based diet is the key. I would love for it to be that simple. I would love to believe this for myself. When I eat vegetables, I have inflammation and major symptoms. When I cut veggies out, I seem to be able to avoid a lot of symptoms.

    How do you get to a stage where you can eat vegetables and digest them again? How do you heal your gut so you can absorb iron and necessary vitamins and minerals without animal products?
    I have been pretty much living the GAPS diet for over a year and a staple is bone broth and eggs and kefir. How else can you heal the gut without these nourishing foods?
    I can tell you, I feel better drinking Raw milk, kefir, eating eggs and drinking bone broth then I do eating veggies.
    Yet, I’m getting tired of the way I’m just surviving instead of thriving. I miss vegetables!
    Thanks,
    Julia




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  24. Hi
    I noticed the best remission rate is 92% 2 years. I would like to tell you that I was diagnosed with Crohn’s disease in September 1996 and I have not taken any medication or had any symptoms since January 1998 after attending a Jesus Christ is Lord healing meeting in Tauranga New Zealand. I have medical reports confirming disgnosis and hospital clinical notes. The last colonoscopy I had was 2 years ago and it was still all clear.




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