Should people with inflammatory bowel disease re-introduce fibre into their diets? A UBCO researcher suggests maybe it’s time they do.
A UBC Okanagan researcher wants to turn the tables on the long-held practice of restricting fibre completely for people living with inflammatory bowel disease (IBD).
Dr. Natasha Haskey, a registered dietitian who works with the Irving K. Barber Faculty of Science‘s Centre for Microbiome and Inflammation Research, focuses her research on nutrition for people with digestive diseases. Her most recent paper examines whether it’s time to re-think what people living with certain conditions—including Crohn’s disease and ulcerative colitis—should eat.
Both Crohn’s and colitis cause inflammation of the gastrointestinal tract. Still, Dr. Haskey says, while millions of North Americans live with the symptoms of the disease and daily discomfort, scientists don’t know the exact cause of IBD.
“I wanted to work with the Centre for Microbiome and Inflammation Research to look a bit deeper into how we can help people manage their disease using diet therapy because we don’t have all the answers,” she says. “We believe it’s due to a combination of factors which could be genetic, changes in the function of the immune system or changes in a person’s microbiome, along with their diet.”
Adopting westernized eating habits—consuming more highly processed, high sodium and sugary foods—has led to a significant reduction in fibre consumption and is linked to an increased prevalence of digestive diseases such as IBD, partially through alterations in microbial composition, she explains.
In the past, when a patient was diagnosed with IBD, doctors would recommend a low-fibre diet to help with their symptoms and manage their condition. But as more research has emerged around the importance of fibre to a healthy microbiome, Dr. Haskey says the issue of whether to consume fibre or not has swung the other way.
“We know that in healthy individuals, when we increase fibre it benefits the digestive tract,” she says. “Here we’ve been telling these patients for the longest time to avoid fibre. Maybe that’s not the right answer.”
There is limited knowledge about what fibre is optimal and in what form and quantity it should be consumed to benefit patients with IBD. Part of the answer, she suggests, is learning about the various fibre sources, and also slowly introducing fibre into the diet.
“It’s a real shift in the mindset,” she adds. “If you lived with a disease for a long time, you’ve figured out what works. And in all likelihood, you’re scared to introduce these foods because you don’t want to end up back where you used to be.”
For example, if a person has been told to avoid leafy greens, she suggests some could be blended into a smoothie or another example might be to remove the peel from an apple. These foods can then be added to the diet if there is no increase in symptoms.
As more research about the gut microbiome takes place, more detail about how the gut bacteria digests and breaks down foods is coming to light.
And it’s as individual as a fingerprint, Dr. Haskey adds.
Individual microbiomes, she says in her paper published recently in Nutrients, play a strong role in determining how we respond to diet treatments and require a more personalized nutritional approach to implementing dietary changes.
“The pendulum has swung because of our increased understanding of the importance of fibres in maintaining a health-associated microbiome. Preliminary evidence suggests that dietary fibre can alter the gut microbiome, improve IBD symptoms, balance inflammation and enhance health-related quality of life,” she adds. “Therefore, it is now more vital than ever to examine how fibre could be used as a therapeutic strategy to manage and prevent disease relapse.”
