"Dietary factors in chronic inflammation: Food tolerances and intolerances of a New Zealand Caucasian Crohn's disease population" in Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis (2010)
"Abstract
Diet is known to play a major role in the symptoms of the inflammatory bowel disease, Crohn's disease (CD). Although no single diet is appropriate to all individuals, most CD patients are aware of foods that provide adverse or beneficial effects. This study seeks to categorise foods in relation to their effects on symptoms of CD, in a New Zealand Caucasian population. Four hundred and forty-six subjects from two different centres in New Zealand were recruited into the study. An extensive dietary questionnaire (257 food items in 15 groups) recorded self-reported dietary tolerances and intolerances. Across each of the food groups, there were statistically significant differences among responses to foods. A two-dimensional graphical summary enabled stratification of foods according to the probability that they will be either beneficial or detrimental. A small number of foods are frequently considered to be beneficial, including white fish, salmon and tuna, gluten-free products, oatmeal, bananas, boiled potatoes, sweet potatoes (kumara), pumpkin, soya milk, goat's milk and yoghurt. Foods that are typically considered detrimental include grapefruit, chilli or chilli sauce, corn and corn products, peanuts, cream, salami, curried foods, cola drinks, high energy drinks, beer, and red wine. For a number of the food items, the same item that was beneficial for one group of subjects was detrimental to others; in particular soya milk, goat's milk, yoghurt, oatmeal, kiwifruit, prunes, apple, broccoli, cauliflower, linseed, pumpkin seed, sunflower seed, ginger and ginger products, beef, lamb, liver, and oily fish. It was not possible to identify a specific group of food items that should be avoided by all CD patients. The wide range of detrimental items suggests that dietary maintenance of remission is likely to be difficult, and to exclude a substantial number of foods. Personalised diets may be especially important to these individuals." [emphases mine]
"Immune sensitization to food, yeast and bacteria in Crohn’s disease" in Alimentary Pharmacology and Therapeutics (2001) [full article]
"The following groups of antigens were utilized:
1 Cereal grain mix (barley, corn, oat, rice, rye and wheat), 1/10 weight for volume.
2 Cabbage group mix (broccoli, brussel sprouts, cabbage and cauliflower), 1/10 weight for volume.
3 Citrus mix (grapefruit, lemon, lime and sweet orange), 1/10 weight for volume.
4 Whole cow’s milk, 1/20 weight for volume.
5 Bakers yeast and brewers yeast (Saccharomyces cerevisiae), 1/10 weight for volume.
6 Peanut mix (runner peanut, Virginia, Spanish), 200 protein nitrogen units/mL. ...
The following positive proliferative responses were noted in Crohn’s disease patients: 13 to milk, 16 to cabbage, 14 to cereal, nine to citrus, 16 to peanut, 18 to E. coli, 11 to Bacteroides, 10 to Klebsiella, six to bakers yeast, and nine to brewers yeast."
"Gut mucosal response to food antigens in Crohn's disease" in Alimentary Pharmacology and Therapeutics (2002) [full article]
"Although the strongest data were obtained for a response to citrus fruit and yeast antigens, the individual data supported the possibility of an abnormal response to the full range of antigen groups tested. In an individual, any one or more of these protein groups may be important." [emphasis mine]
"What Is the Role of Food Allergy and/or Intolerance in the Genesis of IBD?" in General Gastroenterology (2006)
"True food allergies constitute a different pathogenesis and pathology from true IBD. Although the true cause of IBD remains elusive, it appears to involve a combination of genetic susceptibility, immune dysregulation, and environmental pressures. Patients with IBD are more likely to suffer from food allergies or intolerances than the normal population, but there is not good evidence to suggest that an allergy is the trigger for the underlying inflammatory process. Whereas some groups have been able to demonstrate immune responses to certain food antigens in patients with Crohn's disease, these findings cannot be replicated in other populations, making this mechanism for a pathogenesis unlikely. In patients with subclinical disease, an allergy can precipitate IBD phenotypes, but again, the link between allergies and causation is weak. Certainly those patients who have undiagnosed food intolerances are less likely to respond to standard IBD therapies.
Patients should be counseled regarding their dietary habits to monitor which specific foods or food groups may trigger worse gastrointestinal or systemic symptoms. Elimination diets, however, are rarely needed in the IBD patient."
"The role of diet in the management of inflammatory bowel disease" in World J Gastroenterol (2010) "Studies that aim to isolate culpable food groups have shown that individuals react differently on exposure to or exclusion of various foods. The commonly identified food sensitivities are cereals, milk, eggs, vegetables and citrus fruits"
Crohn's and Colitis Foundation of America, Diet and Nutrition
"Do any specific foods worsen the inflammation of IBD?
No. Although certain foods may aggravate symptoms of these diseases, there is no evidence that the inflammation of the intestine is directly affected. Obviously, any contaminated food that leads to food poisoning or dysentery will aggravate IBD. ... Again, there are no blanket rules or recommendations. If a particular kind of food causes digestive problems, then try to avoid it. But it's important to distinguish between an actual allergy to one kind of food and an intolerance. Many people have food intolerances -- far more than really have true food allergies. Elimination tests are better at diagnosing which foods must be avoided or modified than the standard allergy skin or blood testing. Many good books discuss the proper way to follow such an "elimination diet," which involves keeping a food and symptom diary over several weeks."
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