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Crohn's Disease Forum » Diet, Fitness, and Supplements » Carb related inflammation


07-01-2015, 04:52 AM   #1
hugh
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Carb related inflammation

Listening to a Chris Kressler Podcast [1] earlier and it really crystallised something that I have been thinking for a while…..

The podcast was about a response to a question about whether a vegetarian diet is better for your microbiome or not, and I have posted a link at the end – well worth listening too and I am going to poach liberally from it……

Professor Ian Spreadbury wrote a paper called “Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity.”[2], and, as the title says, it is predominately concerned with obesity and metabolic disorder, but the relevance is obvious.
His theory is that a diet high in acellular carbohydrates creates an inflammatory microbiome, which in a large portion of the population, translates as obesity, but for a different portion of the population will translate as a different disease.

The crux of the matter (or, as Chris puts it, “The biggest diet factor that determines gut health”) is the ratio of cellular to acellular carbohydrates consumed……
“…...the basic idea is that all carbohydrates that were part of the ancestral diet, which would be tubers, fruits and vegetables, plant parts like stems and leaves, store their carbohydrates in fiber-walled, living cells, and those cells remain largely intact during the cooking process, and they also resist digestion or absorption in the small intestine, and therefore, the fiber remains intact all the way down to the colon, where it then becomes food for beneficial gut bacteria that are living in the large intestine. So those are the cellular carbohydrates, and they’re, like I said, found in all ancestral carbohydrate sources.
On the other hand, in the Western or industrialized diet, you have a lot of acellular carbohydrates. These are things like flour, sugar, and other processed starches that have no living cells. These industrial foods are much higher in carbohydrate density than anything the microbiota of our upper GI tract would have encountered during our long evolution. And these foods, because they have no living cells, they’re absorbed higher up in the GI tract, and they can stimulate the overgrowth of bacteria in the upper GI tract, AKA SIBO, or small intestinal bacterial overgrowth, and they preferentially will feed some species of bacteria over others, and that can in turn lead to an inflammatory gut microbiota.”
“And so they have a completely different impact on the gut microbiome. When you compare diets and you take one diet that has 25% or 30% of calories as carbohydrate in the form of these cellular carbohydrates, the tubers and the fruits and the vegetables, and then you have another diet that’s 30% of calories as carbohydrate in the form of flour and sugar, those are going to have a completely different impact on the body. And Spreadbury’s argument is the thing that’s mediating that difference in impact is the gut microbiome. “


Pretty straight forward, because the provcessed food (acellular carbs) is predigested it is consumed by bacteria further up the GI tract, and consumed by different bacteria because the ones that broke down the fibre (cell walls) in the lower GI are no longer required.
Listen to the podcast and read the paper if you are interested, but as a theory it is pretty solid.

Goes on to talk about paleo, elemental diets, temporary carb restriction to bring gut bacteria under control, and why you may not want to be on FODMAPS for too long……
paleo…...
“We’re telling them to eat a diet that is very rich in fruits and vegetables and fermentable fibers and fermented foods and things that support the gut microbiome that also happens to include meats because meats are very nutrient dense and have a lot of other beneficial impacts on health, even if they don’t have, necessarily, a beneficial impact on the gut microbiota. “
sibo (and elemantal)…….
“And another angle or way to look at it is, like, in clinical practice, if I’m treating SIBO, one of the strategies that we use is a diet that’s low in fermentable fiber. We put patients on a diet that is low in these fibers because we know that these fibers can feed bacteria that have become overgrown in the small intestine. “
“one of the treatments for SIBO, for example, is an elemental diet, which is composed of only simple carbohydrates, like glucose and fructose, that are absorbed extremely high up in the digestive tract and thus don’t become food for bacteria lower down in the gastrointestinal tract. And we know, studies have shown that people who are on elemental diets experience a dramatic shift in the composition of their gut microbiome. “
fodmaps…….
“if FODMAPs are an issue for you, obviously cut them out while you fix the root causes, and it’s an indication that your gut is really messed up. The more sensitive you are to FODMAPs, it appears that you’re having some definite issues. And then over time, you want to get those foods back in as fast as possible. “

[1] RHR: Are Vegetarian Diets Better for the Microbiome?
http://chriskresser.com/are-vegetari...he-microbiome/

[2] Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402009/
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07-01-2015, 10:05 AM   #2
teeny5
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My question is...how does this information apply to those with the disease only in the small intestine vs someone like me who only has it in the colon? It all is very interesting to me, but I don't understand how the effect would be the same when different parts of the digestive tract are inflamed.
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07-02-2015, 02:24 AM   #3
hugh
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My question is...how does this information apply to those with the disease only in the small intestine vs someone like me who only has it in the colon? It all is very interesting to me, but I don't understand how the effect would be the same when different parts of the digestive tract are inflamed.
Firstly, I don't think it is the only source of disbiosis, other things have been shown to throw the balance of gut bacteria out (anti-biotics, stress, gluten, etc) but it is probably one of the major factors.

When there is this disbiosis the immune system considers it a threat and attacks bacteria in the intestine that would normally be tolerated.

"The most widely held hypothesis on the pathogenesis of IBD is that overly aggressive acquired (T cell) immune responses to a subset of commensal enteric bacteria develop in genetically susceptible hosts, and environmental factors precipitate the onset or reactivation of disease. This complex theory involves four separate components that must intersect in multiple ways for disease to become clinically apparent "
http://www.nature.com/nrgastro/journ...p0528.html#bx2


Even if it is a combination of four factors, only one need be removed

If you have a disbiosis in the upper GI tract (or anywhere), then
1/ The balance of bacteria will be out throughout the tract (like if I pour poison in a river then everything downstream will be affected), but more importantly.....
2/ it is possible/probable that immune reaction will happen throughout the tract and these may develop into lesions anywhere or in multiple locations. Once your immune system has set these T-cells into motion they travel around looking for whatever they are programmed to attack. this is why crohn's can be found in the mouth, the t cells travel through the blood to wherever they detect 'the threat'

"The GI tract normally contains harmless bacteria, many of which aid in digestion. The immune system usually attacks and kills foreign invaders, such as bacteria, viruses, fungi, and other microorganisms. Under normal circumstances, the harmless bacteria in the intestines are protected from such an attack. In people with IBD, these bacteria are mistaken for harmful invaders and the immune system mounts a response. Cells travel out of the blood to the intestines and produce inflammation (a normal immune system response). However, the inflammation does not subside, leading to chronic inflammation, ulceration, thickening of the intestinal wall, and eventually causing patient symptoms."
http://www.ccfa.org/what-are-crohns-...rohns-disease/

So, if the balance of bacteria is out, the immune system tries (and fails) to do something about it. This is a new problem (too much overly processed food) that our evolution has not prepared us for, and our immune system does not have an adequate response. On top of this we keep feeding the bad bacteria even as our body attacks it.
This only happens to those genetically disposed to crohn's, but since you can't change your genes you might as well change your diet.

Having said that, it probably wont be enough to just stop eating these foods, some measures to redress the balance may be required, like low carb for a while, probiotics or elemental diet etc
07-04-2015, 12:23 PM   #4
Crohn2357
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Thank you very much for posting this.
07-05-2015, 11:59 PM   #5
hugh
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My question is...how does this information apply to those with the disease only in the small intestine vs someone like me who only has it in the colon?
"These CD-specific host and microbe profiles identify the ileum as the primary inductive site for all forms of CD and may direct prognostic and therapeutic approaches"

http://www.jci.org/articles/view/754...58a68bb4625d5a
07-19-2015, 08:45 AM   #6
Crohn2357
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hugh, have you eliminated rice from your diet completely?
07-19-2015, 04:51 PM   #7
hugh
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hugh, have you eliminated rice from your diet completely?
No, I am under the impression that rice falls in the cellular carbs category. White rice has the outside layer polished off but is still unground.
I did eliminate all carbs for month while on scd, and then gradually reintroduced tubers as i found paleo a better fit, and reintroduced rice much later after moving to paleo-based PHD..
I do not know how important carb restriction is but I think it it probably pretty important for rebalancing the gut biome at the start.
11-03-2015, 12:10 PM   #8
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Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402009/

...

I remembered this article again. Very enlightening article, it has changed my mind.
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