Diet for Ulcerative Colitis

How important is diet for ulcerative colitis?

This is from Web MD. It has interesting implications, but I personally
suspect it is mostly BS, as the good Dr. says, more gently!
Boyd

Diet May Affect Development of Ulcerative Colitis

Does New Finding Really Show Diet Plays a Role?

By Sean Swint
WebMD Medical News

May 18, 2000 -- Just what causes ulcerative colitis -- a type of
inflammatory bowel disease -- is still unknown. It may be genetic, or it may
be caused by a virus or bacteria that prompts the body's immune system to
cause an inflammatory condition in the intestinal wall. To date, there has
been little proof that diet plays a role in the disease.

Ulcerative colitis, which can be hereditary, affects nearly one in 10,000
people, typically between ages 15 and 40, although older people do get it.
The inflammation of the colon and rectum causes diarrhea, ulcers, and
bleeding. In about 20% to 30% of patients, surgery may be necessary to
remove the colon. For the rest, it may come and go, but is generally a
distressing condition to live with.

Researchers at the University of Maastricht in the Netherlands now suggest
high intakes of monounsaturated fats, polyunsaturated fats, and vitamin B-6
were associated with an increased risk of developing ulcerative colitis,
according to lead researcher Bertine J. Geerling, ScD, PhD, with the
university's department of gastroenterology. Monounsaturated fats are found
in oils, such as olive and canola, and polyunsaturated fats are found in
oils, such as corn and fish.

But at least one expert in the field says to take the information with a
dose of caution. "You can't jump to the conclusion that vitamin B-6 is not
good," Shanthi Sitaraman, MD, PhD, tells WebMD. "I think it is one of the
first studies that have shown a correlation between B-6 and ulcerative
colitis. I doubt the reports about fat because it was not a significant
result, and fish oil is used as a treatment for ulcerative colitis, and it's
hard to correlate their results with the treatment, which they themselves
point out." Sitaraman is an assistant professor of digestive disease at
Emory University in Atlanta.

"All the known studies show no correlation with diet and ulcerative
colitis," she says. "Patients always ask me 'what sort of diet should I eat?
Can I eat spicy food? Can I not?' and this is the answer I give them: 'It's
like having a cut on your finger and then you pour lime juice on it. It's
going to hurt, but it doesn't make the cut any worse.'"

The researchers compiled data from 43 patients who had been diagnosed with
ulcerative colitis within six months of the beginning of the study, and 43
other people of similar ages and gender, who did not have ulcerative
colitis, were recruited to act as a control group. Participants were all
asked by a dietician to recall their dietary intake five years before the
beginning of the study, and researchers also studied the fatty acid
composition of the participants' fat tissue in order to see what kind of
fats they had been consuming.

After the numbers were tabulated, the diets of the ulcerative colitis group
were compared to the nonulcerative colitis group. "High intakes of mono- and
polyunsaturated fat were associated with a significantly increased
ulcerative colitis risk ... [and] of all micronutrients, only vitamin B-6
was significantly associated with an increased risk of ulcerative colitis,"
writes Geerling. The results were recently published in the April 2000 issue
of The American Journal of Gastroenterology.

The researchers were not able to give the reasons for their findings, just
guesses. For instance, polyunsaturated fat in the form of fish oil may
actually help lower the inflammation of ulcerative colitis, but perhaps none
of the participants ate enough fish to get that benefit, Geerling writes,
and most of their polyunsaturated fats came from sources other than fish.

As for B-6, which can come from a variety of food sources like bananas,
potatoes, tuna, or turkey, it, too, is useful to the body. But, B-6 also is
involved in the process of breaking down fatty acids, which "may be
important," writes Geerling.

Despite some other limitations in the study, Geerling writes that high
intake of B-6, monounsaturated and polyunsaturated fats "may enhance the
risk of developing ulcerative colitis. Whether the reported findings are
true risk factors in the development of ulcerative colitis, or rather a
reflection of a certain dietary lifestyle," needs to be explained with
further research.

"From my standpoint, this is a very poor study," Sitaraman says, because the
number of participants is small and smoking is not even mentioned as a
factor in the study. This is odd, since smoking may actually be good for
ulcerative colitis, she says, perhaps because of the nicotine. And Sitaraman
says getting a person to remember their diet from five years ago is very
difficult, if it even mattered.

"I do research in this area," Sitaraman tells WebMD. "It could be that the
patients who have ulcerative colitis are just taking multivitamins just
because they don't feel so well, and therefore their intake of B-6 might be
higher."

Although high levels of B-6 can be harmful to a person, "the levels they're
reporting are far, far from too high; it's a very small increase ... not
significant for any side effects, [and] toxic effects of B-6 are incredibly
rare," Sitaraman says.

"I would completely negate their results with fat," Sitaraman tells WebMD.
"Like I said, it wasn't even significant, and it doesn't even make any sense
in terms of clinical correlation, because fish oil does make ulcerative
colitis better. The population that they have is very small, and it could be
a selected population whose dietary habits are just different.

"I'm not going to go tell patients don't take B-6 ... it's suggestive, but
it may not have any correlation," Sitaraman says.