Individuals living with Crohn’s disease may find relief from their symptoms through a dietary approach known as time-restricted eating, a form of intermittent fasting. New research suggests this method can significantly reduce disease activity and inflammation in patients who are also overweight or obese.
Researchers at the University of Calgary in Canada, along with colleagues at the University of British Columbia, observed substantial reductions in both symptom activity and systemic inflammation among participants who limited their eating to an eight-hour window each day, followed by a 16-hour fasting period. The findings, published on , in the journal Gastroenterology, offer a potentially new avenue for managing this chronic inflammatory condition.
“There’s still data that seems to suggest that intermittent fasting can be beneficial at different levels in the general population,” commented Dr. Roy Hajjar, a colorectal surgeon at the Montreal University Health Centre, in a related discussion. “But it’s certainly true that this new evidence in patients who have inflammatory bowel disease opens a door to other ways of approaching these chronic diseases.”
Crohn’s disease, a type of inflammatory bowel disease (IBD), requires long-term treatment to control inflammation. Dr. Hajjar suggests that a non-pharmacological intervention like intermittent fasting could be a valuable addition to existing therapies. “If a non-medication measure like intermittent fasting can help, why not?” he asked.
Study Details and Findings
The study involved adults with Crohn’s disease who also had overweight or obesity. Of these, participants adhered to the time-restricted eating schedule. Over a -week period, researchers noted a reduction in disease activity – measured by stool frequency – and a decrease in abdominal discomfort among those following the intermittent fasting regimen.
patients in the intermittent fasting group lost an average of approximately kilograms (roughly pounds), while those in the control group gained around kilograms (approximately pounds), despite comparable dietary intake between the two groups.
The Canadian researchers concluded that “randomized controlled trial provides promising evidence that time-restricted eating can reduce Crohn’s disease clinical activity in patients with overweight or obesity, including those in remission, suggesting a potential role in maintaining long-term remission.”
In addition to symptom improvement, time-restricted eating also “significantly improved body composition by reducing body mass index and visceral adiposity, accompanied by favorable changes in pro-inflammatory cytokines and adipokines.”
Impact on Gut Microbiome
The study also revealed changes in the participants’ gut microbiome. Researchers observed a shift towards bacteria that produce short-chain fatty acids (SCFAs). Dr. Hajjar expressed enthusiasm about this finding, stating, “I’m a big fan of short-chain fatty acids because we know they are beneficial against inflammation, beneficial against colorectal cancer and beneficial in general for gut health.” The relationship between microbiome changes and overall improvement remains a subject of ongoing investigation – whether the improved gut flora contributes to weight loss and symptom relief, or vice versa.
Important Considerations and Limitations
Despite the promising results, experts emphasize several important caveats. Dr. Hajjar noted that all participants in the study were in remission at the start, meaning their disease was quiescent and not experiencing an active flare-up. This suggests the approach may be most effective for managing Crohn’s disease when This proves well-controlled, rather than during acute episodes.
Researchers also measured fecal calprotectin levels, a sensitive marker of intestinal inflammation. However, no significant differences were found between the two groups. Dr. Hajjar explained that this doesn’t invalidate the findings, but it does raise further questions about the specific mechanisms at play. “It may be that the disease was quiescent at the time of the study,” he said, “but it gives us a lot of ideas to dig a little deeper to see what’s going on exactly.”
all study participants were overweight or obese, and it remains unclear whether the same benefits would be observed in individuals with a normal weight. The researchers also questioned whether the positive changes in the microbiome would be reproducible in all patients, or only those with an initially suboptimal microbiome profile.
“Studies like this are very interesting and encouraging,” Dr. Hajjar concluded. “They provide momentum to investigate because we know there is an effect.”
The Crohn’s & Colitis Foundation funded the research, highlighting the growing interest in exploring dietary interventions for managing IBD. According to Andres Hurtado-Lorenzo, PhD, the senior vice president of Translational Research & IBD Ventures at the Crohn’s & Colitis Foundation, “This research suggests that changing when we eat — not just what we eat — can improve metabolism, help the immune system work better, and support long-term remission from Crohn’s disease.”
