Intermittent Fasting & Ulcerative Colitis: Should You Try It?
- Intermittent fasting (IF) – an eating pattern cycling between periods of voluntary fasting and non-fasting – has gained popularity for potential health benefits, including weight management and reduced...
- The appeal of IF for those with UC often stems from the idea that giving the digestive system a break could lessen pain, reduce symptom flares, and decrease...
- Priya Sehgal, MD, MPH, an assistant professor of gastroenterology and hepatology at Thomas Jefferson University’s Sidney Kimmel Medical College, emphasizes that IF is not a cure for UC...
Intermittent fasting (IF) – an eating pattern cycling between periods of voluntary fasting and non-fasting – has gained popularity for potential health benefits, including weight management and reduced inflammation. But for individuals living with ulcerative colitis (UC), a chronic inflammatory bowel disease, the question of whether IF is safe, and even helpful, is complex. While some individuals with UC report symptom relief through time-restricted eating, experts caution that it’s not a one-size-fits-all approach and carries potential risks.
Understanding the Potential Benefits and Risks
The appeal of IF for those with UC often stems from the idea that giving the digestive system a break could lessen pain, reduce symptom flares, and decrease the frequency of bowel movements. Some proponents believe that IF may reduce systemic inflammation, potentially easing localized inflammation associated with UC. A study published in examined the impact of IF during Ramadan on 80 individuals with inflammatory bowel disease (IBD), and found a reduction in inflammation markers. However, the study also revealed that participants experienced worsened symptoms and doctors rated their disease as more severe after fasting.
Priya Sehgal, MD, MPH, an assistant professor of gastroenterology and hepatology at Thomas Jefferson University’s Sidney Kimmel Medical College, emphasizes that IF is not a cure for UC and shouldn’t replace conventional medical treatment. “It’s not a tool that’s meant for everyone, but I think there may be a subset of the population that may benefit,” she says. She notes that IF might be a useful adjunct therapy for individuals with both UC and metabolic syndrome – a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol levels – as time-restricted eating can encourage weight loss, particularly abdominal fat, which is linked to inflammation.
However, IF also presents potential downsides. A significant concern is the increased risk of nutrient deficiencies or malnutrition, particularly for individuals already vulnerable due to UC. Stacey Collins, RDN, a registered dietitian-nutritionist specializing in IBD nutrition, points out that restricting food intake can be detrimental, especially during a flare-up. “Healing from a flare often requires more – not less,” she states. Prolonged bowel rest, she adds, should be reserved for severe, acute cases preparing for surgery, not as a routine strategy.
Who Should Avoid Intermittent Fasting?
According to Dr. Sehgal, certain individuals with UC should avoid IF altogether. These include:
- Those currently experiencing an active UC flare. During a flare, maintaining adequate nutrition and hydration is paramount, and restricting food intake can exacerbate symptoms.
- Individuals taking steroids.
- People with existing nutrient deficiencies.
- Those with a body mass index (BMI) less than 20.
Potential Candidates for Intermittent Fasting
Despite the cautions, IF may be considered by individuals with UC who meet specific criteria. Dr. Sehgal suggests that those with both UC and metabolic syndrome might be suitable candidates. Individuals whose UC is stable, with a consistent and predictable number of daily bowel movements, may explore IF, but only after receiving clearance from a gastroenterologist or an IBD-specialist registered dietitian.
The study examining fasting during Ramadan also highlighted the importance of individual factors. Participants older than 30 with higher baseline levels of calprotectin – a marker of inflammation in the stool – experienced the most significant worsening of symptoms after fasting. This suggests that baseline inflammation levels and age may influence how individuals respond to IF.
The Importance of Personalized Nutrition
The overarching message from experts is that a personalized approach to diet is crucial in managing UC. Simply restricting food intake without careful consideration of individual needs and disease status can be risky. The gut microbiome plays a vital role in UC, and adequate food intake is necessary to “fertilize” and support a healthy microbial environment.
the decision of whether or not to try intermittent fasting with UC should be made in close consultation with a healthcare team. A thorough evaluation of individual health status, disease activity, and potential risks and benefits is essential to determine if IF is a safe and appropriate strategy.