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Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease

Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease

"C-reactive protein did not significantly change during study. Mean fecal calprotectin improved from 471 (SD 562) to 112 (SD 104)"

Official Journal of the Crohn's and Colitis Foundation.

Is the Autoimmune Paleo diet bogus? A V-blog analysis

"1-This pilot study looked at people with active (medically documented) gastrointestinal disease with and AVERAGE of 20 years.

2-The 6 week pilot study saw all participants not only finish the trial, but they also experienced complete remission in disease symptoms.

3-The misapplication of the Mediterranean Diet concept may be at least partially implicated in the increase in non-celiac gluten sensitivity."

Interesting pilot study.

Note the participants were on various medication during this trial - biologics, immunomodulators, mesalamine, steroids.

A cautionary note from the article "One participant with postoperative recurrence of ileal CD with known ileocolonic anastomotic stricture required hospitalization for partial small bowel obstruction approximately 3 weeks after study start. This was attributed to a significant increase in raw vegetables, salad, and meat consumption. " and "Another participant with ileal CD with ileocecal valve stricture withdrew before the end of elimination phase because of worsening symptoms."
Indeed an interesting study. It is worth noting though that the term autoimmune implies the presence of autoantibodies. Such markers have not been found in CD patients to a degree where it can be concluded that CD is an autoimmune disease, as stated in the article
Antibody markers in the diagnosis of inflammatory bowel disease

At present, no single marker with qualities that are satisfactory for the diagnosis and treatment of IBD has been identified, although panels of some antibodies are being evaluated with keen interest.

Dr.Marcel Behr from Canada also talks about this misconception in the lecture Crohn's Disease - Autoimmune or Infectious Disease?

The reason I write this is I think it is really important to understand that CD is not caused by the body attacking itself for some unknown reason. There is much more evidence that imbalances in the gut microbiota combined with pathogens cause the disease.

These findings do indeed build the case to eating way more healthy than the average western diet.
(whole foods, no processed foods, no food additives, organic, no simple sugars, lots of resistant starch and fibre)
Paleo diets do not necessarily aim to target disease aetiologies. You are referring to the aetiology of CD. I think, on the most general level, the primary aim of the paleo diets is to target the common link in the pathogenesis of different diseases, which is an unhealthy gut.

This is from JHT's website:
How does MAP actually cause disease?

MAP itself does not directly cause gross inflammation by taking on the immune system head-to-head. In fact, MAP minimises its own immune recognition. Instead it initiates a cascade of events with disastrous consequences. The first is to cause dysregulation of the immune system which then destabilises the gut wall, rendering it leaky. Leakiness of the gut wall allows it to be penetrated by other gut organisms (e.g. bacteria such as E.coli, yeasts and viruses) and irritant food residues. It is these secondary invaders and irritants that cause the massive inflammatory response which creates the Crohn’s pathology. The second is to damage and inflame the delicate nervous system in the gut wall which makes the consequences of the immune dysregulation a lot worse.
Paleo diets, in the case of CD, are useful because they can positively affect the mechanism behind the disease. They affect these secondary causes by changing what you eat, how you eat what you eat, and also changing your lifestyle.
Worth a listen.....
my thought at the end.

Episode 379 – Angela Alt and Dr. Gauree Konijeti – Autoimmune Protocol Diet Study
"On this episode of the podcast we have guests Angela Alt and Dr. Gauree Konijeti. Dr. Konijeti is a gastroenterologist, head of inflammatory bowel disease at the Scripps clinic, and currently researching inflammatory bowel disease with an NIH grant. Angela Alt is a certified health coach and nutritional therapy consultant, partner at Autoimmune Wellness, author of The Alternative Autoimmune cookbook, co-author of The Autoimmune Wellness Handbook, co-host of the Autoimmune Wellness podcast.

In this episode we talk all about the Autoimmune Protocol (AIP) diet for autoimmune disease and the study on the efficacy of the Autoimmune Protocol for inflammatory bowel disease done by Dr. Konijeti."


Episode 83: Medical Study on the Paleo AIP for Inflammatory Bowel Disease
There are literally thousands of anecdotal stories into the benefit of the paleo autoimmune protocol (AIP) as a treatment for autoimmune disease. But until recently, there was no scientific research to back up these claims. That changed with the publication of this study. 15 patients with active IBD (Crohn's disease or ulcerative colitis) transitioned to the paleo autoimmune protocol. Result? 73% achieved remission. In this podcast, I interview Dr. Gauree Konijeti, gastroenterologist and lead researcher, and Angie Alt, the lead AIP coach for the group.

my thought
A six week coached and staged transition phase with five weeks coached maintenance phase will probably produce better results than extreme and uncertain dietary change made suddenly.
Might be worth checking out the AIP diet websites to get an idea of how to transition and what to eat, (hint, give up gluten, then sugar, then processed foods, then see what's left.)

The AIP protocol requires a 30 day (or longer) elimination of everything that might be an issue and adding them back in in a staged manner to see if they are tolerated.

A gentle intro to that severe month is a good idea, and a plan of how to reintroduce foods is good (hint, the safest ones first).
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