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New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
New Perspectives on Nutrition
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New Perspectives on Nutrition

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A presentation that takes a new look at nutrition for Crohn’s and Ulcerative Colitis patients.

A presentation that takes a new look at nutrition for Crohn’s and Ulcerative Colitis patients.

Published in: Health & Medicine
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  • 1. New Perspectives on Nutrition f or Crohn’s and Ulcerative Colitis Patients Frank W. Jackson, M.D. Gastroenterologist Camp Hill, PA
  • 2. Plan <ul><li>Plain Talk on Diet </li></ul><ul><li>Gut Bacteria </li></ul><ul><li>Probiotics </li></ul><ul><li>Prebiotics </li></ul><ul><li>Hydrogen Sulfide Gas and Ulcerative Colitis </li></ul><ul><li>Food Emulsifiers and Crohn’s </li></ul>
  • 3. &nbsp;
  • 4. References <ul><li>Jackson GI Medical: www.jacksongi.com </li></ul><ul><ul><li>Ulcerative Colitis Diet </li></ul></ul><ul><ul><li>Crohn’s Disease Diet </li></ul></ul><ul><ul><li>Crohn’s Patients: Plug Your Leaky Gut! </li></ul></ul><ul><li>Crohn’s and Colitis Foundation of America </li></ul><ul><ul><li>ccfa.org </li></ul></ul><ul><ul><ul><li>Search: Diet and Nutrition </li></ul></ul></ul><ul><li>Mayo Clinic </li></ul><ul><ul><li>mayo.org </li></ul></ul><ul><ul><ul><li>Search: Ulcerative Colitis, Lifestyle and Home Remedies </li></ul></ul></ul><ul><ul><ul><li>Search: Crohn’s Disease, Lifestyle and Home Remedies </li></ul></ul></ul>
  • 5. Plain Dietary Talk for Crohn’s and Colitis <ul><li>Protein – weight </li></ul><ul><li>Dairy Products </li></ul><ul><li>Complex Carbs &amp; Adequate Fats </li></ul><ul><li>Vitamins </li></ul><ul><ul><li>Multi-vitamin </li></ul></ul><ul><ul><li>B12 &amp; Crohn’s </li></ul></ul><ul><ul><li>Vitamin D </li></ul></ul><ul><li>Minerals </li></ul><ul><ul><li>Calcium </li></ul></ul><ul><ul><li>Iron </li></ul></ul><ul><ul><li>Selenium </li></ul></ul><ul><li>Fish, Fish Oil &amp; Flax Seed </li></ul><ul><li>Herbs </li></ul>
  • 6. Lactose Intolerance <ul><li>12-16 Oz. Skim Milk in AM </li></ul><ul><li>If no… </li></ul><ul><ul><li>Cramping </li></ul></ul><ul><ul><li>Diarrhea </li></ul></ul><ul><ul><li>Excess Flatus… </li></ul></ul><ul><li>In 4-5 hours, then </li></ul><ul><li>You don’t have Lactose Intolerance </li></ul><ul><li>(If symptoms do occur, see your physician) </li></ul>
  • 7. Minerals <ul><li>Calcium </li></ul><ul><ul><li>Dairy Products </li></ul></ul><ul><li>Iron </li></ul><ul><ul><li>Consider Supplement </li></ul></ul><ul><li>Selenium </li></ul><ul><ul><li>Brazil Nuts </li></ul></ul><ul><ul><ul><li>1-2/Day </li></ul></ul></ul>
  • 8. Herbs <ul><li>An herb is any plant which is dried &amp; ground up! </li></ul><ul><li>100’s of different chemicals/molecules in every plant </li></ul><ul><ul><li>Broccoli </li></ul></ul><ul><ul><li>Apples </li></ul></ul><ul><ul><li>Ginko </li></ul></ul><ul><ul><li>Echinacea </li></ul></ul><ul><ul><li>St. John’s Wort </li></ul></ul><ul><ul><li>Spinach </li></ul></ul><ul><li>BUT: Use only recognized food herbs. Avoid other herbs. </li></ul>
  • 9. Gut Bacteria <ul><li>Microbiota </li></ul><ul><ul><li>Mostly colon bacteria </li></ul></ul><ul><ul><li>Over 1,000 species </li></ul></ul><ul><ul><li>Trillions and trillions! </li></ul></ul><ul><li>What we know now </li></ul><ul><ul><li>The colon is a health organ when the good bacteria grow and proliferate </li></ul></ul><ul><ul><li>Take care of it! </li></ul></ul><ul><ul><li>Don’t abuse it! </li></ul></ul>
  • 10. Prebiotics <ul><li>Soluble Plant Fibers </li></ul><ul><li>NOT digested by human gut </li></ul><ul><li>Fermented by gut bacteria </li></ul><ul><li>Positive health benefits demonstrated </li></ul>
  • 11. Prebiotics Remarkable Benefits When Colon Bacteria are Fed Well <ul><li> Calcium </li></ul><ul><li> Bone Density </li></ul><ul><li> Immunity </li></ul><ul><li> Good Bacteria </li></ul><ul><li> Regularity </li></ul><ul><li> Allergies/Asthma </li></ul><ul><li> Triglycerides </li></ul><ul><li> Cancer Factors </li></ul><ul><li> Appetite/Weight </li></ul><ul><li> Bad Bacteria </li></ul><ul><li> Flatus Smell </li></ul>
  • 12. Oligofructose-Inulin Rich Foods*: Prebiotics <ul><li>Chicory Root (65% prebiotics by weight) </li></ul><ul><li>Jerusalem Artichoke (32%) </li></ul><ul><li>Dandelion Greens (24%) </li></ul><ul><li>Garlic (18%) </li></ul><ul><li>Leek (12%) </li></ul><ul><li>Onion (9%) </li></ul><ul><li>Asparagus (5%) </li></ul><ul><li>Wheat (5%) </li></ul><ul><li>Banana (1%) </li></ul><ul><li>Thousands more &lt;1% </li></ul>The King of Prebiotic Foods: Chicory Root is 65% Prebiotic Fiber by Weight! * The Journal of Nutrition , 2007
  • 13. Prebiotin <ul><li>Oligofructose-Enriched Inulin </li></ul><ul><ul><li>Combines prebiotics with both shorter and longer molecular chains to nourish entire colon </li></ul></ul>
  • 14. Probiotics - Bacteria
  • 15. Probiotics - Bacteria <ul><li>Healthy: more hype and hope than fact. </li></ul><ul><li>UC: VSL#3 – maybe </li></ul><ul><li>Crohn’s: Unknown </li></ul><ul><li>Bottom Line for UC and CD patients </li></ul><ul><ul><li>Regular/natural yogurt probably okay </li></ul></ul><ul><ul><li>Bacteria “Enhanced” Yogurts, like Activia, and all other probiotics – avoid </li></ul></ul><ul><ul><li>Talk to your physician. </li></ul></ul>  
  • 16. The Colon Right (ascending) Colon Left (descending) Colon Transverse Colon
  • 17. Ulcerative Colitis <ul><li>Outside Surface </li></ul><ul><li>Inside Lining Cells </li></ul><ul><li>Mucus Layer (Biofilm) </li></ul><ul><li>Bacteria </li></ul><ul><li>Hydrogen Sulfide Gas </li></ul>Ulcerative Colitis results in inflammation of Interior lining cells. H 2 S H 2 S
  • 18. Hydrogen Sulfide (H 2 S) <ul><li>Made by Colon Bacteria </li></ul><ul><ul><li>Low Concentration = Smelly Flatus </li></ul></ul><ul><ul><li>Medium Concentration = Irritate Eyes &amp; Airways </li></ul></ul><ul><ul><li>High Concentration = as deadly as Cyanide </li></ul></ul><ul><li>A nasty gas! </li></ul>
  • 19. Hydrogen Sulfide (H 2 S) <ul><li>Noxious Flatus Odor </li></ul><ul><li>Made in the Left (descending) colon </li></ul><ul><li>Why? </li></ul><ul><li>H 2 S bacteria do not grow in acid environment </li></ul><ul><li>Left colon is neutral – neither acidic nor alkaline </li></ul>
  • 20. .org
  • 21. Prebiotics <ul><li>Prebiotic Foods and Oligofructose-Inulin Formula (Prebiotin) </li></ul><ul><ul><li>Feeds good bacteria which in turn make short-chain fatty acids (SCFA) - Energy Pods </li></ul></ul><ul><li>Energy Pods (SCFAs) </li></ul><ul><ul><li>Nourish the colon cell wall itself </li></ul></ul><ul><ul><li>Create energy </li></ul></ul><ul><ul><li>Protect mucous layer </li></ul></ul><ul><ul><li>Acidify the Colon </li></ul></ul>Prebiotic Energy Pods (SCFA)
  • 22. Does Acidifying the Colon Help U.C.? <ul><li>Prebiotics decrease production of H 2 S </li></ul><ul><li>How do we know? </li></ul><ul><ul><li>Flatus stops smelling </li></ul></ul>
  • 23. .org
  • 24. Crohn’s Disease Outside Surface Cell Lining Mucus Layer Bacteria Healthy Crohn’s In Crohn’s, the bacteria penetrate the mucus layer and invade the inside lining cells.
  • 25. Bacterial invasion of mucus layer and cell lining in Crohn’s Healthy Crohn’s
  • 26. Prebiotics <ul><li>Prebiotic Foods and Oligofructose-Inulin Formula (Prebiotin) </li></ul><ul><ul><li>Feed good bacteria which in turn make short-chain fatty acids (SCFA) - Energy Pods </li></ul></ul><ul><li>Energy Pods (SCFAs) </li></ul><ul><ul><li>Nourish the colon cell wall itself </li></ul></ul><ul><ul><li>Create energy </li></ul></ul><ul><ul><li>Acidify the Colon </li></ul></ul><ul><ul><li>Protect mucus layer </li></ul></ul>Prebiotic Energy Pods (SCFA)
  • 27. Emulsifiers Food Additive: What are they? <ul><li>Why are Emulsifiers Used? </li></ul><ul><ul><li>Prolong shelf life </li></ul></ul><ul><ul><li>Blends and homogenizes water, oil &amp; any liquid </li></ul></ul><ul><ul><li>Binder </li></ul></ul><ul><ul><li>Increases Taste </li></ul></ul><ul><ul><li>Mouthfeel </li></ul></ul><ul><ul><li>Substitute for Fat and Gluten </li></ul></ul><ul><ul><li>Allow labeling of foods as fat free, low calorie, etc. </li></ul></ul><ul><li>FDA classes them as GRAS ( G enerally R ecognized A s S afe) </li></ul><ul><ul><li>Therefore, manufacturers often do not have to declare on ingredients label </li></ul></ul>
  • 28. Emulsifiers Who are They? <ul><li>Cellulose (derived from wood chips) </li></ul><ul><ul><li>Methyl Cellulose (Citrucel) </li></ul></ul><ul><ul><li>Carboxy Methyl Cellulose (most used) </li></ul></ul><ul><ul><li>Hydroxy Propyl Methyl Cellulose </li></ul></ul><ul><li>Gum (gum trees &amp; plants – natural, organic) </li></ul><ul><ul><li>Guar Gum </li></ul></ul><ul><ul><li>Xantham Gum </li></ul></ul><ul><ul><li>Gum Arabic </li></ul></ul><ul><ul><li>Taro Gum </li></ul></ul>
  • 29. Emulsifiers are everywhere
  • 30. Emulsifiers at work… Oil + Water Oil + Water + Cellulose Emulsifier (Carboxy Methyl Cellulose) Oil + Water + Xantham Gum
  • 31. WOW!
  • 32. WOW!
  • 33. Food Emulsifiers <ul><li>A profound experiment on an unsuspecting public </li></ul><ul><li>Probably safe for the otherwise healthy </li></ul><ul><li>For the Crohn’s Patient: </li></ul><ul><ul><li>They may damage the mucus layer (biofilm) </li></ul></ul><ul><ul><li>They may allow invasion of bacteria! </li></ul></ul>
  • 34. Recommendation for UC and CD Patients <ul><li>Good Dietary Health </li></ul><ul><li>Eat prebiotic rich foods </li></ul><ul><li>Consider a prebiotic supplement such as Prebiotin (www.prebiotin.com) </li></ul><ul><li>Restrict emulsifiers as much as possible. </li></ul>

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