- Crohn’s disease is a chronic bowel condition that requires lifestyle adjustments and multiple medications for effective management.
- Researchers are exploring the potential of intermittent fasting as a treatment option for Crohn’s disease.
- A randomized controlled trial found that consuming food within an eight-hour window led to weight loss, reduced disease activity, and improved inflammation in participants who are obese or overweight.
A recent study published in Gastroenterology assessed the effects of time-restricted feeding (also known as time-restricted eating), where participants consumed food only during an eight-hour window each day.
The study revealed various advantages, including weight loss and a reduction in symptoms such as decreased abdominal discomfort.
These outcomes suggest that time-restricted eating may be beneficial for individuals with Crohn’s disease across multiple health dimensions.
In this randomized controlled trial, researchers aimed to compare the effects of time-restricted eating against a control group, focusing on participants with Crohn’s disease who were also classified as overweight or obese.
The study highlighted that visceral fat, which is fat stored deeper in the abdomen, can affect Crohn’s disease by contributing to inflammation and worsening disease severity. Time-restricted eating, categorized as a form of intermittent fasting, involves eating only during specific timeframes.
Participants were divided into an intervention group and a control group, with all having Crohn’s disease in remission. The intervention group included 20 participants while the control group had 15 participants.
The intervention group practiced time-restricted eating, consuming meals solely during an eight-hour window and fasting the remaining 16 hours for six days each week, while still adhering to their regular diet. In contrast, the control group ate their typical diet without any time restrictions.
Members of the intervention group monitored their eating windows and documented when they began and ended their meals. Researchers determined adherence by ensuring participants followed the time restrictions at least five of the six days per week.
Evaluations were conducted at the beginning of the study and after 12 weeks. Participants were regularly contacted biweekly to report on various factors, including symptoms, and they provided dietary information at baseline and week twelve. Some participants underwent whole-body scans to assess fat and lean body mass.
Blood work and stool samples were also collected from participants.
The findings illustrated several advantages for the intervention group. Primarily, there was a decrease in body mass index (BMI) compared to the control group. Given the similarity in diets and caloric intake between the groups, researchers posited that the weight change was not influenced by dietary quality or total calorie consumption.
Moreover, Crohn’s disease activity diminished: participants experienced a 40% decrease in stool frequency and a significant reduction in abdominal discomfort.
The study also noted a decline in critical markers, such as leptin—a protein linked to fat accumulation and inflammation. In a subgroup, there was a reduction in visceral fat levels among the intervention group, while the control group exhibited an increase.
Further analyses indicated that greater reductions in BMI correlated with changes in pro-inflammatory and anti-inflammatory cytokines.
The intervention group also demonstrated improvements in gut health, evidenced by increased microbial diversity and the presence of taxa that produce short-chain fatty acids, beneficial for gut regulation. Although some species increased as BMI decreased, the significance of these findings was marginal.
Study author Maitreyi Raman, MD, a gastroenterologist and clinician scientist at the University of Calgary, who conducted the study with funding from the Crohn’s Colitis Foundation and Imagine Clinical Networks, remarked:
“Our findings indicate that time-restricted eating not only improves clinical symptoms of Crohn’s disease but also several systemic inflammation markers. Participants in the time-restricted eating group showed increased microbial diversity, and those who achieved at least a one-point reduction in BMI experienced a rise in short-chain fatty acid-producing bacteria. The interplay between the gut microbiome and immune system may facilitate the restoration of intestinal inflammatory balance,” she shared with Medical News Today.
Babak Firoozi, MD, board-certified gastroenterologist at MemorialCare Orange Coast Medical Center, commented on the trial, stating:
“Any non-pharmacological strategy that enhances both Crohn’s disease management and overall health is valuable. This study stands out as the first randomized clinical trial to showcase the positive impact of intermittent fasting in Crohn’s patients. While prior meta-analyses suggested similar results, this trial provides improved, high-quality evidence.”
The Role of Time-Restricted Eating in Managing Crohn’s
“The observed benefits are likely due to significant weight loss and reduction in visceral fat. Since visceral fat is known to promote systemic inflammation, its reduction may subsequently alleviate Crohn’s disease symptoms by lowering the overall inflammatory burden.”
— Babak Firoozi, MD
Despite the promising findings, this study has notable limitations. Primarily, the sample size was limited, and the study duration was only twelve weeks. The authors acknowledged that these factors restrict broad application and suggest the results are more hypothesis-generating than definitive.
The research exclusively included participants with obesity or overweight status, leaving unclear how effective intermittent fasting might be for individuals outside these categories. Additionally, researchers used body mass index as a measure of weight categories, which can be an imperfect metric. Data on dietary habits were derived from two 24-hour recalls, leaving room for potential inaccuracies in participant reporting.
Conducted in Canada, the study only involved participants aged eighteen to seventy-five, potentially limiting applicability to broader populations. Although one author received targeted funding, no conflicts of interest were disclosed.
While researchers acknowledged that weight loss likely played a role in the observed benefits, they posit that time-restricted eating may contribute unique advantages. Continued research into the relationship between time-restricted eating, weight management, and Crohn’s disease is essential.
Future studies are needed to evaluate the long-term effects of intermittent fasting on Crohn’s disease remission and to address further outcomes, including the need for surgical interventions and risks of complications.
This research opens up new possibilities for managing Crohn’s disease over the long term. The authors suggest that time-restricted eating may support individuals with this condition in maintaining remission.
“For the time being, intermittent fasting is an effective strategy to promote weight loss, reduce visceral fat, enhance clinical symptoms, and improve metabolic function in those with obesity and Crohn’s disease,” Raman emphasized.
Anyone contemplating intermittent fasting should first consult their healthcare provider to understand the potential risks involved.
“For individuals managing Crohn’s disease, the cornerstone of treatment remains following a balanced diet and adhering to prescribed medications. For those who are overweight or have obesity-related issues, tackling excess weight is particularly crucial. In that context, intermittent fasting might be a helpful component of a comprehensive management strategy,” Firoozi advised.
