For all that a patient recently told me that their GI doctor dismissed the effects of their diet on their Inflammatory Bowel Disease (IBD) symptoms, a recent study demonstrates a likely mechanism by which sugar worsens IBD severity. With around 3 million or more in the United States suffering from Crohn’s disease or ulcerative colitis, the two main forms of IBD, apparently conventional medicine needs some re-education. The study, led by a Ph.D. student, produced striking results with a simple design. With a little digging, a likewise simple mechanism emerged as the reason that high sugar intake led to the death of all the mice on the high-sugar diet in the study.
While these diseases, lumped together as IBD, do come under the purview of gastroenterology doctors because of the organs they target, in reality they are similar to other autoimmune diseases normally cared for by rheumatologists. Autoimmune diseases result when the body’s immune defenses, normally hard at work preventing infections, turn its sights on our own cells, proteins, tissues, and organs. In its simplest form, immune cells or the antibodies they produce treat some protein or other molecule of our body as if it was the enemy and begin to destroy it through a variety of mechanisms. In IBD, this immune dysfunction damages the lining of the GI tract in various places depending on which specific form is occurring. Pain, malabsorption, GI bleeding, diarrhea, weight loss, fevers, and blockages result over time from this damage.
Given the potential for adverse effects including death, much research is going into how to help these 3 million plus sufferers in our country and more across the world. Both universities and drug companies are searching for therapies that can relieve symptoms and prevent further harm. Anti-inflammatories like steroids and immune modifiers do a decent job in the short run but long-term therapies with less side effects than chronic steroids are needed. Therapies broadly known as biologics take molecular engineering to create artificial antibodies or small molecules to block steps in the inflammatory pathway. While quite effective in the medium term while avoiding many of the side effects of steroids, these biologics often wane over a few years in efficacy and have long term risk of infections and cancer. Besides that, they can be outrageously expensive. Clearly, more options are needed for these IBD patients.
In this study, researchers took two groups of lab mice and administered a chemical that causes colon damage and inflammation similar to IBD to each group. For one group, they fed the mice a normal, lower sugar diet over the 2 weeks of the study before sacrificing them and studying the microscopic changes in their colons. All mice in this groups lived until the 14 days was over. For the other group, besides the chemical for colon inflammation induction, the mice were fed a higher sugar diet. Strikingly, all of the mice in this high sugar group died within 9 days. Researchers then looked at the colons of these mice in order to compare them to the other group.
The stark contrast appeared to be in how the high sugar content affected the growth of new colon cells from the crypts of the epithelial surface. Epithelial cells cover all our body surfaces but their shapes differ between different parts. In the colon they grow up from the base of what could be described as shag carpet, working their way over about 5 days to the tips of the carpet, known as villi in the colon epithelium. With our colon surface regenerating and replacing itself every 5 days, any interruption in this recycling could obviously be detrimental to colonic health.
Beyond just seeing slower growth of these colonic cells, they investigated why they were growing slower. Normally, these cells depend more on fatty acids for metabolic energy production, but when a high sugar diet was added, they shifted to burn sugars. This sugar burning process also slowed other metabolic processes leading to a slower regeneration of the cells. In a colon damaged by the experimental chemical, this hindrance to regeneration meant that the colon surface was damaged without the ability to repair itself, unlike in the low sugar mice.
While this study was done on mice who had a chemically induced form of IBD rather than humans with actual IBD, the study’s striking findings demand further research. If high sugar intake is truly harming over 3 million IBD sufferers, they deserve to be told about this dietary intervention rather than just putting them on one medication after another costing thousands of dollars. In our patients with IBD, we have seen improvements with a low-inflammatory diet that starts with low sugar, but also urges a low intake of processed foods, and a high content of phytonutrients if not supplements.
One would think that a simple intervention like a low sugar diet or other nutritional therapies would be welcomed by the conventional GI establishment. With the striking results of this study, if further validated by further studies, GI doctors should print out countless educational flyers and post signs in their offices urging their IBD patients to lower their sugar intake. With the myriad other medical propaganda posted in offices and the short time it would take to say “Mr. Smith, cutting down on sugar will improve your IBD symptoms. Could you decrease the amount of sugar in your daily intake?”, this seems like a no-brainer.
Helping those with autoimmune disease like inflammatory bowel disease requires applying all the tools of conventional and natural medicine if we want them to achieve healthier more abundant lives. Don’t let yourself be shortchanged by conventional medicine.
Original Article:
Ansen H.P. Burr, Junyi Ji, Kadir Ozler, Heather L. Mentrup, Onur Eskiocak, Brian Yueh, Rachel Cumberland, Ashley V. Menk, Natalie Rittenhouse, Chris W. Marshall, Pailin Chiaranunt, Xiaoyi Zhang, Lauren Mullinax, Abigail Overacre-Delgoffe, Vaughn S. Cooper, Amanda C. Poholek, Greg M. Delgoffe, Kevin P. Mollen, Semir Beyaz, Timothy W. Hand. Excess dietary sugar alters colonocyte metabolism and impairs the proliferative response to damage. Cellular and Molecular Gastroenterology and Hepatology, 2023; DOI: 10.1016/j.jcmgh.2023.05.001
Thanks to Science Daily:
University of Pittsburgh. “Study may explain why high-sugar diets can worsen IBD.” ScienceDaily. ScienceDaily, 22 May 2023. <www.sciencedaily.com/releases/2023/05/230522131405.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
