The Microbiome, Nutrition and IBD

Managing inflammatory bowel disease (IBD) involves more than just medication—it requires a comprehensive approach to diet and lifestyle. Our third IBD Insights: living with the disease explores the relationship between the microbiome, nutrition, and IBD, offering patient insights and scientific perspectives to help navigate the disease effectively.

Patient-to-Patient Tips: Diet and Lifestyle

Receiving an IBD diagnosis often brings a heightened focus on food and diet. Approaching this with a positive mindset can foster a healthier relationship with food. Here are some practical tips from individuals living with IBD:

Benefits of a Balanced Diet:	Prioritize Whole Foods – Avoid processed foods and embrace fresh, unprocessed ingredients. Eating a variety of fruits and vegetables ensures a diverse nutrient intake—think "eat the rainbow!"
1. Enhances overall well-being, both physically and mentally.	Cooking from Scratch – Preparing meals at home is an effective way to control ingredients and minimize processed food intake. Even those with limited cooking skills can find easy and quick recipes to prepare wholesome meals.
2. Encourages exploration of new flavors and ingredients.	Navigating Food While Traveling – A varied diet reduces dietary challenges when exploring different cuisines. Being open to diverse food options can make traveling more enjoyable and stress-free.
3. Develops valuable cooking skills and fosters a social connection through food.

The Microbiome: The Science Behind It

The gut microbiome consists of trillions of microbes that interact with the nutrients we consume, influencing our overall health.

Origins of the Microbiome – It is established at birth and influenced by factors such as mode of delivery (vaginal vs. C-section) and early nutrition (breastfeeding vs. formula feeding).
Role of Gut Bacteria – These microbes support immune function and gut health, but their composition is influenced by diet and lifestyle.
Microbiome and IBD – A disrupted microbiome can contribute to inflammation and has been associated with the development and progression of IBD. Lifestyle factors such as diet, exercise, and medication use can reshape the microbiome over time.

Impact of Diet on the Microbiome:	Healthy Food Sources:
1. Fibrous foods (whole foods, whole-grain carbohydrates) nourish beneficial bacteria.	1. Healthy Fats: Avocado, fish (salmon, trout, mackerel, sardines), nuts, seeds, olive oil, tofu, and lean meats.
2. Some fibres ferment in the gut, producing compounds that strengthen the intestinal barrier and reduce inflammation.	2. Whole Carbohydrates: Vegetables, fruits, legumes, quinoa, potatoes, beans, oats, whole grains, and brown rice.
3. A diverse diet rich in fruits, vegetables, proteins, healthy fats, and whole carbohydrates promotes a balanced gut microbiome.	3. Protein-Rich Foods: Fish, poultry, eggs, dairy, nuts, legumes, and seeds.

Diet and IBD: Scientific Insights

Research suggests that dietary patterns in industrialized countries may contribute to the rise in IBD cases. The Western diet, characterized by high saturated fats, refined sugars, and processed foods, may promote gut inflammation.

Foods to Limit:

High in Saturated Fats	Refined Carbohydrates & Simple Sugars	Emulsifiers & Artificial Sweeteners	Natural Alternatives
Butter, cakes, biscuits, fatty meats (bacon, salami, sausages), pastries, and chocolate spreads.	Sugar-sweetened beverages, sweets, white bread, and processed baked goods.ods.	Found in processed foods like ice cream, processed meats (nuggets, sausage rolls), diet sodas, and packaged desserts. While research is ongoing, some emulsifiers and sweeteners have been linked to microbiome changes and increased gut inflammation.	Not all emulsifiers are harmful—ingredients like eggs, chia, and flax seeds act as natural binding agents.

Common Nutrient Deficiencies in IBD

Individuals with IBD are more susceptible to deficiencies in essential vitamins and minerals, which can affect energy levels, bone health, and immune function.

Iron	Vitamins D & B12	Calcium
Iron is important for making red blood cells, which carry oxygen around the body. Deficiencies may lead to anemia, causing fatigue and weakness. During flares, intolerance to oral iron supplements may occur. Intravenous iron infusions can be administered in hospitals if needed.	Regulates the immune system and supports calcium absorption for bone health. Vitamin B12 is used by our body for many processes. For example, keeping healthy blood and nerve cells and helping our body replicate DNA correctly (a process which happens continually to allow our tissue to repair).	Important for bone strength and normal blood clotting.
Iron-Rich Foods: Red meat, beans (kidney beans, chickpeas), nuts.	Vitamin D Sources: Sun exposure, full-fat dairy, oily fish, egg yolk, liver, and fortified foods.	Sources: Dairy products, kale, almonds, and fish with edible bones (sardines, canned salmon).
	Vitamin B12 Sources: Fish, meat, poultry, eggs, dairy.

Iron

Vitamins D & B12

Calcium

Iron is important for making red blood cells, which carry oxygen around the body.

Deficiencies may lead to anemia, causing fatigue and weakness. During flares, intolerance to oral iron supplements may occur. Intravenous iron infusions can be administered in hospitals if needed.

Regulates the immune system and supports calcium absorption for bone health.

Vitamin B12 is used by our body for many processes. For example, keeping healthy blood and nerve cells and helping our body replicate DNA correctly (a process which happens continually to allow our tissue to repair).

Important for bone strength and normal blood clotting.