Is diet the cause of IBD and how far away are we from dietary therapy?

On Friday 11th November I delivered the John Lennard-Jones Lecture at the St Mark's Frontiers Meeting at Glazier's Hall in London. There was an in person audience and 2000 people virtually from across the world. This is a new recording of that lecture:

"Is diet the cause of IBD, and how far away are we from dietary therapy?"

Video Editing by @IBDNathan Nathan Constantine-Cooke
Graphic design by @ErikRva

#atomicIBD #crohnsdisease #crohn #IBD #inflammatoryboweldisease #colitis #ulcerativecolitis #UC @crohnsandcolitisuk

PROFESSOR CHARLIE W LEES FRCP(Ed) PhD
Charlie is Professor of Gastroenterology at the University of Edinburgh, a UK Research and Innovation Future Leaders Fellow (UKRIFLF) and Consultant Gastroenterologist in the Edinburgh IBD Unit. His clinical, teaching and research interests have been focused on inflammatory bowel disease (IBD) since 2003. He was awarded his PhD in the Genetics of IBD and the prestigious UEG Rising Star award in Gastroenterology, both in 2009. Following this he spent 10 years working as a full-time consultant gastroenterologist leading an increasingly busy and complex IBD clinic.

In 2019 Charlie was awarded a personal fellowship from UKRI - worth £1.7m - that enabled his transition to full-time academic gastroenterology. His research team are based in the Centre for Genomics and Experimental Medicine within the Institute of Genetics and Cancer in Edinburgh.

Charlie’s core mission is to improve outcomes for people living with IBD.

His team are working on predicting outcomes in IBD, using routinely collected NHS data (the Lothian IBD Registry) and dedicated multi-modal prospective cohorts to build predictive models.

He is Chief Investigator of the PREdiCCt study, which has recruited 2650 patients in clinical remission with detailed baseline phenotyping (clinical, psycho-social, lifestyle, environmental, dietary, microbiome and genomics) and a minimum of 24 months longitudinal follow-up.

Conflicts of Interest
Professor Charlie Lees has acted as a speaker and/or consultant to Abbvie, Janssen, Takeda, Pfizer, Galapagos, GSK, Gilead, Vifor Pharma, Ferring, Dr Falk, BMS, Boehringer Ingelheim, Novartis, Sandoz, Celltrion, Fresnius Kabi, Tillotts, Trellus Health and Iterative Scopes.

[petercherry]

I've suffered with Crohns for 43 years. 7 months ago i was advised by a knee surgeon to lose weight to delay the need for knee replacement. I decided to just eat meat and eggs to achieve this. This has worked incredibly well. I've lost 32kg which has been wonderful. But what really astounded me was that my Crohns started to abate after only 1 week. It's gone from constant discomfort, diarrhea pain, bleeding, running to the loo 10 times a day to no pain and i only need to go once a week now. For me its been a miracle. I'm scared I'm gonna wake up. And its been so easy. And i haven't got tired of it. I look forward to the next steak so much. I thought initially that it would be difficult to maintain due to the cost of meat but it turned to be 2/3 of my previous monthly grocery spend. I only found out months after starting this that it's called the Carnivore diet. There is so much info out there. Dr. Chaffe on YouTube is a super resource. I'm slowly weaning myself off Salazopyrin, 800gm down to 100g per day and weekly Methotrexate injections down to 1 per month. I've had extensive blood tests done and all parameters are great. Even my diabetes is gone with an HbA1C down to 4.5. It's been wonderful. I've never been in real remission until now. In fact it was so bad a year ago i wanted to have my colon removed and just wear a bag. The surgeon talked me out of it for which I'm extremely grateful now. That's my story. Maybe it helps someone.

[larsschmidt]

Awesome video. The impact of the diet is completely underestimated. My mother keeps getting CD flares for decades and it told "eat what you want" essentially. We need more of those videos and more discussions with patients like in the comments below.

[edwardkennedy]

The carnivore diet has helped me greatly I've had ulcerative colitis for 18 years, not on any medication the last 3 years.

[marcjames]

IBS has exploded since the move away from healthy saturated fats to Industrial unsaturated fats. Yes Sugar and carbs. Also eating habits we're simply not meant to be eating and snacking throughout our waking hours. I've experimented with all diets except vegan and find intermittent fasting and a keto-mediteranean diet works best for me.

[TheAnjanisoni]

Brilliant talk. There is a lot of promise in dietary therapy. The IBDAID diet, CDED diet, Mediterranean diet, and anti inflammatory diet all show promise

[victorhristov]

Thank you for this! I love watching and learning about IBD and Crohn's in particular (since I've been recently diagnosed). As soon as I came back from the hospital (from a risky stenohsa), I started a whole-foods plant-based diet + fish. No processed food of any kind. I'm slowly experimenting with adding hardier vegetables and legumes since I got to watch out for the stenosa. It's been awesome since then! It feels overwhelming knowing that I won't have any more pizza, or ice-cream and my favourite chips but if this food has been damaging me this much then I got to to what I have to. I need to stay healthy for myself and my family.. so what if I don't get those dopamine kicks anymore, I'll just try to get them from other sources that won't damage my health.

I'll see if you have made any videos on stress and Crohn's. You mentioned it for a bit in the video but not extensively.

[chadkent]

Thank you for sharing your work. Very appreciated. Looking forward to learning more for my wife.

[animeart]

Watched the whole thing, this video should have 1 million views

[sp-zg]

Thank you so much for doing this! Great work! My 8 year old son was diagnosed with Crohns so this is very helpful in trying to help him with this horrible disease. Thanks again!

[TheAnjanisoni]

It would be nice to have had a mention of the CDED diet and Omega 3 fatty acids

[MdivalG]

Awesome! Super excited for the PREDICCT study! Thank you for all your excellent work 👍

[shiv.seeking]

Great presentation, very engaging tone of voice

[SuperMth]

As always Charlie so informative, thank you so much. I wish you were my GI consultant!

[Tysonbax]

Ulcerative colitis here. 14 years since diagnosis.

Carnivore diet works the best, organic meats are ideal. Salt, and water always induces remission in me while giving me a clearer mind, and less sleep i require to feel refreshed.

However, i worry that im not getting everything i need..

So, I've been slowly re introducing fiber into my diet to feed my gut microbes, promote a healthy gut barrier and optimise eubiosis of the gut.

I'm currently on nsaid's, mesalamine. I wish I could come off the drug, however this is my current predicament.

I found removing emulsifiers helped tremendously, also, artificial sweeteners, excess sugar, roughage, such as dominant insoluble fiber, and the most impactful environment issue being stress.. if im playing a game and it jump scares me I will get symptomatic.

I'm currently eating lamb, cooked with duck fat, vegetables like carrot, corn, peas, beetroot, and some potatoes in small amounts. I take milk kefir in very small amounts. Water kefir in very small amounts, coconut yogurt with blueberries, and dark chocolate drops. (High cocoa)

My idea of a cheat meal is a mcchicken patty from mcdonalds which is 160 calories.

Supplements i take are curcumin with every meal, glucosamine, b12, and glutamine.

I try very hard to both optimize my gut biome, and keep asymptomatic.

I don't have any symptoms at present, no blood or mucus, and use the bathroom 1-2 times a day in the morning.

I hope some of my adventure can help someone else suffering.

Please note: what is working for me isn't necessarily what will work for you.. so, please listen to your body and what it is and isn't okay with. :)

If anyone has advice or recommendations I would appreciate that wholeheartedly.

[dalemartinrunning]

Thank you for putting this on youtube in the public domain. I really enjoyed the 'state of the nation' approach and the insightful summary in the last few minutes. The information regarding antibiotic quantities at an early age as a potential cause or risk factor was new data for me, as I had not heard about that before.

[LenkaSaratoga]

Excelllent talk!
First time here.
Subscribed.
Would like to know what your credentials are. Is there a video where you introduce yourself, please ?
PS Just found your intro in the description under the video. Thanks.

[alisoncook]

Really interesting and accessible talk. I love the graphics! I’m a lay person in remission with mild Crohns. Desperate to try and find the diet that works for me. Watched it with my geneticist dad. We both got a lot out of it. I took part in a study may be the one you are talking about ‘INTICO’ was it? Pretty much follow your recommendations although I should try sticking with more fermented foods. Do have trouble eating a lot of fibre though. My microbiome might like it but it gives me the runs 😂

[AyurvedicDoctor-yq]

Nice diet tips sir ....Pitta shamak 2 from Planet Ayurveda are really great results on IBD problem.

[SabrinaWohlman]

Please I need an explanation of the difference between avoiding emulsifiers, sugars, highly processed foods and EEN? EEN can put someone in remission what is it made of?

[mickl]

Why are NHS gastroenterologists still telling patients that diet has no relationship with IBD (UC)? All I keep getting told is it's an autoimmune disorder, keep taking your meds and eat as healthily as possible. My UC came out of the blue at age 40 as proctitis. Now it's virtually the whole colon five years later after a recent flare up. Been fine for two years until