Can a Paleo Diet Treat Ulcerative Colitis?

When Shawn Mynar experienced a severe UC (ulcerative colitis) flare in 2013, her doctor told her she would be on medication for the rest of her life — and that diet had nothing to do with her disease or treating it. “That awful conversation turned into the moment that changed my life,” she writes on her website. “I knew he was wrong, and I went on a mission to prove it.”

Mynar, who is now a certified nutritionist and wellness therapist, found stories online of people with UC and other autoimmune diseases eating themselves back to good health by replacing processed foods with highly nutritious ones. “There was hope for a life free of pills!” she writes.

Mynar started on the Paleo diet and after a month, she went off medication and into remission. Although she has had a few setbacks, including a diagnosis of Hashimoto’s disease — an autoimmune disorder where the body attacks its thyroid gland — Myner still swears by the Paleo diet. Four-and-half years after starting it, she’s in remission and off medication.

“I’ve had no symptoms of UC or Hashimoto’s for the past two years,” says Mynar, who eats a 90 percent Paleo diet, rich in high-quality organic vegetables and well-raised, locally sourced animal proteins, eggs, and seafood.

“It’s not only about eliminating inflammatory foods, but also about adding healthy, healing foods,” she says.

Mynar is one of many who champion the Paleo diet for IBD (inflammatory bowel disease), which restricts dairy, grain-based foods, legumes, extra sugar, and refined fats or carbohydrates with the notion that people should instead eat more like our ancestors.

Paleo pundits argue that the typical Western diet, high in fats and refined carbohydrates, preservatives, colorants, stabilizers, and other additives, may explain the rise in several diseases, including IBD.

An October 2015 study published in the American Journal of Clinical Nutrition compared a Paleo diet to control diets. Researchers found that people following a Paleo diet had greater short-term improvements in risk factors for chronic diseases. Another paper published in January 2017 in the journal Gastroenterology found that diets that are high in red meats and processed foods and low in fruits and vegetables increase inflammation.

“For years, diet was ignored, but we physicians are starting to get the message that we need to pay attention to it,” says Ed Loftus, MD, a gastroenterologist at the Mayo Clinic in Rochester, Minnesota.

What the Research Does Show

A study published in May 2014 in the journal Gut showed that a high intake of omega-3 fatty acids — found primarily in seafood, and part of the Paleo diet — lowers the risk of UC, while a high intake of saturated fats increases the risk. Another study published in November 2013 in the journal Gastroenterology found that high fiber intake is shown to reduce the risk of Crohn’s.

“So we have high-level epidemiological evidence that one’s diet probably influences one’s risk of IBD and that the Western diet, which is high in fat and sugar and low in fiber, may be one of the culprits,” says Dr. Loftus.

One problem with a dietary solution is that a diet that works for one person with IBD may not work for another. “There are probably over 50 types of IBD,” Loftus says. “We can’t say that one diet will work for everybody, just like no one drug works for everyone.”

Colleen Webb, RD, of the center for inflammatory bowel disease at the Weill Cornell Medical Center in New York City, agrees but believes that the Paleo diet can be beneficial. “Any diet that eliminates highly processed foods, colorants, stabilizers, additives and other unrecognized ingredients will make people feel better,” she says, adding that diets like Paleo influence the growth of good bacteria in the gut, which strengthens the immune system.

She warns against interpreting Paleo as a diet high in animal fats. Instead, the diet should favor plants over animals. “People think that it’s all about burgers and bacon, but studies show that too many animal fats can be harmful for the colon,” she says.

Starting the Diet

Before getting started on the Paleo diet, it’s best to talk to a dietitian. Webb also recommends doing food sensitivity testing. “It’s one thing to do Paleo, but what if you’re allergic to almonds and chicken?” she says.

A Paleo diet consists of:

  • vegetables, including tubers like sweet potato
  • fruits
  • nuts and seeds, which may need to be consumed in spread form so they don’t irritate the GI tract in people with UC
  • lean meats, preferably organic, grass-fed, or wild
  • fish, particularly those rich in omega-3 fatty acids, such as salmon, tuna, and mackerel
  • eggs, preferably organic or enriched with omega-3s
  • oils, specifically high-quality nut and vegetable oils, such as extra-virgin olive oil and avocado oil

Note that the high-fiber raw foods in the Paleo diet can be challenging during a flare. Webb recommends cooking and pureeing fruits and vegetables and choosing softer fruits and vegetables where the skin is not eaten, such as bananas and avocados.

There’s no doubt that following a Paleo diet is challenging, but Myner advises people to at least try it. “Give yourself 30 days to try it out. It’s about creating new habits, which is what we do for anything in our lives that we want to change.”

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