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Authors: Joel Fuhrman; Neal D. Barnard

Tags: #Fasting, #Health & Fitness, #Nutrition, #Diets, #Medical, #Diet Therapy, #Therapeutic Use

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The underlying cause of disease must be treated whenever possible. While the specific etiology of lupus even now is still not well defined, there is sufficient evidence to attempt this most conservative, safe, and ultimately effective approach before using the "big guns," such as steroids and chemotherapeutic drugs, which have numerous hazardous side effects. If a patient is treated early enough with this nondrug approach, drug-based treatment of lupus can usually be eliminated.

Inflammatory Bowel Disease: Ulcerative Colitis and Crohn's Disease
Ulcerative colitis and Crohn's disease are inflammatory diseases involving the lining of the intestines. They are considered idiopathic, meaning that the cause of the disease is unknown. Colitis involves the large' intestine, or colon. It is accompanied by pain and loose stools that can contain blood and mucus.

Crohn's disease affects mostly young adults. Separate areas of the bowel can be ulcerated or inflamed though other segments between the ulcerations can be unaffected.

The abnormal interaction between the immune system and the digestive tract causes these diseases to evolve. Rarely, colitis may be caused by infection, and anyone with inflammatory bowel disease should initially undergo appropriate stool analysis to rule out infectious causes such as parasites or bacterial pathogens.

Patients with these physically and emotionally devastating diseases may have as many as 20 bloody bowel movements daily. Sometimes, even the strongest medications cannot help.

As with other autoimmune disease, inflammatory bowel disease is common in 124

the developed countries. This is clearly related to the animal food and cow's-milk-rich diet we feed ourselves and especially our children. How we are fed at a young age is crucially important and can have a profound effect on our future health.

In recent decades the incidence of irritable bowel disease has rapidly increased in our children.47 Rather than raising infants as nature designed on an early diet exclusively of breast milk with the later addition of natural plant foods, many parents raise their children primarily on substances that breed illness: formula, then sugary foods, bottled fruit juices, processed foods, cow's milk, and other high-fat animal products.

Prolonged breast-feeding and the delayed introduction of other foods in other countries may point to the cause of our own high incidence of autoimmune illnesses and especially inflammatory bowel disease. It is well established that the digestive tract in the bottle-fed infant is exposed to insults from potentially pathogenic microorganisms and offensive food antigens. The rich levels of secretory IgA (an immunoglobulin) in mother's milk protect against these digestive problems.48 Therefore, the continuation of breast-feeding when solid food is first introduced is especially important in the second half of the child's first year.

The damage from our aberrant infant feeding practices in this country cannot be overemphasized. It has been repeatedly noted in the medical literature that the exposure to cow's milk (a food obviously designed for infant cows, not humans) increases the risk not only of adverse reactions to this milk, but also of developing allergies to other foods.49

Potentially damaging cow's milk proteins are also present in many cow's-milk-based infant formulas. In the genetically sensitive individual, the lack of breast-feeding or abbreviated breast-feeding, combined with the early

introduction of cow's milk, could significantly contribute to the later development of inflammatory bowel disease.

Cow's milk protein has been implicated as a causative factor in ulcerative colitis for more than three decades.50,51 In some clinical trials, remission and relapse were correlated with milk intake.52 Scientific investigations have illustrated that cow's milk proteins are so inflammatory in ulcerative colitis patients that the way in which lymphocytes react to cow's milk may serve as a marker of active disease.53

Obviously, it is important for all inflammatory bowel disease sufferers to avoid any and all dairy products. The harmful and disease-producing effects of cow's-milk-based food fed to our infants span the broad spectrum of autoimmune diseases, frequent infection, and decreased immunity to disease in general. Milk is a contributing factor to all the other diseases mentioned in this chapter, as well as to ulcerative colitis.

Evidence now suggests that the increased intake of dietary sugars, acetaminophen, and other non-narcotic analgesics may also exacerbate Crohn's 125

disease.54 Therefore, the intake of refined sugars, or too many sweet fruits, may also need to be carefully monitored in those with Crohn's disease or other autoimmune diseases.

If we exceed the capacity of our digestive apparatus to absorb sugar, the unabsorbed sugars can be fermented by bacterial action lower down in the gut, forming acetic acid, lactic acid, alcohol, and other irritating products. Both sucrose and gluten have been implicated in inflammatory bowel disease for decades.55,56 One reason for this may be the way these elements affect bacterial activity in the gut. Therefore, it is often necessary for patients to religiously avoid breads and cereals in order to completely remove from their diet gluten that is contained in grains such as wheat, barley, oats, and rye.

Clearly no specific diet is appropriate for all patients. The diet must be always modified to the severity of the illness and the uniqueness of each individual.

When the disease is relatively mild or takes a mild form—such as proctitis—

often all that is needed is a change in diet that eliminates sugar, fats, oils, and dairy products. When the disease is more extensive and aggressive, however, more broad dietary intervention is needed.

Elimination diets have repeatedly been shown to be beneficial to those with any type of autoimmune illness. An elimination diet begins with either a fast or with eating only a few foods. Gradually, other foods are added, usually only one new food daily, and then that food is eliminated if it triggers a reaction or causes additional symptoms. One study of inflammatory bowel disease patients who followed elimination diet regimens reported a remission rate of 62 percent after one year and a cumulative remission rate of 45 percent after five years.57

Exclusion diets have also been studied and shown to be highly effective in those with Crohn's disease.58 An exclusion diet consists of only a liquid that has in it vitamins, minerals, glucose, and water, but no food. It is like a partial fast. In one study, after 14 days on the supplemented fast, 78 of the 93

patients (84 percent) achieved remission. Those who achieved remission with this partial fast were then split into two groups. One group received further treatment with prednisone and the other group was slowly reintroduced to foods. Only a single new food was introduced per day. Any food that provoked symptoms of diarrhea or pain was thereafter excluded. The researchers found intolerance to many foods in various patients. These foods included corn, wheat, milk, yeast, egg, potato, rye, apples, mushrooms, and oats. Coffee, tea, and chocolate were also revealed as exciting factors.

Relapses occurred in 66 percent of the steroid-treated group, while only 30

percent of those treated with the elimination diet showed any
signs
of recurrence. This study corroborated my personal experience that each patient's special needs and individual tolerances need to be taken into consideration at all times.

Frequently, when the disease is active and there is bleeding, individuals cannot tolerate any uncooked food. They are best fed with stewed or steamed 126

vegetables exclusively. Persons who are actively bleeding should consume a diet of soft (steamed or stewed) vegetables until they can embark upon a fast.

The diet should be composed of vegetables such as stewed zucchini, sweet_

potato, squash, and new potatoes (no skin). All food should be chewed exceptionally well. No fruit juices, citrus fruits, or tomatoes should be eaten; even other fruits may need to be avoided. Avoid cereals and all grains except for well-cooked rice. Raw vegetable juice (cabbage or lettuce juice with a little carrot juice added) is usually nonirritating. Taking large amounts of essential fatty acids, such as flax oil, borage oil, evening primrose oil, or fish oils, is sometimes helpful as a natural anti-inflammatory to help patients avoid or lessen the need for medication.

Fasting should not be avoided in those with Crohn's disease, even if they respond to the above dietary changes without fasting. Fasting is an important element if a sustained remission is to be expected. The fast allows the entire system to restore its cellular and immunogenic integrity. The inflamed bowel can rest and heal because the main irritant to the system—food—is withdrawn.

With any autoimmune illness, fasting should be employed at the earliest possible point. In many instances, however, fasting must be delayed until the patient is slowly tapered off medications. During this period prior to the fast, the inflammatory bowel disease sufferer should be eating primarily stewed, baked, and steamed vegetables.

Once an adequate remission has been obtained from the use of the modified diet in conjunction with an extended fast, foods should be introduced very gradually, beginning with the stewed and baked vegetables that we used before the fast. In time, the diet can gradually be broadened to include more raw and high-fiber fruit, vegetables, and grains. Nuts, seeds, and legumes may be consumed sparingly. Later on, after a remission has been induced, high-fiber diets have actually been shown to be of definite benefit.59,60

A physician experienced in caring for these patients through nutritional means can obtain excellent results in minimizing or avoiding the use of toxic drugs, such as prednisone, and preventing radical bowel surgery, which is so often performed in these cases.

One of my patients has a strong family history of ulcerative colitis. She and all of her siblings have the disease. She fasted for three weeks to place the disease in remission. Now she undergoes an extended fast every few years to ensure that she maintains her remission. Periodically, we order blood tests to check for markers of inflammation even though she is well and has no symptoms. In this manner, we can detect early signs that a flare-up may occur and then, if indicated, she can begin another fast before an actual flare-up of the disease develops.

Superior Nutrition Is Essential After the Fast
One of the reasons why certain diets have not been shown to be universally successful with autoimmune diseases is that just eliminating a few foods from 127

the pitiful American diet is not sufficient. Also, there is no particular diet that is just right for everyone. Each patient may need certain modifications to avoid consuming foods that excite an excessive immune response and those they do not digest well.

Sometimes patients with severely leaky guts may have to avoid certain foods that may be perfectly fine for another patient with the same illness. For example, a very small percentage of arthritis patients note that their condition is worsened by the consumption of foods in the nightshade family, such as tomatoes, peppers, eggplant, and white potatoes. Citrus fruits or wheat products are also common offenders. The foods that need to be avoided can often be identified by blood or urine testing.

Ferric nitrate urine testing can be useful to help identify foods that are not digested properly. During this test, the person eats only one food; then the first urine passed after that meal is tested to see how much sediment it contains.

One can learn how efficient digestion of that particular food was, and whether or not the body was flooded by immune complex formation after eating it. In this manner we can customize the diet to ensure it is the best possible one for each.

A review of the scientific literature regarding autoimmune disease and food allergy shows that patients consistently improve when care is taken to customize a diet through elimination of those foods that may be sensitizing for that individual. The improvement is often striking when the proper diet is designed individually for each patient.61 Very often researchers first employ the fast in their treatment because fasting is well known to bring about a quick remission of symptoms.62 Once the symptoms are improved .or resolved as a result of the fast, it is easier for the physician and the patient to determine which foods can exacerbate the pain. By carefully reintroducing foods slowly, one at a time, and by eliminating any food that causes an increase in symptoms, each individual can recognize optimal nutrition.

The human body contains powerful self-remedying forces. If we can unleash this healing potential by removing the causes of illness and remove all impediments to healing, the results can be truly remarkable.

The greatest enemy to healing is the well-meaning physician who initially starts the patient with autoimmune disease on powerful drugs. Treatments build complications and prolong the illness so that the sufferer now has multiple reasons for systemic toxicity. One also should be in touch with his or her body to know if overeating, insufficient rest, or dietary indiscretions will cause symptoms. Through healthful living and avoiding suppression of early symptoms with drugs, we can avoid the development of chronic disease or the return to the former disease condition once a recovery has been achieved.

The sooner a person is placed on drugs, including the stronger and more toxic medications, the more difficult and prolonged is the healing process when he or she finally decides to get off the drugging merry-go-round.

128

Massage, hot baths, herbs, mineral salts, acupuncture, serums, and electric therapies have all been found to be ineffective, though some have afforded temporary relief, because no true healing can take place unless the causes of ill health are removed. The primary cause of illness can be summed up in one word: toxicosis. The self-pollution that destroys our bodies from the inside out, from wrong living and wrong eating, is a dangerous lifestyle to continue.

Unfortunately, many patients have been drugged and treated for so long that by the time they are ready or aware that there is a way to get well from their condition, they already have skeletal deformity, fused joints, and some degree of irreparable damage.

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