Intermittent fasting has become a popular diet regimen. Intermittent fasting (IF) is a diet that alternates between short periods of fasting with either no food or a significant decrease in calories, and periods of unrestricted eating. There are many different types of IF, so let’s compare the different types and how each may affect someone with Ulcerative Colitis (UC).

Key Differences Between 4 Intermittent Fasting Methods

There are many different methods of doing intermittent fasting, but here are the main differences between four different types:

1. Time-Restricted Fasting (TRF) is the most common type of fasting. It is when a person’s eating time is limited to the time of day by having set fasting and eating windows. There are two different methods that are typically used for TRF – the 16/8 method and the 14/10 method. Some of the most common ways are only eating between 10 a.m. and 6 p.m. for the 16/8 method and only eating between 9 a.m. and 7 p.m. for the 14/10 method.
2. Alternate-Day Fasting (ADF) is a type of intermittent fasting approach that consumes of fasting on one day and then consuming a regular diet the next day. It also involves a “modified” version of limiting the calories on the fasting day to 500.
3. Twice-A-Week Method (5:2 Method) is a type of fasting that involves eating a maximum of 500 calories on two days a week and then consuming a regular diet the other five days. You can choose whichever two days of the week to fast, as long as there is a non-fasting day between the two days.
4. 24-Hour Fast (Eat: Stop: Eat Method) is a method of complete fasting for a 24-hour period. It is typically only done once or twice a week and can have extreme side effects.

What is Ulcerative Colitis?

UC is a GI disorder that causes inflammation and ulcers on the innermost lining of the large intestine, also known as the colon, and rectum. It is a rare condition affecting about 1 million people in the United States. Men are more likely to develop UC compared to women.

For more information about ulcerative colitis, please refer to the Crohn’s and Colitis Foundation.

Can You Fast if You Have UC?

While you can fast if you have UC, there hasn’t been a substantial amount of nutritional research conducted yet to show that it is beneficial.

People with UC are at risk for nutrition related problems related to its disease and treatment. Depending on the degree of the disease, this can look different for every person. What’s important to keep in mind is that there is no one specific diet to treat inflammation caused by UC or put into remission.

People often fast not only for religious reasons but has become a popular form of losing weight. When a person begins to fast for a short period of time, this can produce ketosis. Ketosis is when the body doesn’t have enough glucose to provide the body energy, so it uses stored fat. When the body is in a state of ketosis along with consuming fewer calories, it can lead to weight loss, which is already a common symptom of UC.

A Recent Case Study on Intermittent Fasting and Ulcerative Colitis

A recent research study titled “Intermittent Fasting and Reduction of Inflammatory Response in a Patient with Ulcerative Colitis” conducted in Chile explored the effects of intermittent fasting on a 42-year-old female patient diagnosed with ulcerative colitis who was in the remission period. Here are the key takeaways:

• Method: The patient underwent a 10-hour eating and 14-hour fasting regime (10/14 method) for a duration of eight weeks.
• Findings: By the end of the intermittent fasting period, there was a significant reduction in inflammation markers such as C-reactive protein (CRP) and fecal calprotectin.
• Patient Feedback: Notably, the patient reported feeling better and had no flare-ups in the subsequent months while continuing the intermittent fasting regime.

Implications:

• This case study highlights the potential benefits of intermittent fasting in managing ulcerative colitis symptoms, especially when the disease is in remission.
• It provides evidence that intermittent fasting may reduce inflammation markers in patients with ulcerative colitis.
• The study’s findings suggest that intermittent fasting might offer relief to some patients, but as with all treatments, individual responses can vary.
• However, it’s crucial to note that this was a single case study, and more extensive and controlled studies are required to generalize these findings.

What The Research Shows with Intermittent Fasting and Ulcerative Colitis

A few mice studies that have shown that a fasting-mimicking diet may be helpful for those with UC. However, no research has been conducted on humans yet. Therefore, we don’t truly know if fasting is beneficial in humans with UC.

In a recent study from Northwest A&F University and Cornell University found that TRF and IER are effective for relieving colitis. Both TRF and IER decreased inflammatory markers and oxidative stress in the gut and brain.

In another study conducted by the Shanghai Institute of Nutrition and Health, it was discovered that two cycles of fasting significantly improve the symptoms of UC by improving stool consistency and rectal bleeding. Not only did the fasting show anti-inflammatory activity, but it also appeared to enhance the repair process of the damaged intestinal tissues.

Along with the previously mentioned studies, a recent case study conducted in Chile delved deeper into the relationship between intermittent fasting and ulcerative colitis in a human subject. The study found promising results with a significant reduction in inflammatory markers after an 8-week intermittent fasting regimen.

While these findings are encouraging, the study had its limitations, particularly being a single case study. Therefore, while intermittent fasting may offer some benefits to UC patients, it’s essential to approach this dietary method with caution and always under medical supervision.

Does Intermittent Fasting Help Ulcerative Colitis?

With UC, the colon is inflamed causing tiny sores or ulcers. The main goal when trying to manage UC is decrease that inflammation. When it comes to fasting, research has shown that IF can benefit people in the general population, but is lacking with people who suffer with IBD.

Can Fasting Help an Inflamed Colon?

Although there have been a couple studies that have shown that IF can decrease inflammation with UC, there is also evidence that there is no significant change when comparing inflammation markers between two patient groups with UC, one group on a regular diet and the other on an IF diet.

Research aside, people with UC may already have a nutrient deficiency or underweight. By trying IF, this may result in further nutrient deficiencies or weight loss.

With limited research, it is unknown if IF helps UC. More research should be conducted for a professional recommendation.

Fasting During an Ulcerative Colitis Flare

When a UC flare is active, symptoms that were in remission return. These symptoms can include diarrhea, abdominal pain and cramping, rectal pain and bleeding, fatigue, and urgent bowel movements. During this time, the colon is extremely inflamed.

Fasting can lead to unintentional weight loss, a hallmark of malnutrition. Additionally, fasting can heighten other concerns such as irritability, fatigue, difficulty concentrating, and over-eating during non-fasting periods. Instead of cycles of restricting and very large portions, it is recommended to eat slowly and consume smaller, more frequent meals and snacks throughout the day.

A low fiber diet, once referred to as a “low residue diet”, may be recommended during a flare.

So, with an active UC flare, it may be more helpful to reduce fiber intake, rather than focus on the timing of eating.

Take Home Message for is Intermittent Fasting Good for Ulcerative Colitis?

At this time, while there is emerging evidence suggesting potential benefits of intermittent fasting for people with ulcerative colitis, especially from recent case studies, there’s still insufficient evidence to recommend it universally for people with UC and Crohn’s disease. As always, it’s crucial to consult with a dietitian and/or medical doctor before making significant dietary changes.

This article has been updated since its original publish date in October 2022.

ABOUT THE AUTHOR

Danielle Gaffen, MS, RDN, LD

Understanding the link between nutrition and gut disease prompted me to obtain my master’s degree in Nutritional Sciences at San Diego State University and become an IBD Registered Dietitian Nutritionist. Now I work with people who have Crohn’s and colitis who are struggling with confusion around what to eat. My favorite part is helping them to build confidence to eat without fear while managing their symptoms.

Crohn’s disease and ulcerative colitis are types of inflammatory bowel disease (IBD) with symptoms such as persistent diarrhea, rectal bleeding, abdominal pain, and nausea. While primarily affecting the GI tract, IBD can also cause broader health issues, including weight loss, fatigue, and nutrient deficiencies.

Living with Crohn’s or colitis means meal planning can be a real challenge. It’s not always clear what is the best meal for someone with Crohn’s or colitis. Some foods might make your symptoms and inflammation worse, which is why a meal plan for Crohn’s disease and colitis can help. Before we dive into the 7-day meal plan, it’s important to cover some key elements that go into choosing the foods you enjoy.

Understanding What to Eat with Your Symptoms

If you’re flaring or experiencing increased symptoms, inflammation, and disease activity, consider taking your diet back to basics. The texture of what you eat matters. Soft-cooked or mashed foods might be helpful during these times. When your symptoms start improving, you can slowly re-introduce a wider variety of foods and textures.

However, remember to be cautious with foods very high in dietary fiber or fat. These might be harder to digest. When you’re in remission and feeling better, you can eat a wider variety of foods. Always monitor how your gut reacts, especially to potential trigger foods.

Wondering what to eat and when? That’s what our Crohn’s disease and ulcerative colitis meal plan is for!

Please note: Everyone’s gut is unique, especially with IBD. If a certain food causes problems for someone else, it might be okay for you. So, when you introduce a new food, pay attention to any changes, and keep track of symptoms with a tool like a symptom food journal.

If you’re feeling unsure about your diet, it’s always advisable to consult with a dietitian who specializes in IBD.

Dietary Basics for Crohn’s Disease and Ulcerative Colitis

Good nutrition is important for people with IBD. This is because IBD can reduce your appetite while your body is also in need of additional nutrients. Additionally, intestinal inflammation and common symptoms like diarrhea can make it harder for your body to absorb the nutrients it needs.

Eating a variety of foods, like lean proteins, herbs and spices (being mindful of hot or spicy ones), produce, and grains, can provide your gut with essential and anti-inflammatory nutrients.

Common Trigger Foods and Substitutes

It’s worth noting that while some foods are commonly known as trigger foods, reactions can vary from one person to another. For example, dairy, spicy foods, and certain foods high in insoluble fiber might be problematic for some. In such cases, lactose-free alternatives, milder but still flavorful herbs and spices, and well-cooked vegetables might be better tolerated.

The Role of Anti-Inflammatory Foods

The benefits of incorporating anti-inflammatory foods cannot be stressed enough, especially for individuals with Crohn’s or UC. Foods like turmeric, ginger, and berries contain properties that help reduce inflammation in the body, promoting better gut health. Incorporating these into your daily meals can significantly aid in symptom management and overall well-being.

7-Day Meal Plan for Crohn’s Disease and Ulcerative Colitis

This 7-day plan, tailored for those with Crohn’s or ulcerative colitis, comes from Eat Well Crohn’s Colitis recipes. These are just a few ideas to guide you. For the complete recipes with step-by step guidance, download the 7-day meal plan.

Disclaimer: While this 7-day meal plan can serve as a helpful starting point, it’s important to remember that each person’s gut with IBD is unique. If certain complications, such as stricturing or narrowing of the intestines, are present—especially in Crohn’s disease in the small intestine—it becomes critical to work closely with your IBD healthcare team. They can provide guidance on any nutrient limitations, like strict amounts of fiber recommended per day, ensuring that the dietary plan is both safe and effective for your specific health situation.

Day 1

• Breakfast: Oatmeal Cookie Smoothie
• Lunch: Tuna, Rice & Cucumber Bowl
• Dinner: Baked Chicken & Carrots with Cilantro Lime Sauce. Side of Mashed Potatoes.
• Snacks: Salt n’ Vinegar Hard Boiled Eggs, Applesauce & Yogurt
• Dessert: Cantaloupe Sorbet

Day 2

• Breakfast: Oatmeal Cookie Smoothie
• Lunch: Tuna, Rice & Cucumber Bowl
• Dinner: Baked Chicken & Carrots with Cilantro Lime Sauce. Side of Mashed Potatoes.
• Snacks: Salt n’ Vinegar Hard Boiled Eggs, Applesauce & Yogurt
• Dessert: Cantaloupe Sorbet

Day 3

• Breakfast: Bell Pepper & Spinach Egg Bake; Rice Cereal with Peaches
• Lunch: Chicken & Zucchini Skillet, with Steamed White Rice
• Dinner: Salmon Cakes and One Pot Potato & Carrot Soup
• Snacks: Chocolate Peanut Butter Energy Bites, Banana with Creamy Peanut Butter Dip
• Dessert: Creamy Avocado Popsicles

Day 4

• Breakfast: Bell Pepper & Spinach Egg Bake; Rice Cereal with Peaches
• Lunch: Chicken & Zucchini Skillet, with Steamed White Rice
• Dinner: Salmon Cakes and One Pot Potato & Carrot Soup
• Snacks: Chocolate Peanut Butter Energy Bites, Banana with Creamy Peanut Butter Dip
• Dessert: Creamy Avocado Popsicles

Day 5

• Breakfast: Bell Pepper & Spinach Egg Bake; Rice Cereal with Peaches
• Lunch: Chicken & Zucchini Skillet, with Steamed White Rice
• Dinner: Salmon Cakes and One Pot Potato & Carrot Soup
• Snacks: Chocolate Peanut Butter Energy Bites, Banana with Creamy Peanut Butter Dip
• Dessert: Creamy Avocado Popsicles

Day 6

• Breakfast: Hashbrown Egg Cups with Veggies
• Lunch: Ground Turkey & Veggie Stir Fry
• Dinner: Baked Cod & Veggies with Quinoa
• Snacks: Lucky Green Smoothie, Applesauce
• Dessert: Peanut Butter Banana Heart Cookies

Day 7

• Breakfast: Hashbrown Egg Cups with Veggies
• Lunch: Ground Turkey & Veggie Stir Fry
• Dinner: Baked Cod & Veggies with Quinoa
• Snacks: Lucky Green Smoothie, Applesauce
• Dessert: Peanut Butter Banana Heart Cookies

Handy Meal Tips

• Frozen Veggies: They’re just as nutritious as fresh ones and last longer.
• Ready-to-Eat: Some foods are prepped and ready. Just check the label to make sure they’re good for your diet.
• Cook Ahead: Make lots of food at once and freeze the extras.
• Talk to Your Family: Share your diet needs with them. Meals are easier when everyone knows.

Importance of Hydration

Staying hydrated is essential as even mild dehydration can lead to fatigue. Drink 8 or more cups of liquids per day, and for every episode of loose, watery stool, add one to two cups of liquids to your daily intake to replace losses. Options include water, herbal tea, broth, a mix of fruit and veggie juice, and oral rehydration solutions. Infused waters and herbal teas can also serve as flavorful alternatives.

Full Plan, Ready to Go!

Need the full scoop? Download the detailed 7-day meal plan for Crohn’s disease. You’ll find a shopping list, detailed recipes, and more.

Take Home Message

Navigating meals with Crohn’s disease or ulcerative colitis can seem daunting. But a good plan, like our Crohn’s disease and ulcerative colitis meal plan, can help simplify things. Remember, everyone’s needs are unique. It’s okay to adjust the plan based on what works for you. If you’re unsure about something, don’t hesitate to reach out to an IBD dietitian for guidance. We’re here to help!

Want More Guidance?

While this 7-day meal plan provides a solid starting point, managing Crohn’s disease or ulcerative colitis often requires a comprehensive approach.

For further assistance, additional resources, and actionable steps, check out our IBD services page. Let us help you navigate your journey with Crohn’s and colitis more effectively.

ABOUT THE AUTHOR

Danielle Gaffen, MS, RDN, LD

Understanding the link between nutrition and gut disease prompted me to obtain my master’s degree in Nutritional Sciences at San Diego State University and become an IBD Registered Dietitian Nutritionist. Now I work with people who have Crohn’s and colitis who are struggling with confusion around what to eat. My favorite part is helping them to build confidence to eat without fear while managing their symptoms.

The Crohn’s & Colitis Foundation launched a patient-centric Environmental Triggers research initiative in 2016 with the clear vision to better understand how exposure to environmental factors, including stress and diet, can affect Crohn’s disease or ulcerative colitis onset, progression, or relapse. The initiative also hopes to identify the biological changes driving these effects. The Foundation attracted prominent researchers to accomplish this goal, who recently reported the identification of biomarkers that predict which ulcerative colitis patients will experience a flare in response to high levels of stress.1

The research study, conducted by Dr. Emeran A. Mayer, MD, and colleagues at the University of California, included 91 patients with ulcerative colitis; these patients were grouped into a high stress reactivity (SR) group and a low SR group based on their answers to a questionnaire.1,2

At the start, all participating patients were in clinical and biochemical remission, meaning that not only were they symptom-free, but laboratory results indicated that they had no signs of active disease. In addition to their stress reactivity, each participant had their fecal microbe, fecal metabolite, and plasma metabolite profiles analyzed.1

The researchers concluded that certain microbial signatures are associated with high SR and high clinical flare risk. This finding indicates that an ulcerative colitis patient’s microbiome may contribute to stress-induced flares of their disease.1

Participants with higher SR shared several characteristics of their fecal microbes, including an abundance of the Ruminococcaceae and Lachnospiraceae families, as well as shared signatures in their fecal metabolite and plasma metabolite results. These signatures were proven to accurately predict patients’ risk for clinical flares.1

Implications for the Future of IBD Care

Now that it is known that patients with high SR can be distinguished from patients with low SR via their fecal microbe, fecal metabolite, and plasma metabolite profiles, a potential prognostic test could be developed to determine which patients are at greatest risk of experiencing a stress-induced flare.1

In addition to identifying candidate biomarkers that can indicate which patients would benefit most from access to stress management interventions to prevent flares, this study also identified pathways between the gut and the brain that are related to stress. In the future, these stress-related pathways could become therapeutic targets, expanding treatment options for patients.1

1. Jacobs JP, Sauk JS, Ahdoot AI, Liang F, Katzka W, Ryu HJ, Khandadash A, Lagishetty V, Labus JS, Naliboff BD, Mayer EA. Microbial and Metabolite Signatures of Stress Reactivity in Ulcerative Colitis Patients in Clinical Remission Predict Clinical Flare Risk. Inflamm Bowel Dis. 2023 Aug 31:izad185. doi: 10.1093/ibd/izad185. Epub ahead of print. PMID: 37650887.
2. Sauk JS, Ryu HJ, Labus JS, Khandadash A, Ahdoot AI, Lagishetty V, Katzka W, Wang H, Naliboff B, Jacobs JP, Mayer EA. High Perceived Stress Is Associated With Increased Risk of Ulcerative Colitis Clinical Flares. Clin Gastroenterol Hepatol. 2023 Mar;21(3):741-749.e3. doi: 10.1016/j.cgh.2022.07.025. Epub 2022 Aug 8. PMID: 35952942.
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Michelle Falci is the Crohn’s & Colitis Foundation’s Senior Manager of Social Media & Public Relations.