The New Year can bring a lot of good and much-needed change…and also a fair share of ads promoting weight loss, lifestyle changes, fad diets, and juice cleanses.
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If you find yourself wondering about which diet is best for Crohn’s and ulcerative colitis, this post highlights some of the latest research about IBD diet and nutrition guidelines. The evidence consistently points to no single diet being universally helpful for patients with Crohn’s or ulcerative colitis, but recently, a study suggested that the Mediterranean Diet pattern may be easier for adherence since it’s not as restrictive as other medical diets that do not appear to be superior in inducing/maintaining remission or lowering inflammation (1).
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But how can success be measured if a complete diet and lifestyle overhaul is lacking? Here are some suggestions:

1. (a) Take inventory of how you feel. If this is a difficult skill for you; you’re not alone. A recent study suggests that alexithymia, which is the difficulty identifying/describing one’s emotions and sensations in the body, is associated with more severe GI symptoms and increased disease activity in IBD (2). Basically, having more mind-body awareness could be helpful!

3 Tools to bring more awareness into the body:

• Mindfulness Meditation (apps to explore: Headspace, 10% Happier, Calm)
  A review of scientific literature found that mindfulness-based training and meditations, and also dance, theater and art were beneficial in helping participants cultivate a higher mind-body awareness and effectively reduced alexithymia (3). 
• Yoga. A study found an association between time spent practicing yoga and an increase in physical and emotional experiences (reduction in alexithymia) (4). 
• Self-Compassion. Another study found a high positive correlation between self-compassion and empathy. Additionally, this study found that the more self-compassion a person practiced, the less they experienced alexithymia (5). Here you can learn more about the research and application of self-compassion from Dr. Kristin Neff. ‍
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1. (b) Really…how DO you feel?

• Energy levels
• Sleeping quality
• Symptoms (frequency/severity)
• Eating experience (pleasurable, anxiety-driven, or somewhere in-between)

2. Build consistent and sustainable changes. 

• Make specific and attainable goals that lead you in the direction of sustainable and effective change. No need to go big or go home; slow and steady wins the race. For example, laying out your favorite running shoes the night before can be a small/attainable goal that leads you toward going on a morning jog.  
• Know that creating new health-related behavior could be challenging. Research thoroughly documents the challenges in implementing and maintaining meaningful health behavior change over the long term (6). Knowing that you’re not alone when struggling to make inevitably challenging adjustments is an active component of practicing mindfulness (discussed above in first section) (7). 
• Motivation will come and go. Focus on small behaviors that can promote consistency over time regardless if motivation is present. Focusing primarily on consistency and habit-formation, increasing effort/intensity only if motivation and ability are present. Research is currently underway to guide specific recommendations for forming more prescriptive, small health-related behaviors that are easily made into a consistent routine. What kind of small behaviors might be consistent for you? What does consistency look like for you (8)?

3. What can you add?

Struggling to feel hydrated throughout the day? Wanting to eat more fruits and vegetables? Building on making small, sustainable changes, what would it look like to add 2 C of vegetables to dinner? 1 C of fruit at breakfast? Drinking a bottle of water on the commute home from work? What if you focused on adding only 1 or 2 of these goals each week? What small changes can you add that push you in the direction of your nutrition-related goals?‍

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Feeling more energized?
Able to implement behaviors that prove to be sustainable for you?
Feeling like you’re adding attainable nutrition-related goals that fit your lifestyle and not the other way around?
Then you’re doing it! You’re making health strides without dieting!
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If you do find yourself feeling overwhelmed by the inevitable conflicting nutrition information circulating around social media and beyond, don’t hesitate to reach out and apply for a consultation for 1:1 individualized nutrition support!

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References

1. Lewis, J. D., Sandler, R. S., Brotherton, C., Brensinger, C., Li, H., Kappelman, M. D., Daniel, S. G., Bittinger, K., Albenberg, L., Valentine, J. F., Hanson, J. S., Suskind, D. L., Meyer, A., Compher, C. W., Bewtra, M., Saxena, A., Dobes, A., Cohen, B. L., Flynn, A. D., Fischer, M., … DINE-CD Study Group (2021). A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn's Disease. Gastroenterology, 161(3), 837–852.e9. https://doi.org/10.1053/j.gastro.2021.05.047
   
   
2. E Vinni, K Karaivazoglou, T Lourida, M Kalogeropoulou, E Tourkochristou, E Tsounis, E Lampropoulou, G Theocharis, K Thomopoulos, P Gourzis, C Triantos, P194 Alexithymia traits are associated with symptom severity and disease activity in IBD patients, Journal of Crohn's and Colitis, Volume 15, Issue Supplement_1, May 2021, Page S260, https://doi.org/10.1093/ecco-jcc/jjab076.320
3. Norman H, Marzano L, Coulson M, et al. Effects of mindfulness-based interventions on alexithymia: a systematic review. Evidence-Based Mental Health 2019;22:36-43.
4. Jonsson, G., Franzén, L., Nyström, M., & Davis, P. A. (2020). Integrating yoga with psychological group-treatment for mixed depression and anxiety in primary healthcare: An explorative pilot study. Complementary therapies in clinical practice, 41, 101250. https://doi.org/10.1016/j.ctcp.2020.101250
5. Lyvers, M., Randhawa, A. & Thorberg, F.A. Self-compassion in Relation to Alexithymia, Empathy, and Negative Mood in Young Adults. Mindfulness 11, 1655–1665 (2020). https://doi.org/10.1007/s12671-020-01379-6
6. Sheeran P, Webb TL. The intention--behavior gap. Soc Personal Psychol Compass. 2016;10(9):503–18.
7. Dreisoerner, A., Junker, N.M. & van Dick, R. The Relationship Among the Components of Self-compassion: A Pilot Study Using a Compassionate Writing Intervention to Enhance Self-kindness, Common Humanity, and Mindfulness. J Happiness Stud 22, 21–47 (2021). https://doi.org/10.1007/s10902-019-00217-4‍
8. Hollingsworth, J.C., Young, K.C., Abdullah, S.F. et al. Protocol for Minute Calisthenics: a randomized controlled study of a daily, habit-based, bodyweight resistance training program. 20, 1242 (2020). https://doi.org/10.1186/s12889-020-09355-4BMC Public Health