Eggs and ulcerative colitis

Goodness of Eggs

As part of a balanced diet, eggs contribute to a healthy digestive tract and can be helpful during acute digestive problems. In addition to being packed with nutrients, eggs are usually easy to digest compared to some other high-protein foods, such as meat and legumes.

Due to their sulphur content, eggs can contribute to intestinal gas for some individuals, but they are beneficial for other digestive symptoms. When experiencing acute diarrhea, eggs are a more tolerable protein option than beans, nuts, or fried meat.1 Fresh eggs are ideal, because some processed egg and substitute products contain gluten, an ingredient that celiac disease patients must avoid at all times to avoid disease symptoms.

Inflammatory bowel disease (IBD), which mainly includes Crohn’s disease and ulcerative colitis, is one of the most serious digestive diseases. Patients sometimes experience pain and diarrhea during a disease flare. While diet is very individualized, IBD patients frequently report that eggs are one of the most tolerable sources of protein for them. This is important because maintaining a balanced diet and avoiding malnutrition is a challenge for some of these patients, especially while experiencing frequent or prolonged disease flares.

Eggs are also an excellent source of methionine, an essential amino acid.2 Amino acids are the raw materials the body uses to manufacture human proteins, which are vital components of all human cells. Our bodies can only obtain essential amino acids through food or supplements (as opposed to through synthesis, such as the way our bodies produce vitamin D by absorbing sunlight). Methionine is an antioxidant and detoxifier. Research suggests that methionine deficiency could contribute to the development of non-alcoholic fatty liver disease (NAFLD), a condition in which fat accumulates in the cells of the liver (hepatocytes), eventually damaging this vital organ.3

Manufacturers often enrich eggs with omega-3 fatty acids, another type of essential nutrient. Researchers have found that a high dietary intake of docosahexaenoic acid (DHA), one of the three omega-3 fatty acids, is associated with a 77% reduction in the chance of developing ulcerative colitis.4

From helping us avoid ulcerative colitis and liver disease to providing a nutritious source of protein during diarrhea symptoms, eggs are often a terrific choice for digestive health.

First published in the Inside Tract® newsletter issue 190 – 2014

The rotten egg gas, hydrogen sulfide, is one of the main malodorous compounds in human flatus (in other words, one of the main reasons farts can smell so bad) but the larger concern is that it may be responsible for relapses of inflammatory bowel diseases such as ulcerative colitis. In my video Preventing Ulcerative Colitis with Diet, I talk about the role animal protein may play in the development of these diseases, thought to be because of effectively putrefying animal protein gas. (For more on that, see my video Bowel Wars: Hydrogen Sulfide vs. Butyrate.) But what if you already have ulcerative colitis? Can cutting down on sulfur-containing amino acids help? Previously, the only dietary intervention shown to help at all was the withdrawal of milk.

In Treating Ulcerative Colitis with Diet, I discuss the role of diet in ulcerative colitis. Case reports going back decades described patients with ulcerative colitis whose flares appeared to be triggered by cow’s milk. The elimination of all dairy products from the diet was reported to “frequently result in a dramatic improvement in symptoms.” But, when milk was reintroduced back into patients’ diets, it could trigger an attack. The role of milk wasn’t formally studied, though, until 1965. Was it just a small group of patients who were allergic? Or, could a milk-free diet help with this disease in general?

Researchers randomized patients presenting with an attack of ulcerative colitis into a milk-free diet group or a control placebo “dummy” diet group, in which they told people not to eat random foods to make it seem like they were getting special treatment. The milk-free diet worked better: Twice as many were symptom-free when they were off all dairy, and fewer patients suffered relapses. So, there does seem to be a certain proportion of ulcerative colitis patients who would benefit from eliminating all dairy products. These researchers estimated that milk is a trigger in about one in every five cases, so, certainly, sufferers should try a dairy-free trial to see if they’re one of the lucky ones who can control this condition with such a simple dietary intervention.

What about cutting back on sulfur-containing amino acids in general? A study of four ulcerative colitis sufferers found that their daily bouts of bloody diarrhea significantly lessened when they did just that. Reduced intake of sulfur-containing, amino acid-rich foods produced an improvement in moderately severe ulcerative colitis. What happened when they added these foods back into their diets? The researchers felt the effect was so dramatic that going back to eating foods such as meat, dairy, eggs, and wine with sulfites was considered unethical.

That was just a pilot study, though. Researchers then set up a study in which 191 ulcerative colitis patients in remission were followed for a year to determine which foods were associated with a relapse. These turned out to be meat and alcohol, which makes sense because they’re both rich sources of sulfur, which may increase the concentration of hydrogen sulfide, which, if you remember, is toxic because it interferes with our body’s utilization of fiber that our good bacteria turn into a beneficial compound called butyrate.

How can we increase fecal butyrate levels to counteract any hydrogen sulfide? Butyrate enemas have been shown to be of benefit, but if butyrate is made from fiber, can’t we then just get it the regular way—that is, by eating it? Yes. Ulcerative colitis sufferers were given oat bran for three months to make their good bacteria happy. None of the patients relapsed, and their symptoms appeared to be under better control.

One of the common questions we physicians treating patients with inflammatory bowel disease are often asked is whether changing diet could positively affect the course of their disease. So far, our answer—especially for ulcerative colitis––has been, “We don’t know; there are no special recommendations.” This may now change, though, with a study suggesting that consumption of meat may aggravate the course of inflammatory bowel disease. So, folks may want to cut down on meat, eating it no more than once a week. While we don’t yet have confirmation from interventional studies to support the specifics, this could be considered the best available evidence we have right now.

For more information on ulcerative colitis, see my videos Preventing Ulcerative Colitis with Diet, Bowel Wars: Hydrogen Sulfide vs. Butyrate, Striking with the Root: Turmeric Curcumin & Ulcerative Colitis, and Wheatgrass Juice for Ulcerative Colitis. More on this epic fermentation battle in our gut can be found in my Stool pH and Colon Cancer video.

I also discuss inflammatory bowel disease in Titanium Dioxide & Inflammatory Bowel Disease, Preventing Crohn’s Disease with Diet, Dietary Treatment of Crohn’s Disease, and Vitamin D for Inflammatory Bowel Disease.

Is the concept of sulfur-rich proteins new to you? Check out my videos Starving Cancer with Methionine Restriction and Methionine Restriction as a Life Extension Strategy.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

  • 2012: Uprooting the Leading Causes of Death
  • 2013: More Than an Apple a Day
  • 2014: From Table to Able: Combating Disabling Diseases with Food
  • 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet
  • 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

‘Comfort Food’: Dietary Changes Can Ease Ulcerative Colitis

  • Digestive Health

Women. Wisdom. Wellness. Jul 26, 2019

The foods you eat cannot cause ulcerative colitis (UC), however certain foods can trigger and worsen your symptoms, if you have UC.

Dietary changes and good nutrition practices can help you control the symptoms and make living with UC more bearable comfortable.

Like Crohn’s disease, ulcerative colitis is an inflammatory bowel disease (IBD). Unlike Crohn’s, which can affect any part of the gastrointestinal tract, ulcerative colitis targets the colon (large intestine).

UC inflames the innermost lining of your colon. As the disease’s name implies, the inflammation causes ulcers.

What causes UC? One culprit may be an abnormal immune system response that mistakenly attacks the lining of the colon, causing inflammation. Genetics may also play a role. The disease affects people in certain population groups more than others – such as those living in northern climates and people of Jewish descent.

Your health care provider can help you make up for these nutritional deficits by identifying foods to help control your UC symptoms and provide you a well-balanced, nutritious diet.

The Nutritional Impact of UC

Changes in diet and nutrition are one part of a multifaceted approach for treating ulcerative colitis and other IBD conditions. Your doctor also will likely prescribe medication. In more severe cases, surgery may be needed, to repair or remove damaged portions of the colon.

Malnutrition, dehydration, and weight loss are major health risks of UC. When the colon becomes inflamed and ulcerated, it’s less able to absorb fluids and nutrients needed to help sustain your body.

Diarrhea, a symptom of UC, also increases loss of fluids and nutrients, such as sodium, potassium, magnesium, phosphorus, and zinc.

In severe cases, people with UC may need IV fluids to replace these lost nutrients and fluids.

Other UC symptoms, such as abdominal pain and nausea, can further rob you of nutrition as they reduce your appetite, so you consume fewer calories and nutrients.

Nutrition’s Role in Treating UC

Your health care provider can help you make up for these nutritional deficits by identifying foods to help control your UC symptoms and provide you a well-balanced, nutritious diet.

Certain foods or beverages may irritate your digestive tract and trigger flare ups of UC symptoms. Your health care provider will help you identify these foods, so you can avoid them – and identify substitute foods that provide the same nutrients, without flare ups.

Foods more likely to trigger UC symptoms include:

  • Plant foods that contain insoluble fiber, such as fruits with skin or seeds; raw green vegetables, especially cruciferous vegetables, such as broccoli or cauliflower; whole nuts or whole grains; and anything with a peel

  • Lactose, a sugar in dairy products, such as milk, cream, and soft cheeses

  • Sugary foods such as pastries and juices

  • Non-absorbable sugars: sugar alcohols (sorbitol, mannitol) found in sugar-free gum, candy, ice cream, and certain types of fruits/juices such as pear, peach, and prune

  • High-fat foods, including fried or greasy foods, butter, coconut, margarine, and cream

  • Alcohol

  • Caffeinated drinks

  • Spicy foods

Recommended foods for UC include:

  • Refined grains, such as sourdough, potato, or gluten-free bread, white pasta, white rice, and oatmeal

  • Low-fiber fruits, such as cantaloupe, bananas, honeydew melon, and cooked fruits

  • Fully cooked, seedless, skinless, non-cruciferous vegetables, such as asparagus tips, cucumbers, and squash

  • Lean sources of protein, such as fish, white poultry, lean pork, soy, eggs, and firm tofu

  • Lactose-free dairy, such as lactose-free milk, yogurt, and hard cheese (cheddar, parmesan)

Your health care provider may also recommend:

  • Keeping a food diary to help identify foods that trigger symptoms

  • Eating small, more frequent meals

  • Drinking more unsweetened, uncarbonated, decaffeinated liquids

  • Nutritional supplements if you are not absorbing enough nutrients

  • Special diets, based on your condition and medications, such as high-calorie diet, lactose-free diet, low-fat diet, low-fiber diet, and low-salt diet

Source: Crohn’s & Colitis Foundation; National Institute of Diabetes and Digestive and Kidney Disease; ChronsandColitis.com

Still, she said, “This study found a very consistent association. But eggs have some advantages — amino acids and minerals — and these are beneficial. You do want to reduce the number of eggs, especially egg yolks, as part of a healthy diet. But we don’t want people to walk away thinking they shouldn’t eat any eggs. That’s not the right message.”

Current recommendations regarding dietary cholesterol, and eggs in particular, are indeed confusing. The Dietary Guidelines for Americans 2015-2020, published by the Department of Health and Human Services and the Department of Agriculture, for example, states that we “should eat as little cholesterol as possible while consuming a healthy eating pattern.” But the Scientific Report that accompanies those same guidelines says that “cholesterol is not a nutrient of concern for overconsumption,” suggesting that avoiding eggs is not important.

The scientific literature can be equally confusing, with studies reaching varying conclusions about the importance of dietary cholesterol, or eggs in particular, on overall health.

Several aspects of this study make it different from and, to some experts, more convincing than other reports. The authors were able to isolate data for each individual participant, unlike “most previous meta-analyses, which have combined the results that have already been calculated,” Dr. Allen said. They were also able to record the exact amounts of cholesterol in each person’s diet and to sort out the effects of the cholesterol in eggs from all the other foods that contain cholesterol.

Dr. Frank B. Hu, a professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health, found the work interesting and carefully carried out but, he said, “the results are surprising because here even a half-egg a day makes a difference. This study seems to find a much stronger association than what has previously been found.”

The study has limitations. The data depended on self-reports about what people ate, which are not always reliable, and the analyzed studies used varying methods for collecting the diet information. The researchers also relied on a single measurement of egg and dietary cholesterol consumption, even though diets can change over time.

Dr. Allen said of the latest study, “despite its strengths, future studies are needed to understand why we are getting conflicting findings across populations and whether there are some people for whom eating eggs is bad and others who are not affected.”

Are eggs risky for heart health?

Updated: June 24, 2019Published: January, 2017

Q. Does eating the cholesterol in eggs really increase your risk of a heart attack?

A. From what we know today, here’s the bottom line: for most people, an egg a day does not increase your risk of a heart attack, a stroke, or any other type of cardiovascular disease. No more than three eggs per week is wise if you have diabetes, are at high risk for heart disease from other causes (such as smoking), or already have heart disease.

This is definitely not what I was told by my parents, nor by my medical school professors. Back then, we knew that the cholesterol in eggs came from the egg yolks, and we knew that high levels of LDL (bad) cholesterol in the blood increased the risk of cardiovascular disease. So it seemed logical that avoiding cholesterol in the diet made sense.

Since then, however, research has shown that most of the cholesterol in our body is made by our liver-it doesn’t come from cholesterol we eat. The liver is stimulated to make cholesterol primarily by saturated fat and trans fat in our diet, not dietary cholesterol. But a large egg contains little saturated fat-about 1.5 grams (g). And research has confirmed that eggs also contain many healthy nutrients: lutein and zeaxanthin, which are good for the eyes; choline, which is good for the brain and nerves; and various vitamins (A, B, and D). In fact, just one large egg contains 270 international units (IU) of vitamin A and 41 IU of vitamin D. One large egg also contains about 6 g of protein and 72 calories.

The evidence that cholesterol in one egg a day is safe for most people comes from huge studies-many conducted here at Harvard Medical School-that have followed hundreds of thousands of people over decades. They regularly report what they eat and all of the medical conditions that they develop. It is those studies that do not find higher rates of heart attacks, strokes, or other cardiovascular diseases in people who eat up to one egg per day.

Of course, it matters greatly what you eat with your eggs. The saturated fat in butter, cheese, bacon, sausage, muffins, or scones, for example, raises your blood cholesterol much more than the cholesterol in your egg. And the highly refined “bad carbs” in white toast, pastries, home fries, and hash browns may also increase your risk of heart disease, stroke, and other cardiovascular diseases.

Do I eat eggs regularly? I didn’t in the past, but the new knowledge has changed my practice. I typically have a couple of eggs two or three times per week, so it averages out to less than one per day. Often, the eggs are mixed with fresh vegetables, herbs and spices, green chili, or salsa. There’s whole-grain toast, with soft margarine (low in saturated fats and trans fats). It’s delicious, and the best current evidence says it’s healthy.

— Anthony Komaroff, MD

Image: Olha_Afanasieva/Thinkstock

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As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Eggs May Be Bad for the Heart, a New Study Says—But There’s More to the Story

Eggs are a staple of American breakfasts, but they’re a highly controversial food. Are they healthy or not? Do they raise cholesterol? Should you eat only the egg whites, or opt for yolks?

A new study tries to answer those questions, but it also adds to the long-standing debate around eggs. The research, published in JAMA, says that the dietary cholesterol in eggs is associated with a heightened risk of cardiovascular disease and early death — even though the federal dietary guidelines, and plenty of nutrition experts, consider eggs part of a healthy diet. The most recent edition of the dietary guidelines even dropped its recommended cap on daily dietary cholesterol, citing a lack of evidence for a specific limit. (Previously, it was set at 300 milligrams per day, or a little less than the cholesterol content in two eggs.)

“Whether dietary cholesterol is associated with cardiovascular disease or death has been debated for decades. Positive, negative and associations have been reported,” wrote study co-author Victor Wenze Zhong, a postdoctoral fellow in the department of preventive medicine at Northwestern University’s Feinberg School of Medicine, in an email to TIME. “The existing literature is still controversial and inconclusive for nutrition experts and researchers to conclude the safety of eggs.”

Conclusions about eggs based on available scientific evidence vary widely — in part because nutrition research is notoriously hard to conduct accurately. Despite the entrenched belief that eggs raise cholesterol, some studies have suggested that dietary cholesterol intake doesn’t necessarily translate to higher blood cholesterol. One study from last year found that people who ate an egg per day had lower rates of heart disease and bleeding stroke than people who did not eat them, and research from 2016 found that eggs didn’t have a strong effect on risk of coronary artery disease. Some researchers have suggested that links between egg consumption and health problems can largely be explained by the lifestyles of heavy egg eaters, since they may also be more likely to eat foods that are unhealthy for the heart and less likely to exercise regularly.

Zhong’s study, however, adjusted for many of these factors, and still found that eggs may be risky for health.

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Zhong and his colleagues looked at data gathered from six different observational studies, which involved nearly 30,000 U.S. adults with an average age of 51. People provided information about their dietary habits, as well as other health, lifestyle and demographic information. Researchers then tracked their health for up to 31 years, during which time more than 6,100 people died and 5,400 experienced cardiovascular issues.

Both overall dietary cholesterol consumption (from sources including eggs, meat and dairy) and egg consumption specifically were linked to a higher risk of heart problems and premature death, the study found. For each extra half-egg eaten per day — totaling just three to four more eggs per week — a person’s cardiovascular disease risk went up by 6%, and his or her risk of early death increased by 8%, the researchers found.

In reality, that’s not a huge jump; if 1,000 people ate an extra half-egg per day, the researchers estimate that 11 more people than normal would develop heart disease, and 19 more people than normal would die in the next 30 years. But since eating three to four eggs per week is typical for many Americans, according to the paper’s dietary data, it’s a risk worth considering. People who eat eggs every day should pay extra attention, since “greater consumption means higher risk,” Zhong says.

“Limiting foods rich in dietary cholesterol, such as eggs, may be important to consider when choosing a healthy eating pattern,” Zhong says. “Egg whites, which are a rich source of high-quality protein without dietary cholesterol, can be used to replace whole eggs.”

But yolks are the primary source of many nutrients found in eggs, including amino acids, iron and choline, so there is a downside to dropping them. Yolks are also one of the only natural sources of vitamin D, which many Americans lack.

The research on eggs is contradictory — for now — so people (and their doctors) must personally decide how many eggs is too many, Zhong says. Those who are already at risk of cardiovascular issues may want to be more cautious than those who aren’t, especially if they have a family or medical history of heart disease. Your doctor can help define the right range for you.

Write to Jamie Ducharme at [email protected]

IBD diet tips: Nourishing and delicious smoothies

by Judy Palken, MNS, RD, LDN

If you are not feeling well, having a flare, or want a nutritional boost give smoothies a try! Smoothies are a delicious, refreshing way to get in lots of great, nourishing foods. Blending breaks down foods, making it is easier for your gut to absorb the healthful components. If you have digestive issues such as diarrhea, malabsorption, or difficulty eating whole fruits and vegetables, this is important!

This smoothie is sweet, tangy and ever-so-slightly spiced—your family and friends without IBD will want it too! Have one for breakfast, a snack, or a dessert; spoon or straw!

Blueberry-Ginger Smoothie

Ingredits:
  • ½ cup plain low fat or nonfat yogurt
  • 1 cup frozen blueberries
  • ⅓ cup unsweetened almond milk
  • 1 tbsp honey
  • ¼ tsp pure vanilla extract
  • 1 tbsp grated ginger
  • a dash cinnamon

Directions:

  1. Put all ingredients in a blender and purée until smooth.
  2. Add more almond milk if it’s too thick.
    **If you use fresh blueberries, you can add ½ cup ice into the mix to keep the texture. If you are suffering a flare and having trouble with seeds, substitute a different frozen fruit–mango, peaches, or cherries work just as well.

Let’s take a look to see why this smoothie is good for you, especially if you have Inflammatory Bowel Disease (IDB).

Yogurt is an excellent source of beneficial bacteria (probiotics). In IBD, there seems to be an imbalance of good and bad bacteria in the gastrointestinal tract – eating probiotic-rich foods can help to restore the proper balance. Chose a yogurt with live, active cultures. And, always check the “best by” date. Also, it is wise to choose plain, low fat or nonfat yogurt.

Commercially-fruited, flavored yogurts have a lot of added sugar, and are best avoided. All that sugar is inflammatory, and feeds the bad bacteria!

Regular or Greek? Greek yogurt is strained, and has more protein, which is good if your food intake has been low. Either is type is good.

Blueberries contain a type of fiber that the good bacteria love to eat – this makes blueberries a good prebiotic food. Blueberries (and other berries) are a fantastic source ofanthocyanins, plant compounds that seem to protect against cardiovascular disease and certain cancers, and may help prevent the decline in mental functioning as we age. Be sure your frozen blueberries are unsweetened.

Almond milk – buy an unsweetened variety – it may be plain, or vanilla.You can also try soy milk, oat milk, hemp milk, and flax milk in smoothies. have fun trying different plant-based beverages. Soy milk stands out for its good protein and vitamin D content.

Honey is the sweetener of choice, ideally raw, local honey, which will have beneficial bacteria, making it another probiotic food.

Ginger has long been known to help alleviate gastrointestinal distress, and also contains anti-inflammatory compounds called gingerols. Fresh ginger root can be stored in the freezer to keep longer. Just slip it in a zip-loc bag.

Cinnamon, in addition to tasting great, contains proanthocyanidins, plant compounds which may help control blood sugar, and may decrease LDL-cholesterol and triglycerides (fats in the bloodstream).In fact, most herbs and spices are great sources of healthful plant compounds, so use them freely and often in your cooking.

You can learn more about the IBD-AID visiting the UMass Medical School Center for Applied Nutrition

Recipe adapted from: http://www.purewow.com/recipes/Blueberry-Ginger-Smoothie

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