Does the Carnivore Diet Treat IBD?

A small case study suggests that eating carnivore or ketogenic diets can help people with inflammatory bowel disease achieve remission. However, some experts are not convinced about the diets’ therapeutic potential.

Ketogenic and carnivore diets based on animal products and extremely low in carbohydrates have gained traction in recent years. They have been endorsed by celebrities like Joe Rogan and Kourtney Kardashian, while social media users attribute these eating patterns to weight loss and increased energy.

However, carnivore and ketogenic diets go against the general nutrition guidelines emphasizing high consumption of plant-based foods.

A case study that was published in Frontiers last September suggests that switching to ketogenic and carnivore diets may put inflammatory bowel disease (IBD) into remission.

Nearly 1 in 100 Americans have an IBD, an umbrella term for disorders that cause chronic inflammation of the gastrointestinal tract. The most common IBDs are ulcerative colitis (UC) and Crohn’s disease, causing symptoms like diarrhea, abdominal pain, and rectal bleeding.

An expert focusing on IBD treatment tells Wellnesspulse it may be too early to recommend the diet for the treatment of these autoimmune conditions.

'100% symptom resolution'

The study included six individuals with ulcerative colitis and four with Chron’s disease, who were recruited through a social media survey. All participants were responsive to treatment with a ketogenic or carnivore diet without medication or successfully stopped the medication while on any of these diets.

One of the participants is a 62-year-old man who has lived with Chrons’s disease for more than three decades. For the last four years, he has followed a predominantly carnivore diet, which includes small amounts of cooked cruciferous vegetables and fermented foods.

According to his testimony, most disease symptoms resolved, and the latest colonoscopy three years ago showed “no signs of Crohn’s activity in the small or large intestines.”

A keto-carnivore diet let me forget that I have Crohn’s. No drugs, no surgery. The decades that I dealt with Crohn’s are like another lifetime.

A study participant

A 63-year-old woman with more than a two-decades-long history of ulcerative colitis and psoriasis also switched to a diet predominantly based on red meat, eggs, and cheese, which also includes some low-carbohydrate vegetables like mushrooms and sauerkraut.

Shortly after initiating the diet, she noticed complete resolution of her psoriasis and went into remission with “100% symptom resolution,” her testimony suggests.

“After over 20 years, I’m disease and medication free! I was told that diet could not help me, but I guarantee you it helped. I lived it. I will never buy another candy bar again,” she told the researchers.

All participants saw increases in their scores on the IBD questionnaire, a tool assessing health-related quality of life in people with the condition. On average, the score increased by 121 points, from 95 to 216 out of a possible 224.

The findings echoed a case study from 2021. In an individual with severe Chron’s disease, following the paleolithic ketogenic diet led to the normalization of bowel inflammation and intestinal permeability. The individual was able to discontinue medication within two weeks and was free of symptoms and side effects fifteen months later.

The diet can help remove trigger foods

The study authors laid out several potential mechanisms behind low-carbohydrate diets helping achieve clinical IBD remission.

Both the ketogenic diet and the carnivore diet are restrictive, so they can help facilitate the elimination of “problem” foods, including those that may act as immune triggers.

During flares, people with IBD are recommended to limit the intake of foods rich in insoluble fiber, including fresh fruits, vegetables, and whole grains, as they could worsen diarrhea.

Ketogenic and carnivore diets induce ketosis, a metabolic state when the body burns fat for energy instead of glucose, resulting in increased levels of ketone bodies. According to the study, these are potent regulatory and signaling molecules that regulate the immune system and metabolism.

The diet may not be for everyone

The authors warn that the study should not be interpreted as advocating that all cases of IBD will improve with a ketogenic or carnivore diet. They say more research is needed to determine their effectiveness in the management of the condition and factors predicting responsiveness.

As of now, researchers don’t have sufficient data to tell what factors specific to a diet or an individual can improve a diet’s efficacy. They speculate that some individuals are less tolerant of plant matter than others, whereas others may be more reliant on ketosis.

Most importantly, the study isn’t a randomized clinical trial, which would normally compare the effect of a low-carb diet to a high-carb diet in individuals with IBD.

The dangers of low-carb diets

Healthcare professionals have long voiced concern about meat-based eating patterns. A very low-carbohydrate and ketogenic diet ranks lowest in the American Heart Association’s ranking of eating patterns promoting heart health.

Studies associate high consumption of red meat with a 30% higher risk of colon cancer in healthy people. Individuals with IBD are already more likely to develop this type of cancer, raising the question of whether following these diets can further increase the risk.

Due to their restrictive nature, these diets can indeed help lose weight, which normally returns as soon as the person returns to a normal eating pattern.

James Lewis, M.D., a gastroenterology professor at the University of Pennsylvania, says there isn’t enough evidence to routinely recommend a very low-carbohydrate diet for patients with IBD at this time.

Because we need to consume sufficient calories to support our functioning, following a very low carbohydrate diet means that people must consume more of other energy sources, including fat and protein.

Lewis

A 2021 clinical trial led by Lewis demonstrated that in patients with asymptomatic Crohn’s disease, the amount of red and processed meat consumed was not associated with symptomatic relapse. However, observational studies have suggested that there could be untoward consequences of consuming large amounts of red meat in ulcerative colitis.

The long-term health risks of a carnivore diet include the following:

• Deficiencies of essential vitamins, minerals, and phytochemicals
• Digestive issues like constipation, diarrhea, and bloating
• Kidney stones
• Heart disease
• Muscle loss due to rapid weight loss
• Cognitive decline, as carbohydrate is important brain fuel

More than half of people with IBD have micronutrient deficiencies, and many of them are underweight — about 65–75% of those with Chron’s disease and 18–62% with ulcerative colitis. These factors should be considered before switching to very low carbohydrate diets.

What is the best diet for IBD?

Online discussions reveal that more people with IBD found at least a temporary relief in the carnivore diet. One Reddit user claims that the carnivore diet “removed all their UC symptoms,” with the changes felt immediately after starting the diet. Another user with Crohn’s disease says they go on a meat-only diet every time they flare up.

However, it is impossible to verify if these experiences are real. Even if they are, these diets may not be applicable to all IBD patients.

For most people, Lewis recommends a more plant-focused or Mediterranean diet that avoids ultra-processed food to the extent possible. He says such diets are likely good for one’s overall health and potentially benefit IBD.

People with IBD are usually advised to stay away from trigger foods like alcohol, sweets and sweetened beverages, lactose, and fried and fatty foods, among others. However, these foods may impact different people differently.

IBD is a complex condition, and diet is far from being the only factor affecting its severity. Stress, low adherence to medication regime, viral infections, and lifestyle choices like smoking can also worsen IBD.

At this time, there isn’t enough evidence to recommend a carnivore or ketogenic diet for the treatment of IBD. Discuss the diet most suitable to your needs with your IBD doctor or dietitian.