Individuals with inflammatory bowel disease (IBD) are often in, what the scientific community refers to as, “negative nitrogen balance”. This is when nitrogen (i.e. protein) intake is less than that which is lost. In summary, inflammatory bowel disease can contribute to protein malnutrition, of which the consequences are vast—delayed tissue repair, muscle loss, weight loss and growth retardation, to name a few.
When flaring, those with IBD experience gas, bloating, intense abdominal pain and diarrhea (in some cases bloody diarrhea). To mitigate some of the discomfort, these individuals generally select bland, low-fibre foods and reduce the volume they consume. As such, one would be inclined to believe that the degradation of the intestinal tissue, rapid transit time through the bowels and a low-caloric intake are what contribute to the negative nitrogen balance. This is true, but research findings by Lundsgaard et al. have added another layer to the story. In their paper published in the Journal of Hepatology, liver function was also a factor. In the liver, nitrogen is converted to urea for elimination through the kidneys and bowels. However, in those with inflammatory bowel disease, it was discovered that the rate of conversion is accelerated1 i.e. compared to healthy subjects, the rate of nitrogen loss is greater in those with IBD. Therefore, in vulnerable individuals, protein intake must be increased from the standard 0.8g/kg/day.
For optimal health, the University of San Francisco Medical Center has outlined the following protein requirements for individuals with IBD2:
Following a flare, if trying to gain weight or if on corticosteroids (prednisone): 1.5g/kg/day
The very nature of IBD leads to tissue losses, reduced muscle mass and weight loss. These should not be further exacerbated by inadequate protein intake. With the information listed above, those with inflammatory bowel disease are one step closer to optimizing wellness.
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