TREATMENT OFIRRITABLE BOWEL SYNDROMEBY THE ZONE DIET Anthony J Dowell MB,BS, MSc, FACS, FRCS(C) Nanaimo Regional General Hospital
IRRITABLE BOWEL SYNDROME • Chronic functional disorder • Symptoms well known • Cause obscure • Treatments unsatisfactory: Prokinetic & antkinetic agents variably effective – suggests motility disorder neuronally or hormonally mediated.
1800: less than 1oz/day • 1900: 2oz/day • 1950: 5oz/day (3lb sugar beet, 24 apples) • 2000: 8oz/day (180 lb/year)
ZONE DIET • Current healthy diets restrict sugar and refined carbohydrate • Human gut has not had time to adapt to carbohydrate load since agricultural and industrial revolution • Zone diet takes this a step further by using diet to tightly control blood levels of major hormones, principally insulin. • Insulin a storage hormone, stores incoming calories as fuel for future use (fat) • Zone diet aims to control insulin levels within a tight zone by allowing a fairly constant absorption of low-glycaemic carbohydrate
80% of ability to control insulin levels – diet • 20% - exercise
ZONE DIET & I.B.S. • PILOT STUDY– 1 year • 35 patients • All female, 35-75 • Abd symptoms/pain, clinically IBS • TESTS – stepwise approach (Univ of Alberta) - minimize, R/O other causes constipation/diarrhea predominant pain • ZONE DIET - informed consent - prospective - randomized - follow up complete
RESULTS • Compliance 26/35 • Unchanged 0/26 • Improved 10/26 • Much Better 16/26
DISCUSSION • Numbers small, trend seems very apparent • No statistical analysis would be appropriate • Real or placebo effect? • Original observation • No other published literature linking diet or a hormonal mechanism with IBS • Crohn’s disease treated with growth hormone • Confirmatory studies underway Victoria
CONCLUSIONS • Symptoms of IBS seem to improve by controlling production of GI hormones, principally insulin, by The Zone Diet. • IBS may be hormonally mediated in response to excess dietary sugar & refined carbohydrate. • This has not been suggested before. • The best treatment for the condition may be cheap and plentiful, and is called food. • Clinical trial would seem worthwhile to test this. • Fundamental research is planned.