Corinne Metzger, M.S.

You get a cold or a flu and you feel awful. But after a couple days or a week you get back to feeling normal again. These are the typical illnesses most people face. But there are illnesses that do not go away, that continue to impact the way someone feels and lives on a day-to-day basis, and sometimes these diseases even begin to impact other parts of that person’s body leading to more problems. A group of conditions known as inflammatory bowel disease (IBD) are diseases just like that. These conditions involve inflammation along all or parts of the gastrointestinal tract. They often develop in young adulthood and result in a life-long struggle to prevent flare-ups and manage the disease. All current treatments for IBD simply try to manage the symptoms as there is no current cure. But, unfortunately, the treatments often cause other problems like increasing one’s risk of developing serious infections.

IBD not only effects the gastrointestinal tract, but also significantly damages other parts of the body like bone. Patients with IBD have a 40% greater fracture incidence than the average population (Bernstein, Ann Intern Med, 2000). Vertebral compression fractures, fractures of the bones of the spine due to low bone mass, are present in 1 in every 5 patients with IBD (Klaus, Gut, 2002). Amazingly these rates of fractures in young adults with IBD are similar to the incidence seen in post-menopausal women, the population most commonly effected by low bone mass.

So if IBD is incurable and the current treatments can do harm while trying to do good, are there other alternatives? Researchers at Texas A&M University are exploring dietary and exercise interventions using a rodent model of chronic IBD. In one study, IBD rats were fed a soy protein diet to determine if it could mitigate the inflammatory condition and bone loss. The IBD rats with the soy protein had much healthier gut and bone outcomes and were significantly improved from the IBD rats that did not receive the diet. One factor that closely predicted the changes in osteoclasts, the bone cells that digest bone leading to bone loss, was a pro-inflammatory factor, interleukin-18 (IL-18). The soy diet benefited the IBD rats by lowering IL-18 levels and reducing osteoclast activity. IL-18 has also been shown to decrease due to exercise training indicating another potential mechanism to improve the health of patients with IBD. Other studies have shown pharmaceutical intervention of IL-18 can be beneficial to IBD, but we do not know if bone loss is prevented.

So can we cure the incurable with diet and exercise, or perhaps other means? Only time will tell, but the research points to hope that there may be in addition to drugs, non-pharmacological ways to help control

the symptoms of chronic inflammatory conditions that do not have side-effects like making them susceptible to getting sick. In the meantime, it certainly wouldn’t hurt to tie up your running shoes and reach for an extra serving of soy milk!

 

References

1) Bernstein Bernstein CM, Blanchard JF, Leslie W, Wadja A, Yu BN. Incidence of fracture among patients with inflammatory bowel disease. Ann Intern Med. 2000; 133: 795-799.

2) Ghishan, Fayez K., and Pawel R. Kiela. "Advances in the understanding of mineral and bone metabolism in inflammatory bowel diseases." American Journal of Physiology-Gastrointestinal and Liver Physiology 300.2 (2011): G191-G201.

3) Redlich K, Smolen JS. Inflammatory bone loss: pathogenesis and therapeutic interventions. Nature Reviews Drug Discovery 11 (2012): 234-250.