[HN Gopher] Researchers identify major driver of inflammatory bo...
       ___________________________________________________________________
        
       Researchers identify major driver of inflammatory bowel and related
       diseases
        
       Author : racional
       Score  : 178 points
       Date   : 2024-06-05 16:07 UTC (6 hours ago)
        
 (HTM) web link (www.theguardian.com)
 (TXT) w3m dump (www.theguardian.com)
        
       | datameta wrote:
       | Undoubtedly several different factors in the BioPsychoSocial
       | model contribute to epigenetic changes like those described in
       | the article.
        
       | sva_ wrote:
       | > Lee's research team "stumbled" on the discovery after
       | investigating a "gene desert", a stretch of DNA on chromosome 21
       | that does not code for proteins, which has previously been linked
       | to IBD and other autoimmune diseases. Writing in Nature, they
       | describe how they found a section of DNA that behaves like a
       | volume control for nearby genes. This "enhancer" was seen only in
       | immune cells called macrophages where it boosted a gene called
       | ETS2 and ramped up the risk of IBD.
       | 
       | > Through gene editing experiments, the scientists showed that
       | ETS2 is central to the inflammatory behaviour of macrophages and
       | their ability to damage the bowel in IBD.
       | 
       | Sounds like a win for CRISPR-Cas9
        
         | w10-1 wrote:
         | Partly. The "model" for inflammation that confirms a causal
         | relation doesn't look like it's ever been used before.
         | 
         | > To directly confirm that ETS2 was causal, we used CRISPR-Cas9
         | to delete the 1.85 kb enhancer region in primary human
         | monocytes before culturing these cells with inflammatory
         | ligands, including TNF (a pro-inflammatory cytokine),
         | prostaglandin E2 (a pro-inflammatory lipid) and Pam3CSK4 (a
         | TLR1/2 agonist) (TPP model; Fig. 1d and Extended Data Fig.
         | 2a-c). This model was designed to mimic chronic inflammation16,
         | and better resembles disease macrophages than classical IFNg-
         | driven or IL-4-driven models17 (Extended Data Fig. 2).
         | 
         | i.e., gene editing (by whatever means) is not really a win any
         | more than changing bits in memory is. The win comes from having
         | an in-vitro model that replicates the in-vivo disease, or from
         | correctly identifying the relevant genes (e.g., here ETS2 is
         | the furthest gene considered, and could easily have been
         | excluded).
        
           | ejstronge wrote:
           | > i.e., gene editing (by whatever means) is not really a win
           | any more than changing bits in memory is. The win comes from
           | having an in-vitro model that replicates the in-vivo disease
           | 
           | I take your point, but this would have been a challenging,
           | expensive endeavor before CRISPR-Cas9. Likely, the
           | perturbation would not have been done in the same paper as
           | the announcement of the locus due to the challenge of
           | deletion work before CRISPR-Cas systems became readily
           | available
        
       | lawrence1 wrote:
       | every holy grail is 5 years away. i've been reading this for 20
       | years now.
        
         | spondylosaurus wrote:
         | Honestly IBD is one area where we've made massive progress in
         | the past few decades. We went from having zero biologics (which
         | means your only options were mediocre oral meds, long-term
         | steroid use, or various -ectomies) to having dozens of
         | biologics that each target one of a handful of major
         | inflammatory pathways. Remicade was the first holy grail :)
        
           | kbf wrote:
           | I started on Remicade, but sadly I was one of the few who
           | didn't see results and I managed to get a lot sicker while
           | waiting for it to do its thing. I got put on Upadacitinib and
           | so far I feel a lot better, if it keeps working this well
           | then I'm very happy to just have a pill to take daily. It's
           | pretty new, but from what I'm hearing it's very effective.
        
             | spondylosaurus wrote:
             | Fingers crossed for the new pill! I've also heard that JAK
             | inhibitors work wonder for a lot of people who didn't get
             | results from TNF inhibitors. And it's probably way easier
             | to tinker with the dose if need be :P
        
             | jpm_sd wrote:
             | Upadacitinib has been a huge success for someone in my
             | family. Spectacularly effective.
             | 
             | This is after trying the Specific Carbohydrate Diet,
             | 5-ASAs, adalimumab, ustekinumab, and vedolizumab, none of
             | which offered more than minor relief.
        
         | jjtheblunt wrote:
         | i often thing such claims are progress updates from research
         | groups dependent on government grants for funding, so they need
         | to assert they will still need a next round of funding.
        
       | w10-1 wrote:
       | For auto-immune diseases, the question is always whether
       | suppressing over-activity will cause more disease than it
       | prevents.
       | 
       | In this case, the pathway affects macrophages, leucocyte
       | activation and migration, and production of 3 inter-leukin's and
       | other cytokines -- which doesn't offer much hope at avoiding off-
       | target effects. As they mention, this gene is shared as far back
       | as other proto-humans, so it's likely essential.
       | 
       | And they didn't really need this finding to consider targeting
       | (toxic) MEK at macrophages using antibodies, particularly since
       | GI drugs can be made relatively non-absorbable, further reducing
       | off-target effects. But since these are chronic diseases with
       | wide variations between patients of severity and tissue
       | involvement, and since macrophage activity is relatively acute,
       | the narrow therapeutic range of a MEK-based drug is far from
       | ideal: too much opportunity for overdose.
       | 
       | So I hope this stimulates more investigation of the ETS2-mediated
       | pathways, but I don't hold out much hope for a MEK + Ab drug for
       | IBD.
        
       | incomingpain wrote:
       | The major breakthrough is that perhaps a genetic test will be
       | able to identify you. That perhaps there's a drug in a decade
       | from now that might help?
        
         | bpodgursky wrote:
         | I haven't looked in depth but the risk allele info here is
         | probably enough for embryo screening.
        
       | hi41 wrote:
       | My son has Crohn's disease. He was very thin and underweight and
       | under height compared to his peers. My wife and I tried to
       | understand what we did wrong raising our son. Did we feed him too
       | much cheerios. Did we give him too much sugar, bread. Somehow the
       | modern diet is not suiting my son. I feel very guilty for giving
       | the chronic disease to my son with the food choices I made as a
       | parent.
        
         | ceejayoz wrote:
         | Nothing in this research appears to indicate fault of any kind;
         | rather, a genetic cause.
         | 
         | > Lee's research team "stumbled" on the discovery after
         | investigating a "gene desert", a stretch of DNA on chromosome
         | 21 that does not code for proteins, which has previously been
         | linked to IBD and other autoimmune diseases. Writing in Nature,
         | they describe how they found a section of DNA that behaves like
         | a volume control for nearby genes. This "enhancer" was seen
         | only in immune cells called macrophages where it boosted a gene
         | called ETS2 and ramped up the risk of IBD.
         | 
         | As parents we make plenty of real mistakes; blaming ourselves
         | for unavoidable stuff isn't worth adding to the pile.
        
         | Projectiboga wrote:
         | Don't feel bad there are huge corporations and even the
         | government pushing some foods. And the risk gene is rare, like
         | less than 2% Have you tried getting your son off all milk
         | products for a few weeks? And really try and avoid non organic
         | wheat, as it is harvested with roundup which is implicated with
         | leaky gut syndrome.
        
           | Turing_Machine wrote:
           | > And really try and avoid non organic wheat, as it is
           | harvested with roundup
           | 
           | That appears to overwhelmingly _not_ be the case, at least in
           | the United States.
           | 
           | https://www.snopes.com/fact-check/wheat-toxic/
        
         | extragood wrote:
         | I have Crohn 's disease and it's never occurred to me to fault
         | my parents. It is a genetic disease, and I can only hope that
         | the doctors you've worked with have helped you to understand
         | the basics so you can educate yourself and help your son.
         | 
         | There's been a lot of really encouraging progress in the 15+
         | years since my diagnosis, but there are still a lot of
         | unknowns. I got very little support in the dietary side of
         | things other than the infamous elimination diet approach. It
         | took a while for me to dial it in, but I did and am very rarely
         | sick these days, now that I've discovered my own food
         | sensitivities.
         | 
         | As much as you may want to solve this problem for him, it will
         | take an immense amount of maturity on his part to want to
         | discover and understand his limitations and to create and stick
         | to a sustainable lifestyle.
        
         | surfsvammel wrote:
         | I have IBD. Any sensible doctor will tell you that there seem
         | to be no link between diet and IBD, apart from certain food
         | possibly aggravating symptoms.
         | 
         | No use whatsoever to blame oneself for something like this.
        
           | kunai wrote:
           | The idea behind there being no link between diet and IBD is
           | nonsensical and patently unscientific.
           | 
           | From a layman's point of view, IBD is a single disease.
           | However, in reality, it's an umbrella term for a disease with
           | a _common set of symptoms_ and histological changes that can
           | have a variety of underlying etiologies. Some people are more
           | genetically susceptible, with family histories; others with
           | no family history can undergo changes in gut microbiota
           | composition, genome methylation, among other environmental
           | factors that influence development and progression of the
           | disease.
           | 
           | There are a bevy of peer-reviewed studies that show links
           | between better diets/exercise and an increase in SCFA-
           | producing microbiome components, which are known to suppress
           | inflammatory cytokines and improve innate immune mucosal
           | defense systems and free radical scavenging, promoting gut
           | healing. On the flip side, plenty of people with poor diets
           | and a lack of fiber are at a far higher risk of developing
           | IBD or some other autoimmune disease (like SLE or RA), even
           | certain cancers. It's why one of the most common strategies
           | to address mild IBD and IBS cases is to begin an elimination
           | diet and see which foods are triggers for inflammation.
           | 
           | You are correct that for many, diet isn't the reason _why_
           | people have IBD. But it does play a huge role in symptom
           | burden and the overall severity and prognosis of the
           | condition. This isn 't even considering the effect of
           | environmental contaminants (such as PFOA and BPA) on IBD
           | development, which has been well-known for over a decade now.
           | 
           | Ignoring science for a bit, just from the perspective of
           | common sense, the idea of what you put in your body not
           | affecting you is absurd and ridiculous. It's an idea pushed
           | by gastroenterologists who don't want to risk upset patients
           | who would rather not change their entire diet and lifestyle
           | to mitigate their disease, for a small portion of whom the
           | changes will not work anyways due to an underlying genetic
           | component to the disease. Still, there's nothing to lose and
           | everything to gain from adopting a healthier lifestyle.
        
             | spondylosaurus wrote:
             | IBD =/= IBS.
             | 
             | IBS is a common set of symptoms. IBD is short for
             | _inflammatory_ bowel disease, and it 's an umbrella term
             | for Crohn's disease and ulcerative colitis (UC).
        
               | kunai wrote:
               | My point seems to have flown over your head. Obviously
               | it's a given that I know that, I'm a histologist. My
               | point was that IBD is marked by histological changes
               | within gut epithelial tissue that suggest chronic
               | inflammation and elevated TNF-a and cytokine activity.
               | However, it doesn't mean that the causative agent of IBD
               | is the same for everyone.
               | 
               | If this was the case, and IBD was a purely genetic
               | illness with no environmental component, then it would be
               | literally impossible to study it. In labs we force mice
               | to ingest dextran sodium sulfate (DSS) which produces
               | persistent colitis by degrading the gut mucosa. It's
               | impossible to really tell without sequencing someone's
               | entire genome whether their IBD comes from genetic
               | factors or environmental factors.
               | 
               | Both IBD and IBS respond to changes in diet, as both
               | diseases involve degradation of the gut mucosa. Obviously
               | IBD is marked with inflammation as well, while IBS is
               | marked only by dysbiosis and abdominal discomfort.
        
         | Keyframe wrote:
         | is it confirmed? it can be celiac disease which can be managed.
        
         | meowster wrote:
         | Did you feed him what millions of other kids also ate? Since
         | millions of other kids don't have Crohn's disease, I can't
         | imagine that's the cause.
         | 
         | Happiness does not come from beating yourself up, but can come
         | embracing and making the best of a situation.
        
         | rmbyrro wrote:
         | Have you read the book "It Starts With Food"? I follow it 100%,
         | mine and my son's lives have changed for the better in
         | unbelievable ways.
        
         | exolymph wrote:
         | There are millions of kids out there eating nothing but toaster
         | waffles who don't have Crohn's. Your son's disease is not your
         | fault -- it's bad luck. It's certainly possible that eating a
         | specific way could help manage his symptoms, but that's
         | different from his diet (past or current) being the root cause.
        
         | adamredwoods wrote:
         | I'm sorry your son has Crohn's disease. You did nothing wrong.
         | I don't enjoy how people immediately blame themselves or others
         | for "eating wrong foods" when they encounter a new disease.
         | Some diseases will be caused by diet (or viruses, or bacteria),
         | but many others are not. Metabolic versus genetic causes.
         | Consider Celiac's disease: genetic or metabolic? It's a genetic
         | deficiency exacerbated by a metabolic pathway.
         | 
         | Also watch for lactose intolerance, it's easily controlled but
         | can cause discomfort when eating (I'm not saying your son has
         | exclusively this, but rather in addition to).
        
         | thrwwXZTYE wrote:
         | It's not diet. It's genes and stress.
        
         | bwb wrote:
         | Its genetic as well, and in general they just have no idea.
        
         | jononomo wrote:
         | I swear that if you put your son on a strict carnivore diet it
         | will heal his Crohn's disease. Check out the "success stories"
         | section of the carnivore.diet website and do a search for
         | "crohn's".
        
       | surfsvammel wrote:
       | Anyone got a link for the actual study paper?
        
         | breezeTrowel wrote:
         | Here you go:
         | 
         | https://www.nature.com/articles/s41586-024-07501-1
        
       | solfox wrote:
       | I was diagnosed with Crohn's disease when I was 13. I was on
       | various 3x-daily anti-inflammatory medications; doctors said I
       | would be on them the rest of my life.
       | 
       | I started going to therapy as an adult and made a lot of progress
       | in my mental health. I went off my medications 5 years ago and
       | have been healthy since without intervention - I give a lot of
       | credit to this work. I don't think we fully understand the role
       | of the mind/emotions in health; my advice to anyone suffering
       | from IBS and the like is not to forget the mind component to
       | overall health. When you're suffering in your head, it can
       | sometimes manifest in your body.
       | 
       | Gabor Mate talks a lot about this connection:
       | https://www.youtube.com/watch?v=1fPQ7Oc44SU
        
         | voisin wrote:
         | Can you speak more about the type of therapy you undertook? I
         | have a few non-threatening but otherwise annoying autoimmune
         | disorders and my bloodwork, diet, and exercise are all good but
         | have wondered if there is some underlying stress that could be
         | exacerbating things. I've considered therapy but honestly have
         | no idea where to start as there are a lot of different
         | modalities and each are expensive (both in money and time) to
         | spend 12-26 weeks exploring with sufficient depth before
         | determining whether or not it "worked" and then trying another.
         | 
         | After reading Pollan's "How to Change your Mind" I have
         | wondered if Psychedelics could be the answer to resetting
         | pathways.
        
           | bwb wrote:
           | You might look at aip diet. It is more gut centric but good
           | results for MS and similar.
        
         | kunai wrote:
         | Exercise is also a big one. It can be difficult to exercise
         | when you lack energy, but it's critical for your long-term
         | health, both physical and mental. The bidirectional gut-brain
         | axis is poorly studied but seems incredibly powerful compared
         | to the importance that medicine has traditionally given it.
        
         | semi-extrinsic wrote:
         | I also have Crohn's, been on anti-TNF and doing well for the
         | past 12 years.
         | 
         | I think it's absolutely universally accepted that stress is a
         | major factor in autoimmune and inflammatory disease. Reducing
         | stress by working on mental health definitely has the potential
         | to reduce inflammation levels in some people to the point where
         | you need no medication.
         | 
         | But like everything it's not a silver bullet.
         | 
         | Another weird/fascinating factor for me at least is that less
         | convenient access to a toilet seems to correlate with less
         | symptoms. When I'm hiking in the mountains I never seem to have
         | a high frequency of needing to take a dump. I've often wondered
         | if there is something of an explanation there for the rise in
         | rate of Crohn's diagnosis in countries as they develop.
        
           | qup wrote:
           | I don't have Crohn's, but I and many people I know experience
           | "not having to take a dump" for various reasons; for me,
           | traveling. The first few days of a trip I usually don't need
           | to go.
        
           | jkubicek wrote:
           | > Another weird/fascinating factor for me at least is that
           | less convenient access to a toilet seems to correlate with
           | less symptoms. When I'm hiking in the mountains I never seem
           | to have a high frequency of needing to take a dump.
           | 
           | AFAIK I don't have Crohn's or any inflammatory issues, but
           | boy is this an accurate description of me. My theory has
           | always been that my need to use the bathroom was strongly
           | correlated with coffee and food. When I'm home I'm constantly
           | drinking coffee and snacking, when I'm away from home I'm
           | not.
        
             | pvaldes wrote:
             | [delayed]
        
           | pvaldes wrote:
           | Is interesting. I wonder if this is because in absence of
           | stress, less chortisol is released and the body accumulates
           | less "toxics" by that, at a level that can still manage to
           | clean with common periods of rest. When people sleeps it
           | cleans garbage chemicals from the brain, chemicals that may
           | trigger inflamation. When people with Crohns wake up
           | naturally in Sunday or sleep one hour more, their symptoms
           | for the day would improve? If they drink all night and go to
           | bed at 6hAM on a Saturday, those symptoms would be worse?
           | 
           | Just a speculation that came to me after reading the article.
           | I could be wrong, but I would make a interesting test
           | probably IMO.
        
         | thrwwXZTYE wrote:
         | It's pretty obvious to me that asthma and colitis ulcerosa are
         | stress-related. I had asthma for as long as I remember. I'm
         | allergic to pollen and dust, but one of the triggers is high
         | stress situations as well.
         | 
         | I started having symptoms of colitis ulcerosa when I was 18 and
         | had final high school exams. I was under tons of stress. I
         | started to care much less about such things and had years-long
         | remission. There were only 2 other flare-ups - when I was
         | passing driving licence test, and when I had the first big
         | series of exams at university.
         | 
         | Basically every time I drove myself very hard I had another
         | episode. And it's not fun to suddenly shit yourself in public
         | transport let me tell you :/
         | 
         | It's been over 20 years since last time I had colitis ulcerosa
         | flare-up. But, in the meantime I was also diagnosed with
         | autoimmune liver disease (PSC), and I'm not sure this one is
         | stress-related. It seems to me it just ticks away at my liver
         | and even very relaxed lifestyle doesn't help. I'm very hopeful
         | about new drugs for this, as the only alternative seems to be
         | to wait for inevitable liver transplant later in life.
        
           | XorNot wrote:
           | I'm very sceptical of "stress related" explanations. They're
           | convenient in the sense they explain nothing.
           | 
           | Stomach ulcers were "stress related" until whoops: turns out
           | it's H. Pylori infections, and can be cured easily with
           | antibiotics.
        
           | eszed wrote:
           | As a counter-example (and not _at all_ to doubt your story),
           | I had my first (and worst) UC flare when I was literally the
           | happiest and most content I 've ever been in my life. I had
           | my second, a few years later, when I was on a religious
           | retreat, and under absolutely no stress whatsoever!
           | 
           | My UC is entirely diet related.
           | 
           | A doctor friend and I think we have - as amateurs, mind: his
           | specialty is very far from GI, but he reads and shares with
           | me every UC paper that's published; I have no medical
           | training, but am a motivated auto-didact on this subject -
           | identified three or maybe four etiologies which are lumped
           | together as "UC". The best gastro doc I've seen kinda
           | shrugged, and said (roughly) "probably so, but they all
           | respond to the same drugs in the same ways, so there's not
           | much motivation to draw distinctions".
           | 
           | I'm not quite sure what to think about that answer. I do
           | think it's good for patients to identify their own triggers.
        
         | thenerdhead wrote:
         | Regulating your immune system can mean many things. Gabor Mate
         | and Robert Sapolsky for example just talk about how too much
         | stress can affect your immune system and if you have the genes,
         | you may be more susceptible than others.
         | 
         | The good news of all this is that immune therapies are entering
         | their golden age. Hopefully that means in the future you can be
         | cured of these immune based diseases as we find the immune cell
         | culprits like macrophages here.
        
         | 0xcde4c3db wrote:
         | I recommend being careful with Mate. He's worth listening to
         | inasmuch as he has unique experience and some clearly
         | legitimate grievances with the medical establishment, but he
         | also seems indifferent to the limits of his own knowledge. In
         | my (layman's) opinion he tends to be too credulous toward
         | fringe theories/therapies and to make sweeping, radical
         | generalizations that don't comport with the broader evidence
         | base. For instance, his views on ADHD were called "worse than
         | wrong" by Russell Barkley, who is arguably _the_ leading expert
         | on ADHD [1].
         | 
         | [1] https://www.youtube.com/watch?v=bO19LWJ0ZnM
        
       | JohnMakin wrote:
       | God I hope something comes out of this. I have IBD, and it's very
       | difficult to put into words people can relate to how
       | debilitating, uncomfortable, inconvenient, embarrassing, and
       | painful these conditions are.
        
         | jononomo wrote:
         | Please try the carnivore diet. I have listened to dozens of
         | stories of people with IBD, Crohn's etc, who have been
         | completely healed on the carnivore diet. Check out the Revero
         | podcast to find some of the stories.
        
           | JohnMakin wrote:
           | I have noticed high amounts of animal protein and fat
           | sometimes alleviates my symptoms, but sometimes makes them
           | worse.
        
             | naasking wrote:
             | Maybe it's cured or other processed meats that are worse?
             | It was thought that red meat was linked to prostate cancer
             | but it turned out to be all due to processed and cured
             | meats. Perhaps the high salt content.
        
           | hombre_fatal wrote:
           | Or look for a dietary pattern that helps your IBD but isn't
           | atherogenic and doesn't require you to dismiss the science on
           | saturated fat and CVD like Shawn Baker / Revero.
           | 
           | Else you're just trading one problem for another.
        
           | kunai wrote:
           | It's better to attempt elimination diets rather than a single
           | type (low-fodmap, specific carb, carnivore, etc.) What works
           | for one person may not work for everybody.
        
           | covercash wrote:
           | Please stop suggesting this in such a definitive way. You're
           | not a doctor, more importantly you're not a GI doctor, and
           | most importantly you're not _their_ GI doctor.
           | 
           | There is currently zero credible research that shows a
           | carnivore/keto diet will reduce inflammation in patients with
           | IBD. The Mediterranean diet has some research showing
           | potential improvement in patients, so if anything, suggest
           | they talk to their doctor about that one. But don't position
           | it as a cure. There is currently no cure for IBD.
           | 
           | This is an extremely complicated disease and recommending
           | that people try "cures" you heard about on podcasts is not
           | helpful and potentially dangerous. It's the same line of
           | thinking that lead to people eating horse paste to cure their
           | COVID.
           | 
           | The best thing someone with IBD can do is to find a good GI
           | specialist that they trust and feel comfortable discussing
           | potential medications and lifestyle adjustments with. Then
           | when someone online recommends "cures" like carnivore diet,
           | they can take it to their doctor and discuss whether or not
           | it might be worth trying given their specific medical
           | circumstances.
           | 
           | Source: I built r/CrohnsDisease to 50k users
        
             | 93po wrote:
             | If I was desperate and suffering from something as serious
             | as IBD, I would be happy for people to casually suggest
             | trying something that has shown to work for others
             | anecdotally. Especially given the context of this very
             | article, which shows we don't entirely understand it .
        
       | wittystick wrote:
       | What about Arthiris? There's some link between UC and RA. I get
       | both flare up at the same time, and I use the same medication
       | (Azathioprine) to keep both in remission.
        
         | spondylosaurus wrote:
         | It sounds like ETS2 for sure has implications for spondylitis,
         | although unclear to me whether it's a direct link or just
         | because a lot of people who have IBD also have spondylitis. If
         | it's the former, then my guess would be that there's a link to
         | other types of arthritis as well.
        
       | dillutedfixer wrote:
       | I was diagnosed with UC in my mid-30's, am in my early 40's now.
       | I used to deal with flare-ups about twice a year that always
       | coincided with allergy season (May and October/November). I was
       | living in Colorado at the time and was drinking lots of heavy
       | craft beer quite regularly. Three years ago, I cut out about 98%
       | of alcohol from my life, and when I drank, I only drank clear
       | things - hard seltzers and gin. But only once or twice a month at
       | the most. I hadn't had a flare-up in that entire time, until this
       | last holiday weekend when I drank whiskey and was hit with
       | horrible UC symptoms immediately. As someone in the throes of a
       | flare-up right now, I have to say that research like this is
       | promising. But yeah, for me alcohol, primarily darker alcohol
       | like whisky and red wine, are an absolute trigger for me.
        
       | archsurface wrote:
       | "More than half a million people in the UK have inflammatory
       | bowel disease, the two main forms of which are Crohn's disease
       | and ulcerative colitis, with at least 7 million affected
       | globally" - either "at least" is doing a lot of work, or
       | something is going on in the UK.
        
         | erehweb wrote:
         | Maybe because of race. From https://www.ncbi.nlm.nih.gov/pmc/ar
         | ticles/PMC4130615/#:~:tex....
         | 
         | "Crohn's disease is found in all racial groups worldwide.
         | However, historically, the highest prevalence rates have been
         | reported in white populations, particularly those of North
         | America and Europe, with significantly lower rates seen in
         | black and Asian populations within these or any other foreign
         | country"
        
       | jononomo wrote:
       | I know this will get downvoted hard, but if you follow a strict
       | carnivore diet and eat only steak, then you will completely clear
       | up IBS, Crohn's, UC, and all those kinds of issues. You will also
       | completely eliminate acid reflux and any skin issues (eczema,
       | psoriasis, etc) will see dramatic improvement.
        
         | dsjoerg wrote:
         | can you provide a link to the research in support of this?
        
         | kunai wrote:
         | This is irresponsible advice. Some people find that meat
         | alleviates their symptoms while other people find more relief
         | from going vegetarian. Recommending a single type of diet
         | (especially a "fad" diet like the carnivore diet, rather than
         | one with some type of scientific basis like low-fodmap or
         | specific carbohydrate diets) as a panacea is not going to work
         | for most people. People can and should try elimination diets
         | instead, where you eliminate all but the most basic of foods
         | and slowly reintroduce foods over time to see which ones are
         | triggers.
         | 
         | It's entirely possible you or someone you know saw great
         | success with a carnivore diet, but others trying it might not
         | see the same results and need one tailored to their specific
         | gut microbiome.
        
           | amanaplanacanal wrote:
           | It's not uncommon to start your elimination diet with meat
           | only.
        
         | GrantMoyer wrote:
         | For the good of passers-by:
         | 
         | > There is no clinical evidence that the carnivore diet
         | provides any health benefits. Dietitians dismiss the carnivore
         | diet as an extreme fad diet, which has attracted criticism from
         | dietitians and physicians as being potentially dangerous to
         | health[1]
         | 
         | > By completely eliminating fruits, vegetables, whole grains
         | and plant-based proteins, diets like these simply can't provide
         | consumers with the nutrient-dense pattern of eating associated
         | with health benefits -- including decreased all-cause
         | mortality, heart disease, overweight and obesity, type 2
         | diabetes, and some cancers. In fact, dietary patterns
         | characterized by high intakes of red meat are associated with
         | detrimental health outcomes.[2]
         | 
         | [1]: https://en.wikipedia.org/wiki/Carnivore_diet
         | 
         | [2]: https://mcpress.mayoclinic.org/nutrition-fitness/a-meat-
         | only...
        
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