Intelligent Medicine®

Leyla Weighs In: Fasting-Mimicking Diet for Crohn’s and Managing Antibiotic-Associated Diarrhea

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Dietitian Nutritionist Leyla Muedin discusses a Stanford-led randomized controlled trial published in Nature Medicine in which a five-day, calorie-restricted fasting-mimicking diet improved symptoms and inflammatory markers in people with mild to moderate Crohn’s disease. In the three-month study of 97 patients, 65 followed monthly five-day cycles of 700–1100 calories/day with plant-based meals, while 32 continued usual diets; about two-thirds of the fasting-mimicking group reported symptom improvement, with fatigue and headaches but no serious side effects, and fecal calprotectin and other inflammatory molecules decreased. She notes bowel rest and the specific carbohydrate diet as additional approaches. The episode also explains how antibiotics can cause diarrhea by disrupting gut bacteria, lists higher-risk antibiotics, offers supportive steps (hydration, BRAT foods, avoiding irritants), recommends Saccharomyces boulardii taken away from antibiotics, and outlines warning signs requiring medical care, including possible C. difficile.

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