The amino acid glutamine is the preferred fuel for small intestinal enterocytes and can decrease intestinal permeability, a potential benefit for Crohns Disease patients. Duodenal biopsies from healthy volunteers were cultured in the presence of the inflammatory cytokine-enhancing IL-1beta and increasing amounts of glutamine. Glutamine inhibited IL-1beta-induced production of pro-inflammatory cytokines IL-6 (found to be high in the serum and mucosa of Crohn's Disease patients83) and IL-8, and enhanced production of the anti-inflammatory IL-10.247
Despite theoretical indications for glutamine supplementation in Crohn's Disease, several small intervention trials have not yielded benefit. In a double-blind study to determine if glutamine decreases gut permeability in Crohn’s disease, 14 Crohn's Disease patients were randomly assigned to receive 7 g glutamine or placebo (glycine) three times daily along with their conventional treatment. There were no significant changes in permeability during the four-week trial in either the glutamine or placebo groups. In addition, no significant changes were seen in CDAI, CRP, or plasma glutamine/ glutamate levels.248
Two studies investigating high-glutamine diets in children with Crohns Disease also found no significant benefit. Eighteen children received either a low-glutamine (4% of amino acid content) polymeric diet or a glutamine-enriched (42% of amino acid content) polymeric diet to determine whether glutamine enhances rate of remission. After four weeks, 5/9 in the low-glutamine group and 4/7 (two patients dropped out of this group due to diet intolerance) in the high-glutamine group achieved remission. Pediatric CDAI was significantly lower in the low-glutamine group, indicating greater response to the low- than high-glutamine diet.249 In a second arm of the study, glutamine did not affect intestinal permeability.250
Growth is often stunted by childhood Crohns Disease and low serum levels of insulin-like growth factor- 1 (IGF-1) have been implicated. In doubleblind fashion, 15 children with Crohn's Disease were assigned to receive one of two diets (same amino acid content as previous study) and the effect on IGF-1 assessed. No significant changes in IGF-1 were noted after four weeks of supplementation.251 :)
Hey, The dame behind the counter here. IMHO, I have to agree that many if not most protein drinks and bars contain too much junk for Cronies like us. At the suggestion of a co worker dude (76 and still well cut) who chaired the bodybuilders group in our state, I do take 5-10gr of glutamine (as a glutathione process aid, in theory)in 8oz of concord grape juice before long bike rides, and it seems I have less muscle ache when I over do it. I do this often, we have a great new trail system in our city, and I love it. Some of the G/I Docs at a local hospital use 15gr 3x daily for post surgery patients, and they seem to recover well.
Some bars are OK, but I don't know of any that are high protein and tolerated well by IBDer, except a few by Garden of life or Living fuel, but they are totally not cost efficient and contain many seeds, so must be chewed, chewed, and chewed some more. The rest tend to be overrated candy bars.
If I use a protein powder myself I use Bio-Chem, it is GF, lactose free and very easily absorbed. It was designed for IBDers and elderly persons. Many body builders use Designer Whey and it is good, if you can tolerate it well, but I think it has lactose.I tell people to start with the plain or vanilla then add fat, sweeteners, fruit and calories This gives you control over what you put in your body (like 40/30/30), plus you can change up the flavors. Body Builders who shop with us use avocado for some good fats, and often add more protein in the form of Egg White protein. I still like whole eggs, we eat way more than one a day here and with no cholesterol issues, even for my 400lb husband who is diabetic. Bananas for fiber and flavor are good. Some use just protein powder, frozen concentrated. OJ and some water or apple juice with ice in the blender for an creamy orange slush. I can't say enough about berries and red fruit for general health, and many add Acai puree.
Post Edited (Margie11) : 3/3/2009 8:33:24 PM (GMT-7)