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Does What I Eat Matter?

Yes, Food Matters When Planning a Crohn's Diet

Developed with the assistance of Dietitian and Nutritionist Alison Bencke

A healthy, balanced diet is important when dealing with Crohn's disease. When your Crohn’s is inactive (in remission), you need to eat well to help raise your nutrient levels from previous flare-ups. This ensures a good supply of nutrients to replace cells and tissues damaged from the inflammatory processes. (Read more about nutrients important to people with Crohn’s in the Summer 2010 issue of Crohn’sAdvocate magazine.)

A poor or inadequate Crohn’s diet plan can further jeopardize the health of people with Crohn’s. If there is active disease in the small bowel, absorption of nutrients into your body may be reduced. Therefore increased energy and nutrients, especially protein, are needed during and following disease flare-ups.

If you have active inflammation in your ileum (the lower end of your small bowel) your doctor may suggest bolstering your Crohn’s diet plan with nutritional supplements including folate, iron, and vitamin B12. Absorption of these nutrients normally occurs in the ileum and may be impaired by a flare-up. Other nutrients, such as fat-soluble vitamins A and D, may need to be supplemented if you are on certain medications. Always talk to your doctor before taking any new vitamin supplements.

The role of food in managing Crohn’s disease

The exact causes of chronic gut inflammation are unclear. However, poor eating habits and "junk food" high in animal fat or saturated fats, typical in western-style diets, are suspected of triggering Crohn’s in genetically susceptible people. Omega-3 fats in fish oil and in some vegetables and nuts may help protect against inflammation.

One Crohn’s diet plan suggested for people who are feeling well is similar to a Mediterranean-style diet and is recommended for everyone wishing to reduce their risk of chronic illnesses. For adults, this means an eating pattern with reduced fat (low in saturated fat particularly), increased omega-3 polyunsaturated fats (omega-3), and increased fiber.

Foods to possibly include are:

  • Fish, which contain omega-3 fats
  • Lots of fruits and vegetables
  • Legumes
  • Some nuts (crush if necessary)
  • Whole-grain cereals and breads
  • Olive or other oils high in omega-3, such as canola or grape seed oils

You might consider adding lean red meats and dairy products for additional vitamins and minerals. If you have food allergies or are vegan or vegetarian, check with your doctor, dietitian, or nutritionist.

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ChooseMyPlate recommendations

ChooseMyPlate, offered by the USDA as a guideline for good nutrition, recommends selecting a wide variety of foods every day from its 5 food groups. This will help you to achieve a well-balanced diet that gives you adequate energy and all essential nutrients. Please check with your physician before making any changes to your eating habits, or if you have questions about the following recommendations:

  • Grains: These include whole-grain breakfast cereals (many are fortified with folate), whole-grain breads, crackers, muffins, rice, pasta, and corn (use creamy corn only if you have strictures). These foods provide soluble and insoluble fibers, starches, carbohydrates, B vitamins, iron, and some zinc. The amount required depends on your energy needs; however, a minimum healthy guideline is 6 ounces of grains, including 3 ounces of whole grains every day
  • Vegetables: These are good sources of many vitamins, minerals, and fiber. Many provide potassium, dietary fiber, folate (folic acid), and vitamins A, C, and E. Aim for 2 1/2 cups of vegetables every day
  • Fruits: Like vegetables, fruits are an important source of nutrients like potassium, dietary fiber, vitamin C, and folate (folic acid). Aim for 2 cups of fruit every day
  • Dairy: Milk, yogurt, and cheese are included, especially varieties fortified with calcium. In addition to providing calcium, these foods contribute significant protein, potassium, and Vitamin D. Aim for 3 cups of fat-free or low-fat dairy every day. If you avoid milk because of lactose intolerance or personal choice, the most reliable way to get the health benefits of milk is to choose lactose-free alternatives within the milk group, such as cheese, yogurt, or lactose-free milk, or to take the enzyme lactase before consuming milk products so you can tolerate them
  • Protein: Select lean meat cuts (try to avoid chicken skin) and eggs. Eat fish, particularly oily fish, at least once a week. You might include lean red meat (beef, lamb, or pork) 3 to 4 times a week for adequate iron and zinc. Soy products are another useful source of protein. Healthy eating guidelines suggest 5 1/2 ounces of these protein-rich foods every day

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Have strictures in your small intestine? Avoid these foods

Crohn's disease patients with strictures (narrowing in the gut) may have problems with hard foods like whole peas, whole corn, and some seeds. These foods may be unable to pass through the stricture, leading to pain and possible bowel blockage. Please check with your physician, dietitian, or nutritionist regarding what diet you should follow. Some recommendations may include avoiding hard foods like whole peas, whole corn, and some seeds. Whole nuts or hard raw vegetables should be avoided or should be pureed or finely chopped in recipes.

If any strictures are high up in the small intestine, meats may need to be cut up or minced. Lean red meat should not be avoided without consulting your doctor and dietitian as this meat supplies significant amounts of protein, iron, vitamin B12, and zinc. Large volumes of fiber may also cause discomfort or blockages in patients with strictures. A low-residue, or low-fiber, diet should be used during this period.

Note: These tips should not replace advice from your physician. Always check with your physician before making any changes to your diet or exercise habits.

See also: Registered dietitians: your new best friend, Videos of people living with Crohn’s, Doctors and insurance

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