3 common diet recommendations we don’t recommend for Crohn’s & colitis

You've likely heard these common diet recommendations for Crohn’s disease or ulcerative colitis, but we don't recommend them to most of our clients. Here’s why:

1. We generally don’t recommend tracking your diet for a long time

If you know what you're looking for, or are working with an IBD focused dietitian, tracking your diet for short periods of time may be helpful. But it may not be helpful to track your diet if you:

• Have a history of an eating disorder or an active eating disorder
• Believe your relationship with food is not in a good place
• Have feelings of guilt/shame after eating certain foods
• Think it might lead you to hyper-focus on food and restrict too many foods
• Have a fecal infection. If you have C. diff - you need to be on a antibiotic that will address the infection, and you need more nutrients, not less, during an infection
• Have severely active disease. If you have severe inflammation, it's likely not the food that's causing symptoms. You may want to reach out to your doctor about adjusting your medications. If you need help minimizing symptoms, work with an IBD focused registered dietitian (like us!)

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2. We generally don’t recommend eating 6 small meals a day

If you just had an IBD-related surgery, or are struggling to gain or maintain your weight, it can be helpful to eat every few hours. However, we don’t usually recommend this for the majority of people with Crohn’s and colitis because

• It’s not practical for most people: People often don't actually eat 6 small meals when given this recommendation, instead, they tend to eat 6 snacks throughout the day and snacks may not include all the nutrients you require which could lead to nutrient deficiencies. .
• Fatigue is a common problem: Up to 72% of people with active disease and 47% of individuals in remission experience fatigue.^  Three meals a day may already be a daunting task for those experiencing chronic illness related fatigue, and six can often feel overwhelming.. When you’re low on energy, the last thing you want to do is make preparing and eating meals harder than it already is. 

3. We generally don’t recommend following a low fiber diet

Fiber is essential for the health of our GI tract. In fact, diet guidelines for IBD recommend people with Crohn’s and colitis consume the same, if not more, fiber than the general population.^ So, instead of a low fiber diet, we recommend adjusting how you consume fiber  to make it better tolerated. If you find that certain types of fiber cause symptoms for you, or you’re not used to consuming a lot of fiber in your diet today, consider adjusting the type, texture, and amount of fiber in your diet to improve tolerance . 

• Type: peeled fruits or vegetables, and smooth nut butters tend to be better tolerated than unpeeled fruits/vegetables and raw nuts
• Texture: chopped, well-cooked, pureed, blended, or food-processed foods are typically better tolerated than raw and whole foods
• Amount: it's easier to tolerate small increases in fiber overtime instead of large increases in fiber quickly

‍Important note: If you have stricturing Crohn's disease, always talk with your IBD dietitian about how to include fiber in the safest way for you as an individual

Get support

If you’re experiencing symptoms, feel restricted on your current diet, or just want to improve your relationship with food, we can help! Reach out to learn more about working one-on-one with a dietitian who specializes in treating IBD.

We’ll help you sustainably expand your diet and reduce your symptoms so you can eat confidently again. Request a call to learn more or to get started!

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