The Best Diet for Crohn's Disease

A type of inflammatory bowel disease (IBD) known as Crohn’s disease is a chronic illness that can affect any part of your GI tract, but most commonly the lower part of the small intestine and the beginning of the colon. Crohn’s disease can affect the thickness of the bowel wall and cause inflammation, ulceration, intense abdominal pain, diarrhea, and nutritional deficiencies¹. While there might not be a cure for Crohn’s disease, what you eat plays a critical role in managing it. The best diet for Crohn’s disease will vary from person to person. You should also talk to your doctor or your registered dietitian about your nutritional plan and about what supplements are right for you, such as vitamins, probiotic pills or drinkable probiotics.

Is there a special diet for Crohn's Disease?

While there is no specific cure-all diet known for Crohn’s disease, there are several diets that can be tried to help ease the symptoms. Eating or avoiding certain foods may help prevent flare-ups as well. With individual nutritional needs, the diet that best works for you and helps manage your Crohn’s disease symptoms, might not work for another person. Below are a couple of diets full of healthy nutrients that have shown positive results. You should always discuss any diet with your health care professional to avoid any nutritional deficiencies and ensure the diet fits with your lifestyle.

Low FOODMAP Diet

A low FODMAP diet, or FODMAP elimination diet, is a temporary eating pattern that limits the intake of food compounds called FODMAPs. FODMAPs are short-chain carbohydrates that the small intestine absorbs poorly and can cause digestive discomfort. Also, the primary diet in a SIBO diet plan, the low FODMAP diet is very restrictive and is suggested only as a temporary solution. Rolled out in three phases, Phase 1 is a complete restriction of high FODMAP foods. Phase 2 looks at the reintroduction of different FODMAP groups, one at a time, to find which foods trigger Crohn’s disease symptoms. After the FODMAPs that trigger symptoms have been identified, Phase 3 looks at modifying and adapting the FODMAP diet to form a personalized Crohn’s disease diet.

Several studies have been conducted on low FODMAP diets, and it has been found that the diet has an average success rate of about 68-76% of significantly improving IBD symptoms such as abdominal pain, bloating, and overall symptom response^2,3,4,5.

Specific Carbohydrate Diet (SCD)

The Specific Carbohydrate Diet (SCD) is a diet that only allows the consumption of certain carbohydrates called monosaccharides, or simple sugars of certain carbohydrates called monosaccharides, simple sugars and lactose but low in quantity. Any of the more abundant carbohydrates are excluded from the SCD diet (in other words, it is a grain-free diet). The SCD diet can help reduce inflammation in the digestive tract and was designed to help address IBD diseases such as Crohn’s disease. The theory behind the SCD diet is that by avoiding complex carbohydrates it will decrease the overgrowth of the unhealthy bacteria when having an inflammatory bowel disease and helping promote a balanced gut microbiota.

Foods allowed on the SCD: Fresh vegetables and fruits, (except those listed below and no added sugar or preservatives), unprocessed meat, fish, and chicken, eggs, homemade yogurt, oils, nuts, some legumes (lentils and lima beans), spices, very dry wine, and the occasional gin, bourbon or vodka.⁶

Foods not allowed on the SCD: All whole grains, starchy vegetables (such as potatoes, yams, and corn), added sugar, high lactose dairy (milk, ice cream, processed cheeses), processed meats and fish, dried and canned fruits, some legumes (soy, canned beans, pinto beans, etc.), beer, coffee, liqueurs, and juice boxes.⁶

The results? The SCD is a relatively new diet, but some of the early testing has shown positive results. In one study, 50 cases of IBD in remission were followed for 2-years, 36 of those being Crohn’s disease. Subjects followed the SCD diet, and it was shown effective in controlling acute flare symptoms by a mean of 91.3% and 92.1% effective at maintaining remission⁷.

Plant-Based Diet

A plant-based diet focuses on plant-based foods while reducing the intake of animal products and processed items. Looking very similar to vegetarianism or veganism, a plant-based diet doesn’t completely restrict animal products but limits their intake. The plant-based diet can vary depending on the extent a person limits the animal product in their specific version of the diet.

The basics of the plant-based diet include: limiting or avoiding animal products, focusing on plants, including vegetables, fruits, legumes, seeds, and nuts, and excluding refined foods like added sugars, white flour, and processed oils.

Can the plant-based diet help with Crohn’s disease? A study on one man found that switching to a plant-based diet relieved his symptoms and healed the mucosa in his gut. No evidence of Crohn’s disease was evident after about 18 months, and he was able to stop taking medicine⁸.

Gluten-Free Diet

A gluten-free diet is a diet that eliminates gluten, a protein found in wheat, barley, rye, and spelt. Eliminating gluten can help ease stomach pain and bloating for some people. Inflammatory bowel disease patients may notice some reduction in their symptoms with a gluten-free diet, but research has not proven the effectiveness yet^9,10. Gluten also happens to be the primary protein to cut out when looking for celiac disease foods to avoid.

What foods reduce intestinal inflammation?

If you have Crohn’s disease, you have probably found that certain foods can trigger your symptoms. Learning which foods spark your symptoms and avoiding them can help reduce your intestinal symptoms and help you self-manage your Crohn’s disease. Certain foods such as tomatoes, olive oil, green leafy vegetables (such as spinach, kale, and collards), nuts (almonds and walnuts), fatty fish (like salmon, mackerel, tuna, and sardines), and fruits (strawberries, blueberries, cherries, and oranges) are found to reduce levels of inflammation.¹¹ Making sure these foods are abundant in your Crohn’s disease diet can help decrease your inflammation if you are able to tolerate them well..

Are eggs good for Crohn's Disease?

Yes, whether you are having a flare-up or are in remission, eggs are a lean, easily digested protein. They are more tolerable to digest than other proteins such as beans, nuts, or meat. Eggs contain an essential amino acid, methionine, which is an antioxidant, and a vital part of all human cells. Packed with nutrition and protein, eggs are great to eat if you have Crohn’s disease,¹² as people with Crohn’s disease may have a higher need for proteins.

Foods to eat and avoid:

If you’re not following a specific diet, are there certain foods that you should be avoiding? Yes, some foods have proven to increase the symptoms of Crohn’s disease. These foods and their effects on symptoms will vary from person to person.

Foods to eat: Whole vegetables and fruit, fish, poultry, soluble fiber (oats, psyllium, and pulses), healthy fats (olive oil, non-hydrogenated nut/seed butters), eggs, dairy substitutes (almond or soy which are enriched in vitamin D and calcium) and water.

Low-fiber fruits such as bananas and peaches are easy on the digestive tract and can help control diarrhea. In particular, bananas are rich in potassium and can help maintain the balance of fluid in the body. Potatoes also happen to be a great source of potassium but should be eaten without their skin, which is high in dietary fiber and could cause intolerances for people with IBD.

As tolerated, you should look at eating insoluble fiber, which is in whole wheat bread, pasta and brown rice, dairy products, and nuts/seeds. These should be eaten in moderation, and each person will have a different tolerance level to these foods.

Foods to avoid: Red meat (beef, pork, lamb), processed meats, sugary beverages, soft drinks, juices, sweeteners, highly processed foods, safflower oil, corn oil, margarine, fast foods and “fad diets” full-fat dairy products, alcohol, coffee¹³.

Should I be incorporating Probiotics into my diet plan?

The large intestine is home to over 2,500 different species of gut bacteria known as the gut microbiota. The gut microbiota can contribute to the symptoms of Crohn’s disease through changes in the abundance of “bad bacteria.” Probiotics are considered “good bacteria” and are a bacterium that we eat for health benefits. They can help alter the balance of bacteria that already exist in the gut. The addition of probiotics to a Crohn’s disease diet plan can help promote intestinal healing by decreasing inflammation, remedying “leaky gut,” strengthening the tissue of the bowel wall, and regulating the response of the immune system. They are a primary component of a leaky gut diet as well.

Probiotics are made up of different strains or combinations of strains. Research suggests that probiotics may be useful in Crohn’s disease, but their effectiveness might differ depending on the strains that you ingest and which strains already exist in your gut. The different strains of probiotics can either have a positive or neutral effect on the symptoms of Crohn’s ^14,15,16,17.

Changing the gut microbiota with probiotics can be a therapeutic option for Crohn’s disease. When selecting the probiotic that is right for you, product-specific research is fundamental. Consider using an evidence-based probiotic like Bio-K+ ®. We have organic brown rice-based, milk-based, soy-based, pea-based, and vegan probiotics. Consult your doctor to make sure that taking probiotics is compatible with taking other medications such as corticosteroids and biological medications.

Fun Meal Ideas:

Not sure where to get started in the kitchen? Here are a couple of meal ideas to help kick things off.

For breakfast: Lactose-free yogurt parfait, scrambled eggs, fruit smoothies (make sure to pack some greens in there too!),

For a snack: Cucumber cottage-cheese toast, nut and seed banana slices, celery with peanut butter

For lunch: Turkey veggie roll-ups, tuna cucumber bites, chopped salad with hard-boiled eggs

For dinner: Butternut Squash Soup, Black bean burgers, and grilled fish with roasted asparagus and sweet potatoes.

Sources:

• ¹“Causes of Crohn's Disease.” Crohn's & Colitis Foundation, www.crohnscolitisfoundation.org/what-is-crohns-disease/causes.
• ²“Extending Our Knowledge of Fermentable, Short-Chain Carbohydrates for Managing Gastrointestinal Symptoms.” Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/23614962/.
• ³“Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols: Role in Irritable Bowel Syndrome.” Expert Review of Gastroenterology & Hepatology, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/24830318/.
• ⁴“Low FODMAP Diet: The D.I.Y Beginner's Guide (Plus PDFs).” Diet vs Disease, 10 July 2019, www.dietvsdisease.org/diy-low-fodmap-diet/.
• ⁵“Reduction of Dietary Poorly Absorbed Short-Chain Carbohydrates (FODMAPs) Improves Abdominal Symptoms in Patients With Inflammatory Bowel Disease-A Pilot Study.” Journal of Crohn's & Colitis, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/21172242/.
• ⁶“Specific Carbohydrate Diet (SCD) for Gut Health: Does It Really Help?” Diet vs Disease, 12 Aug. 2019, www.dietvsdisease.org/specific-carbohydrate-diet/.
• ⁷“The Specific Carbohydrate Diet for Inflammatory Bowel Disease: A Case Series.” Redirecting, doi.org/10.1016/j.jand.2015.04.016.
• ⁸“Crohn's Disease Remission with a Plant-Based Diet: A Case Report.” MDPI, Multidisciplinary Digital Publishing Institute, 20 June 2019, www.mdpi.com/2072-6643/11/6/1385/htm.
• ⁹“Special IBD Diets.” Crohn's & Colitis Foundation, www.crohnscolitisfoundation.org/diet-and-nutrition/special-ibd-diets.
• ¹⁰“Tyrosine Cross-Links: Molecular Basis of Gluten Structure and Function.” Journal of Agricultural and Food Chemistry, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/11368646/.
• ¹¹“Foods That Fight Inflammation.” Harvard Health, www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation.
• ¹²“Goodness of Eggs.” Gastrointestinal Society, 20 Apr. 2020, badgut.org/information-centre/health-nutrition/goodness-of-eggs/.
• ¹³“An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease.” Nutrients, MDPI, 10 Mar. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5372922/.
• ¹⁴“Crohn's Disease Diet: Explaining The Evidence in Plain English.” Diet vs Disease, 18 Mar. 2020, www.dietvsdisease.org/crohns-disease-diet-treatment/.
• ¹⁵“Intestinal Microbiota, Probiotics and Prebiotics in Inflammatory Bowel Disease.” World Journal of Gastroenterology, Baishideng Publishing Group Inc, 7 Sept. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4155344/.
• ¹⁶“Irritable Bowel Syndrome Symptom Severity Improves Equally with Probiotic and Placebo.” World Journal of Gastroenterology, Baishideng Publishing Group Inc, 28 Dec. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5192275/.
• ¹⁷“Modulating Composition and Metabolic Activity of the Gut Microbiota in IBD Patients.” International Journal of Molecular Sciences, MDPI, 19 Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4849034/