Note: these tips should not replace advice from your physician. Always check with your physician before making any changes to your eating habits.
Yes, Food Matters
A healthy, balanced diet is important when dealing with Crohn's disease (CD). When your disease 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.
A poor or inadequate diet further jeopardizes the health of people with CD. 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 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.
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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 CD in genetically susceptible people. Omega-3 fats in fish oil and in some vegetables and nuts may help protect against inflammation.
One diet suggested for CD patients when they are feeling well is a diet that is recommended for everyone wishing to reduce their risk of chronic illnesses. It is similar to a Mediterranean-style diet. 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. A low-fiber/roughage diet may not be necessary when your disease is in remission unless you have strictures or fistulas.
Foods to possibly include are:
- Fish, which contain omega-3 fats
- Lots of fruits and vegetables
- 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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MyPyramid, offered by the USDA as a guideline for good nutrition, recommends selecting a wide variety of foods every day from its 6 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 bread or its equivalent 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
- Milk: Milk, yogurt, and cheese are included, especially varieties fortified with calcium. In addition to providing calcium, these foods contribute significant protein, zinc, and some vitamins. Aim for 3 servings 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
- Meats and Beans: These foods provide concentrated sources of protein. Select lean meat cuts (try to avoid chicken skin) and omega-3 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
- Oils: These provide vitamins A, D, and E, and essential fatty acids. Choose olive, canola, and flaxseed oils, and canola margarine, which are good sources of the beneficial omega-3 fats
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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.
Beautiful on the plate and good for you, too.
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