Controlling your IBD
Diet and Nutrition - Introduction
Everyone is different, and there is no 'Wonder Diet' for
people with IBD. So, consult your healthcare professional before
undertaking any dietary change, or experimenting with a new diet
When you have IBD it is common to be concerned that
particular foods may 'trigger' the condition or make symptoms worse.
Diet is not the cause of IBD, but dietary choices can help to manage
your symptoms. Other lifestyle factors can affect your health in
IBD, such as exercise; a modest 30-minute walk three times a week
has been shown not only to improve mental outlook, but also to
improve bone mineral density, an important predictor of osteoporosis
risk in later years.
The more varied your diet, the healthier it will be. A
healthy diet is more about what you keep in your diet, rather than
what you cut out. If you exclude foods but find no real difference
in your symptoms then you should reintroduce them back into your
Healthy eating keeps the body well, helps it repair any
damage, resist inflammation and to heal more quickly if symptoms
So what is a healthy diet?
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The Food Standards Agency has defined the 'Eatwell plate' to
show how much of each food group you should eat to have a healthy
balanced diet (Figure 1).
Figure 1. The Food Standards Agency 'Eatwell Plate'
showing food proportions in a healthy diet
(© Crown copyright material is reproduced with the
permission of the Controller of HMSO and Queen's Printer for
contain soluble fibre - a gel-like fibre digested by bowel
bacteria. This type of fibre is sometimes called 'prebiotic' as it
helps healthy 'probiotic' bacteria to survive and multiply. Soluble
fibre is gentle on the bowel wall; it can absorb water and so reduce
diarrhoea and produce a softer stool.
Soluble fibre is found in
all types of carbohydrate foods, including white bread, porridge
oats and some vegetables and beans.
include meat (beef, lamb, chicken, pork), fish, dairy foods
(milk, yoghurt, cheeses), soya milk and tofu. All these are fibre
free. Protein from peas, beans, lentils and soybean also provides
Proteins are needed daily because we don't store
protein to call on when our bodies need more. Protein maintains a
healthy bowel and boosts your immune system - both essential for
good health. If you have inflammatory bowel disease you may need
additional protein to help repair your bowel. Try to include protein
foods at every meal.
are high in protein, fibre-free and rich in calcium and
phosphate - essential for healthy bones. Bone strength is related to
its density, which peaks in your early 30s. Prolonged use of
steroids can weaken bones, so calcium-rich foods, such as dairy
products, are important to help bones recover. However, dairy foods
may be poorly tolerated. This can be due to fat content, protein
type, or sugar content. If you find dairy products (particularly
cheese) 'hard to digest', try lower fat options first. Choose
semi-skimmed and skimmed milks, low fat yoghurts, reduced fat
cheeses (such as half-fat cheddar or Edam) or low fat cheeses (such
as cottage cheese) to reduce
fat but keep essential
protein. You may need to reduce the amount of other fats in your
diet as well.
Milk protein is made of casein and whey. Whey
protein empties from the stomach more quickly and so lessens
feelings of 'fullness'. Goat's milk and cheeses have a higher whey
content which may be preferred.
Dairy foods contain milk sugar (lactose) which is
found in milk, yoghurt and soft cheeses: windy, explosive diarrhoea
is commonly associated with lactose intolerance. If these symptoms
seem familiar try a
Fruits and vegetables
are rich in vitamins, minerals, anti-oxidant plant
substances and many contain soluble fibre and insoluble fibre, all
useful to boost our health. Research shows that people with IBD don't eat enough fruits and vegetables. When your IBD is under
control include fruits and vegetables throughout the day. If you're
worried about symptoms, start with a small portion and gradually
increase over time. You may tolerate cooked or canned versions
better than raw.
Fats and oils
provide calories, essential fats we can't make ourselves,
and fat-soluble vitamins A, D, E and K.
Vitamin D seems to have an important role in Crohn's
disease. Fat also helps the body absorb important plant
anti-oxidants such as beta-carotene and lycopene.
Olive oil and rapeseed oil, both rich in
mono-unsaturated fats, are the healthiest oils to use. Omega-3 fats,
found in oily fish and rapeseed oil, may help to reduce
inflammation, but not during active phases. For an average adult
diet, 70-90g of fat daily is an acceptable amount. Some people find
a high-fat diet worsens their symptoms and that reducing fat intake