Diet and Nutrition
Diet and nutrition is important to everyone’s overall health, but plays an even bigger role for people living with Crohn's or colitis. While you're staying home during the COVID-19, it is important to try and identify food and drink that can worsen symptoms of IBD like diarrhea, constipation, fatigue or low energy, abdominal pain, bloating and cramping.
It is also important to understand your risk of becoming malnourished as it can increase your level of COVID-19 risk. You and your health care providers may need to use a combination of therapies to manage your nutritional health. This could include supplements and vitamins, enteral nutrition (feeding), or specific diets such as the Low FODMAP.
eating and drinking with ibd
Trigger and safe foods are different for everyone. As you live with this disease, you will learn to identify what they are.
During a flare, foods high in fibre can trigger obstructive symptoms – particularly if the bowel is narrowed due to inflammation – and should only be consumed after consultation with your healthcare provider.
Other trigger foods and drink may include the following:
Corn and snack foods made with corn like nacho chips
Whole nuts and seeds such as sunflower and pumpkin
Raw vegetables including tomatoes and bell peppers
Oranges and orange juice
Fried and fatty foods including high animal protein (red and processed meats)
Sports drinks and sweetened beverages
Alcohol and coffee
With careful supervision by a dietitian or your primary health care provider, it is not recommended to start avoiding specific foods or food groups for long periods. When you are in a flare-up and your gut is sensitive, you may choose to avoid eating certain foods for the time being and return to a more balanced diet when you feel better.
Tracking your food will help you to identify other trigger foods. Download the Crohn’s and Colitis Canada MyGut app to help you track how you feel after eating certain foods. This can help you and your health care provider to start to identifying the foods that cause discomfort.
For more information about Diet and Nutrition, check out our Eating Well with IBD webinar.
Nutrition and Supplements
People with Crohn’s or colitis are at risk for a variety of complications related to nutrition. When there is any stress related to illness, the body has to work harder to maintain good nutrition. You may be at risk of becoming malnourished and dehydrated if you are not getting the nutrition you need.
Nutrition is linked to immunity and infections and poorly nourished individuals are at a greater risk of infections including COVID-19. Infections can also lead to nutritional disorders or worsen the nutritional status of affected people
When you have a poor appetite, vomiting, diarrhea, cramping, gas, bloating or abdominal pain, it is clear why you may not feel like eating. You may avoid eating and drinking for fear of worsening your symptoms. This reduced nutritional intake can cause weight loss and growth impairment, specifically in children.
People with IBD typically experience nutrient losses, such as B12, calcium, vitamin D, and iron, due to poor food intake, malabsorption that occurs during digestion, and loss of blood during bowel movements. When the body does not receive or absorb the necessary amounts of nutrients, it has more nutritional requirements to keep it in good health.
Nutritional supplements and drinks can help increase your intake and limit further weight loss. Since your body may not be able to absorb sufficient amounts of vitamins and minerals, your healthcare provider may also recommend taking a daily multi-vitamin or supplements such as:
Nutritional supplements should not be considered to be substitutes for a good diet, because no supplement contains all the benefits provided by healthy foods.
Because COVID-19 is a new disease, there is currently no specific studies of special foods or supplements that help treat or prevent the infection. Vitamins and minerals can impact overall immunity, but no single one can solely influence immunity.
Nutrients related to immunity include:
Antioxidant-rich foods that may help boost your immune system include:
Vitamin A and beta-carotene: pumpkin, squash, carrots, spinach, sweet potatoes, cantaloupes, dark leafy greens, and mangoes
Vitamin C: citrus fruits, strawberries, bell peppers, cauliflower, broccoli, tomatoes, sweet potatoes, and asparagus
Vitamin E: vegetable oil, almonds, whole grains, wheat germ, sweet potatoes, and yams
Selenium: salmon and haddock
Zinc: oysters, beef roast and patties, baked beans, fortified breakfast cereal, pumpkin seeds, yogurt, cheese, oatmeal, peas, crab, lobster.
The internet can provide plenty of answers — some reliable, others not. It is important to use reliable sources and speak to your health care provider. A healthy, balanced diet should provide all the necessary nutrients we need.
Watch the 2-minute below to learn more from a registered dietitian and IBD specialist about using supplements for your IBD symptoms during the COVID-19 outbreak.
Make sure you’re eating:
A variety of fruits, vegetables, whole grains, legumes, and nuts
Moderate consumption of fish, dairy foods, and poultry
Limited intake of red and processed meat, refined carbohydrates, and sugar.
Specific diets and nutritional therapies can help achieve some of the health goals for people with IBD. Although there is no one special diet for people with IBD, but there are several diets that people commonly experiment with to find what works for them.
The low FODMAP diet is a well-known diet to help improve symptoms of IBD and irritable bowel syndrome (IBS), but is not known to help inflammation. Foods containing FODMAPs can trigger symptoms like gas, bloating, diarrhea, and abdominal pain in some people. Studies suggest following a low FODMAP diet may be useful to manage symptoms of diarrhea in some cases. Studies do NOT show this diet reduces inflammation in IBD.
FODMAP is an acronym that stands for different carbohydrate and sugar alcohols found in foods that ferment in the body. The key to this diet is eating less of the foods that ferment in your gut. The fermenting process results in a build-up of gas, which causes discomfort.
The following acronym depicts foods high in FODMAPs:
Oligosaccharides: Onions, garlic, wheat, rye, barley, artichokes, beans, and lentils
Disaccharides (Lactose): Milk
Monosaccharides And (Glucose & Fructose): Honey and certain fruits, such as apples, pears, and watermelon
Polyols: Artificial sweeteners in chewing gum and mints, and certain fruits and vegetables, like mushrooms and cauliflower
The way the diet works is to eliminate FODMAPs for 6-12 weeks to see if symptoms improve. If they do not change during this period, this diet may not be working for you. After the elimination period, slowly reintroduce the FODMAPs one by one to help identify the trigger. Work with a dietician to ensure you are following the diet correctly.
In general, FODMAPs are part of a healthy diet. Only lower your FODMAP intake if recommended by your healthcare provider.
Watch the 3-minute below to learn more from a registered dietitian and IBD specialist about using the Low-FODMAP diet to help manage IBD symptoms during the COVID-19 outbreak.
Vegetables: Onions, garlic, cabbage, broccoli, cauliflower, snow peas, asparagus, artichokes, leeks, beetroot, celery, sweet corn, brussel sprouts, and mushrooms
Fruits (“stone fruits” in particular): Peaches, apricots, nectarines, plums, mangoes, apples, pears, watermelon, cherries, and dried fruits
Other: Beans and lentils, wheat and rye, lactose, nuts, and sweeteners
During a pandemic grocery shopping may cause a lot of anxiety. During a time when food supply is limited and grocery store access is reduced, there are ways that can help. For example, home delivery services, special grocery store hours for high risk groups, and contactless curb-side pickup.
When you do go grocery shopping, try to spend as little time there as possible. This means that you should go to a store you know well and write a shopping list ahead of time.
Watch the 1-minute video below to get tips on grocery shopping during a pandemic from a registered dietitian.
You may find it more difficult to find fresh produce. Canned or frozen fruits and vegetables are a good alternative to make sure you are still receiving the nutrients you need. Keep an eye on your vegetables as you cook them; the more colour they lose, the more nutrients they lose - so don't cook them too long!
Watch the 2-minute video to learn how IBD patients can respond to the lack of fresh produce from a registered dietician.
take-out and delivery
Many people are wondering whether it is safe to order take-out or delivery food. As far as we know, experts say that it is safe to order take-out. Cooked foods are preferable because the high temperatures will kill the virus. Be sure to wipe down any external surfaces such as containers and wash your hands well.
Watch the 4-minute video of a registered dietician and IBD expert giving advice about ordering take-out, eating probiotics
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