A starting point of discussion on diet and IBD

In 2020, The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) released evidence-based dietary guidelines for controlling or preventing relapse of IBD. Their recommendations focus on specific dietary components, food groups and food additives that may be prudent to increase or decrease in the diet in patients with Crohn’s disease and ulcerative colitis. 

Here are their key recommendations summed up in a pretty chart:

Video abstract on the IOIBD guidelines

Have 5 minutes? Check out this very brief video abstract where I discuss the study’s findings, strengths and limitations:  


RDNs Weigh in on IOIBD Guidelines

This video abstract sparked a lively discussion on Twitter (@IBDClub) where IBD dietitians shared their expert advice…

Here are five of my favorite takeaways: 

  1. Dietary fiber does not cause flares, so IBD patients are not destined for a life without fruits, vegetables and other high-fiber foods. 
  2. Repeatedly, evidence shows that fiber is good for gut health. It feeds the beneficial gut microbes, promotes bowel regularity, supports the gut barrier and reduces inflammation. 
  3. HOWEVER, not everyone with IBD can eat all forms of high-fiber foods. Those with active symptoms or risk for obstruction (e.g. stricturing Crohn’s) will benefit from limiting or avoiding roughage. Choose foods that are soft or pureed (think peanut butter vs peanuts / a smoothie vs a salad). 
  4. Consider the overall dietary pattern versus individual foods or ingredients. For example, if someone with ulcerative colitis eats a well-balanced diet with lots of whole or minimally processed foods, it’s very doubtful they’d have to worry about some coconut oil. 
  5. There is no one perfect diet for everyone with IBD. Diets MUST be personalized.