Staying Strong With UC: 9 Foods That Boost Nutrition
Ulcerative colitis, a type of inflammatory bowel disease, can cause things like diarrhea and abdominal pain, but it also impacts the body’s ability to properly absorb nutrients. In fact, more than half of folks with IBD experience weakness and fatigue from a micronutrient deficiency, according to a report in Current Opinion in Clinical Nutrition and Metabolic Care. “Many will have to take supplements, but diet changes can help, too,” says Ryan Warren, R.D., with The Jill Roberts Center for Inflammatory Bowel Disease at Weill Cornell Medicine in New York City. Here, nine foods to keep in your rotation for when you’re feeling good…and want to keep it that way!
Avocados are packed with potassium, magnesium, vitamin C, B vitamins, and folate—all nutrients that individuals with IBD tend to be short on. “They’re also a rich source of heart-healthy monounsaturated fats and healthy calories,” says Warren. That’s important because getting adequate calories is needed to prevent complications associated with IBD-related malnutrition. It’s estimated that 18% to 62% of those with ulcerative colitis experience malnutrition and that number grows to up to 75% of folks with Crohn's disease.
“Protein needs often increase with active IBD,” says Warren. “That’s because inflammation can decrease appetite, thus protein intake. But also, the inflammation of IBD may increase the body’s demand for protein on a cellular level.” A fab healthy-protein option: Fatty fish, such as salmon, tuna, sardines, or mackerel. Not only does a 3-ounce serving of wild Atlantic salmon clock 17 grams of protein, but “it’s a wonderful source of anti-inflammatory omega-3 fatty acids,” says Warren. And that’s why a 2019 report in the Current Treatment Options in Gastroenterology recommends that individuals with IBD incorporate omega-3-rich foods, like salmon, into their diet.
Sometimes it’s the foods you add into your meals or snacks that make a big difference. Take hemp hearts: This mild, nutty flavor pop is a nutritional powerhouse that can be sprinkled into smoothies, yogurt, cooked veggies—honestly, anything. “Hemp hearts are readily digestible and high in protein with about 10 grams per three tablespoons,” says Desiree Nielsen, R.D., author of the Eat More Plants Cookbook. “They’re also surprisingly high in minerals such as magnesium, zinc, and iron,” all nutrients that many with IBD struggle to get. (PS: Hemp hearts are unshelled hemp seeds that contain zero CBD or THC, which are chemicals found in cannabis.)
“I love spinach for helping to boost nutrition in IBD,” says Nielsen. “It’s got immune-supportive vitamin A and it’s rich in folate, iron, magnesium, and calcium, which individuals with IBD are often deficient in.” Leafy greens also contain a special sugar called sulfoquinovose that research suggests may be particularly beneficial to the gut microbiome. (Note: Skip the green stuff if you're mid-flare, as its high-fiber could make symptoms worse). The key, however, is to cook your spinach. This’ll help break down the fiber, making it easier to digest. While you can roast, grill, or boil, Nielsen prefers steaming her spinach. “It helps concentrate the nutrients, while also helping to improve bioavailability of the iron,” she says.
Plain Greek Yogurt
Inflammation of the small bowel can hinder the absorption of calcium. “And if you’re taking prednisone for IBD, that can further interfere with calcium retention,” says Warren. Plus, lactose (the sugar found in dairy) can trigger IBD flares. That means a lot of folks with IBD are dairy-avoidant and calcium deficient. But, if you can tolerate dairy, Warren suggests plain Greek yogurt. “It’s high in calcium and protein, but short on lactose and it has naturally occurring beneficial probiotics,” says Warren, further noting that consuming probiotic-rich foods can help restore the balance of bacteria in the GI tract.
Nuts, This Way
“Protein-rich nuts may not always be well-tolerated by those with IBD, but nut butters and blended cashew cream are easy to digest and mineral-rich,” says Nielsen. That’s great news since nuts are also a stellar source of healthy fats. “People with IBD often have difficulty getting enough nutrition, so being able to eat healthy fats can really help increase energy intake while being easy on the gut,” says Nielsen. You can use cashew cream as a stand-in for dips or sandwich spread, blend it into soups, or jazz it up for an alfredo-like sauce. Meanwhile, nut butters can be added to smoothies, used in energy bars, or grain-free cookies.
If you’re dealing with frequent bouts of diarrhea because of your IBD, you likely need to up your hydration game. When bowel movements are frequent and not well-formed, you get dehydrated and your body becomes sapped of fluids, nutrients, and much-needed electrolytes, such as potassium, magnesium, and zinc. To help, Nielsen recommends always having a large 32 oz water bottle with you to remind you to sip frequently. “Adding just a splash of fruit juice, say 1/4 cup per 32 oz, and a tiny pinch of salt can help you drink more and support better electrolyte balance,” says Nielsen.
“It’s a common misconception that those with IBD can’t have fruit,” says Nielsen. “You can build tolerance if you take it slow and steady.” Her suggestion: Start with fruit smoothies. The blending process breaks down the fruit, so your digestive system doesn’t have to work as hard. “I encourage those with IBD to keep it simple with 1 or 1.5 cups of 1 to 2 fruits,” says Warren. Next, add a nutrition boost, like nut and seed butters, silken tofu, avocado, or a protein powder made from an easily digestible source, such as brown rice protein.
“Broth-based soups can pack a lot of healthy vegetables, soft fibers, micro- and macronutrients, as well as hydration into your diet,” says Warren. Some of her favorite veggie add-ins include well-cooked carrots, parsnips, turnips, asparagus tips, and peeled squash, zucchini, and sweet potato. “They’re all nutrient-rich and filled with easily-digested fiber,” she says. Got leftover vegetable stock? Add it to rice or pasta dishes. And consider bone broth, too. “It’s a great source of easy-to-digest protein,” says Warren. “Sip on it as you would tea for a soothing, protein-rich drink that also helps folks with IBD meet their hydration needs.”
Deficiencies in IBD: Current Opinion in Clinical Nutrition and Metabolic Care. (2015.) “Micronutrient deficiencies in inflammatory bowel disease.” journals.lww.com/co-clinicalnutrition/Abstract/2015/11000/Micronutrient_deficiencies_in_inflammatory_bowel.9.aspx
IBD and Omega-3s: Current Treatment Options in Gastroenterology. (2019.) “Diet as Adjunctive Treatment for Inflammatory Bowel Disease: Review and Update of the Latest Literature.” link.springer.com/article/10.1007/s11938-019-00231-8
Spinach and the Gut: Nature Chemical Biology. (206.) 1“YihQ is a sulfoquinovosidase that cleaves sulfoquinovosyl diacylglyceride sulfolipids.” nature.com/articles/nchembio.2023
What to Eat With IBD? Crohn's & Colitis Foundation. (2017.) “General Nutritional Considerations for IBD Patients.” crohnscolitisfoundation.org/sites/default/files/legacy/science-and-professionals/nutrition-resource-/nutrition-fact-sheet-for.pdf
Malnutrition and IBD: Crohn's & Colitis Foundation. (n.d.) “Malnutrition and IBD.” crohnscolitisfoundation.org/diet-and-nutrition/malnutrition-and-ibd
Malnutrition Stats: Gastroenterology Research and Practice. (2017.) “Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide.” ncbi.nlm.nih.gov/pmc/articles/PMC5239980/