Should You Try This Diet With UC?
Keto. Paleo. Gluten-free. With new trendy diets popping up on the regular—and going mainstream—it can be tempting to want to see what all the fuss is about. But if you have UC, caution is king (as if we had to tell you that, right?). Even if a diet sounds healthy, there could be hidden minefields of ingredients that cause symptoms to flare. We asked the experts for insight on some of the latest diet trends to get a bottom line on those you can embrace, and others to avoid.
What Should I Eat, Anyway?
That’s a great question—with no easy answer, because what may cause your buddy to sail through a meal could make you skip to the loo. “There is no one diet per se that is best for UC, but in general any food that decreases inflammation is what we’re looking for,” Gabriela Gardner, R.D., a clinical dietician with Memorial Hermann-Texas Medical Center's Ertan Digestive Disease Center in Houston. “This means healthier fats, staying away from additives, and sticking to a natural diet is generally a good bet for those with the condition.”
Vegetarian and Vegan
Eschewing meat and/or dairy may seem healthy for the general population—but what about those with UC? The main consideration with a veggie-focused diet is fiber, says Sunitha D. Posina, M.D., an internal medicine specialist in Stony Brook, NY. “Plant-based diets can be very high in fiber, which may be too activating for your bowels,” she says. “If you’re eating all these fruits and vegetables, you really have to test it out. I’d stay away from raw vegetables because it’s harder on your digestion.”
As with vegetarian diets, the Mediterranean diet’s high-fiber content is a potential drawback. But otherwise, our experts gave it an enthusiastic thumbs up. “I love the Mediterranean meal pattern, it’s one of the things I generally recommend for those with UC,” says Gardner. “The focus on fruits and vegetables, fresh foods, olive oil, nuts and seeds, and it’s something I absolutely encourage my patients to try.” Her advice: Start slow and incorporate the meal pattern based on your individual tolerance and symptoms.
A gluten-free diet keeps diarrhea, constipation, and bloating associated with celiac disease at bay. But it probably won't have much affect on your UC: While celiac disease and gluten sensitivity are related to the small bowel, ulcerative colitis affects the large bowel. “I see more gluten intolerance with Crohn’s patients than UC patients,” says Gardner. “UC has to do with the colon more than digestion, and while it’s possible someone with UC could have intolerance to gluten, we don’t have evidence that gluten actually causes inflammation.”
The goal of this high-fat, low-carb diet is to force your body into ketosis, where it burns fat for fuel, not carbs. But those with UC should steer clear, says Gardner. “I do not recommend a keto diet for several reasons,” she says. “First of all, keto doesn’t always promote healthier, leaner sources of protein. Secondly, a keto diet is going to be higher in saturated fats and there’s a connection between consuming saturated fats and increased inflammation. It’s also not going to be as well-balanced as you’d want for UC.”
If there’s anything positive for someone with ulcerative colitis to take from the keto diet, it’s that foods like avocadoes, salmon, and olive oil are encouraged, and these omage-3-rich foods are beneficial to the gut in people with UC. Plus, salmon has virtually no FODMAPs—an acronym for types of short-chain carbohydrates that can make UC symptoms even worse. But given the diet’s overall fixation with fatty foods, give your gut a break and steer clear of keto.
As the name suggests, Whole 30 is a month-long diet emphasizing whole foods (vegetables, fruits, fish, meat, nuts, seeds, eggs) and eliminating sugar, alcohol, grains, legumes, soy, and dairy. While the nutrition plan itself isn’t an issue for UC, its restrictive nature can be a drawback. “I do like the idea that the diet encourages fresh foods, but there’s no research that it decreases inflammation and it can be restrictive—not great when those with UC might already have mild malnutrition based on not being able to eat enough,” says Gardner.
This plan stems from what we noshed on during our caveman days: Lean meats, fish, fruits, vegetables, nuts, and seeds. Meanwhile, it limits dairy, legumes, and grains. Paleo is similar to a beneficial anti-inflammatory diet, but with potential downside, says Gardner: Going grain-free. “Grains can provide important nutrients for those with UC, such as B vitamins, magnesium and iron,” she says. “If you have sensitivity to wheat or gluten, you should eliminate those, but not all grains.”
Before You Try Anything…
No matter what diet you’re tempted to try, always clue your doctor in first. “There are so many variations of diets out there, it’s important to talk to someone knowledgeable to make sure you’re not nutritionally depleting yourself, which can be an issue with UC,” says Dr. Posina. And no matter what changes you’re considering, it’s more important than ever to pick up the pen, she says: “Keeping a food journal can help you and your doctor discover the ideal diet plan for you.”
- UC and Diet: Crohn’s & Colitis Foundation. (2019). "Diet and Nutrition." crohnscolitisfoundation.org/diet-and-nutrition/
- Low-FODMAP Diet: Michigan Medicine, University of Michigan. (2015). “Low-FODMAP Diet Introduction.” med.umich.edu/1libr/Gastro/LowFODMAPDietIntroduction.pdf
- Mediterranean Diet and UC: The Mayo Clinic. (2019). “Mediterranean Diet: A Heart-healthy Eating Plan.” mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801