Planning a Healthy Diet
Do I need to watch what I eat?
Jenifer Hampsey is a nurse practitioner at the Johns Hopkins Hospital in Baltimore, Maryland, specializing in nutrition. To meet Ms. Hampsey, click here.
“It's important for everyone, including people with ulcerative colitis, to get solid nutrition every day. Good nutrition is helpful in improving your immunity and your energy level.”—Jenifer Hampsey, NP
Ms. Hampsey believes in following a healthy, well-balanced diet. It's all about making food choices that work for you, she says:
I tell patients it's not that you need to eliminate certain food groups, but instead you need to choose the right foods that can help you get the nutrition you need. You should always talk with your health care team before you make changes in your diet. They are closest to your case and know best what is right for you. Here are some things I suggest you discuss with your doctor and nutritionist to determine a plan that is right for you:
Drink plenty of the right fluids. When you have severe diarrhea during a flare, you're at risk for becoming dehydrated. It may be helpful to offset the loss of fluids by drinking plenty of water and nutritious drinks. Alcoholic beverages and drinks with caffeine can cause or aggravate diarrhea, so it's generally best to avoid them altogether.
Eat the right fruits and vegetables. Are you afraid to eat fruits and vegetables because they worsen your symptoms? Certain fruits and vegetables can be more easy to digest and still provide the essential nourishment you need. Some people have found that good fruit choices include papaya, mango, and cantaloupe. They are among the highest in nutrients and are soft and easy to digest. With vegetables, eating them soft and well-cooked is a good approach for many people with UC.
- Peel the skin off of your fruits and vegetables. Skin can be hard for some people with UC to digest
- Some people find it helpful to avoid berries, like strawberries, blackberries, etc. Berries have seeds, and seeds may irritate the bowel
- The National Institutes of Health (NIH) now recommends 9 servings of fruits and vegetables per day instead of 5. Since most people don't even get 3 servings a day, look at every meal and every snack as an opportunity to eat a colorful (and nutritious) fruit or vegetable
Choose lean proteins. Protein is a critical component of everyone's diet. The body relies on protein for building and maintaining body tissue and for transporting vitamins and minerals where they need to go. Muscle weakness and poor immune function could result if you don't get enough protein. Again, you should talk to your health care team. They are the best source of information about the right amount and sources of protein for you.
- General nutrition guidelines say that protein should be 25% of your diet
- It is helpful for most people to get 2 or 3 servings daily
- Some choices to discuss with your doctor include eggs, lean meats, fish, poultry, soy, and smooth nut butters
Select soft breads, cereals, and grains. Breads, cereals, and grains give us energy and fuel. But some people with UC find they can irritate an inflamed bowel. The best way to look at this food group is to think "soft" and "soluble" (can easily dissolve). Discuss these choices with your health care team and come up with a plan for you.
- Try for 6 to 11 servings daily
- Many people find foods with more-soluble fiber (oatmeal, oat bran, legumes, barley) to be helpful
- For most people with UC, avoiding seeds and nuts is a good idea; they can scrape an already inflamed bowel
- White pasta and white rice are good choices for many people with IBD
Enjoy dairy on your own terms. I suggest to people with ulcerative colitis that they approach this food group with caution, and work with their health care team to choose dairy that works for them. For some people with UC, dairy causes problems, like diarrhea, abdominal pain, and gas. For others, these foods aren't a problem at all. To know for sure, talk to your doctor and track what happens when you limit or eliminate dairy altogether. Do symptoms improve? Beyond that, I've found these suggestions helpful for many people:
- Try for 2 or 3 servings daily, if possible
- Milk substitutes, like soy milk or lactose-free milk, may be a good choice for some people
- Yogurt can be a good substitute for other dairy
- Swiss or cheddar cheese may be good choices for some people, as they are easier than other cheeses for the digestive system to break down
Cook with healthy fats. You're going to have some fats in your diet, but my recommendation is to use them sparingly and to make them healthy fats.
- Prepare meals with healthy fats such as olive or canola oil
- Avoid unhealthy fats such as butter, lard, margarine, high-fat meats, and fried foods
Vitamin and mineral supplements. Episodes of chronic diarrhea and some ulcerative colitis medications can leave your body deficient in certain vitamins and minerals. It’s also common for people with UC to have iron deficiency (anemia) due to rectal bleeding. You should talk to your doctor about the specific supplements you need, based on your overall health profile.
