Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) affecting an estimated 600,000 to 900,000 Americans. It's characterized by inflammation and ulcers in the inner lining of the large intestine, triggered by an abnormal immune response. Diagnosing UC can be challenging, as symptoms can develop gradually or suddenly, and the path to managing the condition isn't always straightforward.
The dietary approach to managing ulcerative colitis isn't a one-size-fits-all solution. The foods that either benefit or worsen the condition are unique to each individual and can vary depending on whether they're experiencing a flare-up or are in remission. The key lies in understanding personal food tolerances and adjusting the diet accordingly, all while ensuring adequate nutrition.
Understanding Ulcerative Colitis and Its Symptoms
Ulcerative colitis symptoms vary from person to person; not everyone experiences the same symptoms, and severe symptoms are less common. About half of those with UC experience only mild symptoms, such as diarrhea or irritated eyes.
The Importance of Diet in Managing Ulcerative Colitis
While diet isn't the direct cause of gut inflammation in UC, certain foods can exacerbate symptoms during a flare-up. Identifying trigger foods often involves working with a registered dietitian to analyze how the diet affects symptoms. Common culprits include lactose, high-fat foods, and raw, fibrous foods, although tolerance to these foods can change during remission.
Nutrient-dense meals are crucial for individuals with UC to ensure sufficient vitamin and mineral intake, as gut inflammation during flare-ups can impair nutrient digestion and absorption.
Read also: The Mediterranean Diet Guide
Dietary Approaches During Flares and Remission
Managing Diet During a Flare
During a flare, a gentle diet focusing on easily digestible foods can be beneficial. Lean protein sources like roasted chicken, fish, or scrambled eggs are good options. Softer sources of nuts and beans can also be included. The GI gentle diet can help soothe inflamed intestines by focusing on soft-textured foods and moderate fiber.
Optimizing Diet During Remission
Remission is an opportunity to establish healthy eating habits and identify enjoyable, nutritious recipes. The Mediterranean diet, known for its anti-inflammatory properties, is often recommended. It emphasizes plant-based foods such as fruits, vegetables, nuts, beans, and whole grains, alongside moderate amounts of seafood, poultry, and eggs, while limiting red meat.
The Mediterranean diet can be customized to individual preferences and may include options not traditionally associated with it.
Personalizing Your Nutrition Plan
The foods to include or avoid are unique to individual UC symptoms and lifestyle. While a universal list of foods for people with colitis doesn't exist, a GI-specialized registered dietitian (RD) can help identify specific food triggers and tailor a diet for flare-ups.
Keeping a food journal can help track food intake and its effects, either as a standalone strategy or in collaboration with an RD.
Read also: Managing UC in Children with Diet
Recipe Ideas for Ulcerative Colitis
Finding healthful recipes can be easier than navigating lists of foods to eat or avoid.
Here are some recipe ideas:
Breakfast
- Pumpkin Buckwheat Bowl: Buckwheat groats, pumpkin puree, cinnamon, pumpkin pie spice, diced apple, and chia seeds, sweetened with unsweetened applesauce if desired.
- Zoatmeal Bowl: Oatmeal with shredded zucchini, banana, raspberries, and nut butter, sweetened with date syrup if desired.
- Yogurt Parfait: Plain non-fat Greek yogurt with blended strawberries for sweetness and almond butter.
- "Cheesy" Tofu or Egg Scramble on Avocado Toast: Tofu scramble (tofu squeezed to resemble eggs, tahini, nutritional yeast, olive oil, sweet paprika, coriander, salt) served on avocado toast with fruit.
- Berry Smoothie: Spinach, baby carrots, blueberries, banana, nut milk, and nut butter. Adjust fiber content based on tolerance, especially for those with stricturing Crohn’s disease.
Lunch
- Beet Hummus & Grilled Chicken (or Tofu) Sandwich: Bread topped with beet hummus, avocado, cucumber, and chicken or tofu.
- Protein-Packed Avocado Toast: Bread with mashed avocado, egg or tofu, salt, and pepper.
- Miso Ramen Soup: Chicken broth with miso paste, sesame oil, tahini paste, gluten-free soy sauce, lime juice, carrots, mushrooms, scallions, ginger, turmeric, and cilantro.
- Tuna Salad on Toast: Tuna with avocado, diced pickles, and green onions on bread.
- Butternut Squash & Tofu Soup: Butternut squash in broth with tofu, garlic-infused olive oil, salt, and pepper, served with bread.
Dinner
- Stuffed Butternut Squash: Roasted butternut squash with wild rice, pureed mushrooms, ground turkey, and seasonings.
- Buddha Bowl: Rice, roasted sweet potatoes, zucchini, yellow squash, hummus, and tahini dressing.
- Mediterranean Bowl: Cucumbers, olives, rice, olive oil, vinegar, grilled chicken, roasted red peppers, and hummus.
- Burrito Bowl: Ground turkey, green onions, cilantro, avocado, lime, roasted zucchini, and yellow squash.
- Salmon Dinner: Roasted salmon, rice, and steamed carrots.
Dessert
- Pumpkin Energy Balls: Pumpkin puree, oats, dark chocolate chips, and nut butter.
- Fig Yogurt Bark: Figs, Greek yogurt, date syrup, granola (optional), frozen into bark.
- Orange Cranberry Muffins: Flour, cranberries, orange zest, and orange juice.
- Apple Pumpkin Bread: Flour, diced apple, pumpkin puree, apple sauce, cinnamon, and pumpkin spice.
- Loaded Chia Pudding: Chia seeds, nut milk, blueberries, bananas, and cinnamon.
Additional Meal Ideas
- Cassava Flour Waffles
- Gluten-Free Lemon Blueberry Muffins
- Turkey Lettuce Wraps
- Spinach Egg Bake
- Instant Pot Honey Garlic Chicken Thighs
- Air Fryer Pancakes
- Gluten-Free Turmeric Chicken Nuggets
- Fennel Soup
The Gut-Brain Connection and Stress Management
The connection between the brain and digestive system can impact UC symptoms. Stress management techniques can help alleviate symptoms like cramping by promoting calmer signals from the mind to the gut.
The Role of Sleep and Exercise
Sufficient sleep (seven to nine hours) is crucial. Poor sleep has been linked to more UC flares, while quality sleep can reduce them. Light to moderate exercise can also benefit UC management.
The Mediterranean Diet and IBD
The Mediterranean diet is a well-researched nutritional strategy for IBD, emphasizing plant-based foods and limiting red meat. While some aspects may be challenging for individuals with IBD, the diet's potential to reduce intestinal inflammation and support a healthy gut microbiome makes it worth exploring.
Read also: The Hoxsey Diet
Focusing on plant-based foods to increase fiber intake is important when starting a Mediterranean diet.
Mediterranean Diet Shopping List
- Fruits: 2-4 servings per day (avocados, apples, grapes, peaches, oranges, strawberries, tomatoes).
- Vegetables: 4-6 servings per day, cooked and peeled if necessary.
- Whole Grains and Lentils: 2-4 servings per day of oats, quinoa, bread, tofu, and lentils.
- Healthy Fats: 4-6 servings per day of olive oil, almonds, pistachios, and walnuts.
- Dairy Products: 1-2 servings per day of cheeses, Greek yogurt, milk, nut milk, and soy milk.
- Seafood: 2-3 servings per week (clams, crab, salmon, sardines, tuna).
- Poultry and Eggs: 2-3 times per week.
- Herbs and Spices: Basil, bay leaves, cumin, garlic, mint, oregano, parsley, rosemary, sage, tarragon, and thyme.
Mediterranean Diet Recipes
- Baked Spinach and Eggs
- Banana Berry Pancakes
- Egg and Brown Rice Breakfast Bowl
- EVOO Oatmeal With Berries
- Muffin Pan Frittatas
- Smoothie Bowl
- Avocado, Arugula, Tomato, and Walnut Toast
- Chickpea and Quinoa Salad With Tahini Dressing
- Greek Lentil Soup
- Mediterranean Pita Pizza
- South American Vegetable and Rice Soup
- Almond Cookies With Tahini and Honey
- Anything-Goes Energy Balls
- Avocado Hummus
- Black Bean Brownies With Walnuts
- EVOO Cake
- Asparagus and Ginger Fried Rice
- Brazil Nut Pesto With Pasta
- Chickpea Sweet Potato Shawarma Salad
- Cod and Corn Chowder
- Mediterranean Lentil-Stuffed Peppers
- Summer Green Pea Salad
Quick & Easy Weeknight Dinner Ideas
For a UC-friendly weekly meal plan, focus on lean protein, simple low-carb grains, cooked produce, and healthy fats.
1. Turkey Tacos
Brown lean ground turkey with roasted vegetables, served in a soft whole-wheat tortilla or a crunchy corn taco shell. Top with plain Greek yogurt.
- Why It’s a Good Ulcerative Colitis Meal: Protein, healthy fats, cooked vegetables for easier digestion, calcium, protein, and probiotics from Greek yogurt. During a flare, switch to a white tortilla and cooked, low-fiber vegetables.
2. Asian Bowl
Combine grilled chicken, cooked white rice, baby corn, water chestnuts, and steamed vegetables with low-sodium soy sauce.
- Why It’s a Good Ulcerative Colitis Meal: Nutrients from vegetables and protein, easily digestible white rice.
Seeking Professional Guidance
For a well-rounded colitis diet plan, consult a GI specialist, such as a registered dietitian or GI provider. Oshi Health and other specialized services offer medical, dietary, and gut-brain treatments provided by GI specialists. An IBD dietitian can help identify trigger foods and create a personalized, enjoyable diet.