Nutrition Therapy
Why is nutrition important?
Nutrition plays an important role in the treatment of Inflammatory Bowel Disease (IBD). A healthy diet can help prevent malnutrition and correct nutrient deficiencies. Good nutrition will make you feel better, improve your body’s ability to heal, improve the way your immune system functions, and enhance your quality of life.
What is malnutrition?
Malnutrition occurs when there is a lack of nutrients being provided to the body. Weight loss, especially rapid or unintentional weight loss, is a common indication of malnutrition.
Why are IBD patients at risk for malnutrition?
In IBD, various parts of the gastrointestinal tract are inflamed. The inflammation can lead to diarrhea, pain and nausea. When these symptoms are present, patients with IBD do not feel well and may not be meeting their nutrition needs because they do not feel like eating. The following factors place a patient with IBD at risk for malnutrition:
- Loss of appetite
- Decreased food intake
- Food intolerances
- Increased nutrient requirements
- Side effects of medications Elimination diets
- In some cases, malabsorption of nutrients
What are the most common nutrient deficiencies in IBD?
| Most Common Nutrient Deficiencies | Functions of the Nutrient | Food Sources |
|---|---|---|
| Energy (Calories) |
Provides the body with energy to perform daily tasks and maintain a healthy weight. |
Fat, carbohydrates, and protein together contribute to overall energy. |
| Protein |
Maintains muscle, helps promote wound healing. |
Meat, nuts, fish, poultry, eggs, & dairy. |
| Iron |
Helps our red blood cells transport oxygen throughout our bodies. Lack of iron may result in anemia. |
Meat, fish, poultry, whole grains, enriched breads, & fortified breakfast cereals. |
| Vitamin B12 |
Plays a key role in the functioning of the brain and nervous system and in the formation of blood. |
Meat, fish, poultry, dairy products, & eggs. |
| Folic Acid |
Important for production of healthy new cells. |
Leafy green vegetables, enriched and whole grain products. |
| Calcium |
Important for maintaining healthy bones. |
Dairy products, fortified soy products or orange juice, almonds, & canned salmon/sardines with bones. |
| Vitamin D |
Helps body absorb calcium and important for a healthy immune system. |
Sunlight, fortified milk, eggs, organ meats & vitamin D supplements. |
You may need to supplement your diet with nutrition supplements. Your dietitian will determine which supplements may be necessary to meet all your nutrition requirements.
What diet should patients with IBD follow?
There is no specific diet for patients with IBD. Diet is very individual because it depends on your diagnosis, the location of the disease and status of your disease (remission or a “flare-up”). Intolerances to foods vary from patient to patient; for example some patients have difficulty tolerating milk products while others report no difficulties.
When you are free of symptoms and your IBD is in good control, there is no need to follow a special diet. If you are having a ‘flare up” of IBD, modifying your diet can be helpful in controlling symptoms such as bloating, diarrhea and abdominal pain.
The most important change that you can make to you diet is to eat an individualized healthy, balanced diet that tastes good and makes you feel well. If your diet is well balanced you should be able to maintain your weight and have the energy to complete your daily activities.
What happens if I remove foods or food groups from my diet?
People living with IBD will often remove foods or food groups from their diet, in hopes of preventing symptoms of IBD. Removing foods or whole food groups from your diet for an extended period can place you at nutrition risk. Some of these nutrition risks include nutrient deficiencies, malnutrition, weight loss, and fear of eating or food obsessions. It is important to tell your doctor and dietitian if you are removing foods or food groups from your diet, so they can provide you with alternate food choices or supplements to ensure you are receiving the best nutrition possible.
Where do I go for individualized help with my diet?
You can speak to a dietitian about how to modify your diet to meet your nutrition requirements.
References
- Aghdassi, E., Wendland, B., Stapleton, M., Raman, M., & Allard, J. (2007). Adequacy of nutritional intake in a Canadian population of patients with crohn’s disease. American Dietetic Association, 107(9), 1575-1578.
- Carter M. J., Labo, A. J., & Travis S. P. L. (2004). Guidelines for the management of inflammatory bowel disease in adults, British Society of Gastroenterology, 53, v1-v13.
- Crohn’s and Colitis Foundation of Canada. (2009). Food For Thought. Toronto: Crohn’s and Colitis Foundation of Canada.
- Crohn’s and Colitis Foundation of Canada. (2001). Nutrition, Diet and Inflammatory Bowel Disease. Toronto: Crohn’s and Colitis Foundation of Canada.
- Hartman, C., Eliakim, R., & Shamir, R. (2009). Nutritional status and nutritional therapy in inflammatory bowel disease. World Journal of Gastroenterology, 15(21), 2570-2578.
- Jeejeebhoy, K. N. (2002). Clinical Nutrition: 6. Management of nutritional problems of patients with crohn’s disease. Toronto: Canada Medical Association, 166(7), 913-918.
- Lucendo, A., & De Rezendo, L. (2009). Importance of nutrition in inflammatory bowel disease. World Journal of Gastroenterology, 15(17), 2081-2088.
- Nelms, M., Sucher, K., & Long, S. (2007). Nutrition Therapy and Pathophysiology. Belmont, CA: Thomson Brooks/Cole Co, 488-498.
- Razack, R., &Seidner, D. (2007). Nutrition in inflammatory bowel disease. (2007). Current Opinion in Gastroenterology, 24(4), 400-405.
- Steinhart, H.A., & Cepo, J. (2008). Crohn’s and Colitis Diet Guide. Toronto: Robert Rose Inc, 8-24, 63-94.
Handout designed by Amanda Lachowitzer, Brooke Guedo and Leah Edmonds, College of Pharmacy & Nutrition, University of Saskatchewan. Funding for this project provided by the Interprofessional Health Collaborative of Saskatchewan and the Saskatoon Health Region.