Mediterranean Diet Introduction
The Mediterranean Diet (MED) is characterized by a high intake of vegetables (2 servings per meal) and fruits (1-2 servings per meal), extra virgin olive oil (3 tablespoons per day), breads and cereals (1-2 servings per day), legumes (2 or more servings per week), seafood (more than 2 servings per week), eggs (2-4 servings per week), poultry (2 servings per week), limited dairy (1-2 servings per day), low intake of red meat (less than two servings per week), and limited sweets (less than two servings per week).
In addition to improving symptoms in IBD, it has been shown to have health benefits for other conditions, such as cardiovascular disease, cancer, and diabetes, with much of its benefit attributed to reductions in inflammation from higher consumption of vegetables, fruits, nuts, and healthful fats from avocados, fish, and olive oil. The MED may further help protect against colon cancer.
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Mediterranean Diet and IBD
The MED has been shown to significantly reduce symptoms of Crohn’s disease or ulcerative colitis, lower C-reactive protein and fecal calprotectin levels, and improve quality of life. As an added benefit, it is easier to implement than a therapeutic diet, making it a viable option for a greater number of patients desiring nutritional therapy with a less significant impact on lifestyle. For patients with IBD who prefer a dietary therapy that is easier to follow, the MED adjunctive to traditional medications is a strong candidate.
Following the MED can be a challenge for some patients with IBD, especially if they have been following a low-fiber diet or they have strictures present. In this case, juicing or pureeing fruits and well-cooked vegetables when beginning the diet may help. As symptoms improve or inflammation goes down, patients can start incorporating whole fruits and vegetables. Cereals in the diet refer to ancient grains (farro, wild rice, spelt, etc). Rice is a good carbohydrate choice for this diet. Nuts and seeds for the MED can be consumed cooked and pureed (peanut butter and hummus), or even as homemade almond milk.
The MED is similar to therapeutic diets in that it emphasizes whole foods and fruits and vegetables and it limits sweets/sugar and processed foods. It differs from most therapeutic diets in its emphasis on whole grains and cereals, which are often limited by therapeutic diets. Patients who have difficulty with whole grains may want to shift this emphasis to fruits and vegetables. The MED was not designed specifically with IBD in mind, and thus does not list specific foods that are included or excluded as do therapeutic diets. Instead, it recommends serving frequencies of the various food groups with no limitations on what items can be eaten within that food group.
See The Mediterranean Diet Page of NTforIBD.org for reference citations. See MED publications on the NTforIBD website for a listing of the research on MED.
Healthy Eating Options for IBD
Nutritional therapy options that provide benefit to IBD patients while being less restrictive and requiring fewer lifestyle commitments