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Nutritional Therapy Support for Patients with Crohn's Disease or Ulcerative Colitis

Focus on Variety within Therapeutic Diets

While therapeutic diets are frequently referred to as "restrictive" and sometimes termed "exclusion" diets, long-term healthy use requires maximizing diversity of foods within the parameters of the diet.

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Therapeutic diets are often referred to as restrictive and sometimes called exclusion diets because they are built on the premise of excluding specific foods that are thought to be detrimental in patients with IBD. However, the secret to successfully implementing a therapeutic diet is focusing on the inclusion and diversity of beneficial foods.

When Disease Is Active

When disease is active, it is common to struggle with adding in foods, and you may need to limit your diet in order to function. However, once healing has begun, you should be able to start expanding the diversity of your diet within the array of included foods. All therapeutic diets have guidelines for phases/stages that can be used to assist with expanding the diet. If you cannot expand your diet to include a healthy diversity of foods, something is not working and you should consult with your care team to discuss options.

Replace Restricted Foods with Diverse Alternatives

Your dietary plan should be implemented in such a way that for every healthy food that is limited, it is replaced with a variety of healthy alternatives. When a food like potatoes is removed from the diet, it is optimally replaced with healthy alternatives like cauliflower, squash, rutabaga, and celeriac. When wheat pasta is restricted, patients find a role for spaghetti squash, spiralized zucchini and butternut squash, and pastas made from legumes like beans and lentils. For every food that is restricted, a door opens for trialing new healthy alternatives. The end result should be a diet that is much healthier than the standard American diet, limiting processed foods and sugar consumption; increasing diversity and quantity of fruits and vegetables; and focusing on consuming a nutritionally complete, balanced diet. Consult a dietitian to ensure your diet is balanced and to help you continue to expand and diversify your diet in healthy ways.

Picky Eaters

Some worry about children on a therapeutic diet who are already known to be picky eaters. There is a concern that a therapeutic diet will only further limit the diet. Many parents of picky eaters have found the opposite to be true: once healing has begun and the foods eaten do not exacerbate the symptoms of IBD, children eat much better and are accepting of a wider diversity of foods.


The important takeaway from this is to understand that if you continue to be stuck consuming a limited selection of foods beyond the first few months, even if you feel well, your treatment plan is not working. It is not healthy to continue on such a path. It may be that a different dietary approach will better suit you, or adding/adjusting medications is required. The healthy path is one that is always looking to add healthy diversity and not the one that is constantly forced to restrict.

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