Don't Let Diverticulitis Drive You Nuts

Good news for people with diverticulitis: it appears to be safe to fearlessly eat nuts, corn, seeds, and popcorn. What’s more, nuts and corn might actually protect against the disease. According to the authors of a study published in the Journal of the American Medical Association, “These findings refute the pervasive but unproven belief that these foods are associated with diverticular complications and suggest that the recommendation to avoid these foods in diverticular disease should be reconsidered.”

Nuts or no nuts?

Diverticulosis is a condition in which the walls of the colon develop out-pouchings, or diverticula. Sometimes, a person may have no symptoms of diverticulosis, but the pouches can become filled with fecal material, making them prone to infection. Once symptoms are evident—abdominal pain with bleeding or infection—the disease is called diverticulitis.

Traditionally, doctors have recommended that people with diverticular disease avoid nuts, seeds, corn, and popcorn, as these foods were believed to get stuck in the pouches and to irritate the tissue. Although this sounds plausible, there is no scientific evidence to support this idea.

The new study questioned the rationale behind certain dietary restrictions for people with diverticular disease. The study included 47,228 men ages 40 to 75 who were part of the Health Professionals Follow-Up Study. During 18 years of follow up, the men gave information about their dietary habits, including eating foods suspected of worsening diverticular disease.

During the study, 1,184 men developed diverticular disease. Contrary to the previous fears of the medical community, eating popcorn and nuts was associated with a decreased diverticulitis risk. Men who ate nuts and popcorn at least twice per week were 20% and 28% less likely, respectively, to develop diverticulitis than were men who ate these foods less than once per month. Eating corn did not increase the risk of diverticulitis, and diverticular bleeding was not associated with eating nuts, corn, or popcorn. Neither were tiny seeds found in blueberries and strawberries associated with complications of diverticular disease.

Prevention—the best medicine

The prevalence of diverticular disease has increased in stride with the shift from plant-based, high-fiber diets to those high in processed foods. Dietary fiber helps waste to pass more easily through the colon. Eating lots of meats and low-fiber processed foods makes the colonic muscles work harder to move fecal material along, and a chronic increase in colonic pressure may lead to the development of diverticula.

To help prevent diverticular disease, emphasize fiber-rich foods such as vegetables, nuts, fruits, and legumes in your diet. Beans and lentils are particularly rich in fiber, and, when eaten with a grain, they are great protein sources for those wishing to cut down on meat.

(JAMA 2008;300:907–14)

Kimberly Beauchamp, ND

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