Diet and Nutrition

Since Crohn's can lead to a reduced appetite, weight loss, and poor absorption of vitamins and minerals, maintaining a healthy diet and good nutrition are vital aspects of managing the disease. Depending on the severity of your condition, you may need to restrict certain aspects of your diet. Talk to your gastroenterologist or nutritionist about customizing a diet to your specific nutritional needs.

Eating right

Eating right is the key to good health for everyone. But it is especially important for people with Crohn’s, since the disease can deplete their bodies of essential nutrients. Just like everyone else, people with Crohn's need to take in enough protein, calories, vitamins (A, D, C, B-12, and folic acid), minerals (calcium, iron, and zinc), and other nutrients to stay healthy.

To ensure that you are getting a sufficient amount of nutrients from your diet, it’s best to eat a balance of foods from the four food groups:

Meat (or alternative sources of protein)
Dairy
Cereal and grains
Fruits and vegetables

The key to formulating a diet that is right for you is paying attention to the way certain foods affect your body. If they seem to worsen your Crohn’s symptoms, eliminate them from your diet.

The following are some tips for healthy eating:

Eat three meals a day in addition to three smaller meals every day.
Include a source of protein at every meal. This includes meat, chicken, fish, peanut butter, egg, cheese, tofu, and yogurt.
Include milk products, which are good sources of protein, calories, and minerals. If you have lactose intolerance, you can buy Lactaid milk or Lactaid drops to add to milk. Yogurt and hard cheeses are lower in lactose than milk and may be better tolerated. Soy products, such as soy milk, soy yogurt, and soy ice cream, are also a good substitute for milk.
Eat foods with extra fats, as tolerated. Fat sources include nuts, peanut butter, canola oil, butter, and margarine. Fat provides twice the calories per gram than other nutrients, such as carbohydrates or protein.

Vitamins and minerals

A person with Crohn’s may not get enough nutrients because the disease causes poor digestion and malabsorption of dietary protein, fat, carbohydrates, water, and essential vitamins and minerals. Your gastroenterologist or nutritionist may recommend adding a multivitamin or other dietary supplement, such as vitamin B-12 or folic acid, to protect against nutritional deficiencies and round out your diet. Crohn’s causes certain symptoms in your body that may deplete your body of essential nutrients.

The most commonly recommended vitamin supplements include vitamins B-12 and D and folic acid, while the recommended mineral supplements include calcium and iron. However, most people with Crohn’s benefit from simply taking a multivitamin regularly.

It is important to note that supplements should not take the place of food — they contain no calories — and that you should consult with your gastroenterologist before you begin taking any supplements.

The following table shows sources of important vitamins and minerals, though some foods may not be right for you. Be sure to talk to your doctor about a diet that is suitable for you.

Nutrient	Source
Vitamin A	Liver, eggs, dairy products, fish liver oils, dark green leafy vegetables (e.g., green peas, spinach)
Vitamin D	Liver, fish liver oil, fortified food products (e.g., milk, butter, and cereals)
Vitamin C	Fruits (e.g., citrus fruits, bananas, apples)
Folic Acid	Liver, beets, corn, legumes, green leafy vegetables
Vitamin B-12	Meat, fish, poultry
Calcium	Cheese, ice cream, milk, yogurt, sardines
Iron	Red meat, fish, poultry, eggs
Zinc	Animal protein (e.g., beef, chicken), plant foods, (e.g., legumes, bran, green peas)

Stay hydrated

In addition to eating enough, you also need to drink enough fluids to keep your body well hydrated. The diarrhea and intestinal inflammation associated with Crohn's can cause fluid loss, and when you are not feeling well, you may eat and drink less, limiting the amount of fluid you take in. To make sure you take in adequate fluids, try drinking small amounts several times a day, ideally whenever you eat. A good goal to strive for is drinking half an ounce of liquid (preferably water) for every pound of your body weight.

Foods you might need to avoid

Some people with Crohn's find that eating certain foods makes their symptoms worse. With the help of your gastroenterologist or nutritionist, you can determine what foods you can eat comfortably and find a healthy diet you will enjoy.

Fatty foods such as butter, margarine, gravies, vegetable oil, processed snacks (like cookies and crackers), meats, fast food, some dairy products, and fried or battered food may trigger abdominal symptoms. If you develop gas and diarrhea after you eat fatty or greasy foods, you may be suffering from malabsorption, a condition in which fat is not easily absorbed and passes quickly through the intestine. Avoiding fatty foods and using easily absorbed fat can help.
High-fiber foods can also cause abdominal discomfort. They increase diarrhea because they are not fully digested, and when these foods enter the intestine, they trigger contractions. Limiting fiber during a flare-up can keep symptoms in check. However, there is no concrete evidence that a long-term, low-fiber diet can permanently decrease the symptoms of Crohn's.
Alcohol and caffeine stimulate the intestines and can intensify diarrhea. Try to avoid them when your symptoms act up.

Some information adapted from the Remicade Website. For more information and resources on Crohn's disease, or to find more information regarding Remicade, please visit the Remicade website.