Dietitian: Focus on ‘more options, less restrictive diets’ in Crohn’s management
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DENVER — Nutrition therapy for patients with Crohn’s disease should focus on increased and varied consumption rather than restrictive diets, according to a presenter at the Crohn’s and Colitis Congress.
Priorities for medical nutrition therapy in patients with inflammatory bowel disease include optimizing nutrition status, relieving digestive symptoms, reducing inflammation and assessing quality of life, Therezia AlChoufete, MS, RD, LDN, lead dietitian in the division of gastroenterology, hepatology and nutrition at the University of Pittsburgh Medical Center, told attendees. And while medical nutrition therapy can increase a patient’s quality of life regardless of their disease stage, this is especially true for those in remission.
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“In remission, this is a really great time to talk about diet, because it helps to improve that patient’s relationship with food but also work on those symptoms they might be having that are not just inflammation,” AlChoufete said.
She advised providers to review individualized nutrition goals with their patients when they are in remission and encourage texture, if they do not have stricture or obstructive disease. Additional considerations include promoting a “nutritionally balanced plate,” incorporating more plant-based foods, and recognizing and identifying gut irritants and food intolerances.
Conversely, for patients with active disease, the main goal of nutrition should be increased caloric and protein intake, despite their potential aversion to food perceived to worsen symptoms.
“We can do this by increasing the frequency of their meals but making those meals smaller,” AlChoufete said. “Again, texture modification would be very helpful in this case.”
A simple solution to minimize over-restriction of these foods is to “make it soft,” she said, by increasing soluble fibers and decreasing insoluble fibers. Also important is decreasing common flares by recognizing and removing triggers and exploring the use of over-the-counter supplements to ensure daily vitamin needs are met.
Considering established dietary strategies for the treatment of CD, AlChoufete noted that the Mediterranean diet underscores the positive effect increased consumption of whole foods, lean protein and healthy fats can have on helping patients improve digestion and reach symptomatic and clinical remission.
“Research is definitely expanding our nutrition therapy options for Crohn’s disease. We want to focus on more options, less restrictive diets and make sure we are encouraging plant-based foods,” she concluded. “Making sure we are referring to dietitians is an important part of treatment.”
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AlChoufete T. Presentation Sp49: What your patients want to know: Dietary considerations for Crohn's disease. Presented at: Crohn’s and Colitis Congress; Jan. 16-21, 2023; Denver (hybrid meeting).
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