Nuts, Seeds, and Diverticular Disease

One third of Americans have diverticular disease, a digestive disorder common in the Western world but rare in areas such as Africa and Asia. The disease consists of three conditions including diverticulosis, diverticular bleeding, and diverticulitis. The cause of the disease remains complex but often an interaction between low fiber intake, low physical activity, obesity, smoking, bowel motility, and mucosal changes are factors increasing the risk of developing the disease.

Small pouches form in the colon when there are weakened spots in the intestinal walls and when colonic pressure increases. Since the 1950’s people with diverticular disease have been advised to avoid nuts and seeds due to the theory that undigested food would become trapped in the small pouches of the colon causing inflammation and infection.

Despite the theory, it has been confirmed and published in the Journal of Family Practice as well as the Nutrition in Clinical Practice Journal that there is no evidence supporting the recommendation to avoid nuts and seeds for people with diverticular disease. In contrast eating a high fiber diet has been associated with lower risk of complications. One study published in The Journal of the American Medical Association following 47,228 men with diverticular disease for 18 years found eating nuts, corn, and popcorn did not

increase risk of diverticular complications. In fact eating nuts and popcorn reduced the risk of complications such as diverticular bleeding and infection.

The National Digestive Diseases Information Clearinghouse as well as the Academy of Nutrition and Dietetics Nutrition Care Manual guidelines state eating a high-fiber diet can help prevent diverticular disease as well as prevent complications in those who already have the disease. People with the disease do not need to eliminate foods such as nuts, seeds, popcorn, corn, tomatoes, zucchini, cucumbers, strawberries, and raspberries.

Fiber recommendations are 38 g per day for men and 25 g per day for women ages 18-50. For men and women over the age of 51 recommendations are 30 g per day and 21 g per day respectively. Fiber rich foods include peas, lentils, black beans, lima beans, artichokes, broccoli, Brussels sprouts, raspberries, blackberries, pears, oatmeal, whole grains, flaxseeds, and nuts. Drinking sufficient water with fiber rich foods is important as well for fiber to work effectively.

Although more research is needed, probiotics have shown some positive impact in treating symptoms and preventing complications of diverticular disease. Probiotics are live bacteria found in certain foods such as yogurt, kefir, buttermilk, kimchi, kombucha, and in supplemental form. Regularly consuming probiotics can help support a healthy GI tract and may help with diverticular disease as well.

For people with diverticular disease eliminating certain foods is not necessary, however any foods that worsen your symptoms should be avoided. If you are experiencing a flare-up or complications a high fiber diet might not be appropriate. Discuss your symptoms and appropriateness of your diet with your doctor to best manage your condition.