8 Dietary Myths Related to IBD   

8 Dietary Myths Related to IBD

Middle-aged woman eating Greek yogurt.
Clinical Contributors to this story:
Alyssa M. Parian, M.D.
Jessica Dominguez, MPH, RDN

You were recently diagnosed with inflammatory bowel disease (IBD) and now your relationship with food feels complicated. Is dairy off the table? Will your morning coffee trigger a flare? What about indulging in the occasional burger? With so much conflicting information online, it’s hard to know what’s fact and what’s false when it comes to managing IBD through diet.

To help clear up the confusion, Alyssa M. Parian, M.D., a gastroenterologist at Hackensack University Medical Center, and Jessica Dominguez, a registered dietitian, share their expertise on the dietary dos and don’ts for IBD patients. 

Myth 1: You Can’t Eat Dairy if You Have IBD

One common misconception is that all IBD patients must avoid dairy entirely. While it’s true that some people with IBD develop lactose intolerance—especially during flare-ups—this doesn’t mean dairy is automatically off-limits for everyone.

“Lactose intolerance can wax and wane depending on the state of the disease,” explains Dr. Parian. “For example, during remission, some patients can tolerate certain dairy products, like yogurt or harder cheeses, which have lower lactose content.”

It’s also worth noting that dairy has been shown to have pro-inflammatory effects in some adults. This doesn’t mean all dairy must be avoided, but it highlights the importance of making mindful choices. Harder cheeses, such as Parmesan, have very low lactose content and are usually well-tolerated.

If you’re unsure about your tolerance, keeping a food diary can help identify triggers. “It’s all about understanding your individual response to different foods,” adds Dominguez. 

Myth 2: You Must Cut Out All Fruits and Vegetables 

Fruits and vegetables are often labeled as problematic for IBD patients because of their high fiber content. While it’s true that raw, fibrous produce can be hard to digest during a flare-up, avoiding these nutrient-rich foods entirely is a mistake.

“We used to recommend a low-fiber diet for everyone with IBD, but that’s not the case anymore,” says Dr. Parian. “For patients in remission, whole fruits and vegetables are anti-inflammatory and beneficial for gut health.”

Keep in mind that preparation matters. Dominguez suggests cooking vegetables until they’re soft or blending fruits into smoothies to make them easier to digest. “Sometimes it’s as simple as steaming, peeling or removing seeds to make the foods more tolerable,” she explains. 

Myth 3: Junk Food Causes IBD 

Diet alone doesn’t cause IBD, which results from a combination of genetics, immune system dysfunction and environmental factors. But Dr. Parian notes that a diet heavy in processed foods, red meat and added sugars can exacerbate symptoms.

“Highly processed and fatty foods may disrupt the gut microbiome, leading to inflammation,” she says. “While these foods didn’t cause the disease, they’re not helpful in managing it.”

It’s wise to focus on whole, minimally processed foods, which are staples of the Mediterranean diet. “This diet, which is rich in fruits, vegetables, whole grains and healthy fats like olive oil, has the most data supporting its anti-inflammatory benefits,” Dr. Parian advises. 

Myth 4: High-Protein or Trendy Diets are Safe

Popular diets like keto or high-protein plans may not be ideal for people with IBD. Excessive protein, especially from red meat, can strain the digestive system, while highly restrictive diets can lead to nutritional deficiencies.

“Any diet that’s too restrictive can create anxiety around food and worsen deficiencies,” says Dominguez. “We aim for a balanced diet that includes whole grains, lean proteins and plenty of anti-inflammatory foods.”

Vegetarian and vegan diets are also options, but they require careful planning. “Protein sources like tofu and legumes need to be balanced with other nutrients to ensure you’re meeting your needs,” adds Dr. Parian.

IBD patients are at a higher risk for nutritional deficiencies due to malabsorption, frequent diarrhea and inflammation. Key nutrients to prioritize include:

  • Vitamin B12: Commonly deficient in Crohn’s disease, especially if the small intestine is affected.
  • Iron: Chronic blood loss from the gut can lead to anemia.
  • Vitamin D: Low levels are associated with increased flare-ups and hospitalizations.
  • Folic acid: Essential for patients on medications like methotrexate.

“Monitoring and supplementing these nutrients as needed is crucial to maintaining overall health,” Dr. Parian emphasizes.

Myth 5: You Can’t Eat Spicy Food with IBD

Spicy food often gets a bad rap when it comes to digestive health. In general, the idea that everyone with IBD must avoid spicy food is a myth. While spicy dishes might trigger symptoms for some people during a flare-up, others might tolerate them just fine.

If you enjoy spicy foods, try incorporating them when your IBD is in remission and monitor how your body reacts. Keeping a food diary is helpful in this scenario, too — it can help identify specific triggers without unnecessary restrictions.

Myth 6: IBD Patients Must Avoid Nuts and Seeds Entirely

Nuts and seeds are often labeled as no-go foods for people with IBD because they’re high in fiber and can be tough on the digestive system. In most cases, this only applies to certain circumstances.

“For patients in remission, nuts and seeds can be an excellent source of nutrients like healthy fats, protein and fiber,” explains Dr. Parian. “But during a flare-up or if a patient has strictures (narrowings in the intestine caused by inflammation or scar tissue), they may need to avoid these foods temporarily or consume them in forms like nut butters or ground seeds.”

Myth 7: Drinking Alcohol is Always Harmful for People with IBD

While it’s true that alcohol can irritate the gastrointestinal tract and should be consumed with caution, it’s not universally off-limits for people with IBD.

The key is moderation. Alcohol can trigger symptoms for some, especially during active disease, but others may tolerate a glass of wine or beer occasionally when in remission. Pay attention to your body’s cues and discuss alcohol consumption with your health care provider.

Myth 8: A Vegetarian or Vegan Diet Isn’t Suitable for IBD

Many people assume that plant-based diets lack the necessary nutrients for people with IBD, but that isn’t necessarily true. Vegetarian and vegan diets can be appropriate as long as they’re carefully planned.

“Plant-based diets can provide anti-inflammatory benefits and help manage symptoms,” says Dominguez. “You need the right amount of protein, iron and vitamin B12, which are commonly found in animal products. A dietitian can help tailor a plant-based diet to meet your nutritional needs.”

Building a Sustainable Diet for IBD

Navigating your diet with IBD doesn’t have to feel overwhelming. While some adjustments may be necessary, many patients find that small tweaks – like changing how food is prepared or choosing nutrient-rich options – make a big difference. 

The key to managing IBD is personalization. Every patient has unique triggers and tolerances, so working with a dietitian is invaluable. Focus on these principles:

  • Avoid foods that are personally triggering or hard to digest.
  • Include nutrient-dense options like salmon, spinach and fortified cereals.
  • Opt for anti-inflammatory cooking methods, like steaming or roasting.
  • Prioritize whole, minimally processed foods.

“Diet isn’t a one-size-fits-all solution for IBD, but it plays a critical role in symptom management and overall health,” says Dr. Parian.

If you’re struggling to manage IBD or have questions about your diet, reach out to your health care team. They’re here to help.

Next Steps & Resources

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

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