Fats You Should Eat or Avoid When You Have Crohn’s Disease

Fats You Should Eat or Avoid When You Have Crohn’s Disease

Fats You Should Eat or Avoid When You Have Crohn’s Disease
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Eating well when you have Crohn’s disease, a form of inflammatory bowel disease (IBD), means both consuming enough calories and getting macronutrients, including fats, in the right proportions. Fats, for example, should make up 15 to 30 percent of your daily calories, according to the World Health Organization (WHO). The WHO advises limiting saturated fat to no more than 10 percent of your total daily calories.

One gram (g) of fat equals 9 calories, so the average 2,000-calorie-a-day diet translates to between 33 and 67 g of fat, and that total includes no more than 22 g of saturated fat. If your dietitian or doctor recommends a different calorie goal, increase or decrease the amount of fat accordingly to keep the percentage the same.

Unsaturated, or ‘Good’ Fats

Unsaturated fats, which are also known as “good fats,” are considered beneficial because they can help lower low-density lipoprotein (LDL), or so-called “bad” cholesterol, and most also raise “good” cholesterol, or high-density lipoprotein (HDL). These healthy fats are categorized as either monounsaturated fats or polyunsaturated fats.

Monounsaturated fats are found in foods such as:

  • Olive oil
  • Canola oil (it’s also high in polyunsaturated fats)

  • Peanut butter
  • Many kinds of nuts and seeds
  • Avocado
Polyunsaturated fats are found in foods like:

  • Fatty fish
  • Soy milk
  • Tofu
  • Sunflower, corn, soybean, and flaxseed oils
Lisa Simon, RD, a registered dietitian in London, says people with Crohn's disease should be encouraged to eat foods with healthy fats, such as avocados, tahini, and extra-virgin olive oil. Nuts and seeds are also good options, though eating them isn’t recommended when you have strictures.

When adding good fats to your diet, try to consume omega-3 fatty acids (a kind of polyunsaturated fat) as well. They’re in fatty fish like salmon, mackerel, and tuna, as well as in walnuts and flaxseeds. Omega-3s are believed to have anti-inflammatory effects in the body, and they can also be found in supplement form.

One research review that included 13 randomized controlled trials that enrolled people with IBD came to a different conclusion. It found that the long-term effects of increasing omega-3, omega-6, and other polyunsaturated fats in the diet had little or no effect on IBD treatment, and didn’t do much to modify inflammation long-term, either.

But two studies that looked at the effects of supplementing intravenous (IV) nutrition with omega-3 fatty acids after surgery for Crohn’s suggest they may have benefit in specific situations. The first found that the 83 participants receiving the omega-3 fatty acids had lower levels of the inflammation marker they measured, shorter hospital stays, and significantly fewer complications. The second study found that the 134 participants in the treatment group had lower levels of inflammatory proteins, as well as fewer surgical complications.

Saturated, or ‘Bad’ Fats

So-called “bad” fats are saturated fats and trans fats. Saturated fats can be found in animal products like meat, eggs, and dairy that isn’t nonfat, and while trans fats were effectively banned by the U.S. Food and Drug Administration (FDA) in 2020, they may be found in foods manufactured elsewhere, and foods with under 0.5 g per serving can list the amount as 0 g. Most trans fats come from partially hydrogenated oils, but some occur naturally in small amounts in animal products like meat and dairy.

Diets high in saturated and trans fats increase the risk for heart disease and stroke, putting them on everyone’s “to avoid” list. Trans fats can also lower your good HDL cholesterol, and are connected to an increased risk of type 2 diabetes.

Replace ‘Bad’ Fats With ‘Good’ Ones

Increasing the amount of healthy fats in your diet, like any dietary modification, can feel overwhelming, especially when you’re experiencing symptoms or a flare. One way to cut out saturated and trans fats is to limit or rule out fried and processed food and choose unsaturated fats instead.

Enjoy a grilled or baked salmon steak (high in healthy omega-3s) instead of fried chicken, for instance. Gradually switch over to more plant- and fish-derived fats rather than eating as much saturated fat from meat, poultry, and dairy.

“Animal fats are often difficult for people with Crohn’s disease to digest, so they frequently worsen symptoms of abdominal pain, diarrhea, and fecal urgency,” says Colleen D. Webb, RDN, a registered dietitian-nutritionist and adjunct professor at NYU Steinhardt School of Culture, Education, and Human Development in New York City.

Simon says that saturated fat may increase inflammation in the body.

 She recommends following a predominantly plant-based diet. “People who eat more plants and fatty fish have been shown to live longer, healthier lives and have a reduced risk of flares,” Webb says.

According to research, Western diets and animal-based diets high in meat, saturated fats, and that include more omega-6s than omega-3s, and diets lacking in fruits and vegetables may contribute to intestinal inflammation.

7 Ways to Increase Your Healthy Fat Intake if You Have Crohn’s

Learn how to work healthy fats into your everyday diet.

1. Try Nut and Seed Butters

Not only are nut and seed butters delicious, you can add them to all sorts of things, like a banana, rice cake, or a slice of sourdough bread. Pureed butters are also a way to consume nuts and seeds without irritating your digestive tract. In fact, nut and seed butters are even safe to consume if you have strictures.

“Sometimes people with Crohn's disease struggle with the amount of fiber that's in whole nuts, but that doesn't mean that you have to cut out nuts altogether. Having lots of different nut butters … is a really great way of incorporating nuts,” says Sophie Medlin, RD, a consultant dietitian at City Dietitians and the chair of the British Dietetic Association for London.

"Almond butter and peanut butter are go-to favorites, but there are all kinds of delicious nut and seed butters, including cashew, walnut, pecan, pistachio, hazelnut, and sunflower seed,” says Webb.

2. Experiment With Avocados

Avocado toast anyone? Avocados are a versatile food that can incorporate healthy fats into any meal. Add slices to a sandwich or salad, make a breakfast taco with chopped tomato and scrambled eggs in a corn tortilla, or enjoy avocados in guacamole. Avocados not only taste delicious; they’re jam-packed with nutrients.

"Avocados are full of healthy fats, and they're a great source of potassium, magnesium, and easy-to-tolerate fiber," says Webb.

Avocados have vitamin C, vitamin E, folate, and, since they have lots of monounsaturated fats, avocados help reduce LDL or “bad” cholesterol levels. Be aware, however, that avocado is high in certain FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), indigestible carbohydrates that can cause gas in people with irritable bowel syndrome (IBS), a condition that commonly coexists with Crohn’s.

3. Use Pesto or Hummus Instead of Cheese on a Burger or a Grilled Chicken Sandwich

Topping your hamburger or grilled chicken sandwich with pesto or hummus rather than cheese will help you replace saturated fat in your diet. Hummus is also delicious as a dip or in pasta sauce if you’re lactose intolerant. During a flare, it can also be a good way to get fiber into your diet in a way that’s less likely to irritate your digestive tract, as the garbanzo beans in hummus are pureed.

4. Snack on Dark Chocolate

If you have a sweet tooth, you may be happy to know that eating dark chocolate is recommended for people with Crohn’s disease as a healthier — and often better-tolerated — alternative to milk chocolate.

 Antioxidants and flavonoids, active components in dark chocolate, may be good for gut and cardiovascular health, respectively. Unsurprisingly, however, dark chocolate should make up only a small portion of a balanced diet that promotes low inflammation.

Eating dark chocolate on its own is unlikely to confer health benefits, unfortunately. It needs to be part of a healthy diet, along with other antioxidant- and flavonoid-rich foods, including brightly colored fruits and vegetables, Medlin says.

5. Swap in Greek Yogurt for Mayonnaise

For a healthier, low-fat option, Greek yogurt can replace mayonnaise in potato salads and on burgers. Try it with canned salmon and a squeeze of lemon — it’s more easily digested by people with Crohn’s than mayo, and it contains probiotics.

Medlin says yogurt that contains probiotics helps promote gut bacteria that aid digestion. “[It’s] something that people should be consuming or adding to the diet if it’s not already there,” says Medlin.

But traditional dairy-based yogurt contains lactose, making it a high-FODMAP food that can cause gas and bloating in people with IBS or lactose intolerance. If lactose is a concern, there are lactose-free dairy yogurts, and many plant-based yogurts also contain probiotics. Coconut yogurt in particular is low-FODMAP.

6. Add Anchovies or Sardines to Pasta, Sandwiches, or Pizza

Trying anchovies or sardines on pasta, sandwiches, or pizza is another way to increase your consumption of healthy fats. Medlin says increasing your oily fish intake is one way to consume more omega-3 fatty acids. As previously mentioned, increased omega-3 intake may lead to better health outcomes and lower levels of inflammatory markers in Crohn’s, though other studies haven’t found such benefits in people with IBD.

“Omega-3 fats found in fatty fish, such as salmon and sardines, have been linked to a decreased risk of developing IBD, improved gastrointestinal symptoms in people with IBD, and a reduced risk of colon cancer [in the general population],” Webb says.

If you’re a firm believer that anchovies don’t belong on a pizza, consider making a tuna sandwich for lunch or grilled salmon with vegetables for dinner.

7. Drizzle More Olive Oil Than Coconut Oil Onto Your Pan

Medlin recommends extra-virgin olive oil for its many health benefits. “[It] contains lots of amazing plant powers that really help people cope with inflammation….” Olives and olive oil are great things to include in your diet, whether or not you have Crohn's disease, she says.

If you’re deciding between oils, choose olive oil over coconut oil. “The only [oils] you really want to avoid or not have too much of are coconut oil and palm oil. Coconut oil is very high in saturated fat,” Simon says. “I wouldn't say it's a banned food and not to have it at all — you should have it in moderation like you would any other form of saturated fat.”

Proper nutrition is crucial for a strong immune system, and increasing the proportion of healthy fats in your diet can help you reach your nutritional goals.


The Takeaway

  • Adequate nutrition is important when you have Crohn’s disease, and a balanced diet that’s high in so-called “healthy” fats can help you manage your illness.
  • The World Health Organization recommends that 15 to 30 percent of your daily calories come from fats, with no more than 10 percent of the day’s calories from saturated fats.
  • Healthy fats include monounsaturated and polyunsaturated types; they are known to improve cholesterol, among other health benefits.
  • Saturated and trans fats are connected to heart disease and stroke, so experts recommend replacing them with monounsaturated and polyunsaturated fats.

Additional reporting by Kaitlin Sullivan.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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Ira Daniel Breite, MD

Medical Reviewer

Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patients and helps run an ambulatory surgery center.

Dr. Breite divides his time between technical procedures, reading about new topics, and helping patients with some of their most intimate problems. He finds the deepest fulfillment in the long-term relationships he develops and is thrilled when a patient with irritable bowel syndrome or inflammatory bowel disease improves on the regimen he worked with them to create.

Breite went to Albert Einstein College of Medicine for medical school, followed by a residency at NYU and Bellevue Hospital and a gastroenterology fellowship at Memorial Sloan Kettering Cancer Center. Working in city hospitals helped him become resourceful and taught him how to interact with people from different backgrounds.

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