Crohn’s Disease Diet: What to Eat and Avoid and Sample Menu
Crohn’s disease is an inflammatory condition that affects the digestive tract.
It causes abdominal pain, bloating, excess gas, diarrhea, and unintentional weight loss.
Along with medications, diet plays an important role in managing these symptoms.
This article explains what to eat and avoid with Crohn’s disease and provides a 3-day sample Crohn’s disease diet menu.
What is Crohn’s disease?
Crohn’s disease is one of the major types of inflammatory bowel disease, the other being ulcerative colitis.
However, ulcerative colitis only affects the colon or large intestine, whereas Crohn’s disease can affect any part of the digestive tract (1).
Crohn’s disease affects the small intestine in about 30% of patients, the large intestine in about 20%, and both the small intestine and colon in about 50% of patients (1).
The signs and symptoms of Crohn’s disease usually depend on the area of the digestive tract involved, but generally include (1):
- abdominal pain
- excessive gas
- bloating
- diarrhea
- fever
- fatigue
- unintentional weight loss
- poor appetite
In severe cases, painful swelling near the anus or an abnormal connection between the intestinal tract and the skin may develop that allows the contents of the intestines to leak through to the skin.
Some people with Crohn’s disease may also develop conditions that affect the eyes, liver, joints, and skin (1).
It’s common for people with Crohn’s disease to experience flare-ups, during which symptoms temporarily worsen, as well as periods of remission, during which they disappear.
The exact cause of Crohn’s disease is unknown, but multiple factors related to genetics and the environment are thought to play a role (1).
There is no cure for Crohn’s disease. Instead, treatment focuses on managing symptoms and preventing or reducing the risk of complications, in part with diet.
Types of diets for Crohn’s disease
Although the exact cause of Crohn’s disease remains largely unknown, it’s thought to develop as a result of an inappropriate immune response in the digestive tract — possibly linked with poor vagal tone — to environmental factors in genetically susceptible people (1).
One important environmental factor is diet.
For example, the Western diet — rich in sugar-sweetened beverages, refined grains, and other highly-processed foods, and poor in fruits, vegetables, and whole grains — has been associated with an increased risk of developing Crohn’s disease (2).
This is because the Western diet consists of foods that disrupt the gut’s balance of good bacteria and promote intestinal inflammation, which can lead to small intestinal bacterial overgrowth (SIBO) and leaky gut.
Conversely, several diets have been suggested to reduce intestinal inflammation and alleviate symptoms.
- Low-FODMAP diet: This diet restricts fermentable oligo, di-, and monosaccharides and polys. Eating these carbohydrates can cause digestive symptoms in some people.
- Specific carbohydrate diet (SCD): This diet restricts specific types of carbohydrates, namely those found in grains, milk, and processed foods.
- GAPS diet: This diet is based on the specific carbohydrate diet and limits many of the same foods.
- Semi-vegetarian or flexitarian diet: This diet consists primarily of minimally processed plant-based foods while allowing meat and other animal products in moderation.
- Low fat/fiber limited exclusion (LOFFLEX) diet: This diet is low in fat and fiber — similar to a bland diet — and excludes foods that are thought to trigger symptoms in people with Crohn’s disease.
- Autoimmune protocol diet: A paleo-style diet that restricts foods and ingredients thought to trigger intestinal inflammation.
- Maker’s diet: This diet allows only foods that are unprocessed, unrefined, and organic.
- Gluten-free diet: This diet restricts gluten, a protein found in wheat, rye, barley, spelt, and Kamut.
- Exclusive enteral nutrition (EEN): A liquid diet that provides all nutrition orally or by a feeding tube using elemental, semi-elemental, or polymeric formulas.
Of these, EEN is the most studied and widely used diet for Crohn’s disease for achieving and maintaining remission, primarily in children and adolescents with fewer studies performed in adults (5).
However, because Crohn’s disease affects each person differently, none of these diets have consistently been shown to work for everyone (6, 7).
Still, there are some best diet practices that you can implement and individualize to fit your needs, ideally with the guidance of a registered dietitian.
Best diet practices for Crohn’s disease
Diet recommendations for Crohn’s disease are based on whether you’re experiencing a flare-up or if your symptoms are in remission.
Flare-up
During a flare-up, you should increase your protein intake to replace losses caused by certain medications and to combat muscle loss.
Aim to consume protein in the range of 0.55–0.68 grams (1.2–1.5 grams per kilogram) of body weight (5).
This equates to 83–102 grams of protein per day for a 150–pound (68.2-kg) person.
Good sources of protein include seafood and lean cuts of beef, poultry, and pork, and — if you can tolerate lactose — dairy products like milk, yogurt, and cottage cheese.
Plant-based protein sources include beans, peas, nuts, and seeds, but not everyone may tolerate these foods.
You should eat enough calories to at least maintain your weight to prevent the protein you eat from being used as energy.
Tube feeding or intravenous nutrition may be needed if you’re unable to get the nutrition you need by mouth or if you have a complication, such as a blockage or intestinal stricture, or area of narrowing.
Beyond calories and protein, you should eat an overall healthy diet and restrict foods that worsen your symptoms.
Common food intolerances in people with Crohn’s disease include (8):
- Fruits: apples, kiwifruit, oranges
- Vegetables: onions, tomatoes, corn, cabbage, broccoli, garlic
- Grains: full-grain bread, wheat and wheat products
- Dairy: ice cream, cheese, cream, yogurt, cow’s milk
- Fried foods: french fries, fried chicken, churros, onion rings, cheese sticks, etc.
- Beverages: fruit juice, coffee, alcohol
- Other: chili sauce, chili, chocolate, peanuts, cashews
Remember, Crohn’s disease affects everyone differently so you may still be able to tolerate these foods in certain amounts or not at all.
Remission
When you aren’t experiencing symptoms, continue to follow a healthy diet and avoid foods to which you are intolerant.
Your protein needs aren’t as high in remission as they are during flare-ups, but you should still aim to consume at least 0.45 grams (1 gram per kilogram) of protein per pound of body weight.
Continue to eat enough calories to at least maintain your weight, supplementing your diet with high-calorie protein supplements like Ensure or Boost if needed.
Eating enough calories from a variety of fruits, vegetables, whole grains, seafood, and lean proteins helps reduce the risk of malnutrition, which is estimated to affect 65-75% of people with Crohn’s disease (9).
Malnutrition increases the likelihood of hospitalization, infection, and emergency surgery.
To this point, studies have shown that people with Crohn’s disease tend to have inadequate intakes of calories, beans, fruits, vegetables, and dairy (10).
Consequently, people with Crohn’s disease commonly experience a variety of nutrient deficiencies, especially calcium, folate, iron, magnesium, zinc, and vitamins A and D.
A standard multivitamin and mineral supplement can decrease the risk of developing these deficiencies but more severe deficiencies may need to be treated with higher doses than what vitamin supplements can offer (9).
And although supplementing with a specific probiotic mixture has been shown effective for maintaining remission in people with ulcerative colitis, probiotic supplements aren’t recommended with Crohn’s disease (5).
3-day sample Crohn’s disease diet menu
Here’s a 3-day sample Crohn’s disease diet menu that includes foods that tend to be well-tolerated (8):
Day 1
- Breakfast: Rice Chex cereal made with fortified soy milk
- Lunch: grilled lemon chicken salad
- Snack: Greek yogurt topped with blueberries
- Dinner: pot roast with potatoes and carrots
Day 2
- Breakfast: scrambled eggs and white toast with butter
- Lunch: grilled chicken sandwich on white bread
- Snack: protein drink and a banana
- Dinner: baked pork chop, sweet potato, and roasted zucchini
Day 3
- Breakfast: spinach omelet and oatmeal cooked with fortified soy milk
- Lunch: turkey melt panini
- Snack: mozzarella cheese sticks and strawberries
- Dinner: baked salmon, quinoa, and sauteed green beans
Use this sample menu to help guide your food choices.
You may be unable to tolerate some of these foods but aim to include as many fruits, vegetables, legumes, seafood, nuts, seeds, and lean proteins as you can tolerate to promote gut health and reduce the risk of nutrient deficiencies.
Other lifestyle tips for managing Crohn’s disease
Diet is just one important aspect of Crohn’s disease management.
Here are other lifestyle tips to reduce flare-ups and the risk of health complications from Crohn’s disease (5, 11):
- Avoid nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen, aspirin, and other NSAIDs can worsen your symptoms.
- Don’t smoke. Tobacco smoking worsens symptoms and can trigger symptoms more easily.
- Seek therapy and treatment if needed. Stress, depression, and anxiety are common in people with Crohn’s disease and can worsen symptoms and decrease the effectiveness of medical or dietary treatments.
- Lift weights. Lifting weights promotes muscle gain and reduces the risk of muscle loss caused by medications or flare-ups. Other forms of exercise like walking, jogging, biking, and hiking are beneficial too.
The bottom line
Crohn’s disease is a major type of inflammatory bowel disease that causes a variety of digestive symptoms and health complications.
Diet plays an important role in Crohn’s disease management, but there isn’t one specific diet that works the best for everyone.
During flare-ups, follow a high-protein diet and restrict foods that worsen your symptoms.
In remission, follow a healthy diet and continue to restrict foods to which you are intolerant.
In addition to these diet strategies, you should avoid NSAIDs and smoking, seek therapy or treatment for anxiety or depression, and exercise regularly.
