In the world of nutrition, it seems nothing lasts forever. First you hear ‘X is the best food for health’ and before you know it a new study comes out that suggests ‘X is not good for health and you should steer clear’… sure seems awfully confusing and hard to stay on top of …..and I am a Dietitian!
As a Dietitian who works with many clients seeking to improve their digestive health, I get asked all the time about nuts in particular – whether they are good, which ones are best and how much is too much. There is no shortage of headlines on nuts – a quick Google search turns up many headlines including this one from The Globe and Mail just last week: If You are Looking for a Healthy Heart, Go Nuts
So it might be no surprise that my clients who are living with a condition called diverticulosis unhappily tell me they were told by their doctor they shouldn’t eat nuts……everWhy is that? Are nuts really off the table forever? Let’s take a closer peak….
First a refresher diverticulosis vs. diverticulitis – Diverticulosis is a condition that occurs when little pockets called diverticula form on the wall of the colon within the intestinal tract. The mere presence of diverticula isn’t a real problem and many people have diverticula without evening know it. What is a problem is when these diverticula become inflamed and infected which can result is severe abdominal pain which can be accompanied by nausea, vomiting, cramping, bleeding etc. For more background info on diverticular disease, check out this great little video below I found on the the Canadian Society of Intestinal Research (CSIR) website.
During an episode of diverticulitis, when the diverticula are inflamed and tender many patients are advised to back off on fibre in their diet and in some cases resort to only fluids for a short period of time to give the bowel rest. After rest and/or treatment with medication these patients would be advised to return to their normal diet. Back in the day many physicians would recommend that patients diagnosed with diverticulosis (which in many cases is found during routine colonoscopy monitoring) should avoid eating nuts, seeds, corn, popcorn etc. as the thought was that these high fibre foods could be problematic even in the absence of the infection associated with diverticulitis and could cause 'trauma' in the intestine that could make someone more susceptible to developing diverticulitis. So, this meant once diagnosed with diverticula, these foods were off limits for life.
However, this recommendation has since changed after some studies emerged which suggested that avoiding nuts, seeds, popcorn etc. forever might not be such a good idea. One of the big studies was a prospective study published in 2008 which included over 47,000 men in the US that looked at diet and diverticulitis and diverticular bleeding. No association was found between nut consumption and increased risk of complicated diverticular disease. In fact it was suggested that including nuts in the diet as a fibre source might actually be a benefit…...not a harm!
In addition to tasting great and serving as a fibre source they are loaded with other good things which might explain why more and more health organizations are standing behind nuts. The Clinical Practice Guidelines from Diabetes Canada (formerly known as the Canadian Diabetes Association) point to nut intake and the association with nut intake and improved A1C – an indicator of blood sugar control – as well as improved lipid control in people living with diabetes. The Canadian Cardiovascular Society’s Guidelines for the Management of Dyslipidemia suggest regular nut consumption should be considered for management of elevated cholesterol with expected improved LDL and TG levels in those who consume nuts (>30g/day) frequently.
So the verdict is in – no need to avoid nuts if you have been diagnosed with diverticulosis. In fact avoiding nuts may deprive you of the health benefit nuts have as they relate to other conditions and may offer no benefit with respect to diverticular disease.