by Mila McManus, MD

We frequently come across patients with a diverticulosis.  And we also have been told by these patients that a dietitian has provided a restrictive diet plan that excludes nuts, seeds, and popcorn.(And this is what we learn to tell patients in medical school as well).  We disagree with this nutritional approach as folklore, and here’s why.

Let’s start by understanding the difference between diverticulosis and diverticulitis.  Diverticulosis is a common condition where small pouches form in the inner lining of the colon. It’s usually asymptomatic, and less than five in 100 patients will experience issues. Diverticulitis occurs when one or a few of these pouches become inflamed, bleed, or develop an infection, leading to lower abdominal pain, changes in bowel function, nausea, and possibly bloody stools.

There are two known risk factors for getting diverticulitis: genetics and lifestyle.[1] Over half of a person’s risk of getting diverticulosis is genetic [i.e., inherited]. The remainder of the risk is for those who are sedentary, obese, smoke, take non-steroidal anti-inflammatory drugs [NSAIDS], and consume the Standard American Diet [SAD], which is high in refined grains, sugar, and ultra-processed foods [UPFs]. In other words, it is not nuts, seeds, or popcorn CAUSING diverticulitis. (Conventional wisdom has been that these small seeds or parts of corn kernel will get trapped in a diverticulum ‘pouch’ and create the diverticulitis)  People who eat a diet that’s rich in fruits, vegetables, nuts, seeds, quality protein, and healthy fats and are active have a much lower risk of developing diverticulitis.

Lisa L. Strate, MD, and a team of researchers conducted a comprehensive study, following roughly 47,000 men for 18 years. The findings were clear and reassuring: the risk for diverticulitis was lower – not higher-  in those who ate a lot of nuts and popcorn.[2]

Our approach is clear and straightforward: we aim to heal the gut, reduce inflammation, and recommend a whole food diet. This diet includes nuts and seeds, and yes, occasionally, even some organic, buttered popcorn. We believe in empowering our patients to make healthier dietary choices.

Be nourished. Be well.

Resources

[1] Dow, Caitlin (July 21, 2022). Should you avoid nuts and popcorn if you have diverticulitis? Center for Science in the Public Interest, Nutrition Action Newsletter.

[2] https://jamanetwork.com/journals/jama/fullarticle/1028647