Home Health Diverticulitis isn't anti-nut any more


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Physicians have long warned people not to eat nuts, popcorn, and corn if at risk for diverticulitis, a condition where small pouches develop in the colon. However, a new study says such a warning is nutty; in fact, it’s just the opposite: eat all you want to lower your risk.

Dr. Lisa L. Strate (of the University of Washington’s School of Medicine, and the Division of Gastroenterology, Department of Medicine, Harborview Medical Center, both in Seattle) and her colleagues state, “Patients with diverticular disease are frequently advised to avoid eating nuts, corn, popcorn, and seeds to reduce the risk of complications. However, there is little evidence to support this recommendation.”

According to the WebMD article “Nuts Don't Up Risk of Diverticulitis,” “About a third of Americans will develop small pouches of the colon, a condition known as diverticulosis, by the time they reach age 60; two-thirds have the pouches by age 85.”

Of these people, over 25% will advance to diverticulitis, a serious condition that can result in intense pain in the area of the abdomen, along with symptoms of vomiting, cramping, and nausea.

Because of this, physicians have advised patients for over fifty years to refrain from eating nuts, corn, popcorn, seeds (such as from tomatoes, etc.), and other similar foods if they are at risk for developing pouches in their intestines and diverticulitis.

The reasoning for this medical advice was that such foods are difficult to digest, could become trapped in these pouches, and compound the problems of diverticulosis.

However, Dr. Strate comments, “It is not exactly clear where this idea came from because there are no studies showing this to be the case. It just became a part of medical lore." [WebMD]

Please read page two for the specifics about reversing this "urban legend" belief.

Strate and her colleagues published the results of their study in the Tuesday, August 27, 2008 issue of the Journal of the American Medical Association (JAMA). Its title is “Nut, Corn, and Popcorn Consumption and the Incidence of Diverticular Disease.”

Strate’s team used the Harvard University (Massachusetts) School of Public Health’s Health Professionals Follow-up Study (HPFS) to study 47,228 men aged 40 to 75 years with respect to incident diverticulitis and diverticular bleeding.

At the beginning of the study, all of the male subjects did not have the medical condition diverticulosis, and did not have any incidences of cancer or inflammatory bowel disease.

After eighteen-years of study, the Strate researchers found there were 801 incident cases of diverticulitis and 383 incident cases of diverticular bleeding.

However, the researchers report, “We found inverse associations between nut and popcorn consumption and the risk of diverticulitis.”

The subjects who ate nuts, corn, or popcorn frequently were found by the researchers to have no more risk in developing diverticulitis or diverticular bleeding than men who rarely ate such foods.

In fact, the Strate team stated that men who ate nuts at least twice a week had a 20% lower risk of diverticulitis than men who ate nuts less than once a month.

In addition, they found that men who ate popcorn at least twice a week had a 28% lower risk of diverticulitis than the men who ate popcorn less than once a month.

Page three continues the team's findings.

The researchers found no association between eating corn and diverticulitis.

And, the Strate team also saw no association between corn, popcorn, and nuts and diverticular bleeding. Plus, they did not see a link between these three foods and the development of uncomplicated diverticulosis.

They concluded, “In this large, prospective study of men without known diverticular disease, nut, corn, and popcorn consumption did not increase the risk of diverticulosis or diverticular complications. The recommendation to avoid these foods to prevent diverticular complications should be reconsidered.”

The authors of the study are: Lisa L. Strate, Yan L. Liu, Sapna Syngal, Walid H. Aldoori, and Edward L. Giovannucci.

They are associated with the University of Washington School of Medicine, Seattle (Strate); Division of Gastroenterology, Department of Medicine, Harborview Medical Center, Seattle (Strate); Departments of Nutrition (Liu and Giovannucci) and Epidemiology (Giovannucci), Harvard School of Public Health, Boston, Massachusetts; Harvard Medical School, Boston (Syngal and Giovannucci); Division of Gastroenterology (Syngal) and Channing Laboratory (Giovannucci), Department of Medicine, Brigham and Women's Hospital, Boston; Division of Population Sciences, Dana Farber Cancer Institute, Boston (Syngal); and Wyeth Consumer Healthcare Inc, Mississauga, Ontario, Canada (Aldoori).

The WebMD article concludes by saying, “Many doctors [today] recommend that patients with diverticular disease eat a high-fiber diet; nuts, corn and popcorn are high-fiber foods.”


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