Number one is to know what foods make you feel bad, and avoid them 100%. Every little cheat or error brings in the inflammatory disease process of Crohn’s that you don’t want. The more you allow the inflammation, the more scar tissue develops, and the less you are able to absorb nutrients or handle larger pieces of food.
If eating something like raw bell peppers makes you feel a little blocked hours later, you should be avoiding large pieces of any vegetables. They need to be either chopped up finely, cooked until mushy, or added to a smoothie. This may not be an effort you need, if you haven’t developed much scar tissue or strictures yet, but, again, you don’t want to play with anything that upsets your intestines when you have Crohn’s.
Juices are good and the ones you mention don’t have too much sugar, but don’t forget the fiber. When added to frozen fruits and other ingredients, cabbage, carrots, beets and other vegetables can hide nicely in smoothies. We just use a regular blender for these. It just needs a little coaxing. We add a few nuts, especially one Brazil nut for the day’s selenium, soy milk, cinnamon, vanilla, and maybe cocoa or carob powder.
There is a spectrum of fatty acids that are all important nutrients. Nuts and seeds offer a wide variety. Egg fats and cholesterol are valuable as well. We all tend to need more of the omega-3 fatty acids and many of us who have health problems or who are older don’t convert well from the precursors, like those you get from flax, to the DHA and EPA found in fish oils. Crohn’s sufferers are shown in studies to respond well to fish oil supplements. One gram per day of EPA plus DHA should be your minimum intake. Two grams would be useful during a healing phase. You also get these from salmon, liver, and a little from tuna and other fish. Crohn’s sufferers also tend to handle certain oils better than others. Pay attention to how you react to various oils in order to find your favorites. Healthy palm and olive oils should go well with you. Avoid all trans fats, known as hydrogenated vegetable oils.
You mention cold cuts. It’s best to avoid the nitrates and nitrites which are added to all the mainstream sliced sandwich meats. You can find nitrite-free cold cuts at healthfood stores and at some of the in-between type stores such as Trader Joes (which I love for their BPA-free cans). It’s best not to have red meat such as beef more than once per week; maybe twice. Fish and poultry are your better meat sources and eggs are great. Sometimes when a Crohn’s sufferer is experiencing a bad bout, their intestines leach a large amount of inflammatory proteins and thus they lose a lot of protein in their stools. A little ankle swelling will appear if this happens to a great degree. Because of this, and because fat absorption is a little tricky for some, those with Crohn’s may want a little more protein daily than the rest of us, and lean meats may be more easily digested and absorbed than nuts and beans.
You also mention preferring to reduce bread and rice consumption. First of all, you need to determine whether you react negatively to gluten. If you are having any inflammatory reaction to glutens you should avoid them entirely. In general, I do prefer to recommend grains be kept on the lower side for most healthy diets, and certainly prefer whole grains be consumed. I have seen Crohn’s sufferers who have delicate bowels and problems keeping weight on do well with white rice and white bread. These are gentle and easy to digest and absorb for many. If needed to keep weight on and intestinal irritation minimal, I say go for it. I would aim for the vitamin-fortified versions at least. Fruit and vegetable fibers are gentler for some, especially when cooked, than whole grain fibers.
Every time you have an inflammatory bout with diarrhea, you are likely losing iron from your intestines, as the little iron-absorptive surfaces become damaged and because you may be losing some blood. It’s best not to take iron supplements unless you are proven anemic on a blood test, and a blood test is a good idea if your iron hasn’t been measured within a year. If your iron is on the lower side, consuming high iron foods such as dark greens, legumes, and meats, is a good idea and gentler on your intestines than iron supplements.
Lots of Crohn’s studies show good results with regular consumption of probiotics. You will want to find a vegan probiotic if you are avoiding milk products. A probiotic that says “no dairy,” may still have tiny traces of milk proteins but one that says “no milk products” shouldn’t. Since there are so many studies on so many different kinds of probiotic bacteria (and fungi), I like to select products that have lots of different kinds; maybe even two different brands if they have many different strains.
Turmeric, or curcumin, a curry spice, is a powerful antioxidant shown to be helpful for Crohn’s sufferers. You’ll want to take 1 or 2 grams per day in supplements as it’s difficult to eat enough curry to be highly effective. Resveratrol, found in peanuts or grapeseeds and skins, is another great antioxidant supplement. Glutamine is an amino acid (not related to monosodium glutamate) given often to premature babies to encourage intestinal growth and healing. It’s found to be effective for adults as well although some studies show less benefit than once thought. Three to 7 grams per day would be an effective dosage. GNC sells chewable glutamine tablets since such a “large” dose is recommended. You might save them for when your intestines are needing some extra healing.
Of most importance with Crohn’s is that you don’t consume any milk proteins, meaning nothing containing milk, whey, casein, cream, butter (has traces of proteins), “hydrolyzed protein” (unless it specifies what it’s made from), cheese, yogurt, etc. unless you can prove to yourself with certainty that you do not react to milk proteins. Blood tests aren’t all that useful. One month 100% milk free, and then some good doses of milk, will tell.
There was a summary of multiple studies (a meta-analysis) released a few years back reporting that adults with Crohn’s did just as well on polymeric formulas as elemental formulas. Elemental formulas have all proteins broken down to their basic building blocks so that the body won’t recognize them for what they used to be and won’t find anything to react to. It’s very well known that pretty much all Crohn’s sufferers will go into “remission” on elemental diets. I was very curious about this polymeric formula report, as most of them contain intact milk proteins. I dug up every study in that analysis and read them thoroughly and found that the analysis was comparing all different kinds of diets --- apples to oranges to tuna, so to speak --- and the one diet in the study that had intact milk proteins excluded those participants who were known milk allergics. This study proved nothing except that dairy industry formula companies continue to rule doctors’ opinions for their own benefits.
It’s also very curious that the chief risk of exposure to a bacterium that is strongly associated with Crohn’s disease, mycobacterium avium subspecies paratuberculosis, (MAP), is through cow’s milk. MAP is killed with the best pasteurization but milk processing errors are quite common and this bacterium can often be found in commercial milks.
A large portion of those with Crohn’s will eventually develop intolerance of other milks as well, such as goat or sheep. Some bodies generalize or expand their milk allergies to become beef allergic as well. Some occasionally develop allergies to other foods that were consumed along with something that caused an attack.
I tend to see children from parents with Crohn’s, displaying milk allergies and other various food allergies, and/or gluten intolerance (celiac disease). The genes for these seem to be partly shared, with environmental factors (diet, stress, intestinal infections, etc.) and other genetic factors determining the expression and degree of expression of symptoms. I’ve not really gotten to watch any children of Crohn’s parents grow up, other than my own son (to age 16) from a Crohn’s father. I imagine that those whose parents caught on early and kept their intestinal irritations down, seldom went on to develop full-blown Crohn’s, and may even have few or no food intolerances. Those who pay no attention to diet and other intestinal health measures, who are exposed to unrelated intestinal infections, or who use antibiotics frequently, are far more likely to develop Crohn’s.
What I do find very often is that when putting breastfeeding mothers on various food elimination diets in effort to resolve intestinal symptoms in their nurslings, a large portion of moms report great improvements in symptoms they’ve been experiencing themselves. There certainly is a genetic component to intestinal distresses.
You mention maintaining a good weight. Most Crohn’s sufferers have trouble keeping enough weight on, though a few have the opposite challenge. Are you wanting to keep your weight up or down? I just want to be sure what we’re talking before I make any recommendations there. Let me know what other specific problems you may be having and where my recommendations don’t work for you.