If your loved one is living with an inflammatory bowel disease like ulcerative colitis (UC), you may know how isolating the disease can be. Symptoms like diarrhea, cramps, and bloody stools can interfere with social events. And although food does not cause the condition, certain foods can irritate the digestive tract, putting a damper on festive meals.
There are many ways you can help someone living with UC, but knowing what foods they should eat and which they should avoid is a powerful one. By learning how to cook for a friend or family member who has an IBD, you can help ease their symptoms and make them feel included in social events, including regular family dinners.
“Food is family, friendship, and love, and cooking food together and having your loved one get healthy because of it is incredibly rewarding,” says Barbara Olendzki, RD, MPH, the director of the Center for Applied Nutrition at the University of Massachusetts Medical School in Worcester.
While there is no one-size-fits-all diet for UC, there are some general rules of thumb that are good to follow when cooking for someone who may not be able to digest certain foods very well.
“I don’t necessarily demonize individual foods, but generally limiting known pro-inflammatory foods is a good way to ensure you are maintaining an anti-inflammatory diet and lifestyle,” says Ryan Warren, RDN, a registered dietitian and clinical nutritionist at the Jill Roberts Center for Inflammatory Bowel Disease at Weill Cornell Medicine and NewYork-Presbyterian.
Here are five tips to help you navigate the kitchen when cooking for someone with ulcerative colitis.
RELATED: Best (and Worst) Foods for UC
1. Understand That a Person With IBD Has Good and Bad Days
First, it’s important to recognize that a person’s disease activity will determine what they can and can’t eat on a given day.
“When a person with UC is not in a flare-up state, the diet that’s recommended for them is mostly just a typical healthy diet,” says Kelly Kennedy, RD, Everyday Health’s staff registered dietitian. In contrast, when a loved one is experiencing UC symptoms, they’ll need to adapt their diet to eliminate foods and ingredients that make inflammation worse.
While there are some basic rules of thumb, each person’s body is different, so people who have UC should work with their doctors or dietitians to determine which foods are most triggering for them. Kennedy suggests keeping a food journal to track both diet and symptoms.
“The main goal is to maximize the amount of nutrients in the food you’re serving someone with UC while limiting the risk that they’ll have a flare-up,” says Kennedy.
For periods when the person is not in a flare-up state, Kennedy says a diet rich in fruits, noncruciferous vegetables, whole grains, and lean protein is ideal. Calcium-rich foods and foods like yogurt that contain probiotics are also important additions to a healthy UC diet.
2. Cook One Meal for Everyone
For starters, try to find dishes that everyone will enjoy so you’re not cooking more than one meal for a group. Kennedy notes that in some cases, everyone can eat the same foods, just prepared differently. For example, you can cook vegetables for someone who has UC and leave them raw for anyone who may prefer to eat them that way.
“It does take time in the beginning to learn new foods and meals,” says Olendzki. But with some practice, she adds, preparing UC-friendly meals will become second nature and may even lead to health gains for everyone at the table.
3. Go Easy on Sugar, Saturated and Trans Fat, Lactose, and Processed Food
Eating more than 25 grams of sugar per day, ultra-processed foods (essentially most packaged food), or high amounts of saturated fats (commonly found in fatty cuts of meat, skin of poultry, whole-fat dairy, lard, shortening, and coconut oil) all can cause inflammation that irritates the digestive tract and triggers UC symptoms, says Warren.
Kennedy notes that in some cases, refined, low-fiber grains like white rice and white bread, which are considered processed foods, may actually be easier to digest for someone who is in the middle of a flare-up. Knowing what works for that person’s body will help determine what foods best quell their symptoms.
Lactose, a sugar found in dairy products like milk, can be hard to break down, too, so avoid things like cream sauces (though fermented dairy products like yogurt and kefir are usually good choices). Also, avoid fried foods when cooking for someone who has UC, since the extra fat can trigger or irritate symptoms.
4. Steer Clear of Emulsifiers
Warren says to stay away from food additives and emulsifiers including carrageenan, polysorbate-80, and carboxymethylcellulose, which studies suggest can also trigger inflammation. Emulsifiers extend shelf life in processed foods, maintain texture, and keep liquids from separating. These additives are everywhere and can be difficult to avoid in foods like store-bought salad dressing, mayonnaise, and ice cream.
One study found that when mice digested polysorbate-80 and carboxymethylcellulose, the bacteria and other microscopic life in the mice’s guts became more conducive to the types of molecules that cause inflammation. Though this study was conducted on mice, not humans, the Center for Applied Nutrition at the University of Massachusetts Amherst still advises people, especially those with IBD, to avoid these products.
5. Modify Diets to Include Soft Fiber and Cooked Veggies
Warren tends to recommend anti-inflammatory diets rather than individual foods. The Mediterranean diet, for example, includes a wide variety of fresh fruits, vegetables, fish, nuts, and small amounts of healthy fats such as olive oil. Warren recommends modifying the basis of this diet to incorporate these foods in a more digestible form. For example, she suggests opting for almond butter instead of whole almonds, cooking green leafy vegetables instead of eating a raw salad, and choosing inherently soft forms of fiber, such as avocado, sweet potato, and papaya.
When cooking vegetables, try steaming or microwaving instead of boiling, which can remove key nutrients, found one study. Warren also suggests pureeing vegetables to make nutritious soups and smoothies that are easier to digest than whole produce.
During a flare-up, Kennedy says it’s best to stick to foods that are easy to digest, such as refined grains (again, white, sourdough, or gluten-free bread and white rice), and low-fiber fruits such as bananas, cantaloupe, and honeydew melon. Removing the peel from other fruit, like apples, also cuts back on irritation-causing fiber.
Kennedy says to incorporate noncruciferous vegetables, including bell peppers, squash, eggplant, tomato, and zucchini, which have low fiber content and are easier to digest. Cruciferous vegetables, such as broccoli and cauliflower, on the other hand, have high fiber content and can be irritating. Avoid dishes that include these ingredients and always avoid spicy foods, says Kennedy.
Ready to get cooking? Start with these UC-safe recipes, like Simple Roast Chicken, Oven-Poached Salmon Fillets, Irish Lamb Stew, and Curried Carrot and Apple Soup.
Additional reporting by Kaitlin Sullivan.
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