Can Patients with Diverticular Disease Eat Nuts, Corn and Popcorn
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Diverticulosis is a common disease of the large intestine characterized by pouches in the colon that bulge outward through weak spots in the colon musculature. These pouches can become inflamed, a complication referred to as diverticulitis, or they can bleed, often profusely. Patients with diverticulosis, particularly those who have complications, are frequently advised to avoid nuts and seeds; however, there is little evidence to support this recommendation. The aim of this study, conducted by researchers from the University of Washington School of Medicine and Harvard Medical School, was to prospectively evaluate whether nut, corn and popcorn consumption were associated with complications of diverticular disease.
From the Health Professionals Follow-up Study cohort, investigators selected 47,228 U.S. men aged 40-75 years at baseline (in 1986) and free of diverticular disease, gastrointestinal cancer and inflammatory bowel disease. Men reporting newly diagnosed diverticulosis or diverticular complications on biennial follow-up questionnaires were sent supplemental questionnaires outlining details of diagnosis and treatment. Recent consumption of nuts, corn and popcorn was determined from a validated 131-item semi-quantitative food frequency questionnaire mailed to the participants every four years. Study endpoints included diverticular bleeding and diverticulitis.
During 18 years of follow-up, researchers identified 383 cases of diverticular bleeding and 801 cases of diverticulitis. Among men with diverticular bleeding no associations were observed for consumption of nuts, corn, popcorn or combined consumption. Again, among men with diverticulitis, no associations were found for corn consumption. However, after adjusting for other known or potential risk factors for diverticular complications, men with the highest popcorn intake (at least two times per week) had a 28 percent decrease in the risk of diverticulitis compared with men with the lowest intake (less than once per month). Similar statistically significant negative associations with diverticulitis were seen for men with the highest nut intake and the highest combined intake of nuts, corn and popcorn.
“In the past, many doctors have recommended that individuals with diverticulosis or diverticular complications avoid nuts and seeds because they believed that these foods could lodge in diverticula and incite inflammation or bleeding,” said Lisa L. Strate M.D., M.P.H., of the University of Washington Division of Gastroenterology in Seattle, Wash. and lead author of this study. “However, data from this large, prospective cohort suggest that these foods do not increase the risk of diverticular complications. In fact, frequent popcorn and nut consumption were associated with a decreased risk of diverticulitis.”
Dr. Strate will present this study on Tuesday, May 22, at 5:15 p.m. in Room 149.
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