New Research Contradicts Old Advice

One of those long-standing “rules” in medicine has been that people who’ve had diverticular disease should not eat nuts, popcorn or corn. But as with so many medical conventions, this one is being called into question. New research finds no evidence to support the recommendation… and in fact, suggests that some of these nutrient-packed foods may actually help reduce the risk of diverticulitis.

CHALLENGING CONVENTIONAL WISDOM

Diverticular disease is a common digestive disorder, affecting about half of Americans over age 60. Diverticulosis is a condition where bulging pouches (diverticula), about the size of a pea or larger, form in the large intestine or colon wall… while diverticulitis refers to infection or inflammation that can cause symptoms such as abdominal pain, fever and nausea. Ten to 25% of people with diverticulosis develop diverticulitis.

Researchers at the Harvard School of Public Health and Harvard Medical School in Boston and the University of Washington School of Medicine in Seattle looked into the connection between consumption of nuts, popcorn and corn and diverticular disease in more than 47,000 men. At the outset, none of the participants (age 40 to 75) had diverticulosis or its complications, cancer or inflammatory bowel disease. From 1986 to 2004, the men filled out questionnaires on their medical status every two years and on their diet every four years.

In the 18 years of follow-up, 801 men developed diverticulitis and 383 experienced diverticular bleeding. Assistant professor, division of gastroenterology at University of Washington School of Medicine, Lisa L. Strate, MD, MPH, who led the team, told me about the surprising findings.

  • Nuts, popcorn and/or corn consumption is not associated with an increased risk of diverticulitis or diverticular complications.
  • Men who ate nuts at least twice a week experienced a 20% lower risk of diverticulitis, compared with those who consumed nuts less than once a month.
  • Men who ate popcorn at least twice weekly experienced a 28% lower risk of diverticulitis, compared with those who consumed popcorn less than once a month.

Results of this study were published in the August 27, 2008, issue of the Journal of the American Medical Association.

The theory behind the old recommendation was that foods like popcorn, nuts and corn are only partially broken down by digestion. The concern was that the remaining kernels and particles were abrasive and might get lodged within diverticula, where they could cause blockage or bleeding.

Based on the results of this study, Dr. Strate believes this advice should be reconsidered. Of course, if you know you are allergic or intolerant to nuts or other foods, you should continue to avoid them. But if these foods have not caused problems before and you enjoy them, you can probably continue to do so even after a bout with diverticular disease — check with your doctor to make sure.