In the news: Diet & Diverticulitis: Study Finds Nuts & Seeds OK

Avoiding Nuts/Seeds/Corn in Diverticular Disease Appears Unnecessary

Diverticulosis is a condition where small pouches or pockets (diverticula) form in the wall of the colon. Diverticulosis is very common, affecting over 30% of people aged 50–59, 60% of those 60 and older, and more than 70% of those over 80 years of age.

The exact cause of the condition is unknown, but several risk factors have been identified. A diet low in fiber and high in red meat, being overweight or obese, smoking, and excessive alcohol intake may increase the risk of developing diverticulosis.

About 5-10% of people with diverticulosis develop diverticulitis, which happens when the colonic pouches become inflamed or infected. Symptoms can include fever, abdominal pain, nausea, vomiting and changes in bowel habits.

Flare ups can be painful and often require medical intervention. Usually, a clear liquid diet is advised followed by a low fiber diet and a gradual increase in fiber. If untreated, diverticulitis can lead to serious complications.

Those who have had diverticulitis are often advised not to eat foods that can become trapped in the pouches. Typically, these foods include nuts, seeds, popcorn, fruits with small seeds like strawberries and tomatoes, and corn.

That advice has been questioned, and researchers from the University of North Carolina at Chapel Hill set out to see whether these food items really do up the risk for diverticulitis(1).

The investigators analyzed government data from a study that asked close to 30,000 women in the US and Puerto Rico aged 35-74 to fill out food frequency questionnaires and answer questions about diverticulosis and diverticulitis. The data was collected every 2-3 years over a 19-year period.

There was no association between eating peanuts, nuts, seeds and fresh foods with edible seeds and the risk of developing diverticulitis in the female participants.

These findings echoed the results of an earlier study(2) involving over 47,000 male participants (Health Professionals Follow-up Study) that specifically assessed intake of these foods and diverticulitis risk. Consuming nuts, corn and popcorn was not linked to the risk of developing the disease in these men.

Debunking the long-given advice to avoid these foods is advantageous since the current study also found that eating a healthy diet lowered the risk of diverticulitis. Healthy diets usually incorporate fresh fruit and nuts.

The researchers found that diets reflective of several commonly recommended ways of eating such the Dietary Approaches to Stop Hypertension (DASH) diet, the Mediterranean Diet, and the Healthy Eating Index, lowered the risk of diverticulitis by about 10-22%.

Another investigation(3) recently confirmed that consuming lots of fiber – from cereals and fruits in particular – helps prevent the complications of diverticulitis. In contrast, too much red meat and a typical “Western diet” was found to up the risk of complications. That means eating less processed and fast foods, refined grains, saturated fats and sugars.

How a good quality diet might influence diverticulitis risk isn’t understood, but it might have to do with the composition of the gut microbiome, with helping to control inflammation or lowering the risk of other diseases linked to diverticulitis such as type 2 diabetes.

References

1. Barlowe T, et al. Diet and Risk for incident diverticulitis in women: A prospective cohort study. Ann Intern Med. 178:788-795, 2025.
2. Strate L, et al. Nut, corn, and popcorn consumption and the incidence of diverticular disease. JAMA. 300;(8):907-914, 2008.
3. Carabotti M, et al. Role of dietary habits in the prevention of diverticular disease complications: A systematic review. Nutrients. 13:1288, 2021.