Dietaty Recommendations for diverticualar disease

Diverticulosis and Diverticulitis are very common diseases and diverticulosis is thought to arise in part because of our American diet. Diverticulosis occurs in about 60% of Americans by the age of sixty.

For years, physicians have told patients to avoid small seeds and nuts because they may flare up an attack of diverticulitis. A recent study may dispel this advice.

A cohort study of 18 years’ duration that included 47,228 men, aged 40 to 75 years, addressed the practice of advising patients with diverticular disease to avoid high-residue foods. At the beginning of the study, all participants were free of diverticula. During the follow-up period, there were 801 cases of diverticulitis and 383 episodes of diverticular bleeding in those enrolled.

The surprising finding in this study was that there was an inverse association between the consumption of nuts and popcorn and the risk of diverticulitis.

The results showed that those with the highest intake of nuts had about a 20% decrease in the risk of diverticulitis and those with the highest intake of popcorn had about a 28% decrease. Corn, either on or off the cob, neither increased nor decreased the risk of diverticulitis. The last finding was there was no association between any of the high-residue foods and diverticular bleeding.

It is now questionable on what to tell patients. From personal experience, when a patient comes in with an acute attack of diverticulitis, popcorn and peanuts are the two most common foods they recall eating in the past 24 hours although most of these patients do eat them all the time.


A number of patients cannot recall a specific food that may have flared up their disease so it is still questionable as to what recommendations to give. This study may be reassuring for many patients and physicians but from experience, this study does not reflect reality of my personal practice and patients.