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If you missed last weeks post about the top 12 trigger foods for people with crohn's or colitis, you'll definitely want to read that blog post first. Both last and this week's posts were based on 10 different research studies that asked people with IBD which foods and beverages they felt triggered an increase in symptoms. The only exception is the research study on the far right in chart #2, which was based on search engine results and the diet recommendations from the chosen websites.

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Keep in mind that just like last weeks post, these studies were based on patient reported triggers... which may or may not be accurate. In my experience, a lot of people with crohn's and colitis are able to locate some, but not all of their trigger foods and beverages so take these research study results with a grain of salt!

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Disclaimer: The information provided is not intended to provide medical advice, diagnose, or treat medical diseases. It is strictly for informational purposes. Prior to undertaking any change in treatment or diet seek the advice of your physician. This blog post does not replace individualized medical nutrition therapy or medical advice. 

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Chart #1 (shown below) illustrates the number of research studies in which patients indicated a particular beverage as a trigger.

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Participants in six out of the ten research studies reported that alcoholic beverages and milk/cream were the two most commonly reported beverages that triggered symptoms. Carbonated beverages, coffee, and tea were reported by study participants to trigger symptoms in four out of the 10 research studies. Energy drinks and soda were reported to trigger symptoms in 3 out of the 10 research studies and fruit juice was reported to trigger symptoms in only one out of the 10 research studies.

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Chart #2 showcases the research studies used, the number of participants, and the country in which the study was conducted, and which beverages participants more commonly perceived to be triggers.

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When reviewing research studies, one thing that's important to keep in mind is the number of participants involved in that study (and where those participants are located-are they all from one geographic area? or multiple areas scattered across the country). In general, the greater the number of participants involved, the more weight that research study carries, especially when participants are from multiple different locations. Therefore, the 2013 crohn's and colitis foundation of America online study that contained over 2,300 study participants carries a lot more weight than the 1999 research study conducted in 153 Canadian pediatric participants. That being said, I still wanted to share all of these studies with you so I created a fun chart.

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Also, keep in mind that some of these beverages may not trigger symptoms but are suggested in research studies to increase the growth of certain types of bad gut bacteria which may lead to worsening inflammation. Others may just trigger symptoms but have no effect on inflammation. For instance, to my knowledge, no research suggests that coffee or tea increases bad gut bacteria but some patients have reported these beverages to worsen symptoms.

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Do you think any of these beverages trigger your symptoms? Let me know in the comments below!

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And stay tuned for next week because I’ll be sharing a flare-friendly recipe you might be interested in!

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P.S. If you’re tired of trying to find your trigger foods on your own and are ready to get guidance to learn which foods and beverages you can safely eat, click here to apply for a complimentary breakthrough session, where we'll chat about what you're struggling with right now and what you want to change. Then, based on our conversation, I’ll make some recommendations for next steps.

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References:

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Cohen, A. B., Lee, D., Long,M. D., Kappelman, M. D., Martin, C. F., Sandler, R. S., & Lewis, J. D.(2013). Dietary patterns and self-reported associations of diet with symptoms of inflammatory bowel disease. Digestive diseases and sciences, 58(5),1322–1328. https://doi.org/10.1007/s10620-012-2373-3

De Vries, J., Dijkhuizen,M., Tap, P., & Witteman, B. (2019). Patient's Dietary Beliefs and Behaviours in Inflammatory Bowel Disease. Digestive diseases (Basel,Switzerland), 37(2), 131–139. https://doi.org/10.1159/000494022

Green, T.J., Issenman, R.M., Jacobson, K. (1998). Patients’ diets and preferences in a pediatric population with inflammatory bowel disease. Canadian Journal ofGastroenterology, 12(8): 544-9. doi: 10.1155/1998/928706

Hou, J. K., Lee, D., &Lewis, J. (2014). Diet and inflammatory bowel disease: review of patient-targeted recommendations. Clinical gastroenterology and hepatology : the official clinical practice journal of the AmericanGastroenterological Association, 12(10), 1592–1600. https://doi.org/10.1016/j.cgh.2013.09.063

Jowett, S.L.,Seal, C.J., Phillips, E., Gregory, W., Barton, J.R., Welfare, M.R. (2004). Dietary beliefs of people with ulcerative colitis and their effect on relapse and nutrient intake. The American Journal of Clinical Nutrition, 23(2):161-70. doi: https://doi.org/10.1016/S0261-5614(03)00132-8

Limdi, J.K., Aggarwal, D., McLaughlin, J.T. (2016). Dietary Practices and Beliefs in Patients with Inflammatory Bowel Disease. Inflammatory Bowel Diseases, 22(1):164 170. 
‍https://doi.org/10.1097/MIB.0000000000000585

Pituch-Zdanowska, A., Kowalska-Duplaga,K., Jarocka-Cyrta, E., Stawicka, A., Dziekiewicz, M., Banaszkiewicz, A. (2019).Dietary Beliefs and Behaviors Among Parents of Children with Inflammatory Bowel Disease. Journal of Medicinal Food, 22(8): 817-822. http://doi.org/10.1089/jmf.2018.0206

Triggs, C.M., Munday, K., Hu, R., Fraser, A.G.,Gearry, R.B., Barclay, M.L., Ferguson, L.R. (2010). Dietary factors in chronic inflammation: food tolerances and intolerances of a New Zealand Caucasian Crohn's disease population. Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, 690(1-2): 123-138. https://doi.org/10.1016/j.mrfmmm.2010.01.020

Vagianos, K., Clara, I., Carr, R., Graff, L.A.,Walker, J.R., Targownik, L.E., Lix, L.M., Rogala, L., Miller, N., Bernstein,C.N. (2016). What Are Adults With Inflammatory Bowel Disease (IBD) Eating? A Closer Look at the Dietary Habits of a Population-Based Canadian IBD Cohort. Journal of Parenteral and Enteral Nutrition, 340(3): 405-11. doi: 10.1177/0148607114549254.

Zallot, C., Quilliot, D., Chevaux,J.B., Peyrin-Biroulet, C., Guéant-Rodriguez, R.M., Freling, E., Collet-Fenetrier,B., Williet, N., Ziegler, O., Bigard, M.A., Guéant, J.L., Peyrin-Biroulet, L. (2013).Dietary Beliefs and Behavior Among Inflammatory Bowel Disease Patients. Inflammatory Bowel Diseases, 19(1),66–72. https://doi.org/10.1002/ibd.22965

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