What is the optimal dietary management for diverticulitis?

From the Guidelines

The best diet for diverticulitis is a high-fiber diet with 25-35 grams of fiber daily from fruits, vegetables, whole grains, and legumes, as it helps prevent future flare-ups and promotes regular bowel movements. During an acute flare-up, it is recommended to follow a clear liquid diet for 2-3 days, including broth, gelatin, clear juices, and water, then gradually transition to a low-fiber diet (less than 15 grams daily) with easily digestible foods like white bread, pasta, eggs, and lean meats 1. Once symptoms improve, shifting to a high-fiber diet can help prevent constipation and future episodes. It is also important to stay well-hydrated with at least 8 cups of water daily, limit red meat, and minimize processed foods and alcohol.

Some key points to consider when managing diverticulitis through diet include:

• A prudent dietary pattern, high in fiber from fruits, vegetables, whole grains, and legumes, and low in red meat and sweets, is associated with decreased risk of incident diverticulitis 1
• A fiber supplement is not a replacement for a high-quality diet, and nut, corn, and popcorn consumption is not associated with an increased risk of diverticulitis 1
• Avoiding seeds and nuts is only necessary if they personally trigger symptoms, as there is no strong evidence to support avoiding them in all patients with a history of acute diverticulitis 1
• Physical activity, particularly vigorous activity, can help decrease the risk of diverticulitis, while obesity, smoking, and regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk 1

Overall, a high-fiber diet, along with a healthy lifestyle and management of risk factors, can help prevent future flare-ups and improve quality of life for patients with diverticulitis.

From the Research

Dietary Recommendations for Diverticulitis

The best diet for diverticulitis involves several key considerations, including:

• A high dietary fibre diet to improve reoccurrence and gastrointestinal symptoms 2
• A liberalised diet as opposed to dietary restrictions for adults with acute, uncomplicated diverticulitis 2
• Increasing dietary fibre to 20 to 30 grams daily or taking dietary fibre in the form of bulk stimulants like psyllium after the acute episode or highly symptomatic period resolves 3

Foods to Emphasize

Some foods and nutrients that may be beneficial for diverticulitis include:

• High-fibre foods to reduce the incidence of diverticulitis 4
• Poultry (white meat) which was not associated with risk of acute diverticulitis 5
• Fish intake which was associated with reduced risk of diverticulitis in age-adjusted model 5

Foods to Limit

Some foods and nutrients that may exacerbate diverticulitis include:

• Red meat which was associated with increased risk of acute diverticulitis, especially when consumed as unprocessed red meat 4, 5
• Low-fibre diet which may contribute to the development of diverticulitis 3, 4
• Refined sugars and milled grains which may contribute to the development of diverticulitis 3