Nuts, Seeds, Popcorn Don't Boost Diverticulosis Risk

TUESDAY Aug. 26, 2008 -- People with diverticular disease, a common digestive disorder, are typically told to avoid eating popcorn, nuts, seeds and corn so they don't get painful attacks.

But, a new study calls into question that conventional wisdom. The study of more than 47,000 men found that eating those foods did not seem to increase the risk of diverticulosis or diverticular complications.

"We found, contrary to current recommendations, that actually, consumption of these foods did not increase the risk of diverticulitis or diverticular bleeding and didn't appear to increase the risk of developing diverticulosis or its complications," said study lead author Dr. Lisa Strate, an assistant professor of medicine at the University of Washington School of Medicine, in Seattle.

The findings are published in the Aug. 27 issue of the Journal of the American Medical Association.

Diverticular disease affects the colon, the part of the large intestine that discards waste. Diverticulosis occurs when pouches -- called diverticula -- form in the colon. Stool or bacteria can lodge in the pouches. Diverticulitis occurs when the pouches get inflamed; symptoms can include bleeding, infection or a blockage of the digestive system.

One third of U.S. adults have diverticulosis by age 60, although most do not experience serious problems. By age 85, two-thirds of people have come down with the condition, according to the U.S. National Institutes of Health.

The exact cause isn't known, although many experts blame a low-fiber diet. Muscle strain during defecation may cause the pouches to form.

The advice to avoid nuts, seeds, popcorn and corn comes from the belief that these foods may be more likely to become lodged within the pouches. But there's been no proof demonstrating such a link.

And Strate's study failed to find a link, either. Evaluating data from the long-running Health Professionals Follow-up Study, a cohort of men followed from 1986 to 2004, she and her colleagues looked at medical records every two years and dietary information for every four years. The men ranged in age from 40 to 75.

At the study start, all were free of diverticulosis or complications. Eighteen years later, 801 had experienced diverticulitis, and 383 had diverticular bleeding.

When the study authors compared men with the highest intake of foods such as nuts with those with the lowest, they found that those who ate the most nuts were actually 20 percent less likely to get diverticulitis than those who ate the least. And those men who ate the most popcorn were 28 percent less likely to get diverticulitis than those eating the least.

No association was found for corn.

Strate thinks the longstanding dietary recommendations should be reconsidered, but she cautioned that hers was just one study. She believes the findings would probably apply to women, too.

Dr. Anthony Starpoli, an attending gastroenterologist at Lenox Hill Hospital in New York City, who is familiar with the new findings, said that even though the study numbers were large, the results may not apply to everyone. "There are probably going to be a subset of people where perhaps a more restrictive diet does benefit them," he said.

Starpoli said that, while the recommendation to avoid nuts, popcorn and seeds isn't based on scientific studies, there are people who do experience distress when they eat those foods.

"If you are a patient with known diverticular disease, and you have had the experience of eating seeds, nuts and popcorn and developed diverticular pain as assessed by your doctor, you should probably not have those foods."

More information

To learn more about diverticular disease, visit U.S. National Digestive Diseases Information Clearinghouse.

Posted: August 2008


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