Can You Eat Nuts and Seeds with Diverticulosis? Here’s What the Science Says

You like nuts and seeds, but you have diverticulosis. That’s the conundrum in a nutshell. Do you really need to avoid them? 

Nobody likes an “Oh nuts!” moment—especially when it means you’ve made a mistake that could contribute to a painful GI condition. Read on to learn more about risk factors for diverticular disease and whether nuts and seeds have anything to do with diverticulitis flare-ups.

Diverticulosis: Understanding the Condition

Diverticulosis is quite common, especially as we age. It’s estimated that more than 30% of US adults between ages 50-59 have diverticulosis, and that climbs to more than 70% among those older than 80. Over time, pouches form on the inside wall of the colon. The pouches are called diverticula, and having them means you have diverticulosis. Diverticula are often revealed during a colonoscopy or GI x-ray. 

Diverticulosis vs Diverticulitis, What’s the Difference?

Usually, diverticula don’t cause any big issues. The vast majority of people with diverticulosis experience no complications or symptoms. And while diverticulosis is common, diverticulitis is not. It’s estimated that less than 5% of people with diverticulosis develop diverticulitis, which is inflammation of the diverticula. Diverticulitis is caused by a bacterial infection (stool passing through the colon can get stuck in the diverticula or tear it, allowing bacteria to get in and multiply). Typically, diverticulitis symptoms include abdominal pain and tenderness, nausea, vomiting, fever, and sometimes rectal bleeding from a burst blood vessel in or near the diverticula. “Uncomplicated diverticulitis” like this generally means you’ll rest, have a liquid diet for a few days, and maybe take some antibiotics. But if you have more serious complications, such as the development of an abscess, fistula, bowel blockage or perforation, you’ll need more aggressive treatment that might include a hospital stay, endoscopic procedures, and perhaps surgery.

Although we don’t know the exact reasons why some people develop diverticulitis and others don’t, we do know that some risk factors are associated with diverticulitis flare-ups. These include: 

• being overweight
• having inflammatory bowel disease (IBD)
• smoking
• having a low-fiber diet
• regularly taking NSAIDs (non-steroidal anti-inflammatory drugs) and steroids
• a diet high in red meat and saturated fat
• being physically inactive

Are Nuts and Seeds Really a No-No? 

It used to be thought (and not so long ago) that people with diverticulosis shouldn’t eat nuts, seeds, or popcorn. The thinking was that bits of those foods (such as the hulls on popcorn kernels and seeds) were likely to get snagged on their way through the colon and stuck in diverticula there, leading to a diverticulitis attack. For years, doctors and dietitians have had a standard “no-nuts-no-seeds” recommendation for people with diverticulosis, but over time, this has been refuted by scientific evidence. 

It’s no longer believed that nuts, seeds, or popcorn increase the risk of diverticulosis or prompt inflammation or infection. So, happily, nuts and seeds are back on the “allowed” foods list for people with diverticulosis. In fact, they are a healthy part of a high-fiber diet that’s deemed protective against diverticular complications. Of course, if consuming nuts, seeds, or popcorn seems to irritate your gut or cause problems for you, avoid them. You can still eat a healthy diet without them. 

High-Fiber Eating and Diverticulitis

Boosting your fiber intake is good for bowel health in general. Fiber helps food move more easily through the gastrointestinal tract and helps prevent constipation (important if you have diverticulosis). Fiber also nourishes the gut microbiome. Beyond the gut-related benefits, eating a higher-fiber diet is associated with lower rates of chronic diseases, lower cholesterol levels, better blood sugar balance, and lower risk of being overweight. 

Unfortunately, most of us don’t get the recommended amount of fiber. The current Dietary Guidelines for Americans recommends 14g of fiber for every 1,000 calories consumed daily. Although current research doesn’t seem to support the idea that eating a high-fiber diet protects against diverticulosis, it may help prevent diverticulitis. But if you’re experiencing a bout of diverticulitis, your physician will often advise against eating high-fiber foods to give your bowel a rest (high-fiber foods are harder to digest). Then, once your symptoms have passed, you can resume your regular diet. 

Nutritional Benefits of Nuts and Seeds

Don’t underestimate the big nutritional value of tiny nuts and seeds. Some of the best things come in small packages! There are numerous nutritional benefits to incorporating a daily handful of nuts and seeds into your diet. Nuts and seeds provide

• protein
• fiber
• multiple vitamins and minerals
• healthy fats
• beneficial natural plant compounds

A diet that includes moderate, measured portions of nuts is associated with a range of health benefits, including lower rates of non-alcoholic fatty liver disease and metabolic syndrome, to name a couple. There’s also plenty of data on the consumption of seeds and health benefits, as they, too, are excellent sources of bioactive compounds like polyphenols, nutrients, and fiber. There is also an FDA-approved qualified health claim for nuts for the daily consumption of 1.5 oz of nuts, which is beneficial for heart disease risk when consumed with a diet low in saturated fat and cholesterol. 

Tips for Enjoying Nuts and Seeds with Diverticulosis

Incorporating nuts and seeds into your diet is easy! Here are a few ideas:

• Always keep portions in mind. Moderation is the name of the game because nuts and seeds are concentrated sources of calories and fat. Stick with about an ounce to 1.5 ounces per day—that’s a good-sized handful for most people, or around ¼ cup. It can help to pre-measure the right amount into a small container or plastic bag.
• Lightly salted and unsalted nuts and seeds are recommended for keeping a lid on sodium intake. 
• Eating nuts as a snack out of hand is my go-to, but for something different, try sprinkling them on salads, over grain dishes (toasting them first enhances their flavor), or on top of yogurt or cereal. 
• Incorporate some nuts and seeds into home-baked goodies.
• Mix up your own trail mix using nuts, seeds, a little dried fruit (watch the portions there as well), and some high-fiber, low-sugar cereal.

What’s your favorite way to eat nuts and seeds?  

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