Good Fats vs. Bad Fats for Crohn’s Disease
Is that the go-ahead to indulge in hot fudge sundaes? Hardly.
It’s important to recognize that all fats aren’t created equal. Unsaturated fats (also known as “good fats”) can lower LDL (bad) cholesterol. These healthy fats are broken down into monounsaturated fatty acids (MUFAs) or polyunsaturated fatty acids. MUFAs are found in foods such as:
- Olive oil
- Canola oil (it’s also high in polyunsaturated fatty acids)
- Peanut butter
- Many kinds of nuts and olives
- Avocado
Polyunsaturated fatty acids are found in foods like:
- Fatty fish
- Soy milk
- Tofu
- Sunflower, corn, soybean, and flaxseed oils
Lisa Simon, RD, a registered dietitian in London, says there’s a wide variety of healthy fats and we should encourage more people with Crohn's disease to eat foods such as avocados, nuts and seeds (unless your doctor says to be careful with these because of strictures), tahini, and extra-virgin olive oil.
When factoring in good fats, aim to get in omega-3 fatty acids (a kind of polyunsaturated fat) as well. They’re in fatty fish like salmon, mackerel, and tuna, as well as in walnuts and flaxseeds. They can also be taken as supplements. Omega-3 fatty acids are believed to have anti-inflammatory effects on the body.
A small randomized trial published in 2020 in the journal Atherosclerosis investigated the effect two types of omega-3s — EPA and DHA — on 21 older adults with obesity and chronic low-grade inflammation. They took one or the other every day for 34 weeks. Though they had slightly different effects, both lowered markers of inflammation.
You Should Avoid These 2 Unhealthy Fats
Unlike healthy fats, “bad” fats are saturated fats (found in animal products like meat, eggs, and whole milk and cheeses) and trans fats, which were banned in the United States in 2020, per the U.S. Food and Drug Administration (FDA), but still may be lurking in processed foods manufactured elsewhere. Both saturated and trans fats increase the risk for heart disease, putting them on everyone’s “to avoid” list.
How to Boost Good Fats for Crohn’s Nutrition
It's not as hard as you might think to make the switch to good fats. One easy step is to limit or rule out fried and processed food. Enjoy a grilled or baked salmon steak (high in healthy omega-3 fatty acids) instead of that greasy fried chicken, for instance. Gradually switch over to more plant- and fish-derived fat than those from other animal sources.
“Animal fats are often difficult for people with Crohn’s disease to digest, so they frequently worsen symptoms of abdominal pain, diarrhea, and fecal urgency,” says Colleen D. Webb, RDN, a registered dietitian-nutritionist, cofounder of Wellness by Food, and adjunct professor at the Inflammatory Bowel Disease Center at Weill Cornell Medicine in New York City. Simon says saturated fat, largely found in meat, may actually be doing more harm than good in the long run because of their propensity to increase inflammation in the body. She recommends following a predominantly plant-based diet. “People who eat more plants and fatty fish have been shown to live longer, healthier lives and have a reduced risk of flares,” Webb adds.
According to a study published in 2021 in Frontiers in Nutrition, Western diets and those high in meat, saturated fats, and that include more omega-6s than omega-3s, and diets low in fruits and vegetables may be a factor that contributes to intestinal inflammation.
7 Ways to Increase Your Healthy Fat Intake if You Have Crohn’s
Learn which healthy fats you should be adding and how to work them into your everyday diet.
- Try nut and seed butters. Not only are they delicious, but you can add them to all sorts of things, like a banana, rice cake, or a slice of sourdough bread. Nut or seed butters are a better way to consume seeds without irritating your digestive tract. “Sometimes people with Crohn's disease struggle with the amount of fiber that's in whole nuts, but that doesn't mean that you have to cut out nuts altogether. Having lots of different nut butters, such as smooth peanut butter or smooth mixed nut butters, is a really great way of incorporating nuts if people with Crohn’s disease find the amount of fiber in nuts is too aggravating,” says Sophie Medlin, RD, a consultant dietitian at City Dietitians and chair for the British Dietetic Association for London. According to Webb. "Almond butter and peanut butter are go-to favorites, but there are all kinds of delicious nut and seed butters, including cashew, walnut, pecan, pistachio, hazelnut, and sunflower seed.”
- Experiment with avocados. Avocado toast anyone? Avocados are a versatile food that can help incorporate healthy fats into any meal. Add slices to a sandwich or salad, make a breakfast taco with chopped tomato and scrambled eggs in a corn tortilla, or enjoy avocados as guacamole. Avocados not only taste delicious but they’re jam-packed with nutrients. "Avocados are full of healthy fats, and they're a great source of potassium, magnesium, and easy-to-tolerate fiber," says Webb. The Cleveland Clinicnotes that avocados have vitamin C, vitamin E, folate, and, since they have lots of monounsaturated fats, avocados help reduce LDL or “bad” cholesterol levels. Note that avocados are also a high-FODMAP food that causes gas in patients with IBS, a condition that commonly coexists with Crohn’s.
- Use pesto or hummus instead of cheese on a burger or a grilled chicken sandwich. Hummus is also delicious as a dip or pasta sauce if you’re lactose intolerant. The Crohn’s and Colitis Foundationrecommends hummus for people with Crohn’s disease on a low-fat diet.
- Snack on dark chocolate. If you have a sweet tooth, you may be happy to know that eating dark chocolate is recommended for Crohn’s disease. The active components of dark chocolate called flavonoids may be good for gut health and cardiovascular health. But before you buy out the candy aisle, know that dark chocolate should make up only a small portion of a balanced diet that promotes low inflammation. “If you just ate dark chocolate you certainly wouldn't get any immediate benefits because you need to eat it in conjunction with lots of other brightly colored plant foods,” Medlin says.
- Swap in Greek yogurt for mayonnaise. For a more healthy but low-fat option, Greek yogurt can replace mayonnaise in potato salads and on burgers. Try it with canned salmon and a squeeze of lemon, which is more easily digested by people with Crohn’s and contains probiotics. Medlin says probiotic yogurt such as Greek yogurt and other natural yogurts helps promote gut bacteria that aid digestion. “It would be great for people with Crohn's disease and something that people should be consuming or adding to the diet if it’s not already there,” says Medlin. Note that yogurt contains lactose, a high-FODMAP food that causes gas and bloating in people with IBS, a condition that commonly coexists with Crohn’s.
- Add anchovies or sardines to pasta, sandwiches, or pizza. Medlin says increasing your oily fish intake gives the body more omega-3 fatty acids. In turn, people tend to enjoy better health and a lower overall inflammatory state within the body. “Omega-3 fats found in fatty fish, such as salmon and sardines, have been linked to a decreased risk of developing IBD, improved gastrointestinal symptoms in people with IBD, and a reduced risk of colon cancer,” Webb says. A study published in 2022 in The International Journal of Molecular Sciencesstudied data from the UK Biobank and found a link between low omega-3 fatty acids and high omega-6 fatty acids and people who developed IBD, particularly Crohn’s disease. The researchers suggested that omega-3 fatty acids could help quell inflammation in people who have Crohn’s disease, but more research is needed. Another study. published in 2022 in Frontiers in Nutrition, also used UK Biobank data. They determined that regular fish oil supplements, which contain loads of omega-3s, appeared to be associated with a lower risk of developing IBD. If you’re a firm believer that anchovies don’t belong on a pizza, consider making a tuna sandwich for lunch or grilled salmon with vegetables for dinner.
- Drizzle more olive oil than coconut oil on your pan. Medlin recommends extra-virgin olive oil for its many health benefits. “[It] contains lots of amazing plant powers that really help people cope with inflammation and manage systemic problems better. Olives and olive oil are great things to include in your diet regardless of whether you have Crohn's disease,” she says. And if you’re deciding between oils, choose olive oil over coconut oil. “The only ones you really want to avoid or not have too much of are coconut oil and palm oil. Coconut oil is very high in saturated fat so there's the misconception that it's a healthier oil, but actually it's not and it affects your blood cholesterol in the same way as eating butter or lard or saturated fats. I wouldn't say it's a banned food and not to have it at all — you should have it in moderation like you would any other form of saturated fat,” Simon says.
Getting the proper nutrition is crucial for a strong immune system and increasing your medical therapies’ effectiveness. When planning healthy menus, don’t forget the (right kinds of) fats.
Additional reporting by Kaitlin Sullivan.
