Nutrition Diet: How to eat more with Crohn's? And thrive during flares and remission

October 20, 2025 •

5 min read

According to studies, anywhere from 28% to 67% of individuals with inflammatory bowel disease (IBD), including Crohn’s disease, are at high risk of malnutrition. Learning how to eat more with Crohn's can be a vital part of managing symptoms and preventing unintentional weight loss and nutrient deficiencies.

Quick Summary

This article explores the challenges of eating with Crohn's disease, offering strategies for maximizing calorie and nutrient intake during both flares and remission. It covers dietary adjustments, food choices, meal timing, and the importance of professional guidance to maintain a healthy weight and nutritional status.

Key Points

Small, frequent meals: Eat 4-6 smaller meals or snacks throughout the day instead of three large ones to ease digestion and maintain consistent energy intake.
Focus on nutrient-dense foods: Maximize calorie and nutrient intake by incorporating high-quality proteins, healthy fats like avocado and olive oil, and easy-to-digest carbohydrates.
Modify food texture during flares: During flare-ups, choose well-cooked, peeled vegetables and soft fruits, and prefer smooth nut butters over whole nuts to reduce irritation.
Use liquid nutrition as a tool: Utilize nutritional supplements, homemade smoothies, and soups during flares or periods of low appetite to ensure adequate calorie and nutrient intake.
Personalize your diet with professional help: Work with a registered dietitian specializing in IBD to create an individualized eating plan that identifies trigger foods and ensures optimal nutrition.

Understanding Challenges with Eating More

For many individuals with Crohn's disease, maintaining a healthy weight and consuming enough nutrients is a constant challenge. The chronic inflammation of the digestive tract, which can affect any part from the mouth to the anus, often interferes with appetite and nutrient absorption. This can lead to a vicious cycle of decreased food intake, weight loss, and malnutrition.

Why Appetite Decreases with Crohn's

Appetite loss is a common and distressing symptom for many with Crohn's. This can be driven by a number of factors:

Symptoms: Abdominal pain, bloating, nausea, and diarrhea can make the thought of eating unappealing. The fear that certain foods will trigger uncomfortable symptoms can also lead to excessive dietary restriction, which further decreases appetite.
Inflammation: Research indicates that inflammatory cytokines, immune system proteins that are overactive in IBD, can directly cause appetite loss.
Medications: Certain medications, particularly corticosteroids like prednisone, are known to affect appetite. While some find their appetite increases, for others, side effects can still interfere with consistent eating.
Hormonal Imbalance: Changes in the gut-brain axis, the communication system between the digestive tract and the brain, may lead to hormone imbalances that signal reduced appetite.

Malabsorption and Increased Energy Needs

Even when calorie intake is sufficient, weight loss can occur. The inflammation associated with Crohn's disease can lead to malabsorption, where the small intestine cannot properly absorb nutrients like protein, fat, and vitamins. The inflammatory process also increases the body's energy expenditure, burning more calories and breaking down body tissues. This means that during an active flare, your body needs more calories and protein, not less.

Eating Strategies for Flare-ups

During a flare, the focus shifts to minimizing symptoms while still providing the body with vital nutrients for healing. The goal is to eat enough to prevent further weight loss without aggravating the digestive system.

Prioritizing a Low-Residue Diet

A low-residue, or low-fiber, diet is often recommended temporarily during a flare-up to give the bowel a rest by limiting undigested food matter. It's not a long-term solution but can help manage diarrhea, cramping, and bloating. Key low-residue foods include:

Refined Grains: White bread, white pasta, white rice, saltine crackers.
Cooked, Peeled Vegetables: Carrots, green beans, asparagus tips, squash, and potatoes without the skin.
Soft, Cooked Fruits: Applesauce, canned peaches or pears, and ripe bananas.
Tender Proteins: Lean chicken, fish, eggs, and smooth nut butters.

Focusing on Small, Frequent Meals

Eating large meals can overwhelm a sensitive digestive system. Instead, try consuming 5–6 smaller, more frequent meals or snacks throughout the day. This keeps energy levels stable and is often better tolerated, reducing bloating and cramps.

Maximizing Nutrient and Calorie Intake

When appetite is low, making every bite count is essential. Nutrient-dense foods and liquid supplements can help.

Nutrient-dense food strategies:

Add healthy fats like avocado, olive oil, and smooth nut butters to meals and snacks for extra calories.
Choose full-fat or lactose-free dairy options like yogurt, cheese, and milk for protein and calcium, if tolerated.
Use broths to cook foods or sip on nutrient-rich soups.

Liquid nutrition options:

Oral Nutrition Supplements (ONS): Products like Ensure, Boost, or Kate Farms can provide concentrated calories and protein when solid food is difficult to consume.
Homemade Smoothies: Blend tolerated fruits (like bananas or peeled peaches), cooked and cooled sweet potato, and smooth nut butter with lactose-free milk or water. Adding a protein powder can boost nutrition.

Transitioning to and Eating in Remission

As symptoms subside and the disease enters remission, the goal is to gradually reintroduce a wider variety of foods to combat deficiencies and promote a healthy gut microbiome.

Reintroducing Foods After a Flare

Following a flare, it is crucial to reintroduce foods slowly to gauge your personal tolerance. Start with one or two new foods every few days and track your symptoms in a food journal. Begin with cooked, peeled vegetables and fruits before trying raw produce or whole grains.

Adopting an Anti-Inflammatory Diet

While there is no single Crohn's diet, many people find success with a Mediterranean-style, whole-foods, anti-inflammatory diet during remission. This eating pattern emphasizes:

A wide variety of fruits and vegetables (as tolerated).
Healthy fats like olive oil, avocado, and oily fish.
Lean protein sources.
Whole grains, beans, and pulses (lentils, peas) as tolerated.

High-Quality Nutrients for Building Back Health

For those needing to regain weight, focusing on specific nutrient groups is paramount.

High-Quality Protein

Protein is critical for repairing intestinal tissue and rebuilding muscle mass, which is often lost during flares. Good, lean protein sources include:

Fish (particularly oily fish like salmon and tuna, rich in anti-inflammatory omega-3s)
Skinless poultry (chicken, turkey)
Eggs
Tofu
Smooth nut butters
Lactose-free dairy products

Healthy Fats

Healthy fats are calorie-dense and can help increase weight without adding volume. They also have anti-inflammatory benefits.

Avocado: Versatile and rich in healthy monounsaturated fats.
Olive Oil: A key component of the Mediterranean diet with anti-inflammatory properties.
Smooth Nut and Seed Butters: Easier to digest than whole nuts and seeds.
Oily Fish: Packed with anti-inflammatory omega-3 fatty acids.

Comparison Table: Crohn's Diet During Flare vs. Remission


Feature	During a Flare-Up	During Remission
Diet Type	Low-residue, low-fiber, bland foods	Broader, balanced diet (e.g., Mediterranean)
Meal Schedule	Small, frequent meals (4-6 per day)	3 main meals with optional snacks
Grains	Refined grains (white bread, white rice)	Whole grains as tolerated (whole-wheat bread, brown rice)
Fruits & Vegetables	Cooked, peeled, seedless options (applesauce, bananas)	Wide variety, including raw, with seeds and skins as tolerated
Fats	Small amounts of healthy oils	Healthy fats (olive oil, avocado) as tolerated
Protein	Lean and tender (chicken, fish, eggs)	Lean protein sources, including beans/pulses if tolerated
Liquid Nutrition	Supplements or nutrient-dense smoothies often needed	Supplements as needed, with a focus on whole foods

The Role of a Registered Dietitian

Since Crohn's disease is highly individualized, what one person tolerates well might be a trigger for another. Working with a registered dietitian, especially one specializing in IBD, is crucial for developing a personalized and sustainable nutrition plan. A dietitian can:

Help identify specific food triggers.
Address nutrient deficiencies with targeted recommendations.
Formulate a strategy for healthy weight gain during and after flares.
Provide guidance on safely expanding your diet during remission.

Conclusion

Eating more with Crohn's disease, especially during periods of decreased appetite, requires a thoughtful and strategic approach. Focusing on nutrient-dense foods, adjusting textures during flares, and incorporating smaller, more frequent meals can help prevent malnutrition and aid recovery. Staying hydrated and considering liquid nutritional support are also essential for managing symptoms and increasing overall intake. For the most effective plan, it is recommended to work closely with a healthcare team, including an IBD-specialized registered dietitian, to create an individualized dietary strategy that supports long-term health and well-being. A healthy relationship with food is possible, even with a chronic illness, and professional guidance can provide the confidence and tools needed to achieve this.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always consult with your doctor or a registered dietitian before making any significant changes to your diet, especially when managing a chronic condition like Crohn's disease.

Frequently Asked Questions

During a flare, focus on a low-residue diet. Good options include refined grains like white rice and white bread, well-cooked and peeled vegetables (carrots, potatoes), tender proteins (lean chicken, fish, eggs), and soft fruits like bananas and applesauce.

To increase calories when your appetite is low, eat smaller meals and snacks more frequently throughout the day. Opt for nutrient-dense foods like avocado, olive oil, and smooth nut butters. Liquid nutrition, such as smoothies or oral nutritional supplements, can also be very helpful.

For many with Crohn's, especially during flares or if strictures are present, whole nuts and seeds can be irritating. Smooth nut butters, however, are often better tolerated. It's best to test individual tolerance with a small amount.

Not necessarily. While many with Crohn's are also lactose intolerant, this isn't universal. If dairy causes symptoms, lactose-free products or alternatives like almond or soy milk are good options. Reintroduce dairy slowly during remission to check your tolerance.

Excellent sources of protein include lean poultry, fish (especially omega-3-rich salmon), eggs, tofu, smooth nut butters, and lactose-free dairy products.

During flares, a low-fiber diet is typically recommended. However, during remission, it's beneficial to slowly increase fiber intake from tolerated sources like well-cooked vegetables, fruits, and whole grains to support gut health.

An IBD-specialized dietitian is invaluable for developing a personalized diet plan, identifying trigger foods, addressing nutrient deficiencies, and guiding safe food reintroduction. They provide evidence-based, compassionate nutritional care.

After a flare, continue with a low-residue diet and slowly add back new foods one at a time every few days. Begin with soft, cooked options and monitor your body’s reaction. A food journal can be helpful for tracking symptoms.

Moderate, low-intensity exercise like walking may help boost appetite and build muscle mass, which can be affected by Crohn's. Always consult your doctor before starting a new exercise regimen.

Fear of food triggers and restrictive eating are common with IBD and can lead to disordered eating behaviors. It is important to speak with your gastroenterologist and a dietitian experienced with IBD to address these concerns and manage your diet in a healthy, safe way.