Posts by Andrew Kornfeld

29 min readA science-based & IBD expert developed visual framework for nutritional navigation with Crohn’s disease and ulcerative colitis by Systema Health Let me say this right from the start: There is no one IBD diet. I know that’s probably not what you wanted to hear. You’re likely searching for a simple list of foods to eat and foods to avoid. I get it. After my Crohn’s diagnosis at 16, I spent years desperately searching for the same thing. But here’s what I’ve learned from working with hundreds of people with Crohn’s disease and ulcerative colitis: every single one of you is biologically unique. You have unique microbiomes, unique inflammatory triggers, unique cultural backgrounds, unique financial situations, and unique food preferences. What sends one person into a flare might be perfectly tolerated by another[1,2]. That said, there are science-backed principles that can guide your dietary choices. There are foods that tend to support healing and foods that tend to promote inflammation[3,4]. That’s why we created the IBD Food Pyramid. Introducing the IBD Food Pyramid You’ll notice this isn’t your grandmother’s food pyramid. We’ve designed it specifically for people with inflammatory bowel disease, based on what we know about gut healing, inflammation, and the microbiome.[5,6] The pyramid puts what most IBD patients should prioritize at the top (the widest section) and what requires more individualized caution at the narrow bottom. Let’s walk through each tier. Systema’s Four Dietary & Nutritional Principles Before we dive into the pyramid, here are the core principles that guide everything we teach: Principle 1: Eat real, nutrient-dense, whole foods and avoid processed and artificial ingredients.[7,8] Principle 2: Your diet is completely unique. Only you can determine what fits your unique biology, needs, and desires.[1,9] Principle 3: Your mental health and well-being around food is just as important as the diet you’re following.[10] Principle 4: You must go through a strategic process to design and test your own diet to truly determine what you do and don’t eat in the context of your current state of health.[11,12] With these principles in mind, let’s explore the pyramid. Tier 1: Lean Proteins & Healthy Fats The foundation of gut-friendly eating for Crohn’s disease and ulcerative colitis. At the top of our pyramid, you’ll find lean proteins and healthy fats. These are foods that most people with IBD tolerate well and that provide essential building blocks for healing.[13,14] Why Proteins Matter When you have IBD, your body is working overtime to repair damaged intestinal tissue. Protein provides the amino acids needed to rebuild.[15,16] Many people with IBD are also at risk for protein malnutrition due to malabsorption.[17,18] Research shows sarcopenia (muscle wasting) is significantly more prevalent in IBD patients compared to the general population.[19,20] Proteins (Incorporate with intention): Why Healthy Fats Are Essential Not all fats are created equal. The right fats reduce inflammation; the wrong ones fuel it.[32,33] Prioritize: Tier 2: Skinned Fruits & Smoothies Nature’s anti-inflammatories, prepared for gut healing. Colorful fruits deliver powerful healing compounds, but preparation matters when you have IBD.[41] Dark Fruits and Berries Dark fruits and berries are powerhouses of nutrition, packed with anthocyanins, flavonoids, and polyphenols. These are potent anti-inflammatory compounds.[42,43] Examples: Blueberries, blackberries (careful b/c of seeds), raspberries, pomegranates (highest antioxidant activity), acai berries, cherries, grapes, bilberries Key benefits: IBD-specific tip: During flares, blend berries into smoothies and strain out seeds. Watch for berry skins, which can be bothersome for some. The anti-inflammatory compounds remain even when texture is modified.[5] Tropical Fruits Tropical fruits offer unique nutritional benefits, particularly digestive enzymes and specific fibers that support gut health.[50] They contain gelatinous fibers that can be particularly beneficial for the microbiome. Examples: Papaya (rich in papain, a digestive enzyme)[51], pineapple (contains bromelain)[52,53], mango, kiwi, banana[54], lychees, dragon fruits, passion fruit (strain seeds) Key benefits: Digestive enzymes, fiber, gut health support, vitamins and minerals[50,51,52] Smoothies: Your Secret Weapon Smoothies allow you to pack in nutrition while keeping texture gentle on your gut. A well-designed smoothie can deliver anti-inflammatory berries, healthy fats, protein, and gut-soothing ingredients.[5,41] A Note on Citrus While citrus fruits contain vitamin C and beneficial compounds, the acidity can irritate inflamed intestinal tissue. During flares, stick to lemons and limes in juice form only. As you heal, you can explore whole citrus more freely. Tier 3: Cooked & Pureed Vegetables Here’s where texture becomes your secret weapon. Vegetables are nutritional powerhouses. But here’s what most IBD diet guides miss: how you prepare vegetables matters as much as which ones you eat.[5,55] The Texture Principle Think about this: if you have active IBD, you literally have wounds inside your intestines. You wouldn’t rub rough sandpaper on a wound on your skin, would you? The American Gastroenterological Association’s 2024 Clinical Practice Update specifically recommends that patients with IBD may not tolerate fibrous, plant-based foods due to their texture. They advise cooking and processing fruits and vegetables to a soft, less fibrous consistency [5]. This approach is supported by evolving clinical guidance that emphasizes texture modification over fiber restriction.[55,56] The Crohn’s & Colitis Foundation explains it beautifully: raw kale and blended kale contain the same nutritional value, but blended kale is much better tolerated because it acts more like soluble fiber in the intestines.[57] During active flares, this phase may resemble the diet of a 9-month-old infant. Soft, pureed, easily digestible. That’s okay. It’s temporary. The Cucurbitaceae Family (Squash, Zucchini, Pumpkins etc.) These are some of the most gut-friendly “vegetables” you can eat (botanically they are actually fruits but we prepare them as vegetables). Their soft, soluble-fiber flesh makes them ideal during flares and foundational phases.[58,59] Examples: Zucchini, yellow squash, butternut squash, acorn squash, pumpkin, spaghetti squash, cucumber (peeled/seeded) Key: These cook down to very soft textures and are naturally low in insoluble fiber. Roast, steam, or blend into soups. Root Vegetables and Alliums (Onions, Garlic etc.) Root vegetables and alliums offer a wealth of nutrients and unique health benefits. Alliums (onions, garlic) are rich in unique prebiotic fibers that feed beneficial gut bacteria [60,61]. Those