What Is the IBD Anti-Inflammatory Diet?

"Paying attention to what you eat is just as important as other lifestyle factors that play a role in IBD, such as exercise, sleep, and stress reduction," says Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California. "Having some guidelines from a specific dietary plan can be useful, especially if it seems to be helping to mitigate symptoms."

The IBD-AID Approach: What to Know

• Reduce monosaccharides and disaccharides, which are both sugars found in carbohydrates; the most common examples are glucose, fructose, sucrose, and lactose.

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• Increase probiotics (beneficial bacteria that improve gut health), as well as prebiotics (mostly nondigestible fibers that feed the probiotic bacteria).
• Emphasize monounsaturated and polyunsaturated fats, which are dietary fats associated with promoting a greater diversity of beneficial bacteria in the gut, particularly the anti-inflammatory kind.

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• Adjust foods based on the phases of IBD (during an active flare, transitioning as symptoms improve, and during remission).
• Reduce consumption of foods connected to inflammation responses in the body, like sodium, sugars, processed and red meats, certain additives, and alcohol.
• Omit wheat, corn, and refined sugar (sucrose).

"The IBD-AID targets IBD's biggest challenges," says Castro. "That differs from a more general approach to reducing inflammation, such as the Mediterranean eating style, which doesn't have phases, doesn't add probiotics and prebiotics specifically, and doesn't restrict lactose or refined sugar."

A dietary approach that's closer to IBD-AID is the specific carbohydrate diet, known as SCD, which eliminates most grains and hard-to-digest complex carbohydrates to help balance the microbiome, Castro says.

"There is a lot of overlap between IBD-AID and SCD, but the latter is more restrictive and does not have any components for different food textures and phases," she says. "Also, the IBD-AID is more liberal with certain carbohydrates, like steel-cut oats for their soluble fiber and prebiotic content to help support the microbiome."

The 3 Phases of the IBD-AID

One of the most distinctive features of the IBD-AID is its correlation with the three phases that most people with IBD experience. Each phase has foods that should be emphasized, says Castro.

Phase 1: Acute Flares

• Smoothies
• Oatmeal
• Pureed vegetables or soups
• Yogurt
• Well-cooked lean protein, like poultry, fish, and eggs
• Applesauce
• Ripe bananas

"Textures are really important during a flare, so it's helpful to puree, mash, or slow-cook foods for easier digestion," Castro says. Processing food this way helps break down fiber, so your digestive system can access nutrients with less work.

Phase 2: Transitioning as Symptoms Improve

As a flare settles, your symptoms will typically improve, and you may experience less urgency and frequency of bowel movements, as well as less pain, Farhadi says. In this phase, more fibrous foods can be added, but you may still have some difficulty with high-fiber choices.

• Cooked or raw soft greens, like collard greens, butter lettuce, or baby spinach (without stems)
• Well-cooked lean meat
• Nut butter
• Baked goods made with bean flour or nut flour
• Aged cheese
• Tomatoes
• Pureed berries, with seeds strained out

Phase 3: Maintenance During Remission

When symptoms have stabilized, you're considered in a maintenance phase, aka remission, says Farhadi. "Although you can eat a much wider variety of foods in this phase, it's still important to pay attention to how they affect you," he says.

• Stir-fried vegetables
• Shellfish
• Whole beans
• Fermented foods that may have been difficult to digest in phases 1 and 2
• Citrus fruits

"The goal would be to have a large variety of whole-food options during phase three," says Castro. A diet with more food diversity helps you build a healthy gut microbiome, she says. Fermented foods in particular add probiotics to boost gut health; options include yogurt, kefir, kimchi, raw sauerkraut and other fermented vegetables, tempeh, and miso.

Preparing to Start the IBD-AID Plan

Before trying the IBD-AID plan, determine which phase you are currently in, says Castro.

"If you are having a flare or bleeding, then you would start in phase 1 and focus on low-fiber, low-residue soft food," she says. "If you have some symptoms, then you would be in phase 2, and you would still pay attention to the textures of foods."

If you don’t have any symptoms and have bowel movements that are normal for you, then you would be in phase 3, or remission, where you would add more fiber in the form of probiotic and prebiotic foods slowly throughout the day, she says.

"In general, remove common triggers like ultra-processed foods, refined and excess sugars, fried foods, trans fats, and food emulsifiers," Castro says. "Also, working with a registered dietitian-nutritionist is super helpful when beginning a therapeutic diet, with an aim of 80 percent compliance on the IBD-AID."

The IBD-AID plan is not a replacement for medical therapies or procedures that may be necessary to control inflammation and damage related to IBD, Farhadi says. But it can give you a structured approach to eating that may act as an anti-inflammatory complement to your IBD management.

The Takeaway

• There is no single dietary approach recommended for inflammatory bowel disease (IBD), but some types of eating plans can help lower inflammation and improve gut health.
• One special IBD diet is called the IBD anti-inflammatory diet, which aims to create balance between harmful and helpful gut bacteria while also reinforcing healthy eating habits.
• The IBD-AID plan limits certain carbohydrates while emphasizing prebiotic and probiotic foods to support a healthy, balanced gut microbiome.