Let Them Eat Nuts (and Popcorn)! Neither Causes Diverticular Complications

Thomas L. Schwenk, MD


Journal Watch. 2008;7(8) 

No evidence of harm, and possibly even some benefit

Patients with diverticulosis often are instructed to reduce their intake of popcorn, nuts, and corn to prevent diverticular complications. This advice is based on a rather intuitive notion that colonic luminal trauma from these foods might initiate inflammation or bleeding within diverticula. In a prospective cohort study of 47,228 male health professionals without prior diagnoses of diverticular disease, inflammatory bowel disease, or non–skin cancer, investigators explored this issue. At regular intervals, from 1986 through 2004, participants provided health-related information and completed food-frequency questionnaires.

During 18 years of follow-up, 801 incident cases of diverticulitis and 383 incident cases of diverticular bleeding occurred. Analyses that were adjusted for potential risk factors yielded a hazard ratio (HR) of 0.80 for diverticulitis in participants who ate nuts at least twice weekly compared with those who consumed nuts no more than once monthly; in a similar analysis of popcorn consumption, the HR was 0.72. Corn consumption was unrelated to risk for diverticulitis, and none of the three foods were associated with diverticular bleeding.

Another bit of "common medical wisdom" has been disproved. If anything, these data suggest that eating popcorn and nuts is somewhat protective against diverticulitis.

— Thomas L. Schwenk, MD

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