Why Texture Modification Matters, and How to Do It

Common Triggers and Smart Swaps

When your UC symptoms are more intense than usual and certain foods and textures are making things worse, try the following expert-recommended swaps.

1. Swap Raw Apples With Skin for Stewed, Skinless Apples

Apples contain a number of naturally occurring substances that promote good health. Their skin contains polyphenols; these plant chemical compounds act as antioxidants, which are substances that protect cells from damage. And apple flesh contains pectin, a soluble (digestible) fiber that increases the number of anti-inflammatory bacteria in the colon. What’s more, pectin can also help lessen diarrhea.

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But eating raw apples whole can cause problems when UC is affecting digestion. “Skins of fruits and vegetables can irritate the walls of the colon, which can worsen symptoms by increasing bowel frequency or urgency,” says Kristen Nicolai, RD, of Mount Sinai in New York City.

Removing the skin and softening the flesh by stewing apples (cooking them in a small amount of water) can help you avoid symptom exacerbation while retaining most of the nutrients. “Apple skin is tough, insoluble [indigestible] fiber,” says Christina Fasulo, RD, who specializes in gastrointestinal disorders at UCLA Health in Los Angeles. “Stewing breaks down the flesh, and removing the skin eliminates the roughest part. You keep the pectin, vitamin C, and potassium.”

2. Swap Raw Almonds for Almond Flour

Research has linked eating almonds with increased production of butyrate, a short-chain fatty acid that supports colon health. Trials on humans and animals with UC have also shown that butyrate can improve intestinal barrier function, which is crucial for protecting against pathogens. In addition, trials showed that butyrate can reduce inflammation of the mucosal tissue that lines the gut, which is why the tree nut can be beneficial during periods of active inflammation.

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But almonds can be hard on the gastrointestinal (GI) tract when eaten whole, so consider swapping a handful of raw almonds as a snack for the use of almond flour at breakfast. “Nuts in their whole form can have large, hard pieces, which can be physically abrasive on the GI tract and brush up against the lining of the gut, causing more irritation,” says Nicolai. “Finely milled almond flour is much less abrasive and allows for a smoother, gentler texture.”

Schuchmann suggests using almond flour for baked goods like muffins, breads, waffles, and pancakes; or try adding almond butter to homemade salad dressings, dips, and smoothies, or putting it over a fruit puree for an alternative to peanut butter and jelly.

3. Swap Roasted Sweet Potatoes With Skin for Skinless Mashed Sweet Potatoes

The skin on roasted sweet potatoes is full of insoluble fiber that can speed up bowel movements and aggravate the colon as it moves through, so it may seem easier to avoid this nutrient-filled vegetable during a flare.

But sweet potatoes do have benefits. Animal research using purple sweet potatoes found that resistant starch, another type of fiber in the vegetable, increased levels of butyric acid, a type of butyrate that may also lower the risk of colon cancer. And you can get resistant starch even when you mash skinless sweet potatoes instead of roasting them.

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“Mashing sweet potatoes without skin gives you a smooth texture while keeping the beta-carotene, vitamin A, and soluble fiber” that’s underneath the skin, says Fasulo. It’s important to eat soluble fiber, as it also helps you pass soft, formed stools.

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”Bonus: Cook sweet potatoes and cool them in the fridge before reheating to convert some starch into resistant starch, a fiber that feeds beneficial gut bacteria,” she says. (When bacteria eats the resistant starch, it’s turned into butryric acid.) “Making them ahead and reheating is not just convenient; it may be better for your gut.”

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4. Swap Fresh Blueberries for a Smoothie With Pureed Blueberries

“Blueberries contain anthocyanins, a type of antioxidant that gives them their deep blue color and provides an anti-inflammatory effect,” Schuchmann says.

Indeed, research has found that anthocyanins, which give fruits and vegetables blue, red, and purple shades, reduce the release of inflammatory chemicals like tumor necrosis factor alpha and interleukin 6, which are both elevated in people with UC.

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So why not include more whole blueberries in your diet during a flare? “The tough skins of blueberries may contribute to increased symptoms for some patients,” says Schuchmann. “But blending blueberries into smoothies or compote to top oatmeal, yogurt, or pancakes is a great way to soften the fiber to reduce symptoms.”

Try making a smoothie using frozen or fresh blueberries and other fruits that are easier to digest, like bananas and mangoes. You can also use Greek yogurt, nut butter, and protein powder to get the protein you need to help heal your body’s inflamed tissue. The European Society for Clinical Nutrition and Metabolism recommends increasing protein intake to 1.2 to 1.5 milligrams per kilogram of body weight during a flare. Research finds that high-quality protein (including soy and whey powders) can help regulate the immune system, reduce levels of inflammatory chemicals, and limit damage to the lining of the intestine in IBD.

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5. Swap Roasted Broccoli for Pureed Broccoli Soup

Diets that include cruciferous vegetables like broccoli have been connected to reduced inflammation and cancer risk, according to research. Broccoli also contains a plant compound that helps activate sulforaphane, a chemical compound that reduced inflammation-related chemicals in studies on IBD.

But they can be tough to eat for people with UC. While raw broccoli is the hardest to digest, roasting the vegetable still leaves you with rough, indigestible fiber, so eating it whole may be off-limits when you’re symptomatic.

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Luckily, there’s a work-around. “Cooking until soft and pureeing into soup makes it easy to digest while keeping the vitamin C, vitamin K, and sulforaphane,” says Fasulo.

Schuchmann agrees: “Finely chopping or blending into soups is an additional step you can take to help mechanically break down the fiber to improve tolerance,” she says.

You can also try pureeing other cruciferous vegetables whose insoluble fiber may exacerbate symptoms in their whole-food forms, like cauliflower, arugula, kale, and watercress. Including as many nutrient-dense foods as possible when you’re dealing with increased symptoms can help you avoid nutrient deficiencies and support the body’s increased energy needs when you have inflammation.

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