Crohn’s Disease Exclusion Diet (CDED) Explained: How It Can Help with Remission
Managing Crohn’s disease can be overwhelming, especially when it comes to figuring out what to eat.
As a gastrointestinal dietitian, I work with many clients to develop individualized nutrition strategies that can help manage symptoms and promote long-term remission. One promising approach is the Crohn’s Disease Exclusion Diet (CDED). If you’ve heard about it and wondered whether it might be right for you, this blog will break down how the CDED works, its benefits, and how it can help with remission.
What Is the Crohn’s Disease Exclusion Diet (CDED)?
The CDED is a specific, structured diet designed to reduce inflammation and help induce remission in people with mild Crohn’s disease. Your gastroenterologist must also be in agreement with using this dietary strategy.
The CDED diet was originally developed as an alternative to Exclusive Enteral Nutrition (EEN)—a liquid diet used to treat Crohn’s disease— offering an easier to adhere to alternative, allowing a mixture of specific whole foods within the diet, whilst still offering the therapeutic benefits of controlling inflammation through diet.
How Does CDED Work?
The CDED is thought to work by targeting the gut microbiome, as dietary components can influence the microbiome and immune responses. It is thought that EEN can help restore gut barrier function and lower pro-inflammatory cytokines, thus reducing inflammation. With the CDED diet, we are reducing common components of the Western diet, which have been associated with inflammation. It also removes difficult to digest foods, including some fibres and processed foods, combined with a partial liquid diet.
The Three Phases of the CDED
Phase 1 (Weeks 0-6): The Strict Exclusion Phase
During this initial phase, the focus is on eliminating inflammatory foods and reducing the overall load on the gut. This phase is the most restrictive and is usually combined with partial enteral nutrition (PEN)—a formula-based supplement.
In Phase 1, you will avoid:
• Processed foods, particularly those with additives like emulsifiers, maltodextrin, and carrageenan
• Red meat
• Dairy
• Gluten-containing grains
• Certain high-fiber foods
You’ll focus on permitted whole foods such as:
• Chicken, fish, and eggs (if you eat these)
• Certain fruits (like bananas and apples, but only cooked)
• Certain vegetables (such as peeled and cooked carrots, courgettes, and potatoes)
• Rice
• Olive oil for cooking and extra virgin olive oil for dressing
50% of your diet will be liquid
The inclusion of PEN during this phase is crucial, as it provides calories, protein, and essential nutrients while reducing the overall inflammatory response. Studies have shown that combining CDED with PEN can help induce remission in children and adults with mild Crohn’s disease, whilst holding the advantage of being much easier to follow than a full liquid diet.
Phase 2 (Weeks 7-12): Controlled Reintroduction
In Phase 2, you begin to reintroduce additional foods while still avoiding those that are known to provoke inflammation or cause symptoms. This phase is a transitional period, where the diet is expanded, but still follows strict guidelines to reduce the likelihood of a flare.
Foods reintroduced in Phase 2 might include:
• More fruits and vegetables (such as berries, spinach, and sweet potatoes)
• Legumes (such as lentils or chickpeas, but in limited amounts)
• Limited whole grains like oatmeal
• Lean meats (like turkey)
25% of your diet will be liquid
The goal is to slowly build tolerance while maintaining the improvements gained in Phase 1. You’ll still focus on whole, unprocessed foods and avoid additives, processed snacks, and sugary foods.
Phase 3 (Weeks 13+): Long-Term Maintenance
Phase 3 is the maintenance phase, where more variety is allowed, but the core principles of the diet remain the same. You will continue to limit or avoid processed foods, certain additives, and pro-inflammatory foods while maintaining a balanced, whole-food diet that supports gut health.
In this phase, you can gradually expand your intake of:
• Fresh fruits and vegetables (focusing on tolerability)
• Whole grains (in moderation)
• Lean proteins like poultry and fish
• Healthy fats like olive oil and avocados
25% of your diet will be liquid
The long-term goal of the CDED is to maintain remission by keeping the gut free from triggers while allowing a more sustainable, diverse diet.
Who Can Benefit from the CDED?
The CDED is particularly beneficial for people with mild to moderate Crohn’s disease, especially those who are seeking to:
• Avoid or delay the need for medication (your gastroenterologist must be agreeable)
• Complement their medication with dietary management
• Use a more food-inclusive approach compared to liquid diets like EEN
How to Get Started with the CDED
Starting the CDED can feel overwhelming due to the restrictions and structured phases. That’s why it’s essential to work closely with a gastroenterologist and a dietitian experienced in IBD. A dietitian can help ensure that you’re meeting all your nutritional needs and guide you through each phase of the diet while keeping it personalized to your lifestyle and preferences.
Looking for personalized guidance on managing Crohn’s disease through diet? Reach out to schedule a consultation, and we can work together to build a nutrition plan that fits your needs and lifestyle!
Lucy Kerrison
Gastrointestinal Dietitian
