That "healthy" spinach salad might be fueling gut inflammation in IBD patients

Spinach, almonds, and sweet potatoes are nutritional staples — but for people with inflammatory bowel disease (IBD), a naturally occurring compound in these foods called oxalate may be quietly making things worse. A new study from UNC School of Medicine, published in Cellular and Molecular Gastroenterology and Hepatology, found that people with Crohn's disease and ulcerative colitis have significantly lower levels of two key oxalate-transporting proteins (SLC26A2 and SLC26A3) in their intestinal tissue — meaning their guts can't clear oxalate efficiently, leaving more of it to amplify inflammation.

Strikingly, Crohn's patients had higher stool oxalate levels than healthy controls despite eating similar amounts of plant-based foods — suggesting the problem isn't diet alone, but a fundamental difference in how the IBD gut processes oxalate. Animal studies reinforced the link: mice on a high-oxalate diet combined with a colitis-inducing agent were 60% less likely to survive than controls.

Key Takeaways:

• Low expression of oxalate transporter SLC26A6 was associated with stricturing Crohn's disease — nearly 75% of patients with low SLC26A6 had this more aggressive, narrowing form of the condition
• Oxalate-degrading gut bacteria (Oxalobacter formigenes) are less abundant in IBD patients, pointing to microbiome therapies as a potential treatment avenue
• Researchers caution that formal dietary guidelines for IBD patients aren't yet warranted — larger longitudinal studies are needed

Why it matters: This research gives clinicians a new molecular framework for understanding how diet intersects with IBD biology — and opens the door to precision nutrition and microbiome-based interventions for a condition that affects millions worldwide.