Nutritional intolerances manifesting as colic in the horse may be largely explained by divergence from the diet and ingestive behaviors to which the feral ancestors of modern domesticated equids had become accustomed and adapted. High-starch diets and abrupt dietary changes are probably foremost in the risk factors for diet-associated colic in the horse and have their basis in disruption of the stability of microbial populations resident within the equine hindgut. Although some general associations between colic and diet may be inferred from several epidemiologic studies, data derived from studies of single and specific disease processes associated with colic allow more effective practical application of corrective dietary management strategies in situations where colic risk is judged to be increased.