Diet is a major factor in 5 of the 10 leading causes of death: heart disease, cancer, stroke, diabetes mellitus, and atherosclerosis. These diseases account for 70% of all deaths in the United States. Over half the calories consumed in this country are from refined foods, from which the bran, germ, and oil have been removed. The average intake of fiber is only 11gm per day, compared to the daily recommended intake of 20 to 30gm. Fiber is important in the prevention of constipation, diverticulosis, colon polyps, varicose veins, hemorrhoids, appendicitis, hiatal hernia, peptic ulcer disease and probably colon cancer.
Soluble fiber consists of the plant’s sticky components, including pectins, gum, and mucilage. Soluble fiber comes from the plant’s skeleton, which consists of lignin, cellulose, and hemicellulose. Foods containing water soluble fiber include fruit, vegetables, oats, barley, wheat, whole grains, cereals, legumes, and psyllium. Most plant foods provide insoluble fiber also. Water insoluble fiber assists in maintaining regular bowel movements, but may have an adverse or detrimental effect on irritable bowel syndrome and Crohn’s disease. Soluble fiber may be beneficial in atherosclerosis, IBS, hypercholesterolemia, hypertriglyceridemia, diabetes, obesity, hypertension, dumping syndrome, and gallstones.
Soluble fiber is fermented by colonic microflora resulting in the production of short chain fatty acids (SCFAs), such as butyric acid. In addition to promoting beneficial SCFA production and intestinal motility, dietary fiber can help to bind endotoxins and facilitate their elimination via the bowel.
Different types of fiber may have protective benefit in various bowel disorders such as irritable bowel syndrome, diverticulosis, colorectal cancer and other conditions such as diabetes, hypercholesterolemia and obesity. The fiber of choice for irritable bowel syndrome is methylcellulose or polycarbophil; for diverticulosis is psyllium, methylcellulose or polycarbophil; for colorectal cancer is psyllium, pectin or guar gum; for diabetes any supplement; for hypercholesterolemia psyllium, pectin or guar gum; and for obesity any supplement as tolerated.
High/Increased Fiber Diet can help with the following
Ulcerative Colitis
Approach a high fiber diet cautiously during periods of inflammation, as it may aggravate the condition. As you stabilize, fiber and unrefined foods are important to continue the health of the colon.
A study found Plantago ovata seed (the whole psyllium seed, not just the husk) at 10gm bid to be as effective as the drug mesalamine for maintaining remission in patients with ulcerative colitis. In addition, the Plantago ovata seed may help prevent colon cancer, a common complication of ulcerative colitis, because it increases colonic butyrate levels.
Hypertension
A study suggests that oatmeal can improve blood pressure and reduce drug costs for 60 million hypertensive Americans. The study found that 73% of participants, each of whom who ate oat cereal daily for 12 weeks, were able to reduce or eliminate their need for blood-pressure medication. Consumption of high-fiber cereals is an easy and simple way for a person
to increase total and soluble fiber intakes, thus helping to reach the dietary fiber goal of 25-30gm per day. [Preventive Medicine in Managed Care; March 1, 2002]
Constipation
A diet with enough fiber (20 to 35gm each day either from food or supplements) helps form a soft, bulky stool. High-fiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, Brussels sprouts, cabbage and carrots. For people prone to constipation, limiting foods that have little or no fiber such as ice cream, cheese, meat, and processed foods is also important.
IBS (Irritable Bowel Syndrome)
The synthetic polymers methylcellulose and polycarbophil have been found to be the most effective fibers or bulk-forming laxatives for use in the treatment of Irritable Bowel Syndrome (IBS). Neither are found naturally in food sources. Methylcellulose is used as a food additive/thickener. Both are available over the counter in commercial products such as Citrucel (methylcellulose) and Fibercon (polycarbophil), among others.
What is frustrating for IBS sufferers is that they are often told to eat more fiber, but aren’t told which kind is best for their condition. Insoluble fiber is difficult on the digestive tract and can trigger severe IBS attacks. According to a study of the effects of wheat bran on patients with irritable bowel syndrome, which appeared in the April 1999 issue of Lancet, 55% of IBS patients were made worse by eating wheat bran, which is an extremely high source of insoluble fiber.
Soluble fiber, on the other hand, is soothing to the digestive tract. It helps prevent painful spasms and relieves both the constipation and diarrhea of IBS. For the IBS individual, soluble fiber should always be the very first thing you eat on an empty stomach and it should be part of every meal. Foods that are naturally high in soluble fiber include oatmeal, pasta, rice, potatoes, sourdough bread, soy, barley, and oat bran.
Heavy Metal Toxicity
Sodium alginate as well as other gel-forming fibers have been shown to inhibit heavy metal uptake in the gut.
Mercury Toxicity / Amalgam Illness
Sodium alginate as well as other gel-forming fibers have been shown to inhibit heavy metal uptake in the gut.
Elevated Total Cholesterol
The fiber of choice for hypercholesterolemia is psyllium, pectin or guar gum. The amount of pectin in approximately two servings of fruit rich in pectin such as pears, apples, grapefruit, and oranges is 15gm. Psyllium or guar gum are obtained by supplement. The RDA for total fiber is 20-30gm. The fiber from whole grains, especially oats does have a cholesterol lowering effect, especially in someone on a previously low fiber diet.
Three months of supplementation with ground flaxseed at 40gm per day reduced serum total cholesterol in a study of postmenopausal women. [J Clin Endocrinol Metab 2002;87(4): pp.1527-1532]
Oat bran (35-50gm per day) reduced total and LDL cholesterol levels in a controlled study of 152 overweight men with hypercholesterolemia. As one tablespoon of oat bran weighs about 6 grams, it would take roughly 6 to 8 tablespoons per day to achieve this total. [Ann Nutr Met 2003;47(6): pp.306-11]
Hypoglycemia
Soluble fiber delays gastric emptying, slows glucose absorption, and minimizes blood glucose swings.
Problem Caused By Being Overweight
Good results in weight loss studies have been achieved with guar gum, a water-soluble fiber obtained from the Indian cluster bean (cyamopsis tetragonoloba). In one study, nine women weighing between 160 and 242 pounds (73 to 110kg) were given 10gm of guar gum immediately before lunch and dinner. They were told not to consciously alter their eating habits. After two months, the women reported an average weight loss of 9.4 pounds (4.3kg) – over 1 pound per week.
An increasing number of studies suggest that any water-soluble fiber may help people lose weight. It is thought to work by decreasing appetite: it bulks up in the stomach and causes a “full” feeling, resulting in fewer calories being consumed.
Metabolic Syndrome (Syndrome X)
Any fiber choice is useful for Syndrome X sufferers, but psyllium, pectin or guar gum would offer the additional benefit of lowering cholesterol. The amount of pectin in approximately two servings of pectin rich fruit such as pears, apples, grapefruit, and oranges is 15 grams. Psyllium or guar gum are obtained by supplement. The RDA of total fiber is 20-30 grams.
Diverticular Disease
A high fiber diet can help relieve symptoms for most people with diverticulosis. The suggested daily total should be 20-35gm. The fiber of choice for diverticulosis is supplemental psyllium, methylcellulose or polycarbophil. These are available over-the-counter in commercial products such as Metamucil (psyllium), Citrucel (methylcellulose) and Fibercon (polycarbophil), among others.
If you suspect that your diverticulosis has turned into diverticulitis, call your doctor and restrict fiber until instructed otherwise.
Oat bran is good for diverticulosis. It is hypoallergenic as compared to wheat containing products, and has additional health benefits. Two tablespoons per day is a reasonable dose and it can be mixed in with foods are added to baked products.
Diabetes Type II
Any form of fiber will be beneficial, so choose those that you most easily tolerate. Dietary fiber helps prevent and moderate diabetes through its effects on glucose and, subsequently, insulin levels. A diet high in complex carbohydrates and fiber helps prevent excess blood-sugar levels following meals and increases tissue sensitivity to insulin. This is achieved mainly by slowing the emptying of the stomach and thereby reducing insulin secretion.
When soluble fiber ferments during digestion it produces ‘short chain fatty acids’ that increase the metabolism of glucose and thus may add to the beneficial effects of dietary fiber on diabetes. Guar and other water-soluble fibers in beans, oats, barley, and fruit are important and are present in large quantities in a plant-based diet.
Researchers at Lund University in Sweden have determined that those who eat the certain grains for breakfast have lower, well-regulated blood sugar throughout the day, even up to and beyond dinner.
Here are the right grains someone with diabetes should eat:
1. Whole-grain barley (this grain worked best)
2. Whole grain rye
3. Other whole grains such as oats
Increased Risk of Diabetes ll
Any form of fiber will be beneficial, so choose those that you most easily tolerate. Dietary fiber helps prevent and moderate diabetes through its effects on glucose and, subsequently, insulin levels. A diet high in complex carbohydrates and fiber helps prevent excess blood-sugar levels following meals and increases tissue sensitivity to insulin. This is achieved mainly by slowing the emptying of the stomach and thereby reducing insulin secretion.
When soluble fiber ferments during digestion it produces ‘short chain fatty acids’ that increase the metabolism of glucose and thus may add to the beneficial effects of dietary fiber on diabetes. Guar and other water-soluble fibers in beans, oats, barley, and fruit are important and are present in large quantities in a plant-based diet.
Researchers at Lund University in Sweden have determined that those who eat the certain grains for breakfast have lower, well-regulated blood sugar throughout the day, even up to and beyond dinner.
Here are the right grains someone with diabetes should eat:
1. Whole-grain barley (this grain worked best)
2. Whole grain rye
3. Other whole grains such as oats.
Gallbladder Disease
Dietary fiber from cellulose (soluble fiber) clearly reduces the risk of gallstone formation.
Increased Risk of Breast Cancer
See reference found in the link between Increased Risk of Breast Cancer and Aerobic Exercise.
Increased Risk of Coronary Disease / Heart Attack
A high-fiber diet, particularly one that is high in water-soluble fiber (such as fruit), is associated with decreased risk of both fatal and nonfatal heart attacks, probably because presence of such fiber is known to lower cholesterol. Making positive dietary changes immediately following a heart attack is likely to decrease one’s chance of having a second heart attack. In one study, individuals began eating more vegetables and fruits, and substituted fish, nuts, and legumes for meat and eggs 24 to 48 hours after a heart attack. Six weeks later, the diet group had significantly fewer fatal and nonfatal heart attacks than a similar group that did not make these dietary changes. This trend continued for an additional six weeks.
In a study of nearly 1,000 heart patients in Milan, Italy, those with the highest intake of cereal fiber (which is mostly insoluble
fiber) actually increased their heart attack risk by more than 10%. This was attributed to the fact that the sources of
this type of fiber appeared to be refined grains that can cause a spike in blood sugar levels. Most people don’t eat enough water-soluble fiber to produce the positive results shown in the Milan study. Unrefined foods containing water soluble fiber include:
Key
| May do some good |
| Likely to help |
| Highly recommended |
| Reasonably likely to cause problems |
Glossary
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Stroke
A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.
Diabetes Mellitus
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Atherosclerosis
Common form of arteriosclerosis associated with the formation of atheromas which are deposits of yellow plaques containing cholesterol, lipids, and lipophages within the intima and inner media of arteries. This results in a narrowing of the arteries, which reduces the blood and oxygen flow to the heart and brain as well as to other parts of the body and can lead to a heart attack, stroke, or loss of function or gangrene of other tissues.
Gram
(gm): A metric unit of weight, there being approximately 28 grams in one ounce.
Constipation
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Diverticular Disease
Some people develop small pouches (diverticula) that bulge outward through weak spots in the colon. Diverticulosis is the condition of having these pouches; diverticulitis is an inflammation or infection in these pouches. The conditions diverticulosis and diverticulitis are both referred to as diverticular disease. Diverticulosis may not cause any symptoms but could include mild cramps, bloating and constipation - all of which are common to other conditions such as IBS or ulcers. The most common symptoms of diverticulitis are abdominal pain and tenderness around the left side of the lower abdomen. When infection is the cause, fever, nausea, vomiting, chills, cramping and constipation may also occur.
Colon
The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.
Polyp
A usually nonmalignant growth or tumor protruding from the mucous lining of an organ such as the nose, bladder or intestine, often causing obstruction.
Varicose Veins
Twisted, widened veins with incompetent valves.
Hemorrhoids
Varicose disorder causing painful swellings at the anus; piles.
Hiatal Hernia
Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm (a diaphragmatic hiatus). This is a common problem and most people are not bothered by it. A hernia may allow stomach acid to flow back into the esophagus ("food pipe"), where it can cause problems. The most common symptom is burning in your chest (heartburn), especially at night when you are lying down. Other possible signs include burping and trouble swallowing.
Peptic Ulcer
A general term for gastric ulcers (stomach) and duodenal ulcers (duodenum), open sores in the stomach or duodenum caused by digestive juices and stomach acid. Most ulcers are no larger than a pencil eraser, but they can cause tremendous discomfort and pain. They occur most frequently in the 60 to 70 age group, and slightly more often in men than in women. Doctors now know that there are two major causes of ulcers: most often patients are infected with the bacteria Helicobacter pylori (H. pylori); others are regular users of non-steroidal anti-inflammatory drugs (NSAIDS), which include common products like aspirin and ibuprofen.
Mucilage
Preparation consisting of a solution in water of the viscous principles of plants; used as a soothing application to mucous membranes.
Irritable Bowel Syndrome
(IBS) A condition that causes upset intestines for a long period of time. It is very unpleasant to the sufferer but tends to be harmless and usually does not lead to more serious complaints. The symptoms vary from person to person and from day to day. In order to be diagnosed with IBS, a person must have at least three of the following symptoms: pain in the lower abdomen; bloating; constipation; diarrhea or alternating diarrhea and constipation; nausea; loss of appetite; tummy rumbling; flatulence; mucous in stools; indigestion; constant tiredness; frequent urination; low back pain; painful intercourse for women.
Crohn's Disease
Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.
Hypercholesterolemia
Excess cholesterol in the blood.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.
Gallstone
(Biliary Calculus): Stone-like objects in either the gallbladder or bile ducts, composed mainly of cholesterol and occasionally mixed with calcium. Most gallstones do not cause problems until they become larger or they begin obstructing bile ducts, at which point gallbladder "attacks" begin to occur. Symptoms usually occur after a fatty meal and at night. The following are the most common ones: steady, severe pain in the middle-upper abdomen or below the ribs on the right; pain in the back between the shoulder blades; pain under the right shoulder; nausea; vomiting; fever; chills; jaundice; abdominal bloating; intolerance of fatty foods; belching or gas; indigestion.
Fatty Acids
Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.
Motility
Capacity for spontaneous movement, frequently in reference to the intestine.
Colorectal Cancer
A cancerous tumor of the large intestine. It is marked by dark, sticky stools containing blood and a change in bowel habits.