Is a fiber supplement right for you?

Fiber is a type of complex carbohydrate that the human body cannot digest. Instead of breaking down into sugar molecules called glucose, it instead passes through the body undigested. Fiber helps regulate the body’s use of sugars, helps feed and support the beneficial bacteria in the large intestine and helping to keep hunger and blood sugar in check.

The Food and Nutrition Board of the US Institute of Medicine recommends a total daily fiber intake of 38 g/day for men and 25 g/day for women. However, the average American consumes only about 17 g/day of dietary fiber, and dietary fiber intake might be closer to 10 g/day in those following a low-carbohydrate diet.

Types of Fiber

Fiber comes in two varieties, both are beneficial to health:

Soluble fiber, dissolves in water and includes plant pectin and gums. As soluble fiber dissolves, it creates a gel that may improve digestion. Foods with soluble fiber include oatmeal, chia seeds, nuts, beans, lentils, apples and blueberries.

Insoluble fiber, which does not dissolve in water, can help food move through your digestive system by bulking up bowel movements, promoting regularity and helping prevent constipation. Foods with insoluble fibers include whole wheat products (especially wheat bran), quinoa, brown rice, legumes, leafy greens, nuts, seeds and fruits like pears and apples. Many foods have both soluble and insoluble fibers.

What are the benefits of fiber?

Soluble fiber

• Lowering cholesterol: Soluble fiber prevents some dietary cholesterol from being broken down and digested. Over time, soluble fiber can help lower cholesterol levels in the blood. Aim for five to 10 grams or more of soluble fiber a day for cholesterol lowering benefits. β-glucan (found in oat bran), raw guar gum, and psyllium are the types of fiber shown to lower cholesterol.

• Stabilizing blood sugar (glucose) levels: Soluble fiber slows down the digestion rate of other nutrients including carbohydrates. This means meals containing soluble fiber are less likely to cause sharp spikes in blood sugar levels.

• Lowering blood pressure: A 2018 meta-analysis of 22 randomized control trials found an overall reduction in blood pressure in people using fiber supplements or diets enriched with soluble fiber. Further analyses showed that psyllium in particular could reduce systolic blood pressure.

• Reducing the risk of cardiovascular disease: By lowering cholesterol levels, stabilizing blood sugars, lowering blood pressure, and decreasing fat absorption, regularly eating soluble fiber may reduce the risk of heart disease and circulatory conditions.

• Feeding healthy gut bacteria: Some soluble fiber-rich foods benefit our microbiome. They act like fertilizers that stimulate the growth of healthy bacteria in the gut.

Insoluble fiber

• Preventing constipation: As an indigestible material, insoluble fiber moves through the gastrointestinal tract absorbing fluid and sticking to other byproducts of digestion that are ready to be formed into stool. Insoluble fiber speeds up the movement and processing of waste, helping the body optimize normal elimination and reduce constipation.

• Lowering the risk of diverticular disease and cancer: By preventing constipation and intestinal blockages, insoluble fiber helps reduce the risk of developing small folds and hemorrhoids in the colon. It may also reduce the risk of colorectal cancer.

Both Soluble and insoluble fiber

• Feeling satiated or full longer after meals: Soluble fiber slows down how quickly foods are digested, meaning most people feel full longer after fiber-rich meals. Insoluble fiber physically fills up space in the stomach and intestines, furthering the sensation of being full. These properties can help people manage their weight.

• Helping lower disease risk: Due to fiber’s many health benefits, a high-fiber diet is associated with a lower risk of many diseases, including obesity, cardiovascular disease, diabetes, metabolic syndrome and others.

Where to find fiber naturally

Good food sources of fiber include whole grains, whole fruit and vegetables, legumes, nuts and seeds.

Some Food Sources of Dietary Fiber Linus Pauling Institute Oregon State University

Types of fiber supplements:

β-Glucans

β-Glucans are soluble fibers found naturally in oats, barley, mushrooms, yeast, bacteria and algae. β-Glucans extracted from oats, mushrooms, and yeast are available in a variety of nutritional supplement capsules without a prescription.

Glucomannan

Glucomannan, sometimes called konjac mannan, is classified as a soluble fiber isolated from konjac flour. Glucomannan is available as powder and in capsules, which should be taken with plenty of liquids.

Pectin

Pectins are soluble fibers most often extracted from citrus peels and apple pulp. Recipe for pectin-rich stewed apples.

Inulins and oligofructose

Inulins and oligofructose, extracted from chicory root are used as food additives. They are also classifies as prebiotics because of their ability to stimulate the growth of potentially beneficial Bifidobacteria species in the colon. Inulin is produced by many plants and is composed mainly of fructose. A number of dietary supplements and packaged “high fiber foods” containing inulins and oligofructose.

Guar gum

Raw guar gum is used as a thickener or emulsifier in many food products. Dietary supplements containing guar gum have been marketed as weight-loss aids, but there is no evidence of their efficacy. Unlike guar gum, partially hydrolyzed guar gum (PHGG, Sunfiber) has no effect on serum cholesterol or blood sugar levels. However, PHGG is a low FODMAP fiber and is less likely to trigger bloating or cramping in people with irritable bowel syndrome.

Psyllium

Psyllium, a soluble, gel-forming fiber isolated from psyllium seed husks, is available without a prescription in laxatives, ready-to-eat cereal, and dietary supplements. Psyllium (the main component of Metamucil) is proven to be effective to lower serum cholesterol and improve blood sugar balance. Because it also normalizes stool form, psyllium is the only fiber recommended by the American College of Gastroenterology to treat chronic constipation and irritable bowel syndrome.

Wheat Dextan

Wheat dextrin (Benefiber) is a form of wheat starch. The manufacturers considers it gluten-free because it contains less than 20 parts per million (ppm) of gluten. However, people with gluten intolerance or celiac disease should not use Benefiber unless directed by a doctor.

Polycarbofil

Polycarbofil (Fibercon) is a synthetic polymer that is used as stool stabilizer to treat constipation, diarrhea and abdominal discomfort.

Methylcellulose

Methylcellulose (Citrucel) found in fiber supplements is a synthetic product derived from cellulose. Methylcellulose is not broken down and digested in the intestines, but rather absorbs water and becomes gel-like to add bulk to the stool. Because methylcellulose does not ferment, it may cause less gas and bloating in some individuals.

Polydextrose

Polydextrose is a complex carbohydrate made from glucose. It is made in a lab and is not digested by the body. Polydextrose is often used as a prebiotic to support the growth of beneficial bacteria in the microbiome.

**Do not take fiber supplements within 1 hour of other medications or some supplements including calcium, iron, and zinc. Fiber can interfere with absorption.

PREBIOTICS VERSE PROBIOTICS
ADVICE FOR STAYING REGULAR WHEN YOU TRAVEL

Is your bloating caused by SIBO?

Small intestine. Image courtesy S Bhimji MD

You have probably heard that we are what we eat. I believe we are more accurately “what we absorb.” Much of our health and wellbeing hinges on a well-functioning gastrointestinal tract to absorb the nutrients that support the rest of the body. Pesky symptoms like constipation, diarrhea or frequent bloating and gas suggest that the GI tract may be compromised. These symptoms can be associated with small intestinal bowel overgrowth.

What is Small Intestinal Bowel Overgrowth (SIBO)?

Before we look at how the bowels can become overgrown with organisms, it is important to understand how the digestive system works. The intestines are comprised of the esophagus, stomach, small intestine and large intestines (also called the colon). Gastric acid produced in the stomach initiates the digestive process but also acts to suppresses the growth of ingested bacteria and control bacterial counts in the upper small intestines. The small intestines are where the majority of food is digested, and nutrients absorbed. The small intestines have an impressive length of approximately 10-15’ and are home to a large network of immune cells that help fight infection and regulate our immune system. The small intestines have a normal muscular activity which creates waves that move the intestinal contents, like food, through the gut. Our entire digestive tract is populated with trillions of organisms that make up our microbiome. The bulk of these bacteria live in our large intestines. The small intestines have relatively few bacteria in comparison to the large intestine. The normal (beneficial) bacteria are an essential part of the healthy small bowel. They help protect against bad (i.e. pathogenic) bacteria and yeast that are ingested. They also help the body absorb nutrients, and produce several vitamins like folate and vitamin K. Any disruption in the quantity of organisms, or balance of species, in the microbiome can be diagnosed as SIBO.   

What causes SIBO?

An overgrowth of organisms in the microbiome can occur when the stomach has inadequate gastric acid or the motility of the small intestines is slow. Food that nourishes us also feeds the microbiome and is subject to fermentation in the small intestines, especially if it spends prolonged time in the small intestines. This fermentation can produce gas (hydrogen or methane) that can be felt as bloating, belching, flatulence, reflux or the gas can trigger symptoms such as diarrhea or constipation. 

The conditions below are risk factors for SIBO and slow motility:

• Anatomic changes due to surgeries, scaring or small intestine diverticula

• Slow motility due to gastroparesis, celiac disease, scleroderma or pseudo-obstruction

• Metabolic changes such as those associated with diabetes or low gastric acid

• Advanced age

• Organ dysfunction like kidney failure, pancreatitis or liver failure

• Frequent medications use with antibiotics or gastric acid suppressers

How do you test for SIBO?

SIBO is most often diagnosed with a breath test. The test measures how much hydrogen or methane gas are in your breath. Both gasses are a byproducts of bacteria breaking down sugar in your gut. There are no blood or stool tests for SIBO. However, anemia, low B12 levels and markers of malabsorption may be seen on blood testing. 

How do you treat SIBO?

SIBO treatment includes 4 goals:

1. Correct the cause: SIBO is notoriously challenging to treat with a high recurrence rate. If possible, identifying and resolving the condition that initially predisposed one to the overgrowth increases the success rate of treatment. 

2. Provide nutritional support: Adopting a nutrient dense diet, supporting digestion/absorption and occasionally using targeted supplements can support gut healing. There are multiple dietary approaches for SIBO that also help relieve symptoms.

3. Treat the overgrowth: Although some antibiotics can predispose users to SIBO, there are other specific antibiotics and anti-microbial herbs that are useful in treating the overgrowth.

4. Prevent relapse: Sometimes it is difficult to completely resolve the predisposing risk(s) for SIBO. Using targeted pro-kinetics supplements of medications to promote small bowel motility can help prevent SIBO recurrence. 

Need help treating bloating, gas or abnormal stool patterns? Relish Health is here to help. 

Learn more about optimizing your gut health:

7 Steps to Fight Reflux and Bloating

Natural Foods for Gut Health

Promote Digestion and Gain Nutrients with Delicious Bitter Greens

Advice for Staying Regular When You Travel

Is a Low FODMAP diet right for you?

References:

• Collins JT, Nguyen A, Badireddy M. Anatomy, Abdomen and Pelvis, Small Intestine. [Updated 2020 Apr 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459366/

• Dukowicz AC, Lacy, BE and Levine, GM.  Small Intestinal Bacterial Overgrowth: A Comprehensive Review Gastroenterology & Hepatology Volume 3, Issue 2 February 2007 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/pdf/GH-03-112.pdf

• Bures J, Cyrany J, Kohoutova D, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010;16(24):2978‐2990. doi:10.3748/wjg.v16.i24.2978

Is a Low FODMAP diet right for you?

Our gut is the unsung hero of our health and well-being. This hard-working organ is responsible for not only nourishing our body, but also housing much of our immune system and playing a significant role in our brain and mood health. When this organ is impaired, our health can suffer. Without a well-functioning digestive system, the body struggles to pass along nutrients to our cells. Unfortunately, having an unhappy gut is very common. It is estimated that approximately 10-20% of adults in Western countries have irritable bowel symptoms (IBS) (1). These include gas, bloating, diarrhea, cramping and constipation— symptoms that indicate our digestion is less than optimal. Fortunately, eating the right food can reverse and improve these symptoms. By healing your gut you are on the path of healing the rest of your body.

A common approach for treating IBS is the Low FODMAP diet. This diet was initially developed by Monash University in Melbourne, Australia. It is well documented and used throughout the world for IBS and other GI disorders (2). FODMAP stands for Fermented Oligosaccharides, Dissaccarides, Monosaccharides and Polyols. This is a group of small and medium-chain carbohydrates and sugar alcohols found either naturally or artificially in food. Examples of these include: wheat (oligosaccharide), dairy (dissaccharide), high fructose corn syrup (monosaccharide) and sorbitol (polyol). For a more complete list, please see this FODMAP guide.

These FODMAP carbohydrates can ferment in the gut and cause the gas, bloating and distention symptoms that are characteristic of IBS. Additionally, these carbohydrates are highly osmotic and pull water into the digestive tract changing the way your gut moves. As a result IBS sufferers may experience diarrhea or constipation. To initiate the diet, you remove all FODMAPs for a short period of time. Eventually the FODMAP foods are reintroduced in a slow and methodic manner to keep GI symptoms at bay.

Do you wonder if a Low FODMAP diet is right for you? Generally speaking, nearly all healing starts with your diet, lifestyle changes and restoring any deficient nutrients. However, for any treatment its important to evaluate your total health, risk factors, mood and emotions. At Relish Health Dr. Erica Leazenby will discuss your individual digestive symptoms and help determine the best approach for you.

Similar articles:

7 Steps to Prevent Reflux and Bloating

Is your bloating caused by SIBO?

1. Ann Gastroenterol. 2015 Apr-Jun; 28(2): 158–159.

2. Gastroenterology. 2014 Jan;146(1):67-75.e5. doi: 10.1053/j.gastro.2013.09.046. Epub 2013 Sep 25.

7 Steps to Fight Reflux and Bloating

Reflux and bloating are common complaints that I hear frequently in the office. If you struggle with these symptoms as well, know you are not alone. It is estimated that 44% of Americans have heartburn once a month and as many as 10 million people have daily symptoms. 

Food is medicine and can be part of the trigger or the healing of these common complaints. Food plays many roles in our lives. It is delicious, comforting and linked to our identity and social connectedness, but is also the fuel and building blocks for health. It is information for your cells and gene expression. You eat approximately one ton of food each year and can change your body chemistry every time you eat.

Listed below are seven steps that may help you identify and address potential triggers for reflux and bloating. At a recent workshop event, we discussed these in more detail and sampled foods that can aid digestion. Look for future sessions like this on the Event page. 

1: Eat mindfully at the table (and your desk and steering wheel are not tables). Mindfulness can promote the parasympathetic nervous system responsible for the “rest and digest” function of the body. Eating slowly and paying attention to your food and how your body is responding can improve your overall digestion.

2: Get your digestive juices going. Bitter flavors can promote digestive juices. Consider adding bitter greens (eg. arugula, endive, radicchio, mustard greens, chard, parsley, cilantro, broccoli rabe or vinegars, etc.) to your plate.

3: Tend your inner garden. Our gut is home to a host of bacteria. Add fermented foods or probiotics to your diet to encouraged friendly flora. Make sauerkraut, kimchi, sour pickles and/or kefir regular condiments on your plate. Consume adequate fiber to keep the good bacteria happy and thriving and avoid processed, refined foods. 

4: Some foods can actually aid digestion. Consider adding ginger, fennel seeds and bitter flavors to your diet. Be aware of foods that may trigger reflux symptoms. They may include: fried and fatty foods, spicy foods, citrus, tomato-based foods, processed foods, alcohol, caffeine and tobacco. 

5: Consider eliminating and re-introducing foods that commonly trigger sensitivities. Start with eliminating gluten and dairy for 2-4 weeks then reintroducing and monitoring for symptoms. If bloating is still an issue, there are other diets to consider that are known to improve symptoms, including the FODMAP diet. 

6: Stay active and get your beauty rest. Movement promotes gastrointestinal motility and helps maintain ideal weight while sleep is important for overall health. Avoid going to bed with a full stomach by eating at least 2-3 hours prior to going to bed. Elevate the head of the bed to minimized night time reflux.

7: Seek help. While these interventions are generally safe for everyone, frequent or daily gastroentestinal symptoms, weight loss, blood in your stool, black tarry stools or a family history of gastrointestinal problems may siginfy more significant problems and need to be further evaluated. If you need more help identifying your particular triggers, come see me at Relish Health and we'll work on an individual treatment program designed for you.