The breeze from your eyes rolling is fluttering my bangs. Fiber.
Fiber, fiber, fiber!
If you’re at a certain age, those last three “fibers” bore a strik- ing resemblance to the Brady Bunch litany, “Marsha, Marsha, Marsha!” I’ve just experienced another birthday, so it must be time to revisit fiber. Middle age is when you choose your cereal for the fiber, not the toy.
I know you don’t believe that fiber makes for sexy reading. However, the fiber story has likely changed since you last visited it—enough so that it’s well worth a reread, and then give your fiber intake some attention as a simple marker of improved gut flora and overall nutrition. And you can relax; this is not an arcane story about the anti-constipation value of fiber, cutting into what is an estimated $80 billion “poop-ease” industry.
The story is that of our nation’s pitiful Standard American Diet (SAD)—a “sweet-meat” diet high in animal proteins, saturated fats, processed foods and simple sugars—with a concomitant drop in whole foods and plant intake. That is—a drop in fiber. Animal proteins contain ZERO FIBER (a shocker to many citi- zens and a marker of failure of our high-school health classes), and the processing that processed foods undergo is generally the removal of fiber.
People don’t want to hear about your diet. Just shut up, eat your fiber, and be sad.
The changes wrought from a suboptimal diet are rapid: It’s been demonstrated that after just two days of adding animal protein intake and reducing fiber intake in a vegan’s gut, their microbiome can shift to a bacteria population that produces triple the amounts of deoxycholic acid, a toxic secondary bile acid that promotes evil DNA change of the colon lining.
A healthy and diverse gut microbiome demands MACs, micro- biota-accessible carbohydrates. MACs are the fiber found in whole-plant foods and resistant starch, mostly in beans, peas, lentils and whole grains. They cannot be digested by humans without the aid of your microbiota. If you don’t consume ade- quate MACs, your gut flora will eat the mucus in your digestive tract, altering your immune system and leading to increases in allergies and autoimmune disorders.
Your gut demands a lot of fiber. But why should gastro-folk care?
You’re endo pros! In a study looking at adenoma and advanced adenoma incidence with self-reported/recalled fiber intake, the median fiber intake of participants was a measly 23 grams daily. Yet there was a significant reduction in both adenoma and advanced adenoma rates in the highest group of fiber consumers.
The humans of yore in Paleolithic (think “stone tool”) times ate a lot more fiber, even as we romanticized them as cave- man carnivores—about 100 grams daily, based on fecal fossil study. (Is there a more poopy job than working in our field of gastroenterology? Apparently so.)
In the early 1970s, surgeon and identifier of Burkitt’s lympho- ma, Denis Burkitt, demonstrated based on population immi- gration studies a goal of at least 50 grams a day of fiber for colon cancer prevention. The main discussion now is whether it’s the fiber and MACs themselves that do the trick, or the phytochemical-rich, plant-based diet and exclusion/replace- ment of saturated fats. And need we really tease out the cor- rect answer, or just advocate a richer plant-fiber and unpro- cessed-food diet?
Apparently, you need to eat healthy more than once to improve your health. This is cruel and unfair.
What else can this magical fiber do?
Higher dietary fiber intake is associated with a reduced risk for diabetes, heart disease, certain cancers, weight gain and obesity, in addition to softer poops.
The lower risk of heart disease is quite significant, with a 9% lower risk for every additional 7 grams per day of total fiber consumed. Read that again: 7 grams of fiber is a half-cup of beans. Name something else with a 9% bang for your buck!
In the NHANES study, where the participants ate a measly average of 16 grams of fiber daily, high fiber intake was negatively correlated with inflammation, metabolic syn- drome and obesity.
And where knee pain from osteoarthritis is concerned, dietary fiber reduces that too, hypothetically by reducing both weight and systemic inflammation.
Cancers with reduced risk via high fiber intake include the expected GI cancers (stomach, pancreas, colon polyps and colorectal), but also breast, endometrial and prostate cancer. Less strong evidence supports reduction of risks of esophageal, renal cell and ovarian cancer in a recent huge meta-analysis.
And every 20 grams of fiber a day was associated with a 15% drop in breast cancer risk.
Studies have demonstrated that your tummy and diet full of fiber isn’t simply displacing “bad foods,” but yielding mechanistic effects in the secretion, turnover or metabolism of insulin, glucose, adiponectin, interleukin-6, free fatty acids and triglycerides.
If you’re like most in medicine, you can’t confidently educate your patients (and yourself) on what your fiber targets should be.
The USDA’s Dietary Guidelines for Americans (being pretty wimpy compared with Burkitt’s daily 50-gram mandate, in my humble opinion) suggests that targets should be:
- 25–28 grams per day for women under 50
- 22 grams per day for women 51 and older
- 31–34 grams per day for men under 50
- 28 grams per day for men 51 and older
Trying to eat more fiber, and almost cut my finger off chop- ping up my salad. All I could think was, “This never happens with cupcakes.”
So how much fiber are you chewing daily? Have you even cal- culated the numbers?
There are plenty of charts to help to calculate your fiber intake—perhaps take one for a spin. The Mayo Clinic offers a good one (although they hide beans down the list—don’t ya’ll eat beans?).
For a fun graphic, check out Simple Happy Kitchen’s digital download that I myself printed up (with the aid of my local FedEx/Kinkos) and hung proudly in my kitchen to help guide my own dietary choices. (You’ll find all these links in the refer- ences at Endopromag.org.)
So your fearless author proactively launched a mission to ingest 50 grams of fiber in a day to demonstrate how simple it was to achieve. (This was during a vacation day visiting my 90-year-old mom, who is decidedly non-vegan.)
- Breakfast: Kashi cereal (3/4 cup = 8 grams fiber) with straw- berries (1 cup = 3 grams fiber), almond milk (0 grams fiber)
- Lunch: cherry tomatoes (1/2 cup = 2 grams fiber), chop salad (kale, broccoli, cabbage = 5 grams fiber), hummus (1/2 cup = 7 grams fiber), peach (3 grams fiber)
- Dinner: chop salad (5 grams fiber), baked salmon (0 grams fiber)
- Total fiber intake—and I was trying, dang it—was 33 grams of
Hmm—33 grams is a third higher than USDA recommendations for a woman of my advanced years, but only 66% of Burkitt’s 50 gram recommendations. And yes, I experienced socially unacceptable flatus from my cruciferous chop salad.
My friend told me about a wonder food that contains pro- tein, fiber and healthy fats. “That’s nuts!” I exclaimed.
I’m aware that pushing fiber is simplistic and reductionistic— like when we try to convince people to improve their health first by reducing sugar at the expense of higher fat intake, then vice versa, then high protein—however, the simple man- date may work well.
Choosing a higher-fiber diet means choosing foods that are less processed: more likely fruits, vegetables, legumes, nuts or seeds. Choosing a fiber goal and trying to eat it likely means you’ll feel more satiated—and as a bonus, you will experience excellent, big, soft poops.
You are more likely to hit a target if you aim at it.
So, what’s next for your health?
Look at what you’ve eaten/are planning to eat today and count the fiber grams. Are you achieving the USDA’s low-to- mid 20 grams? Aiming high at Burkitt’s 50 grams?
When offered dietary options, try choose the one with the highest fiber—there will be benefits beyond large, soft poops. Think of fiber not as fiber itself, but as a marker for wiser di- etary choices.
Don’t worry about which fiber you should eat. Just eat more of them all.
For article references, visit www.EndoProMag.com.
