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Prescription 2017: Eat More Fiber

April 11, 2017 Written by JP       [Font too small?]

When it comes to nutrition, one size does not fit all. Foods that are nourishing to some can be harmful to others. Take, for example, tree nuts. Many studies report that eating almonds, Brazil nuts, pecans, pistachios and walnuts regularly tends to improve the nutrient density of diets and has been linked to lower disease and mortality risk. However, if you’re allergic to tree nuts, they are essentially poison to your system. The same is true of many common and otherwise nutritious foods, including dairy, eggs and shellfish. This concept is sometimes referred to as bio-individuality. In practice, the ideal is to become aware of the foods on which your body thrives and which do not agree with you.

I coach clients who are interested in addressing a wide variety of health concerns. And, I find that in most instances, the addition of more whole foods that are rich in fiber is beneficial. This is borne out of a significant and growing body of research presented in the medical literature. Personally, I’ve yet to find anyone who hasn’t been able to increase dietary roughage with whole foods – provided that they increase consumption progressively. Undoubtedly, adding more fiber-rich foods to your diet can be powerful medicine. But, it introduces a broad spectrum of substances (carbohydrates, nutrients and phytochemicals) to which the digestive system may need to acclimate. It’s a lot like exercise. By virtually all accounts, physical activity is health promoting. That said, if you’re out of shape, you need to slowly ease into an exercise routine.

Note: The addition of dietary or supplemental fiber needs to be approached carefully in those with diagnosed or suspected digestive disorders. In some cases, added “bulk” can be invaluable. Other times, it can be counter-productive and irritating to the gut in the short or long term. Again, this is an example of taking into consideration your individual needs or bio-individuality.

The general recommendation of eating adequate dietary fiber has been popular for quite some time. Arguably, the most widely accepted use for fiber is to alleviate constipation. And, it does work well in that regard, provided that you drink enough liquids. However, it seems that many of fiber’s other benefits aren’t as clear as they ought to be. From my perspective, if more people knew the advantages of a fiber-rich eating plan, they’d be more inclined to seek out foods that fit the bill. Below are some lesser known benefits of eating more roughage.

Fiber (Positively) Affects Hormone-Related Health: The March 2017 issue of the Journal of Diabetes describes that “low circulating levels of sex hormone-binding globulin (SHBG) have been shown to be a direct and strong risk factor for type 2 diabetes, cardiovascular disease, and hormone-dependent cancers”. The publication goes on to report that a high fiber, low glycemic diet was associated with higher SHBG levels in a group of over 11,000 women. Another study published in the very same month revealed an inverse association between fiber rich food and breast cancer incidence. What’s more, a trial from January 2017 reveals that dietary fiber may mitigate the risk of breast cancer incurred by alcohol consumption. Taken together, this collection of evidence may provide a proactive way for women to avoid some of the most prevalent diseases of the modern age.

Fiber for Better Blood Sugar and Metabolic Health: Several new studies offer a unique method of adding more fiber to one’s diet: replacing starch and/or sugar with fiber. One of the experiments evaluated the effect of crowding out some starch by adding oyster mushroom powder to a biscuit recipe. The addition of mushroom lowered the glycemic index of the biscuits “without jeopardizing its desirable sensorial properties”. The two remaining trials determined that using beta glucan, a form of oat fiber, and inulin, a prebiotic fiber derived from chicory root, consistently reduced post meal blood sugar and insulin when incorporate in bread and fruit jam.

Dietary Fiber May Lower Systemic Inflammation: C-reactive protein (CRP) is a marker used to assess systemic inflammation. Elevated CRP is considered an “independent predictor of chronic diseases”, including cancer, mood disorders and stroke. Two recent studies, one in adults and one in children, concluded that nutrient dense foods that were rich in fiber correlated with lower CRP levels. One possible explanation for this is that higher fiber intake often increases the diversity of gut bacteria and, thereby, may discourage gut dysbiosis – a suspected cause of metabolic dysfunction and systemic inflammation.

Dietary Fiber for Healthier Weight Management: The make up of your gut microbiota may, likewise, play a vital role in the prevention of overweight. Low-fiber diets are believed to tip the scales in the opposite direction. Admittedly, this field of research is still in its infancy. Thus far, researchers inform that greater gut microbiota diversity is “negatively associated with long-term weight gain”. Also of interest, prebiotics have shown promise in reducing appetite and caloric intake in those who are struggling with overweight.

Dietary Fiber for Fresher Breath: Admittedly, this symptomatic benefit isn’t as consequential as those previously discussed. Still, bad breath is something just about everyone would rather avoid. It turns out that high-fiber diets may improve halitosis. There are two probable reasons for this clinically documented observation. The first is that fiber rich foods require more chewing, which results in a sort of “self cleaning of the mouth”. Secondly, an imbalance of gut bacteria, the aforementioned gut dysbiosis, can result in bad breath which frequently emanates from further down in the gastrointestinal tract. Fiber comes to the aid here by selectively feeding some of the desirable bacteria causing a greater balance of microbiota.

The track record of fiber in both controlled and population based studies is outstanding. This is true for food-based and supplemental forms of bulk, such as apple pectin and psyllium husks. Having said that, some of the benefits noted anecdotally and in the scientific literature, are likely due to other beneficial components found in fiber-rich foods. For this reason, I recommend getting as much roughage as possible from whole food sources, rather than relying solely on supplements. To that end, I want to close this blog with my top-ten list of foods that are much more than just fiber sources: Almonds: 3.5 grams of fiber / ounce;  Apple: 5.4 grams / large fruit;  Avocado: 13.5 grams / 201 gram fruit;  Blueberries: 3.6 grams / cup;  Broccoli: 5.5 grams / cup; Canned Pumpkin: 3.5 grams / half-cup; Collard Greens: 5.3 grams / cup; Dried Coconut: 4.6 grams / ounce; Flaxseeds: 8.4 grams / 3 Tbs; Raspberries: 8 grams / cup.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Relation of Dietary Carbohydrates Intake to Circulating Sex Hormone (link)

Study 2 - Dietary Fiber Intake and Risk of Breast Cancer Defined by Estrogen (link)

Study 3 – Fiber Intake Modulates the Association of Alcohol Intake with Breast … (link)

Study 4 - Incorporation of Dietary Fibre-Rich Oyster Mushroom Powder … (link)

Study 5 - A Multifunctional Bread Rich in Beta Glucans and Low in Starch (link)

Study 6 - Replacement of Glycaemic Carbohydrates by Inulin-Type Fructans (link)

Study 7 - Serum High C Reactive Protein Concentrations are Related to the (link)

Study 8 - Vegetable and Fruit Intakes Are Associated with hs-CRP Levels (link)

Study 9 - Gut Dysbiosis is Associated w/ Metabolism and Systemic Inflammation (link)

Study 10 - Dietary Fiber Gap and Host Gut Microbiota … (link)

Study 11 - Gut Microbiome Diversity and High Fibre Intake are Related to Lower… (link)

Study 12 - Prebiotic Supplementation Improves Appetite Control in Children (link)

Study 13 - The Effect of a Chewing-Intensive, High-Fiber Diet on Oral Halitosis (link)

Study 14 - Fiber Content of Diet Affects Exhaled Breath Volatiles in Fasting and … (link)

Study 15 - Functional Disorders of the Gastrointestinal Tract (link)

Prebiotic Fiber + Probiotics May Reduce Asthma Symptoms

Source: Nutrients 2017, 9(1), 57 (link)

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5 Comments & Updates to “Prescription 2017: Eat More Fiber”

  1. JP Says:

    Updated 04/11/17:

    https://nutritionj.biomedcentral.com/articles/10.1186/s12937-017-0238-5

    Nutr J. 2017 Mar 7;16(1):17.

    Replacing American snacks with tree nuts increases consumption of key nutrients among US children and adults: results of an NHANES modeling study.

    BACKGROUND: Replacing typical American snacks with tree nuts may be an effective way to improve diet quality and compliance with the 2015-2020 Dietary Guidelines for Americans (DGAs).

    OBJECTIVE: To assess and quantify the impact of replacing typical snacks with composite tree nuts or almonds on diet metrics, including empty calories (i.e., added sugars and solid fats), individual fatty acids, macronutrients, nutrients of public health concern, including sodium, fiber and potassium, and summary measures of diet quality.

    METHODS: Food pattern modeling was implemented in the nationally representative 2009-2012 National Health and Examination Survey (NHANES) in a population of 17,444 children and adults. All between-meal snacks, excluding beverages, were replaced on a per calorie basis with a weighted tree nut composite, reflecting consumption patterns in the population. Model 1 replaced all snacks with tree nuts, while Model 2 exempted whole fruits, non-starchy vegetables, and whole grains (>50% of total grain content). Additional analyses were conducted using almonds only. Outcomes of interest were empty calories (i.e., solid fats and added sugars), saturated and mono- and polyunsaturated fatty acids, fiber, protein, sodium, potassium and magnesium. The Healthy Eating Index-2010, which measures adherence to the 2010 Dietary Guidelines for Americans, was used as a summary measure of diet quality.

    RESULTS: Compared to observed diets, modeled food patterns were significantly lower in empty calories (-20.1% and -18.7% in Model 1 and Model 2, respectively), added sugars (-17.8% and -16.9%), solid fats (-21.0% and -19.3%), saturated fat (-6.6% and -7.1%)., and sodium (-12.3% and -11.2%). Modeled patterns were higher in oils (65.3% and 55.2%), monounsaturated (35.4% and 26.9%) and polyunsaturated fats (42.0% and 35.7%), plant omega 3 s (53.1% and 44.7%), dietary fiber (11.1% and 14.8%), and magnesium (29.9% and 27.0%), and were modestly higher in potassium (1.5% and 2.9%). HEI-2010 scores were significantly higher in Model 1 (67.8) and in Model 2 (69.7) compared to observed diets (58.5). Replacing snacks with almonds only produced similar results; the decrease in sodium was more modest and no increase in plant omega-3 fats was observed.

    CONCLUSION: Replacing between-meal snacks with tree nuts or almonds led to more nutrient-rich diets that were lower in empty calories and sodium and had more favorable fatty acid profiles. Food pattern modeling using NHANES data can be used to assess the likely nutritional impact of dietary guidance.

    Be well!

    JP

  2. JP Says:

    Updated 04/11/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28318400

    J Am Coll Nutr. 2017 Mar 20:1-5.

    New Frontiers in Fibers: Innovative and Emerging Research on the Gut Microbiome and Bone Health.

    The complex interactions between the diet, gut microbiome, and host characteristics that provide a functional benefit to the host are an area of great interest and current exploration in the nutrition and health science community. New technologies are available to assess mechanisms that may explain these functional benefits to the host. One emerging functional benefit from changes in the gut microbiome is increased calcium absorption, increased calcium retention, and improved indices of bone health. Prebiotic fibers enhance microbial fermentation in the gut, providing an ecological advantage to specific nonpathogenic bacteria that have the ability to modify an individual’s metabolic potential. Fermentation of fibers also leads to increased production of short-chain fatty acids. These changes have been positively correlated with increased calcium absorption in humans and increased bone density and strength in animal models. Dietary fibers may offer an additional means to enhance calcium absorption with the possibility of stimulating the gut microbiome to ultimately influence bone health. This hot topic perspectives piece reviews innovative technologies that can be used to assess the impact of prebiotic fibers on the gastrointestinal tract (GIT) as well as the potential mechanisms that may explain their health effects on bone. Validated in vitro models used to measure alterations in the gut microbiome, as well as animal and clinical studies assessing the role of prebiotic fibers on calcium absorption and bone indices through alternations in the gut microbiome, are presented.

    Be well!

    JP

  3. JP Says:

    Updated 04/11/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28303703

    Rocz Panstw Zakl Hig. 2017;68(1):69-76.

    Assessment of dietary choices of young women in the contexts of hormonal contraceptives

    Background: Metabolic changes caused by hormonal contraception combined with unbalanced diet may pose many threats, and deficiency or excess of nutrients may increase the risk of using such contraceptives.

    Objective: The purpose of the survey was to assess the dietary choices of young women using hormonal contraceptives, taking into account their general knowledge about the contraception and its impact on their bodies.

    Material and methods: The survey comprised 67 women aged from 18 to 25 years. In of three-day menus (201 daily food rations) of the women under research the content of energy and most of nutritious ingredients wandered away from recommended values in Poland. Each respondent additionally filled in a questionnaire concerning her: anthropometric data, education, place of residence; the type, name and time of taking contraceptives; purpose for using hormonal contraception along with its determinants; duration of use, breaks in contraceptive practice; occurrence of side effects during contraceptive use; stimulants used; physical activity, incidence of diarrhoea and vomiting, and dietary supplements use.

    Results: The assessment of nutritional status of young women taking hormonal contraceptives has shown a number of nonconformities. The survey has revealed insufficient energy value of the menus, and incorrect proportions of basic nutrients, from recommended values, what was reflected in insufficient intake of vitamins (A, D, E, C, B1, B3, B6, and folates) and minerals (K, Ca, Mg, Fe). An excessive consumption of proteins, animal-based in particular, and insufficient consumption of lipids and carbohydrates, polysaccharides in particular, what resulted in insufficient consumption of dietary fibre.

    Conclusions: Nutritional choices of the respondents were typical to their gender and age, but were not adjusted to the use of hormonal contraceptives. Side effects observed by the respondents, mainly weight gain, may have been a summary result of improper eating behaviors that facilitated accumulation of body fat and water.

    Be well!

    JP

  4. JP Says:

    Updated 04/12/17:

    https://lipidworld.biomedcentral.com/articles/10.1186/s12944-017-0460-3

    Lipids Health Dis. 2017 Apr 4;16(1):71.

    Effects of 3 g of soluble fiber from oats on lipid levels of Asian Indians – a randomized controlled, parallel arm study.

    BACKGROUND: Cardiovascular diseases are more prevalent and severe in Asian Indians. Simple diet-based strategies are important for prevention of cardiovascular diseases.The aim of the present study was to evaluate the effects of oats consumption on lipid parameters in mildly hypercholesterolemic Asian Indians living in India.

    METHODS: A short-term, prospective, open-labeled, randomized controlled, parallel group study was conducted. Mildly hypercholesterolemic (total cholesterol >200 mg/dL and <240 mg/dL) subjects (n = 80) were randomized into two groups: intervention (n = 40) and usual diet (n = 40). Sample size was calculated for a two-group parallel superiority randomized control trial. Out of 80 enrolled subjects 69 subjects completed the study; 33 in the control group and 36 in the intervention group. In the intervention group, patients were served 70 g of oats twice a day in the form of porridge and upma (A thick porridge from oats with seasonings and vegetables) under observation at the study site. Lipid parameters were assessed at baseline and after 4 weeks of intervention.

    RESULTS: There was a reduction of 3.1% in total cholesterol levels in the control group as against 8.1% reduction in the intervention group (p < 0.02). Greater reductions were also seen in low-density lipoprotein cholesterol in the intervention group (11.6%) as compared to control group (4.1%, p < 0.04) over a period of 28 days.

    CONCLUSION: Daily consumption of 3 g of soluble fiber from 70 g of oats leads to beneficial effects on the lipid parameters, specifically total cholesterol and low-density lipoprotein cholesterol in hypercholesterolemic Asian Indians. Large scale studies over a longer period of intervention are required to further establish the cholesterol-lowering effect of oat fiber.

    Be well!

    JP

  5. JP Says:

    Updated 06/29/17:

    http://www.mdpi.com/2072-6643/9/7/667/htm

    Nutrients 2017, 9(7), 667

    Fruit Fiber Consumption Specifically Improves Liver Health Status in Obese Subjects under Energy Restriction

    The prevalence of non-alcoholic-fatty-liver-disease (NAFLD) is associated with obesity, diabetes, and metabolic syndrome (MS). This study aimed to evaluate the influence of two energy-restricted diets on non-invasive markers and scores of liver damage in obese individuals with features of MS after six months of follow-up and to assess the role of fiber content in metabolic outcomes. Seventy obese individuals from the RESMENA (Reduction of Metabolic Syndrome in Navarra) study were evaluated at baseline and after six months of energy-restricted nutritional intervention (American Heart Association (AHA) and RESMENA dietary groups). Dietary records, anthropometrical data, body composition by dual energy X-ray absorptiometry (DXA), and routine laboratory measurements were analyzed by standardized methods. Regarding liver status, cytokeratin-18 fragments and several non-invasive scores of fatty liver were also assessed. The RESMENA strategy was a good and complementary alternative to AHA for the treatment of obesity-related comorbidities. Participants with higher insoluble fiber consumption (≥7.5 g/day) showed improvements in fatty liver index (FLI), hepatic steatosis index (HIS), and NAFLD liver fat score (NAFLD_LFS), while gamma-glutamyl transferase (GGT) and transaminases evidenced significant improvements as a result of fruit fiber consumption (≥8.8 g/day). Remarkably, a regression model evidenced a relationship between liver status and fiber from fruits. These results support the design of dietary patterns based on the consumption of insoluble fiber and fiber from fruits in the context of energy restriction for the management of obese patients suffering fatty liver disease.

    Be well!

    JP

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