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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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12 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

  6. JP Says:

    Updated 08/13/17:

    http://jn.nutrition.org/content/early/2017/07/26/jn.117.254631.abstract

    J Nutr. 2017 Jul 26.

    Plasma F2-isoprostanes Are Positively Associated with Glycemic Load, but Inversely Associated with Dietary Polyunsaturated Fatty Acids and Insoluble Fiber in Postmenopausal Women.

    Background: Dietary factors, such as antioxidant nutrients, contribute significantly to the maintenance of an appropriate balance between antioxidant defense and free radical production in the body.Objective: The objective of this study was to examine the relation between oxidative stress as assessed by plasma F2-isoprostane (IsoP) concentration, glycemic load (GL), glycemic index (GI), intake of antioxidant nutrients, dietary fiber, and polyunsaturated fatty acids (PUFAs).Methods: This study was a cross-sectional secondary analysis of baseline data collected from a random sample of 269 postmenopausal women participating in the Minnesota Green Tea Trial. GL, GI, and dietary variables were calculated from the diet history questionnaire. Subjects filled out surveys about the use of anti-inflammatory drugs and physical activity. Plasma IsoP concentration was assessed by GC-mass spectrometry. IsoP concentrations were compared across quartiles of GL, GI, insoluble fiber, PUFAs, and antioxidant nutrients with the use of linear regression.Results: Antioxidant supplement intake, including zinc, copper, vitamin C and vitamin E, was reported by >60% of the participants. Mean intake of PUFAs was 12.5 g. Mean plasma IsoP concentrations increased from 34 to 36.7 pg/mL in the lowest quartiles of GL and GI, respectively, to 45.2 and 41.6 pg/mL, respectively, in the highest quartiles (P-trend = 0.0014 for GL and P-trend = 0.0379 for GI), whereas mean IsoP concentrations decreased from 41.8 pg/mL in the lowest quartile of PUFAs to 34.9 pg/mL in the highest quartile (P-trend = 0.0416). Similarly, mean IsoP concentrations decreased from 44.4 pg/mL in the lowest quartile of insoluble fiber to 36 pg/mL in the highest quartile (P-trend = 0.0243) after adjustment for potential confounders.Conclusions: We concluded that dietary PUFAs and insoluble fiber are inversely associated with oxidative stress whereas GL and GI are positively associated with oxidative stress in postmenopausal women.

    Be well!

    JP

  7. JP Says:

    Updated 09/14/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28901975

    Epidemiology. 2017 Sep 7.

    Dietary Fiber Intake and Risk of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study of Men.

    BACKGROUND: The limited literature suggests that dietary fiber intake from whole grains, fruits, and vegetables is negatively associated with chronic obstructive pulmonary disease (COPD) via fiber’s anti-inflammatory properties. Therefore, we investigated the association between total fiber and fiber sources and risk of COPD in the population-based prospective Cohort of Swedish Men (45,058 men, aged 45-79 years) with no history of COPD at baseline.

    METHODS: Dietary fiber intake was assessed with a self-administered questionnaire in 1997 and was energy-adjusted using the residual method. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs) adjusted for potential confounders.

    RESULTS: During a mean follow-up of 13.1 years (1998-2012), 1,982 incident cases of COPD were ascertained via linkage to the Swedish health registers. A strong inverse association between total fiber intake (≥36.8 vs. <23.7 g/day) and COPD was observed in current smokers (hazard ratio [HR]=0.54; 95% confidence interval [CI]=0.43-0.67) and ex-smokers (HR=0.62, 95%CI=0.50-0.78) but not in never smokers (HR=0.93; 95%CI=0.60-1.45;P-interaction=0.04). For cereal fiber, HRs for highest vs. lowest quintile were 0.62 (95%CI=0.51-0.77,P-trend<0.001) in current smokers and 0.66 (95%CI=0.52-0.82,P-trend<0.001) in ex-smokers; for fruit fiber the HR was 0.65 (95%CI=0.52-0.81,P-trend<0.001) in current smokers and 0.77 (95%CI=0.61-0.98,P-trend=0.17) in ex-smokers; for vegetable fiber it was 0.71 (95%CI=0.57-0.88,P-trend=0.003) in current smokers and 0.92 (95%CI=0.71-1.19,P-trend=0.48) in ex-smokers.

    CONCLUSION: Our findings indicate that high fiber intake was inversely associated with COPD incidence in men who are current or ex-smokers.

    Be well!

    JP

  8. Chris Says:

    Very right. Its my personal experience eating almonds, pistachios and walnuts increase the nutrient density of diet and amazingly even improve kid’s speech skills.

  9. Alsa Says:

    It’s interesting how great this article is. And I feel great that mango drink was so healthy in our body it helps us to digest food in a nicely way. And I love it thank you

  10. JP Says:

    Thank you, Alsa!

    Be well!

    JP

  11. JP Says:

    Very interesting, Chris. Thanks a lot for sharing that observation!

    Be well!

    JP

  12. JP Says:

    Updated 10/25/17:

    https://link.springer.com/article/10.1007%2Fs00394-017-1555-3

    Eur J Nutr. 2017 Oct 23.

    Effects of supplementation with rice husk powder and rice bran on inflammatory factors in overweight and obese adults following an energy-restricted diet: a randomized controlled trial.

    PURPOSE: Overweight and obesity are major public health concerns worldwide which are associated with a low-grade chronic inflammation. Dietary fiber as an important component of diet could be effective in controlling weight and inflammatory factors. The present study aimed to compare the effects of rice husk powder and rice bran on inflammatory factors along with an energy-restricted diet in overweight and obese adults.

    METHODS: In this randomized trial, 105 eligible individuals were assigned to one of the three energy-restricted diet groups receiving; rice bran (n = 35), rice husk powder (n = 35), and control group (n = 35) for 12 weeks. Demographic data, dietary intake, anthropometric indices and inflammatory factors (serum levels of IL-6 and hs-CRP) were measured at baseline and at the end of the study.

    RESULTS: Weight, BMI and waist circumference reduced significantly in all groups after 12 weeks of study (P < 0.01 for all). However, pre- and post-measure differences between groups were not significant. Moreover, serum levels of hs-CRP and IL-6 were not significantly different between participants in the rice bran or rice husk groups. However, the reduction in serum levels of hs-CRP in rice husk (mean change = – 0.14 ± 0.05 µg/ml) and rice bran (mean change = – 0.13 ± 0.03 µg/ml) was significantly higher when compared to the control group (mean change = – 0.03 ± 0.02 µg/ml) (P < 0.05 for both groups). The same pattern was found when changes in IL-6 serum levels of participants in rice husk (mean change = – 0.48 ± 0.11 pg/ml) and rice bran (mean change = – 0.57 ± 0.13 pg/ml) groups were compared to the control group (mean change= – 0.19 ± 0.07 pg/ml) (P < 0.05 for both groups).

    CONCLUSION: The results of this study showed positive effects of rice bran and rice husk powder supplementation, combined with an energy-restricted diet, on inflammatory markers among overweight and obese adults.

    Be well!

    JP

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