Are you getting enough fiber? The recommended amount of dietary fiber is 14 g per 1000 calories. For most moderately active adults, that equals roughly 25-36 g per day. For colon cancer prevention- try getting up to 50g a day! For some of you- that may sound easy, for others- you may want to consider a supplement. Let’s get into it.
Fiber is the portion of plants that CANNOT be digested by enzymes in the gut. Fiber is classified as soluble or insoluble. Soluble fibers (read: PREBIOTICS= microbiome food) are fermented by your microbiome and may cause more gas and bloating (think of it as a side effect of a good thing happening!). Insoluble fibers move through the gut largely intact and increase stool bulk.
Increased fiber intake is associated with MANY health benefits, including:
Weight loss
Optimizing metabolic parameters: lowering insulin levels and blood pressure, improving lipid profiles.
Decreased risk of: colorectal cancer and colon adenomas (pre-cancerous colon polyps) as well as heart disease and stroke.
Fiber feeds your microbiome. There is an important interaction between the microbiome and fiber in mediating the risk of colorectal cancer. Fusobacterium nucleatum appears to play a role in the formation of colorectal cancer, possibly through suppressing the host’s immune response to the tumor. In a study using data from the Nurses’ Health Study and the Health Professionals Follow-up Study with a total of 1019 colon and rectal cancer cases, diets rich in whole grains and dietary fiber were associated with a significantly lower risk for F. nucleatum-positive colorectal cancer.
What if you want to take a fiber supplement? Fiber supplements are either natural or synthetic polysaccharides or cellulose derivatives that also act as a laxative by absorbing water and increasing poop mass. They are considered bulk-forming laxatives and are effective in increasing the frequency and softening the consistency of stool with minimal side effects. Here they are (and let me be clear— I recommend the first two NATURAL PLANT-BASED fibers but prefer Benefiber):
Psyllium
Example: Metamucil
What is it? NATURAL PLANT BASED fiber from the husks of Plantago ovata seeds
How does it work? Soluble + insoluble fiber.
Dose: Up to 1 tablespoon (≅3.5 grams fiber) up to 3 times per day
Onset of action: 12-72 h
Uses:
Constipation
Reduce risk of heart disease: Psyllium seed husk ≥10.2 g per day (DHHS 1998)
Diabetes mellitus, type 2: 6.8 to 13.6 g/day in 2 divided doses (Abutair 2016; Feinglos 2013)- Used prior to meals
Irritable bowel syndrome (IBS-C): 10 g/day in 1 or 2 divided doses (ACG [Ford 2014]; Bijkerk 2009)- Use with meals by mixing with food
**FYI: Many psyllium products contain sugar, aspartame, artificial coloring – LOOK out for gluten-free, sugar free, natural versions. And allergies do exist!
Wheat dextrin
Example: Benefiber
What is it? NATURAL PLANT BASED fiber
How does it work? Soluble fiber
Dose: 1-3 caplets (1 gram fiber per caplet) or 2 teaspoonsful (1.5 gram fiber per teaspoon) up to 3 times per daily
Onset of action: 24-48 h
Uses:
Constipation
Prevent coronary heart disease
**Benefiber Powder can be mixed into hot or cold beverages (eg, water, coffee, juice), soft foods (eg, applesauce, yogurt), or cooked into recipes for foods; not recommended for use in carbonated beverages
**Benefiber has a low FODMAP product Benefiber® Healthy Balance that is partially hydrolyzed guar gum, also a soluble fiber product
Methylcellulose (Citrucel)
What is it? synthesized fiber
How does it work? Mainly insoluble fiber that are nonfermentable (less likely to contribute to bloating/gas)
Dose: Up to 1 tablespoon (≅2 grams fiber) or 4 caplets (500 mg fiber per caplet) up to 3 times per day
Onset of action: 12-72 h
Uses: Constipation
** FYI: Citrucel contains calcium 85mg and potassium 125mg… and also some not so great products like aspartame, FD&C Yellow #6 Lake, Orange Flavors (Natural + Artificial). It is considered non-allergenic
Polycarbophil (FiberCon)
What is it? Synthesized fiber Calcium polycarbophil 625 mg equivalent to 500 mg polycarbophil
How does it work? Mainly soluble fiber.
Dose: 2 -4 tabs (500 mg fiber per tab) per day
Onset of action: 24-48 h
Uses: Constipation OR diarrhea
**FYI: Fibercon contains some not so great products like caramel, crospovidone, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, silicon dioxide, sodium lauryl sulfate.
GENERAL TIPS ON FIBER SUPPLEMENTATION:
As some may experience increased bloating + gas, I suggest a starting at the LOWEST dose and slowly (over WEEKS) titrated up based on response to treatment.
Drink AT LEAST 8 ounces of liquid with each dose
Separate your fiber by at least 2 HOURS from other drugs.
Contraindication: fecal impaction; GI obstruction, allergy
Adverse reactions: Abdominal cramps, constipation, diarrhea, esophageal obstruction, intestinal obstruction
Safe in pregnancy
***ALWAYS TALK TO YOUR GASTROENTEROLOGIST WHEN HAVING ISSUES WITH YOUR BOWEL MOVEMENTS BEFORE SELF-TREATING!***
Fiber up, folks!
#gutlove