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Potty Talk: Should You Give a Cr@p About Fiber?

by drgangemi on June 19, 2012

Fiber: Digestive problemsFiber is one of those necessary components of a healthy diet along with proteins, fats, carbohydrates, and water. But fiber is also very misunderstood and misrepresented. It’s often thought of as “the stuff you need to have a good bowel movement” and nothing more. People are often told to get enough fiber in their diet and eat foods high in fiber to create a feeling of fullness to aid in weight loss and keep their cholesterol low. Actually that high fiber diet could be contributing to their health problems.

I’m not at all saying that fiber isn’t important. It is, but if you’re going through your day thinking about the 35+ grams you need to get in by nightfall to hopefully have a good bowel movement (BM), well, that’s a crappy way to live and I mean that in more way than one.

I don’t think it’s all that necessary to go too deep into fiber basics here – everybody has access to Google and Wikipedia. But I think it’s important to state the basics about fiber before I discuss what I feel are much more important things to consider when it comes to gut health and your overall health. But first:

Fiber Basics & Highlights

  • Fiber is the part of food from various plants that your body doesn’t digest. There are two types: Soluble and Insoluble. Soluble is the type that get’s fermented in your gut. In other words, too much of this type of fiber makes you all gassy and smelly and no fun to be around. Insoluble fiber is the type that gives more bulk to your feces – which is what most people think of when they think of fiber.
  • Soluble fiber is mostly from foods on the FODMAPS Diet list. Many people with digestive problems are sensitive to FODMAP foods and therefore they can’t eat too many of them or they have problems ranging from fatigue to bloating to even Crohn’s Disease. Yes – this is from too much soluble fiber – the same stuff that is supposed to help with these problems. But it doesn’t always work that way. Prune juice (yum), that many are told to drink to try and have a BM, is soluble fiber – so it doesn’t provide bulk to the stool as is often thought. Psyllium is similar – it is mostly soluble fiber. So those taking Metamucil every day to have a BM are eating mostly soluble fiber, not insoluble. Perhaps your intake of too much soluble fiber is having an irritating effect to your gut giving you the impression that you’re having a healthy BM because you’re not constipated. In other words – your body is unable to handle the heavy load of fiber you’re eating and it’s trying to get rid of it as quickly as possible. That’s not healthy as you’ll have impaired nutrient absorption and perhaps even gut inflammation. This would be like saying you have good energy during the day because you drink a few cups of coffee every morning. It’s a false sense of health.Fiber: Bran
  • Prebiotics are a type of soluble fiber and many take these in supplement forms, (inulin and FOS – fructooligosaccharides), as they are touted to help with the colonization of probiotics (healthy bacteria) in the gut. Though this is true, I never use them in my practice because more people adversely react to them than those who benefit and you can still colonize the healthy gut bacteria just fine without additional prebiotic supplementation.
  • Essentially, most foods have both types of fiber: Insoluble fiber is found in many of the same foods as where soluble fiber is found but even more so in the skins of those fruits and vegetables (and starches).

Fiber and Cholesterol

A lot of the fiber push in our society is based on the erroneous fear that we’re all going to die from high cholesterol and the lower you can get your cholesterol the better. This is, of course, unsupported by any evidence which I discuss here – low cholesterol can be more harmful than high cholesterol. This is not to say that fiber isn’t important for healthy cholesterol levels; actually it’s very good at lowering the “bad” LDL cholesterol which is easily oxidized and responsible for diseases such as atherosclerosis. Now, unfortunately we are told by the media and many doctors that the best way to get cholesterol-lowering fiber is through oat bran and other “whole grain” products. However, these sources are often very harmful to our health, even low amounts in some people, as the excess carbohydrates outweigh the soluble fiber benefits by increasing inflammation in the body and even decreasing nutrient absorption. Additionally many people are gluten sensitive (wheat, rye, barley, and some oats).  Fruits and vegetables are the best ways to get your soluble (and insoluble) fiber.

To What Extent Is Fiber Even Necessary for a Good, Healthy BM?

I’m now in my fifteenth year of practice and I have not once recommended to a patient that they need to consume more fiber. I am always working with patients with various digestive problems ranging from bloating to colitis and everything in between. I often make dietary changes and suggestions and use various treatment therapies including nutrients to help a person’s gut heal. But never have I had to even mention the word fiber unless it was to ask them to stop taking their fiber supplement as many people don’t need them or they take too much. You see, if you eat a healthy diet then you’re going to get all the fiber you need. A truly healthy diet is discussed a bit later.

It’s All in Your Head

Here’s something that not too many people talk about – the fact that your gut is your second brain. Your digestive tract – from your mouth all the way to the other end (your anus) – has a mind of its own. The nerve cells in your gut act independently from the brain in your head but they must communicate and cooperate with one another. This is why people get stomach “butterflies” or a “nervous stomach.” It’s also a reason why people sometimes get constipation and diarrhea. Actually, constipation and diarrhea have a whole lot more to do with lifestyle factors and NOT fiber. Want to start to heal your gut and have normal, healthy BMs? It’s more about how you live, (and eat too), than the oat bran, psyllium husk, and other high fiber foods.

Here’s another fun fact for you to wrap your head, or in this case your gut, around: The majority of your neurotransmitters (brain chemicals) are made in your gut but used by your brain. So if your diet is a disaster and your gut is a mess you will have trouble making important mood chemicals such as serotonin, which is what so many people have an imbalance of leading them to seek out drugs such as Prozac, Paxil, and Lexapro to fight their depression. So if you’re popping Prozac while drinking your Diet Coke and eating Cheetos then you really have some soul searching to do.

Fiber & ConstipationCase History:  Early on in my practice I saw this guy who was suffering from constipation. He had a BM approximately one time a week, at best. (As a side note: “Normal” is at least once a day for both men and women, though I had a woman tell me once with certainty that “only guys have BMs every day as every one of her girlfriends only goes two times a week”.) I treated the guy and discussed some dietary changes and sent him on his way with a follow-up appointment for one week later. He returned a week later and reported something very interesting. He said that after he left my office he had a BM later that day, (I have that effect on people), but then did not have another BM until five days later and then had another one on the sixth day and again on the seventh day before seeing me. I thought I had fixed his problem but really I hadn’t. What happened was on the fourth day he lost his job, which he despised, so it was actually a huge relief for him to be forced out of what he couldn’t stand to do every day. The day after he was laid off his gut issues ended. The emotional toll (stress) on his nervous system was overriding his gut’s nervous system – his second brain.

Sympathetic or Parasympathetic?

Being too stressed out – whether you’re living a lifestyle that is too emotionally draining for you, (long commute to work, long work hours, a job you hate, a boss you hate, family issues), consuming poor food, (too much caffeine, refined sugar, bad fats, artificial preservatives – Splenda is terrible for your digestive tract), or dealing with a lot of physical stress, (past or current pain and injuries, exercising too often or intensely), will all affect your nervous system as well as your hormonal system. Too much stress which accumulates over time will put you in a sympathetic overload – this is that “fight or flight” reaction you may have learned about in school. Sleep problems, body aches and pains, feeling old, sexual dysfunctions, and a host of other symptoms occur when you’re under too much stress, and yes, gut problems are paramount. Some people get diarrhea or loose stools while other people get constipated. Is the solution to consume more Colon Blow Cereal? How about more prune juice or popping  another laxative? Definitely not. The way to fix these problems is to address the cause(s) – that of your sympathetic nervous system overriding your parasympathetic nervous system – what some refer to as the “rest and digest” nervous system. You don’t try to push or stimulate the gut, (the parasympathetic), when you’re sympathetic dominant; that’s like trying to blow a golf ball through a garden hose.Fiber: Fruits & Vegetables

Magazines, Magnesium, and Caffeine

If you have magazines or any other reading material, (including this article), in your bathroom to read while you’re on The John then you’ve got problems. It shouldn’t take you that long to have a BM. If you need to drink coffee (caffeine) to have a BM then that’s not normal either. A lot of individuals have an overactive gastrocolic reflex – which is the stomach telling the colon that food is on its way and to plan on emptying soon. So they eat something that irritates/overstimulates the reflex and the colon flushes out. Also if you take a supplement like magnesium to have a BM that’s also not healthy or normal. Yes, it’s better to take some magnesium than some other laxative and probably better than not having a BM, but don’t fool yourself into thinking that you’re correcting the problem. A magnesium deficiency won’t make you constipated, so although taking magnesium might stimulate the bowels, (as will high amounts of vitamin C), it shouldn’t be used in such a manner.

Final Gut Health Key Points Before We Flush

The three most important points to take from this, which you hopefully found both informative and entertaining, are:

  1. Fiber is not the most important aspect of gut health and a healthy BM
  2. The stress on your nervous system is the influential aspect of gut health and a healthy BM
  3. Your gut is your second brain. Take care of it by:
    1. Eating well – healthy, unrefined fats, clean protein, unrefined carbohydrates, organic fruits and vegetables, nuts and seeds, and plenty of clean water. A healthy diet will provide you with adequate soluble and insoluble fiber. I like a Paleo-Type Diet.
      1. Fats: Coconut Oil & Milk. Eggs. Butter & Cream. Fish & Flax Oil. Raw Nuts & Seeds. Extra Virgin Olive Oil.
      2. Protein: Undenatured Whey. Pasture Beef & Poultry. Eggs. Wild Fish.
      3. Carbs: Lots of Veges. 1-2 Servings Raw Fruit. Sparingly: Potatoes, Sweet Potatoes, Rice, and Corn.
      4. Sweets & Treats: 80%+ Chocolate. Honey. Real Maple Syrup. Coconut & Almond Flour. Real Butter.
    2. Reducing as much emotional stress as you can in your entire life
    3. Exercising aerobically; anaerobically when you’re ready
    4. Sleeping well

 

Thanks for reading and guys don’t forget to put the toilet seat back down.

20 Comments

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  1. Linda permalink

    I really find your website helpful and informative but dont see the need for bad language it spoils it and isnt necessary

  2. Julie permalink

    Great article. Thank you.
    So, if you don’t recommend magnesium and Vit C for constipation, what do you recommend?

    • Thanks Julie. I recommend figuring out what works for you in regards to diet (including removing any food allergies/sensitivities) as well as dealing with stress so your gut functions normally. There will be a Part II to this up soon regarding probiotics as I think they’re overused too, though definitely more necessary than fiber (in supplemental form) and also in the works is an article on the gallbladder – the #1 reason for constipation.

      • Julie permalink

        Thank you Dr Gangemi. I can’t wait for the article on gallbladder as I mine was unfortunately removed 3 yrs ago. I thought that my constipation would improve after that, but no such luck :(
        Magnesium, Vitamin C and Polyethylene Glycol 3350 are the only things that work for me. But like you said, it does not solve the problem it just provides a temporary solution. I’d like to get to the root of the problem. And doctors just say that there is nothing wrong with me. My thyroid is OK, I don’t have Celiac as confirmed by the biopsy, but I am gluten intolerant as per blood tests.
        I went gluten free (~Primal diet) for 2 yrs and tried going dairy free, but that didn’t make any difference. Probiotics only make matters worse for me. I don’t know what else to try… ???

  3. garypassler permalink

    started using hemp protien in my green smoothies instead of whey, is it as complete? My gut brain says it’s good. what do you think??

    • Hemp protein isn’t bad. It’s not as complete as whey and you’re not going to get the beneficial glutathione as you will in clean whey protein. So if you want to mix if up that’s fine but unless you can’t tolerate whey I wouldn’t exclusively use hemp.

  4. JessM permalink

    “Colon Blow Cereal”

    ROFL!!! Oh, and I disagree about the so-called bad language (cr@p??). I love your sense of humor.

  5. Kim permalink

    Hi Dr Gangemi, I was just wondering what diet out there do you feel is the best for healing the digestive tract?
    Thanks!
    Kim

    • FODMAPS is a great place to start.

      • Kim permalink

        Thanks…..I was thinking that too but then I read this in your above article, “Many people with digestive problems are sensitive to FODMAP foods and therefore they can’t eat too many of them “….so I wasn’t too sure it would be a good one.

        • That means you should follow the FODMAP diet (which is no FODMAPS).

          • Kim permalink

            Ok, got it now…thanks. How long is the usual amount of time while following a FODMAPS diet for the gut to heal? And after this amount of time, can most people go back to having occasional treats i.e. bread at dinner, birthday cake, etc?

            Thanks again,
            Kim

          • All depends on the person. You use the FODMAP diet to find your tolerance to these types of foods. Typically best to stay off them all 100% for at least three full weeks, sometimes a bit longer.

  6. Syl permalink

    Too much rapidly fermentable soluble fiber may cause gas BUT poor or non-fermentable soluble fiber supplement should not cause any problems even in larger amount. The TYPE of soluble fiber supplement makes a difference!

  7. Syl permalink

    Correction on the FODMAP. There is no such thing as a NO FODMAP diet. There are low, moderate and high FODMAP foods. Shepherd and Gibson the developers of the FODMAP approach are really clear on this matter. Most carb based food contain some FODMAP even though it might be small or trace amounts. This the reason the recommend consuming foods that for example contain < 0.2 grams of fructans per serving. The FODMAP approach is a LOW FODMAP approach not a NO FODMAP approach

  8. Derrick permalink

    Re FODMAP some more: near the end of your article you include honey & maple syrup as gut-friendly sweeteners. Yet aren’t those two foods on the FODMAP no-no list?

  9. Dareen permalink

    Hi Dr. Gangemi, you have no idea how happy I am to have came across this article!! I wish there was a way I could talk to you about everything that’s been going on with me. Please email me if possible.

    Dareen

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