Fiber Recommendations
The lack of dietary fiber and fluids is a contributing factor to the development of hemorrhoids and anal fissures. We recommend consuming 25-35 grams of fiber and drinking 7 glasses of fluids per day. Fiber can improve the form, bulk, and size of the stool. The addition of 10-20 grams of fiber per day will improve bowel habits and colon health. This may be done by modifying your diet or adding fiber supplements. Fiber will also help decrease your cholesterol, improve your glucose control, and may reduce your risk of diverticulosis, colon cancer, heart disease, and stroke.
Water soluble fiber is preferred and is found in oats, beans, cabbage, squash, carrots, apples, citrus fruits, prunes, strawberries, pears, etc. Soluble fiber forms a viscous gel that increases the amount of water that stays in the colon and coats the intestinal walls which decreases cholesterol absorption and serves as a substrate for fermentation by colonic bacteria. Insoluble fiber passes through the digestive system largely intact. They improve bowel consistency by increasing the water in the stool. Cellulose and lignin are forms of insoluble fibers that increase stool bulk by increasing the microbial mass. The cells are 80% water and this is the main way fruits and vegetables increase the stool size and make them softer. Cellulose is found in whole wheat, bran, cabbage, peas, green beans, wax beans, broccoli, cucumber skins, peppers, apples, and carrots. Lignin is found in cereals, bran, strawberries, eggplant, pears, green beans, and radishes. Brussel sprouts and beet root contain hemicellulose that also increases water holding capacity. They improve stool consistency by increasing the amount of water that stays in the colon and by increasing viscosity. These viscous solutions decrease the rate of gastric emptying, which leads to a slowing of digestion and increased absorption of nutrients.
Increase the amount of fresh fruit and leafy vegetables in your diet. Oatmeal, oat bran, nuts, dried peas, beans, lentils, apples, pears, strawberries, blueberries should be added to your diet for soluble fiber. Use more whole fiber grains, breads, and cereals. It may take up to six weeks to see a benefit. The amount and type of fiber that benefits you the most is variable and must be determined by trial and error. Many sources contain both soluble and insoluble fiber.
Important Notes About Fiber:
- Gradually increase the fiber in your diet until your bowel movements are optimum. A temporary increase in intestinal gas is to be expected. Slowing the rate at which you make these changes will help minimize this. Fennel seed may help reduce flatulence as well. For example, if you are adding fiber supplements, you may want to add it to your meals a few days a week for a week, and then continue to increase the amount you take every week as tolerated until your bowel movements are optimum.
- Be patient as it may take at least 6 weeks to see the ultimate benefit of adding fiber to your diet, and it will take some trial and error to find what works for you.
- Rotate the food and fiber types.
- Avoid foods to which you have food allergies, intolerances or sensitivities
- Diabetics should not change their diet without consulting their physicians as fiber may affect your blood sugar.
- Excessive fiber via supplements may decrease the absorption of iron, zinc and calcium.
- Make sure that you are taking in enough liquids. You should be drinking at least 6-8 glasses of non-caffeinated beverages a day. Remember that you need to add 1 glass of water for every tablespoon of fiber supplement you take.
Supplements
Sometimes, changes in our diets are not quite enough:
You can add 10 grams of fiber by taking two tablespoons of whole oat bran or wheat bran, psyllium (a seed native to Iran and India), Metamucil, Citrucel (methylcellulose), Konsyl, Benefiber or Fibersure to every meal. If you choose to take fiber in pill form, keep in mind that you will usually have to take about 10-20 pills with each meal to get the same amount of fiber. Depending on the type of fiber you use, it may be added directly to your food or may be mixed with water and consumed along with your meals. It will not be as effective if you take it between meals.
Which kind is the best? The one that you take!
DIETARY SOURCES
Fruits Fiber Fiber Fiber
grams grams grams
Figs (3) 5.3 Orange 3.1 Applesauce 1.5
Apple w/skin 4.7 Kiwi 2.6 Peach 1.4
Pears 4.3 Strawberries (6) 2.0 Cantaloupe (1/4)1.1
Dates (5) 3.7 Raisins (1/4 cup) 1.9 Pineapple (1/2 c.) 0.9
Apricots (10) 3.6 Banana 2.4 Grapefruit (1/2) 0.8
Prunes (5) 3.5 Blueberries (25) 1.7 Watermelon (1 c.)2.0
Cranberries (¼ cup) 2.0 Blackberries (1/2 cup) 4.4 Grapes (20) 1.0
Plums 1.0
(serving size is one piece or as noted)
Vegetables Fiber Fiber Fiber
grams grams grams
Baked Potato w/skin 4.2 Broccoli 4.0 Green beans 2.1
Sweet Potato 3.4 Spinach (1c.) 3.5 Tomato (1/2) 0.8
Corn 5.0 Turnip 2.0 Celery 3.0
Peas 2.9 Beets 2.5 Green pepper 1.2
Winter squash 2.9 Cabbage 1.5 Lettuce (1 c) 0.8
Carrot (1) 2.3 Cauliflower 1.4 Mushrooms 1.5
Asparagus 1.7 Brussel Sprouts 2.0 Celery 3.0
Okra 1.6
(serving size is 1/2 cup unless noted)
Legumes Fiber Fiber Fiber
grams grams grams
Pinto beans 14.2 Lima beans 10.3 Lentils 5.6
Kidney beans 13.8 Navy beans 9.0 Split peas 4.1
Black-eyed peas 12.3 Chickpeas 7.1 Tofu 1.4
(serving size is 3/4 cup of cooked beans)
Almonds (1tbsp) 0.6 Baked Beans (4oz)8.0
Grains Fiber Fiber Fiber
grams grams grams
Barley 8.6 Quinoa 4.6 Wheat 3.1
Bulgur 8.1 Brown rice 3.3 White rice 1.3
Bran meal (1tbsp) 2.0 White Bread (2) 1.9 Wheat Bread(2) 6.0
All-Bran (1/2 cup) 10.4 Cornflakes 2.6 Raisin Bran 3.0
Oatmeal 7.0
(serving size is 1 cup unless noted)
Fiber is a polysaccharide, which are carbohydrates found in plants that can not be broken down all the way to simple sugars and thus pass through the intestine partially undigested. The fiber is broken down into short-chain fatty acids, hydrogen, methane, and carbon dioxide. A particular food item will be a combination of nutrients and fiber that will determine how fast it is digested and how much will be quickly turned into simple sugar versus how much will be undigested and serve to increase the stool bulk. The various soluble and insoluble fibers have more specific names. There’s bran, cellulose, gum, hemicellulose, lignin, mucilage and pectin. Each specific fiber serves a specific function as a soluble and/or insoluble fiber type:
- Bran, gums and mucilages—help to regulate blood glucose, aid in lowering cholesterol and help in the removal of toxins.
- Cellulose—an indigestible carbohydrate that is found in the outer layer of fruits and vegetables, so eat the peel and savor the stems. Cellulose absorbs toxins in the intestine and is especially helpful in preventing constipation, hemorrhoids, varicose veins and colitis.
- Hemicellulose—an indigestible complex carbohydrate that also absorbs water. This fiber type is good for promoting weight loss, relieving constipation, preventing colon cancer and controlling carcinogens in the intestinal tract.
- Lignin—an insoluble, woody substance that comes from the stems and seeds of fruits and vegetables and in the bran layer of grains. Lignins help lower cholesterol and help prevent the formation of gallstones by binding with bile acids and removing cholesterol before stones can form. It’s helpful in preventing and managing diabetes and colon cancer and perhaps other cancers as well.
- Pectin—Soluble fibers that form highly viscous solutions that decrease the rate of gastric emptying, slows the intestinal absorption of food, increases absorption of nutrients along a greater length of the small intestine, reducing blood glucose and consequent insulin spikes.
INSOLUBLE FIBER SOURCES
Cellulose Hemicellulose Lignin Bran
Whole grains Cereals Cereals
Whole wheat flour Bran Mature vegetables Bran
Bran Whole grains Whole grains Whole grains
Vegetables Apples Fruits with edible seeds
Apples Bananas Brazil nuts
Beets Beans Carrots
Brazil nuts Beets Green beans
Broccoli Cabbage Peaches
Carrots Corn Peas
Celery Leafy greens Potatoes
Green beans Pears Strawberries
Lima beans Peppers Tomatoes
Pears Brussel Sprouts Radishes
Wax Beans Pears
Cucumber skins Eggplant
Peppers Bran
Peas
Cabbage
SOLUBLE FIBER SOURCES
Gums Pectin Mucilage
Oatbran Apples Psyllium
Guar gum Bananas
Legumes Beets
Barley Cabbage
Dried Beans Carrots
Citrus
Peas
Okra
Adapted by Cynthia Mullen, M.D. from http://www.crhsystem.com/clinical-forms.html
