Margaret Schwiesow, DO, is a board-certified gastroenterologist with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente Falls Church and Caton Hill medical centers.
Carbohydrates often get a bad reputation: They have been demonized and are seen as bad for your health. Many fad diets focus on ways to reduce or even eliminate carbohydrates from your plate. But fiber is a type of complex carbohydrate – and getting plenty of fiber in your diet is vitally important to your overall health.
Yet don't try to increase your dietary fiber intake too much, too quickly. Even though getting enough fiber is important, consuming too much fiber too fast can lead to bloating, gas, constipation and other gastrointestinal problems.
So how do you increase fiber in moderation? What's the right amount of fiber for men and women? Why is fiber important? Here are some questions and answers about fiber to help you reap the health benefits of a fiber-rich diet.
What is fiber, and why is it so important?
Dietary fiber is the part of plant foods that the human digestive enzymes can't break down; instead, gut microbes act on fiber and create short-chain fatty acids. Short-chain fatty acids are powerful anti-inflammatory molecules that help prevent many metabolic diseases (obesity-related), coronary artery disease, inflammatory bowel disease and many cancers, including cancers of the colon, esophagus, breast, prostate and ovaries.
In addition to these health benefits of a fiber-rich diet, fiber keeps things moving in our body, ensuring our bowel movements are regular and our stool passes easily. Having enough fiber helps prevent the frustrating symptoms of constipation.
Fiber also plays a key role in keeping our blood pressure, blood sugar and cholesterol levels within healthy ranges, lowering our risk for heart attacks and stroke. Fiber helps us feel fuller, and faster, which helps us eat less and keep our weight within healthy ranges.
Fiber also: Reduces the risk of hemorrhoids
Reduces the risk of developing diverticular disease. Diverticulosis develops when pouches form in the wall of the colon.
Decreases insulin resistance, which in turn lowers our risk of developing Type 2 diabetes
There are two types of fiber, soluble fiber and insoluble fiber. Soluble fiber dissolves in water and has been shown to lower cholesterol.
Insoluble fiber often referred to as roughage keeps stool soft and helps prevent constipation. Insoluble fiber adds bulk to the stool and cleans out the colon. Insoluble fiber may lower your risk of colon cancer and diverticulitis.
How much fiber do I need?
According to the U.S. Department of Agriculture's Dietary Guidelines for Americans, "more than 90 percent of women and 97 percent of men do not meet recommended intakes for dietary fiber."
The average American eats approximately 10-15 grams of fiber a day. This is not enough!
Standard guidelines recommend women eat a minimum of 25 grams of fiber per day and men eat a minimum of 35 grams of fiber a day. In many cases, I encourage patients to get 40 grams of fiber a day to help ward off health problems. Eating at least five servings of fruits, vegetables, whole grains and legumes is the best way to reach these numbers. (This handout lists the fiber content of many foods.)
You may want to keep a food diary for a week to get a sense of how much fiber you are consuming.
What are the symptoms of a low-fiber diet?
The main sign you are not getting enough fiber in your diet is constipation, often defined as having fewer than three bowel movements a week. Other symptoms of a low-fiber diet may include feeling hungry soon after eating, as well as health problems such as weight gain, diverticular disease, hemorrhoids, polyps, irritable bowel syndrome and inflammatory bowel disease.
What foods are good sources of fiber? How can I add fiber safely to my diet?
Depending on your symptoms, your doctor may suggest you add more fiber to your diet. Adding more fiber is something you should do slowly and gradually; don't try to go from eating 15 grams of fiber a day to 30 grams of fiber a day overnight. Doing so causes gas to accumulate in the body, which leads to bloating, belching, abdominal pain and cramps. Adding fiber slowly over the course of weeks and months gives your body time to adjust.
Fiber is only found in plant-based foods. Fiber is found in fruit, vegetables, whole grains, legumes, nuts and seeds. Meat, fish, eggs or dairy products, such as milk and cheese, do not contain fiber.
If you are trying to add more fiber to your diet, consider: Eating more vegetables. Aim for a rainbow of colors. Lycopene-rich reds can include beets, red bell peppers, radishes and tomatoes. Beta carotene-packed oranges and yellows can include carrots, butternut squash, pumpkin, corn and parsnips. Folate- and iron-rich leafy greens include kale, spinach and broccoli. Flavonoid-rich purples include eggplant, red cabbage and purple potatoes. Eating diverse colors will ensure you are getting all your phytochemicals, vitamins and minerals.
Focusing on whole grains. Whole grains include wheat, corn, rice, oats, barley and quinoa. When choosing a cereal or bread, look for whole grains as the first ingredient on the label. I love recommending patients eat plenty of oats, but rather than instant oatmeal, I suggest whole oats, such as rolled oats and steel-cut oats.
Opting for brown rice over white rice.
Eating plenty of fruit. Peaches, bananas, kiwi, raspberries, apples, oranges and pears are good fiber sources. Eat the skin.
Eating more legumes, such as beans, lentils, chickpeas, soybeans or split peas.
Adding nuts and seeds to your food.
Reducing the amount of packaged, processed foods in your diet. These foods generally have little nutritional value and little-to-no fiber.
When adding fiber to your diet, drink at least 64 ounces of water a day. This is essential to ensuring that fiber gets properly absorbed in your body. If you add fiber without adding water, you may feel extremely uncomfortable.
Many patients ask whether they should try fiber supplements. The answer? It depends. Most healthy people should be able to add fiber to their diet without using supplements, but people with certain health conditions may benefit from fiber supplements. Talk to your physician about your unique circumstances.
Is there anyone who should eat a low-fiber diet?
A low-fiber diet may be suggested for a short period of time after certain bowel surgery or radiation, bowel obstruction due to a tumor or inflammatory bowel disease, acute diarrhea or when preparing for a colonoscopy procedure. This should be done under the supervision of a physician or a dietitian. A low-fiber diet is not recommended long term because it can cause additional health and gastrointestinal problems.
Overall, eating a diet rich in fiber has many long-term health benefits: lowering your risk of heart disease, stroke, Type 2 diabetes and several cancers. And fiber helps regulate your cholesterol, blood sugar and weight. Adding just a few grams of fiber a day can pay off in the long run. If you need help, talk to your physician.
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