First of all I want to start off with a fun fact, not all fiber is the same, nor does it work the same in the gut. Fiber can be complicated. However, today I am going to try and break it down for you. Dietary fiber refers to plant carbohydrates that we humans cannot digest because we lack the digestive enzymes to break them down. These fibers include cellulose, hemicellulose, pectin, lignin, gums, beta-glucans, fructans, galactooligosaccharides, and resistant starches. Each part of the plant (stem, root, leaf, etc) and its age all are factor into what fibers are present upon consumption. See Table 2 below for more info on each type of dietary fiber.
SOLUBLE VS INSOLUBLE
There are two main categories generally used to categorize dietary fiber – soluble fiber and insoluble fiber. We need both for optimal gut health. Soluble fiber dissolves in water and often has a high water holding capacity, creating a gel like (viscous) substance. This gel like substance can firm up and soften stool, and therefore can help reduce severity of diarrhea while also softening hard stools. However, it also slows down the speed of which food/fibers travels through the gut and can reduce the absorption of nutrients. Soluble fiber is also highly fermentable by gut bacteria. Insoluble fiber on the other hand, does not dissolve in water, does not create a viscous gel, and generally is poorly fermented. Instead it acts like straw, bulking up the stool, supporting movement out, and cleaning the gut along the way helping to slough off dead cells. Soluble fiber is more gentle and can be better tolerated if someone has gastritis or intestinal inflammation, while insoluble fiber is more rough and can be irritating to inflamed tissue.
Although both soluble and insoluble fibers can be degraded by colonic bacteria, soluble fibers are fermented at a much higher degree. Fermentation of fibers usually happens in the first part of the colon, where bacteria breakdown the fibers that we cannot digest and produce hydrogen gas as a byproduct. Therefore, fermentable fibers are known as prebiotics, or food for good gut bacteria. The most fermentable dietary fibers include fructans, galactooligosaccharides (GOS), pectin, gums, beta-glucans, and resistant starch type 3. Fermentation produces energy for the beneficial microbes and provides humans with short chain fatty acids (mostly acetic acid, propionic acid, and butyric acid). Short chain fatty acids provide humans with a lot of different health benefits including 1) they stimulate mucous production in the colon which aids in elimination and encourages the growth of akkermansia (a keystone species of gut health), 2) they decrease the pH of the colon which prevents the growth of pathogenic bacteria, 3) they provide fuel for the colon cells, 4) they enhance immune function, 5) they help prevent colon cancer, and 6) they can inhibit cholesterol synthesis in the liver. Each unique bacteria preferentially ferments different fibers and therefore produces different types of SCFAs. Therefore, in order to reap these benefits, we need to eat a wide variety of plant fibers.
Viscosity, or gelling power, varies amongst fiber types. Some soluble fibers are viscous and all insoluble fibers are not. The higher the viscosity, the greater the gelling power, and the higher the water holding ability. Viscous fiber SLOWS stomach emptying and stool transit time. Therefore, it can help increase satiety and provide relief when struggling with loose stools. However, if soluble fiber is also fermentable (most soluble fiber), then it does not provide constipation relief. Since fiber is fermented in the first part of the colon, it loses its water holding capacity, and may therefore contribute more towards constipation (especially in supplemental forms like wheat dextrin). However, if the soluble fiber is highly viscous and NOT fermentable, like psyllium, it can increase stool water content throughout the entire length of the colon, providing relief for both loose stools and constipation.
Viscous fiber can also reduce absorption of nutrients by binding to them and reducing digestive enzyme function. Therefore, highly viscous soluble fiber is found to be helpful at reducing cholesterol and blood sugar levels. However, if someone is already struggling with malnutrition or nutrient deficiencies, too much soluble fiber may further impair nutrient absorption. BUT, if stools are loose, slowing them down with soluble fiber, will increase the time allowed for nutrient absorption, thereby increasing the ability to absorb nutrients from the diet.
Soluble and viscous fibers include pectins (apples, citrus, berries), gums (oats, barley, legumes), beta-glucans (oats, barley, rye, and mushrooms), and psyllium. They are all highly fermentable, except psyllium. The more processed (heat & pressure), the less they retain their viscosity. Therefore, muesli eaten cold with yogurt is going to retain more of its viscosity than Cheerios. Another example would be a functional fiber, partially hydrolyzed guar gum (PHGG). This functional fiber has been chemically altered to remove the viscosity of raw guar gum. Therefore it no longer has gel forming properties but remains soluble and fermentable.
NON-FERMENTABLE, NON-VISCOUS INSOLUBLE FIBERS
Non-fermentable, non-viscous, insoluble fibers not only provide benefit by increasing fecal bulk and speeding up transit time, they also support detoxification. Since insoluble fibers help support regularity, they are essential for eliminating environmental toxins, chemicals, and excess hormones. If stool stays stagnant in the colon for too long, we can reabsorb these chemicals, toxins, and hormones, leading to increased inflammation and hormonal imbalances, and eventually leaving us feeling crummy, fatigued, and inflamed. Can anyone relate? If you don't have your daily poo, you don't feel like you?? Insoluble fibers also help increase stool bulk which aids in the laxation of the colon and reduces straining. Interestingly, research shows that the larger the fiber particle, the more potent the laxative effect. Therefore coarse wheat bran, which is high in insoluble fiber, is a much more effective laxative than fine wheat bran.
YOUR LIKELY NOT EATING ENOUGH FIBER
Unfortunately, 95% of Americans are not getting enough fiber. That means only 5% of Americans are actually meeting the daily recommended intake of 26-38g per day for women and men respectively. And although you may think you are getting enough fiber, research shows that only 1 in 20 actually do! With the rise of grain-free, bean/legume free, and gluten free diets, daily fiber intake can take a significant fall even in health conscious individuals. Ensuring adequate fiber intake is important because it helps eliminate waste products via stool, increases satiety and supports a healthy weight, and feeds good gut microbes. By eating a variety of plant foods, you will get adequate amounts of both soluble and insoluble fiber and plenty of colorful polyphenols to boot! A general rule of thumb is to aim for ~10g of fiber per meal. If you are not sure how much fiber you are getting each day, track it to get a rough estimate, then make intentional changes.
But wait! If you have been eating a low fiber diet, tummy rumbles and gas may be more pronounced initially as the bacterial composition and stool viscosity changes. Therefore, to avoid discomfort make sure to gradually increase fiber over time, drink plenty of fluids, and move your body daily to help support proper elimination. Unfortunately, certain types of fibers may exacerbate GI symptoms for some individuals. For example, if you are struggling with diarrhea, you may want to limit your intake of insoluble fiber rich foods until the diarrhea is resolved. Alternatively, if you struggle with constipation, slowly increasing your insoluble fiber intake can be helpful. If you struggle with SIBO you likely need to be careful with some fermentable fibers, to reduce gas and bloating, until SIBO is addressed. In general, a healthy gut thrives off of a variety of plant fibers. Therefore, just because you cannot tolerate one type of fiber right now, doesn't mean you may not be able to tolerate it again in the future. It just means that you need to be mindful of which fibers you can or cannot tolerate. Ideally, work 1:1 with a gut health dietitian to help you navigate dietary and supplemental fibers and address the root cause of your digestive woes.
When using fiber supplements, you first have to ask yourself why do I need a fiber supplement? Is your diet lacking in fiber, then definitely start here first, gradually increasing fiber rich foods in your diet. If struggle with diarrhea you start by increasing soluble fiber rich foods and reducing insoluble fiber rich foods until loose stools improve. If this doesn't work, then try psyllium or Benefiber for some immediate support. Whereas if you struggle with constipation, you may consider adding in coarse wheat bran or using psyllium husk for relief. Finally, if you have SIBO then you may want to avoid inulin/FOS fiber supplements and try Sunfiber (PHGG). The table above will help guide you towards a fiber supplement that may help address your current needs. Ideally, work with a gut health dietitian to navigate all the other fiber options available and help you select a fiber supplement to fit your unique needs. And remember, if your symptoms worsen on a fiber supplement, please stop taking it, and ask your dietitian how to proceed.
For some fiber rich recipes check out the links below:
Turmeric Quinoa Porridge
Festive Massaged Kale Salad
Hearty Curry Vegetable Soup
Whole Grain Harvest Cornbread
Lemon Curry Four Bean Salad
FeedMe Belly Bowl
Apple Banana Breakfast Muffins
Chickpea Skillet Flatbread
4. Gropper and Smith. Advanced Nutrition and Human Metabolism, 6th Edition.
Listen up! Cranberries are more than just a tasty side to your turkey! These bright red and tart berries are a wonderful source of polyphenols called proanthocyanidins. Proanthocyanidins, otherwise known as PACs, provide many health benefits including anti-inflammatory benefits and anti-bacterial benefits. Research has found that these PACs can inhibit bacterial adhesion to tissue, impair their motility, and inhibit biofilm formation (1). Plus, these polyphenols help encourage the growth of specific good bacteria that are essential to a thriving gut microbiome. Despite these amazing benefits, cranberries are usually just consumed around Thanksgiving and Christmas, and usually served with a huge blow of sugar. Read on to learn more about why cranberries can be a wonderful addition to a gut healing program, including my favorite cranberry products. Plus, if you make it all the way to the end, you will find a delicious recipe for a raw cranberry chutney, filled with only gut friendly ingredients.
Cranberries have anti-biofilm properties against Escherichia coli and Pseudomonas aeruginosa. What are biofilms? They are colonies of bacteria that are hiding under a protective layer made of polysaccharides and therefore can persist even after antibiotic or antimicrobial treatment. Both E. coli and P. aeruginosa are common opportunist gram-negative bacteria that can cause a lot of inflammation in the gut, thriving off of a high animal protein and fat diet. They produce toxic lipopolysaccharides, LPS, that can damage cells of the gut lining and cause leaky gut. High levels may also cause abdominal cramping and loose stools (2).
Cranberry juice can be used to prevent UTI’s and ulcers. How does it help? Cranberries have been found to inhibit E. coli from attaching itself to the urinary tract lining thereby inhibiting E. Coli biofilm formation (3). Similarly, cranberry juice was found to have the same inhibitory effect against H. Pylori, a common culprit to stomach inflammation and ulcer formation (4). How much juice do you need to drink? Most studies have used two cups daily for at least a month if not 2-3 months.
Cranberries encourage the growth of good gut bacteria. Cranberry polyphenols have been shown to increase the growth of Akkermansia muciniphila, a bacteria that is commonly found the in human gut, feeding off of the mucus on our gut lining. Research also suggests that A. muciniphila is inversely associated with obesity, diabetes, and metabolic disorders, likely due to its anti-inflammatory role in the gut. Unfortunately, low levels (which I commonly see in my practice) are associated with a sick gut microbiome and increased inflammation. How do cranberries stimulate A. muciniphila? It seems that PACs help stimulate mucus production and therefore is likely one of the mechanisms why cranberries help encourage Akkermansia to thrive (5,6). Furthermore, cranberries seem to reduce the negative microbiome changes that are seen when humans eat a diet high in animal protein and animal fat, which is consequentially low in fiber (7).
Cranberries support metabolic health. Since cranberries help inhibit the growth of inflammatory gram-negative bacteria, and help support the growth of anti-inflammatory bacteria, it comes to no surprise that they may help improve insulin sensitivity in non-diabetic obese humans thereby supporting weight loss efforts (8).
Phew, that's a lot of good reasons to enjoy cranberries this holiday season! But a couple of tips first. For starters, I suggest choosing organic cranberries only, as conventional berries are high in pesticides. Secondly, choosing raw is ideal. The overly cooked sauce or the canned blob, is not going to provide the same benefits. Thirdly, if you are really looking to improve your gut health, consistency is key. Consider adding cranberries to your smoothies, salads, yogurts, etc. And finally, it’s all about the big picture. Cranberries are going to help improve your gut health much more when combined with a whole foods, low sugar, diet. Yes, that means your super sweet Thanksgiving cranberry sauce, is not the same as enjoying my raw cranberry chutney.
Here are a couple of my favorite cranberry products to add into your daily routine:
Raw Cranberry Chutney
Makes about 2 cups
12 oz fresh organic cranberries
1 organic orange, juice and zest
¼ cup organic maple syrup or raw local honey
¼ teaspoon Redmond’s sea salt
1 teaspoon grated peeled ginger root
Rinse cranberries and strain. Pour onto a clean kitchen towel and pick out any soft cranberries.
Add the fresh cranberries into a food processor. Process until finely minced. Be careful not to process it too much, because then it will become too soggy.
Transfer into a large bowl and mix with orange zest and juice. Add your choice of sweetener (honey or maple syrup). Honey is a little sweeter than maple syrup, so it depends on your preference. Add the sea salt and grated ginger root (I used a microplaner). Stir until thoroughly mixed.
Transfer mixture into a glass jar and allow to rest in refrigerator overnight. The chutney gets more flavorful with time. Tastes great tossed in salads, in wraps, sandwiches, mixed into yogurts, added into smoothie, or of course, along with your Thanksgiving turkey.
Note: You can easily double this recipe!
How are you going to start adding cranberries to your life??
Let me know!
Did you know that grazing or snacking every 1-2 hours may be impacting your gut health?? The migrating motor complex (aka MMC) is a periodic electrical current that migrates along the entire length of the small intestine. During the interdigestive state (time between meals/fasting) hormones called motilin and ghrelin (hunger hormone) induce these electrical currents by stimulating the vagus nerve. The vagus nerve is the main component of the parasympathetic nervous system and transfers information from the gut to the brain. Cool, right??
The migrating motor complex, MMC, is an essential component to supporting good gut health. These electrical currents help clear away bacteria and debris from the digestive tract, therefore giving the MMC the nickname "intestinal housekeeper". An absent or disordered MMC is associated with SIBO and other functional gut disorders.
The Migrating Motor Complex is broken down into THREE separate phases and incorporates the stomach and the small intestine.
Timing Balanced Meals for Gut Health
Now that you understand what the MMC is, I hope you can understand why snacking and grazing between meals can hinder proper clearance of bacteria and debris (no matter how healthy your choices are). These bacteria and debris need to be moved through and out the gastrointestinal tract via stool. Instead of a three meals per day and three snacks per day routine, aiming for at least four hours between meals, is a good practice to support optimal motility and gut health. Since patients with digestive issues often struggle with blood sugar dysregulation, eating FOUR square meals per day can be a great way to keep blood sugars stable, while supporting optimal MMC function. If you can go longer periods of time between meals without feeling "hangry", lightheaded, or fatigued, then three meals per day (with no snacks) is also a great option.
Eating four square meals is a great starting point to support gut health!! But the next important step is to make sure they are balanced, including some quality protein and fat (often protein rich foods naturally have some fat), some slow carbohydrates (think whole grains, tubers, fruit), and of course veggies. For patients with gut symptoms, usually cooked veggies are better tolerated. Balancing meals helps keep you full longer and helps balance your blood sugars, providing more stable, lasting energy. So if you are looking to start with two simple dietary changes to help support your gut health, aim to space your meals apart by at least four hours and make sure your meals are balanced!
If you want some inspiration, download my FREE handout below to help you time and balance your meals appropriately to enhance your MMC and ultimately your gut health!
Have you noticed a difference in your gut health by supporting your MMC?? Share with me below!
Got uncomfortable gut problems such as painful gnawing (especially on an empty tummy), nausea, bloating, or burping? Consider H. Pylori!! Helicobacter Pylori (aka H. Pylori) is a gram-negative bacteria that can colonize the stomach early in life and damage tissues in the stomach and in the upper part of the small intestine, called the duodenum. It can even colonize the oral cavity. Using an enzyme called urease, H. Pylori is able to attack the mucosal lining of the stomach and small intestine, causing inflammation and weakening the protective mucosal barrier. It can also neutralize stomach acid production, making it difficult to properly break down protein rich foods and absorb vitamins and minerals, including iron, B12, folic acid, vitamin E, vitamin C, vitamin A, as well as others. Thus H. Pylori can contribute to micronutrient malnutrition which can increase the risk of chronic disease. Interestingly, about 40% of the American population (and ~70% of the developing world) is a carrier of H. Pylori, and most do not even know they are infected. However, H. pylori can impact your health in many ways and can lead to gastritis, peptic ulcers, and even gastric cancer. If you are diagnosed with H. Pylori, it may be that your partner is a carrier as well. H. Pylori can be transmitted by mouth from kissing and can also be passed by having contact with vomit or stool from an infected person.
There are many different strains of H. Pylori, each sensitive or resistant to different treatment modalities. With increasing antibiotic resistant strains, more research has focused on using alternative tools (such as plant compoundsand probiotics) as an adjunct therapy to traditional triple therapy to increase eradication rates. Therefore, having a multipronged approach to treating H. Pylori infection is important. The following foods (and a few more) have been found to increase eradication rate by inhibiting H.Pylori growth and adhesion, while reducing mucosal inflammation.
Garlic & Ginger
Garlic is rich in organosulfur compounds that have potent anti-bacterial properties against H. pylori. The therapeutic amount used in studies can be obtained by eating 1 medium raw garlic clove per day. Ginger consumption eradicated H. Pylori by 50% in a small pilot study of 15 patients tested positive for H. Pylori.
Tip: Mince up raw garlic really fine and mix with raw local honey OR add raw ginger root to a smoothie.
Broccoli sprouts are rich in sulforaphane, which is a powerful antibacterial against H. Pylori. Studies found that patients who ate broccoli sprouts twice a day for 7 days had increased H. Pylori eradication rates. Regular consumption of broccoli sprouts can reduce levels of urease and reduced gastric inflammation.
Tip: Add broccoli sprouts to your sandwich instead of lettuce.
Studies have found that cranberry juice (250ml twice per day) alone may help improve eradication rates of H. Pylori. Along with traditional triple therapy including omeprazole, amoxicillin, and clarithromycin, cranberry juice increased eradication rates in females. The compounds in cranberries have anti-adhesive properties making it difficult for H. Pylori to burrow into the stomach lining and cause inflammation.
Tip: Add in frozen cranberries while you are cooking your oatmeal or add pure cranberry juice to a smoothie.
Inner aloe vera gel expresses antibacterial properties to H. Pylori due to its unique plant compounds including coumaric acid, ascorbic acid, pyrocatechol, and cinnamic acid. Furthermore, the unique polysaccharides (which are mucilaginous) in the aloe vera, directly inhibit H. Pylori adhesion to the gastric cells. Plus, aloe vera helps soothe and heal irritated lesions in the mucosal lining, including gastric ulcers, often caused by H. Pylori.
Tip: Add pure inner leaf aloe vera gel to smoothies or drink straight. Freeze in ice cube tray and add to smoothies all throughout the year.
Fresh raw okra has strong anti-adhesive qualities. Just like aloe vera, the mucilaginous polysaccharides are also soothing to the gastrointestinal tract, healing and soothing irritated or inflamed membranes.
Tip: Add frozen okra to a smoothie, you won’t even know it's there!
In addition to traditional triple therapy or an herbal protocol the smoothie below can help increase eradication rates and hopefully keep H. Pylori from coming back. BUT remember, if you are tested positive for H. Pylori, your partner may be infected too. Therefore, double up on this smoothie and cheers to love and to getting rid of H. Pylori!
“H. Pylori Be Gone” Smoothie
1 cup frozen organic berries
½ cup Lakewood Organic Pure Cranberry Juice
½ cup frozen okra
¼ cup Lakewood Organic Pure Aloe Vera Juice
1-2 inches raw ginger root, peeled and coarsely chopped
1 serving plain protein powder
2 tablespoons coconut cream
Blend until smooth and divide into two separate containers. If you have a partner, share this smoothie with them. Drink daily during treatment.
If you want to know if H. Pylori could be contributing to your gut problems, make an appointment today! I offer GI Map PCR stool testing which tests for bacterial (including H. Pylori), fungal, and parasite presence that could be contributing to your gut and other non-gut related symptoms.
If you have been following me lately, I have been using the words prebiotics and polyphenols a lot in relation to gut health. Prebiotics are non-digestible carbohydrates and polyphenols found in plant foods that can positively influence the growth of good gut bacteria (such as Bifidobacterium, Lactobacillus, as well as others), thereby reducing the growth of pathogenic or opportunistic bacteria and ultimately improve health. When bacteria consume these prebiotics, they themselves produce short chain fatty acids and other metabolites that influence metabolic pathways. Why is this important?? It is important because this means that your gut bacteria directly influence your health and susceptibility to chronic disease and that your diet and lifestyle directly reflects what bacteria call your gut home.
Since many people have heard the term prebiotics in relation to certain fibers, I want to talk about polyphenols today. Polyphenols are part of a large family of plant compounds collectively called phytochemicals or phytonutrients. In the plant kingdom, polyphenols act as a defense mechanism to increase the survival of the plant. In humans, research has found that phytonutrients offer both preventive and therapeutic benefits to combat chronic disease. Interestingly only 5-10% of consumed polyphenols are absorbed in the small intestine. The remainder reach the large intestine where they are consumed by bacteria which generate bioactive compounds with the ability to both influence bacterial residency (promoting good and reducing bad bacteria) in the gut and human health. Polyphenol rich foods include tea, coffee, cacao, dark chocolate, fruits, vegetables, whole grains, nuts and seeds, beans/legumes, and red wine. However, the foods with the highest concentration of polyphenol content by weight are herbs and spices! If you are just a salt and pepper kind of gal, then consider adding more FLAVOR to your meals. Here is a list of the top polyphenol rich plant foods (based on mg per 100g). Cloves, peppermint, star anise, cacao/dark chocolate, oregano, flaxseed, and elderberry are in the top ten. Each category below is ranked from highest to lowest polyphenol content. Although many of you may see your favorite beverages on this list, I encourage you to aim for a wide assortment. Each polyphenol has its own unique ability to benefit your gut microbiome. Therefore, the more variety the merrier! And just because you do not see your favorite plant food on the list (like kale for example), doesn't mean it is not wonderful in other ways.
So, let’s look at some research in regards to polyphenols and bacteria!
A recent study investigated which of the following seven culinary spices best support the growth of either Bifidobacterium or Lactobacillus. The spices studied include black pepper, cayenne pepper, cinnamon, ginger, oregano, rosemary, and turmeric. Researchers found that all spices except turmeric enhanced the growth of Bifidobacterium and Lactobacillus species. While all spices suppressed the growth of pathogenic bacteria. Inspired to add more spice to you cooking?? Then make your own herb garden, exciting spice blends, or buy fresh herbs and spices locally. Personally, I love making Madras Curry, Ras el Hanout, and Dukkah!
Another research study looking at green tea polyphenols found that daily consumption of green tea altered oral and gut microbiota favorably. After consuming 400ml (~ 2 cups) of green tea per day for two weeks researchers found that the participants had reduced levels of lipopolysaccharide (very inflammatory endotoxin) producing Bacteroidetes, and increased levels of bacteria producing short chain fatty acids in their stools. Green tea consumption was also associated with a reduction of pathogenic oral bacteria fusobacterium. Are you ready to drink more green tea?? Cold brew green tea (recipe to come soon!) contains the highest concentration of polyphenols and the lowest amount of caffeine. This is absolutely a win-win! However, traditionally brewed green tea is also a great choice if you are not sensitive to caffeine.
And if enjoying flavorful meals and sipping cold brew green tea aren’t enough reasons for you to jump on the polyphenol train, cacao (this includes dark chocolate >/=75% cacao) ), also improves the microbiome favorably. Studies have found that dark chocolate consumption in humans encourages the growth of both Lactobacillus and Bifidobacterium, but ultimately tends to favor Lactobacillus growth more. Here is a delicious recipe for double chocolate brownie bites (made without sugar) that hit the spot oh so good!
Do you have SIBO or IBS? Then you may want to tread carefully. Some polyphenol rich foods are better tolerated than others due to their unique fiber and carbohydrate content. Herbs and spices (except garlic and onion powders), cacao, green tea, some berries, as well as extra virgin olive oil are generally well tolerated. Work with a skilled SIBO dietitian to guide you based on your unique tolerance.
Eat the rainbow and reap the benefits!
Are you incorporating a wide variety of these polyphenol rich foods into your diet daily??
Like to read? Then get your evidence based nutrition information here! All posts written by Selva Wohlgemuth, MS, RDN Functional Nutritionist & Clinical Dietitian