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Fiber Supplements



In last week’s article, we discussed how dietary fiber is beneficial for health.  We related that people who consume the recommended 30-40 grams of fiber per day, not only experienced reduced all case mortality, but also had less risk for contracting serious conditions such as heart disease and stroke, diabetes mellitus, colonic diverticulosis, and some cancers.  Unfortunately, the average Western diet is refined and processed and seriously low in dietary fiber.


The majority of the clinical studies showing these health benefits of dietary fiber have been based on the study participants consuming foods that are naturally high in fiber, such as fruits, vegetables, lentil (beans), nuts, and whole grains, and no fiber supplements were added.  However, for those who cannot tolerate high fiber foods or simply cannot meet recommended goals, there are many supplements (packaged fiber) that can be added to any diet.  Prior to the development of the numerous processed supplements, many fiber conscious people would supplement their diets with unprocessed whole grain wheat bran.  This remains a good option and one or two tablespoons can be added to most foods without negatively impacting the food’s palatability.  One tablespoon contains about 1 ½ grams of dietary fiber.


The other commercial products consist of either fiber extracted from plants or synthesized in the laboratory.  Most of these products are chemically similar and the major difference is whether they are soluble or insoluble in water.  Soluble means that they will combine with water.  Insoluble means that they will not. Soluble fibers seem to be more adept at improving metabolic health (lowering blood sugar and cholesterol) and acting as a prebiotic maintaining healthy gut bacteria.


Insoluble fiber seems to provide more assistance with regulating bowel movements and possibly assisting with weight loss by causing early satiety (the feeling of fullness after eating) thus decreasing appetite and caloric intake.   Fiber-rich foods tend to contain both soluble and insoluble fiber while the majority of fiber supplements are soluble fiber.


The following are the best known classes of fiber supplements:  


1) Psyllium is extracted from the seeds and husks of a plant.  It contains both soluble and insoluble fiber in varying percentages.  Psyllium has been marketed for many years as treatment for constipation.  The most common trade names are Metamucil and Konsyl.  Clinical studies have been conflicting, but some experts believe that psyllium improves blood sugar and cholesterol.


2) Two popular products that are synthetic and soluble fiber are methylcellulose (Citrucel) and wheat-dextran (Benefiber).  All fiber products tend to cause gas in the gastrointestinal tract.  This gas is a by-product of bacterial fermentation of the undigested fiber. However, the composition of these two products tend to make them the least “gaseous” of any fiber supplements on the market and they still seem to offer similar benefits as all the others.  Citrucel seems to have the unique capacity to slow digestion and thus absorption of dietary fats and may be beneficial in folks dealing with nonalcoholic fatty liver disease.


 3) Calcium-polycarbiphil (Fibercon) is a synthesized fiber and is insoluble.  It is a prescription fiber product most commonly used to treat patients with irritable bowel syndrome who deal with alternating diarrhea and constipation.


Because of its current popularity for treating constipation, we will mention Miralax.  It is not a fiber supplement but acts similarly to fiber products by increasing the water content of the stool which softens the waste making it easier to pass.  It is not habit forming, like true laxatives can be, because it does not act as a stimulant to bowel muscles and nerves.


Generally, all fiber supplements should be taken with food, either before or after eating.  Otherwise, you may simply pass only fiber through your gut and into the toilet and be fooled into thinking you have passed worms or baby jellyfish!


Fiber supplements can be healthy and beneficial but they should be used as just that: supplements.  They are not superior or even equal to their whole food counterparts that harbor multiple important nutrients not contained in isolated packaged fiber supplements.


Also, please remember that the food industry is once again seeking to profit from the publicity dietary fiber is getting about its health benefits.  Supermarket shelves are filled with processed foods, some that qualify as “junk foods”, whose packaging is labeled with “fiber added”.  Some of the so called “fiber bars” are junk food!  Hopefully most of the public will have enough common sense to choose an apple over a “high fiber” brownie!


There is no doubt that fiber-rich foods are a critical component to a healthy diet and fiber supplements can provide additional benefits.  However, in general, avoid packaged processed foods that claim they contain added fiber. Finally, when adding fiber supplements to your diet, be sure to inform your physician of the products that you have chosen to be sure they do not interfere with the absorption of other medications you might be using.


Dr. Tippett is the founder of Comprehensive Quality Healthcare Providers, a concierge internal medicine practice located at 1210 Commerce Dr. Suite 106, Greensboro, Ga. 30642.  He can be reached at 706-510-3659.  Visit his webpage at www.drtippett.com

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