This was a fun read, thank you! I always enjoy a good meta analysis paper because they tend to really get at the important details rather than irrelevant factors. I think the tl;dr version of this...
This was a fun read, thank you! I always enjoy a good meta analysis paper because they tend to really get at the important details rather than irrelevant factors.
I think the tl;dr version of this is that if you seek the health benefits associated with fiber, you need to make sure the fiber is a soluble, gel forming, non-fermenting variety, like psyllium, and hasn't been hydrolyzed or otherwise processed to prevent gelling.
If you seek the cholesterol reduction or glycemic benefits, then you need to eat the gelling fiber with, or before your meal. For glycemic control, the gel spreads out the time that compounds in the food are broken down so that nutrients are absorbed more slowly over the length of the small intestine as opposed to quickly in the first few feet.
For cholesterol control, the gel traps bile long enough that it can't be recycled, which lowers serum LDL cholesterol by triggering your body to produce more bile, which consumes LDL cholesterol, pulling it from your blood.
If you want more regular, comfortable bowel movements, then I don't suspect it matters if you take it with food exactly. The primary mechanism here is that if the gel is also non-fermenting, then it won't break down in the large intestine and will keep the moisture content and bulk of your stool at a healthy level.
So I suppose understand why you want to take fiber, and take it accordingly. Fortunately, the most effective types seem to be the cheapest and least processed varieties.
There is one important caveat that may not be obvious to some people: be aware that the study only focuses on specific functions of fiber. The other function of fiber is to maintain a healthy gut...
I think the tl;dr version of this is that if you seek the health benefits associated with fiber, you need to make sure the fiber is a soluble, gel forming, non-fermenting variety, like psyllium, and hasn't been hydrolyzed or otherwise processed to prevent gelling.
There is one important caveat that may not be obvious to some people: be aware that the study only focuses on specific functions of fiber.
The other function of fiber is to maintain a healthy gut microbiome. The metastudy did not look at this likely because it's difficult to impossible to clearly say that an effect is positive or negative (even with well known "useful" bacteria it's about balance). But there are now numerous studies on the topic of which specific kinds of fiber affect which bacteria negatively or positively, and the general conclusion supported by some evidence is that in order to maintain ideal health the average westerner should eat more fiber than they do now and mix different fibers from different foods.
That's a good point and probably a common misconception among some regarding scientific papers. Publications generally examine one or more specific claims. In this case, the impact of different...
That's a good point and probably a common misconception among some regarding scientific papers. Publications generally examine one or more specific claims. In this case, the impact of different fibers on modulating cholesterol, glycemic control, and regularity. Any other potential claims are (largely) unaddressed. So if there is some other claim about fermentable fibers, e g. promoting gut fauna for instance, that is unexamined in this analysis. So on the basis of this paper, nothing could be said about those other claims one way or the other.
This paper does briefly discuss prebiotic effects, and argues against the notion that well-fed colon bugs contribute to healthy poop (although not necessarily other health benefits). For myself,...
This paper does briefly discuss prebiotic effects, and argues against the notion that well-fed colon bugs contribute to healthy poop (although not necessarily other health benefits).
For myself, what function do colon bugs serve? If it’s just Eatingg stuff, then feeding them more means just more bugs, and if the stuff we’re feeding them is preferred, maybe they won’t eat the other stuff we need them to?
The paper specifically discusses the probiotic effects within the context of promoting regularity and in lipid level mediation, and argues through the analysis that these claims aren't backed by...
The paper specifically discusses the probiotic effects within the context of promoting regularity and in lipid level mediation, and argues through the analysis that these claims aren't backed by the articles analyzed.
So, there may be some other claims or benefits with respect to prebiotic effects that do have supporting evidence, but those weren't analyzed here. I would have to do a careful literature review to find any high quality claims and evidence, since I'm not really familiar with the current state of this research area.
I do know that many aspects of gut health are being actively researched, including issues like leaky gut, etc, with respect to auto immune disease. But I suspect we are a ways off from seeing high quality meta analyses on those subjects.
Questions about gut flora (3,000+ identified species and still counting) are incredibly complicated. We know there are overt disease states that can happen when the microbial population balance is...
Questions about gut flora (3,000+ identified species and still counting) are incredibly complicated. We know there are overt disease states that can happen when the microbial population balance is disrupted by antibiotics, dietary imbalance, autoimmune disease, etc. We know that we depend on microbial processing for availability of nutrients from food, that some of the byproducts of microbial digestion can be toxic or immunogenic. Not everyone handles those byproducts well, depending on exogenous factors like diet, exercise, and genetics. [Good review paper here on microbial populations and metabolic health/diseases.]
There's suggestive research about what hunter-gatherer vs. modern agrarian vs. highly processed diets do to gut flora diversity. However, there's not enough good evidence about the overall health consequences of those differences, other than "highly processed = bad". We don't really know what a healthy intestinal ecosystem should look like, how best to cultivate it, how human genetic differences interact with the chemical outputs of all those critters, what trace antibiotic and biocide consumption does... Stay tuned for more research, and eat a varied, mainly unprocessed diet.
Without meaning to offend at all, I can't think of other label for this but "so ignorant it's unironically funny". It's difficult to give you a real picture without writing out an entire lecture...
For myself, what function do colon bugs serve? If it’s just Eatingg stuff, then feeding them more means just more bugs, and if the stuff we’re feeding them is preferred, maybe they won’t eat the other stuff we need them to?
Without meaning to offend at all, I can't think of other label for this but "so ignorant it's unironically funny".
It's difficult to give you a real picture without writing out an entire lecture here, but the ultra-tl;dr is that the reason why we want to have a healthy and diverse microbiome is because bacteria create thousands of different metabolites that all have a role in various biochemical processes in our body. Some are directly related to nutrition - they can digest or synthesize vitamins or increase bioavailability of various minerals. Others affect various functions of the immune system, they may both attenuate or increase some types of inflammation. Some affect your mental health - this may sound improbable, but a common side effect of fecal microbiome transplants (FMT) is that people suddenly feel mentally great, and there are documented cases of successfully treating major depressive disorder with FMT. There are also numerous correlational studies, for example between the prevalence of specific gut bacteria and predicted symptom severity of covid.
The recommendation to eat more (and different kinds of) fiber is a result of all of that, from what we know it seems to lead to healthy patterns that promote the wanted parts of the above paragraph (and much more).
However it is a difficult area of study because the microbiome is incredibly complex and most prebiotics affect far more than one type of bacteria. So if you just take a group of people, feed them a specific type of fibre or placebo and watch whether symptom xx changes (this is what most studies referenced in this metastudy did), most of the time you won't get any conclusive data, or the results later won't reproduce when done in a different country (with different diets), because giving the same supplement to people with different starting microbiomes will lead to different results. The best way to get clearer data is to do microbiome sequencing and look at patterns there, which is done more and more often.
It feels like I'm seeing more meta-analyses these days. I don't know if it's because the public and press are more aware of them than we used to be, or if it's because they're actually being done...
It feels like I'm seeing more meta-analyses these days. I don't know if it's because the public and press are more aware of them than we used to be, or if it's because they're actually being done more now than in decades past. Either way, it's good to see.
For cholesterol control, the gel traps bile long enough that it can't be recycled, which lowers serum LDL cholesterol by triggering your body to produce more bile, which consumes LDL cholesterol, pulling it from your blood.
I had my gall bladder out a few years back because the bastard decided to figuratively kersplode on me. This is the first I'm hearing that bile production affects blood LDL levels. I wonder how the inability to store up bile affects this process?
With only a cursory look, there might be an association between gall bladder removal and lower LDL levels for a few days, but rebounds to normal levels. That makes sense, because rather than store...
With only a cursory look, there might be an association between gall bladder removal and lower LDL levels for a few days, but rebounds to normal levels. That makes sense, because rather than store up a reservoir of bile, it will continually release into your digestive system, where 90% is recycled. So having your gallbladder out doesn't prevent your body from recycling bile. That is caused by the gelling fiber binding the bile past the point of being recycled.
As far as the meta analysis, they've been popular for a while, but maybe science writers are starting to pick up on them more, hard to say. They've long been considered the gold standard, when there are enough studies to draw on.
TL;DR: psyllium makes for the best pooping overall. I found this article because I was curious of the chemistry of stomach acid on fiber (still haven’t found that out). I’m curious how much a...
TL;DR: psyllium makes for the best pooping overall.
I found this article because I was curious of the chemistry of stomach acid on fiber (still haven’t found that out).
I’m curious how much a “natural,” as defined by how we might have eaten prior to agriculture, diet would provide the kind of non-fermenting, gel-forming fiber the article suggests is necessary to good pooping.
The meta question is, what is the better existence, a “natural” diet without psyllium supplement, or an agro diet with it?
I’m also curious about how well people poop now, across lots of demographics, and how well different kinds of people pooped in the past. IN other words, I wonder, what is, in fact, a normal, healthy poop?
The natural diet is likely better. The paper questions that since it is difficult to establish causality in the context of natural fiber intake, but generally speaking it is commonly thought that...
The natural diet is likely better. The paper questions that since it is difficult to establish causality in the context of natural fiber intake, but generally speaking it is commonly thought that a person’s diet should have a person eating food that fulfills all of their dietary needs.
I think you might be misunderstanding the audience for the two papers you linked to. The first is meant for researchers and doctors; people who need to know the fine details. The second is meant as more practical advice for everyday people. As such, it is not going to go into the fine details that this paper does. It may not be as accurate, but it is “good enough” and more importantly it has real actionable steps for a person to take.
It should also be noted that this analysis is necessarily limited in scope. There is a lot about digestion that we still do not fully understand. I was only really able to skim through it after about halfway through - it’s too early in the morning for this kind of thing - but it felt like fermentable soluble fibers got something of a bad rap. But those are important too, because those feed the bacteria in your guts, and that is a part of digestion that we understand the least right now.
Healthy bowel movements happen at least once a day - if not more - and produce smooth brown logs. If that’s not what it looks like, assuming no medical conditions or medications that would affect digestion, you are likely not eating enough fiber (the most likely thing in most Western / rich nations), not drinking enough water, or you have ate something you can’t digest properly.
Bad science reporting is a pet peeve of mine, especially in the context of offering guidance and advice. There's no reason the mayo clinic article can't be simple, actionable, and accurate. For...
Bad science reporting is a pet peeve of mine, especially in the context of offering guidance and advice. There's no reason the mayo clinic article can't be simple, actionable, and accurate.
For example, the article recommends "bran" containing cereal as a fiber source, but the journal article makes important distinctions regarding the benefits of bran, which, depending on form, can actually contribute to worse poops, and exacerbate IBS.
I'm also curious, and neither article really addresses this (although the mayo endorses it), whether and how whole grains contribute to healthiness. This goes to my pre-post agro civilization diets. Without doubt, a whole grain alternative is superior to its refined option. But I wonder if grains generally are actually good for us? I mean, there's the whole paleo movement that eschews grains for meat, but that's not really healthy either. Our early diet included lots of leaves, berries, seeds, bark, and roots, probably a lot more of those than meat. And the meat included all the animal except sinew and skin. While grains are seeds, technically, are they a suitable replacement for the other stuff?
I disagree with you about the writing in Mayo Clinic article. There is such a thing as too much information; when you get to that point then people miss important points and are for various...
I disagree with you about the writing in Mayo Clinic article. There is such a thing as too much information; when you get to that point then people miss important points and are for various reasons unable to create an active plan with the information provided. That would be very bad science reporting because the point of it is to make sure the audience understands. If anything, their article leans too far into detail; there is definitely an audience who will not be able to use this information effectively.
They did recommend cereals with bran, but that makes sense to me because they aren’t saying to only eat bran. They are saying to choose cereal that contains bran, which will likely contain other types of fiber and additional nutrients. Most popular breakfast cereals are stripped of all fibers!
It’s pretty well established that whole grains are overall pretty healthy for us. But the thing to be aware of is that like anything, you can over-consume it. Grains can have a lot of calories that are (relatively) easy to overeat because of the ways they are prepared. You should always have a well balanced diet.
I wouldn't read this paper as arguing against fermenting fibers. Rather, it is speaking narrowly within the context of specific benefits. And it is likely correct that fermenting fibers don't have...
I wouldn't read this paper as arguing against fermenting fibers. Rather, it is speaking narrowly within the context of specific benefits. And it is likely correct that fermenting fibers don't have those specific benefits, especially as relating to persisting through the large intestine.
But that doesn't preclude having both if fermenting fibers are associated with specific, different claims such as probiotic functions. But that would require enough other papers making those specific claims to be included in the meta-analysis.
Which makes sense to me. But according to my doctor, when asked about frequency, he said "anywhere from one to three days is normal" As an occasional three day pooper, I'd like to contest his...
Healthy bowel movements happen at least once a day - if not more - and produce smooth brown logs.
Which makes sense to me. But according to my doctor, when asked about frequency, he said "anywhere from one to three days is normal" As an occasional three day pooper, I'd like to contest his theory cause I dont like looking like a semi-pregnant man and it doesn't feel very 'normal'
Ironically, the paper linked gives a very good definition for what constitutes healthy, not constipated poops, and it comes down to water content level. You might poop every three days with...
Ironically, the paper linked gives a very good definition for what constitutes healthy, not constipated poops, and it comes down to water content level. You might poop every three days with healthy water levels, and someone else might poop every day with unhealthy levels. And yes, you could have an unhealthy brown smooth log that's unpleasantly hard or otherwise difficult for the propagating pressure waves to propel
Yeah, skipping a day of dropping the kids off at the pool is one thing, but when it gets to three days it’s worrying. And if you are regularly having no-poo days you are likely to not track how...
Yeah, skipping a day of dropping the kids off at the pool is one thing, but when it gets to three days it’s worrying. And if you are regularly having no-poo days you are likely to not track how often you are going, which can leave you blissfully ignorant until you have painful constipation, which is really fun if you aren’t prepared for it and don’t have any medicine for it.
USDA recommends something like 30g of fiber every day, and that’s actually a really conservative number. Which makes it all the more sad that so many people don’t even eat that much regularly. Which is probably why a physician would say that bowel movements once every 3 days is normal.
Eat veggies, folks. Your grandma was not kidding around.
Anecdotally, spouse makes a week's breakfasts worth of what he calls "goo": steel-cut oats, chia seeds, flaxseed meal, psyllium, and cinnamon, cooked together with just enough water that a spoon...
Anecdotally, spouse makes a week's breakfasts worth of what he calls "goo": steel-cut oats, chia seeds, flaxseed meal, psyllium, and cinnamon, cooked together with just enough water that a spoon will still stand up in it when it's done. [Chia and flaxseed meal are also gel-forming, though the linked study doesn't mention any research on these ingredients.]
A cup of that every day does keep the trains running on time, but it's mighty boring without some preserves or dried fruit. He's fighting a family history of high cholesterol successfully (also takes a statin), and I'm not showing any signs of the family Type II diabetes tendency, so it's working?
We basically put together our mutual nutrition self-research and threw the kitchen sink at our respective ailments, present and potential, to come up with the recipe. No claims that it will cure cancer, arthritis, etc., but my skin and joints certainly aren't any worse for regular goo consumption.
Following Instant Pot and package ratios for water (roughly 2 cups water per cup of ingredients, plus extra for desired consistency): 2 cups (8 servings) of steel-cut, rolled or Scottish oats 8...
Following Instant Pot and package ratios for water (roughly 2 cups water per cup of ingredients, plus extra for desired consistency):
2 cups (8 servings) of steel-cut, rolled or Scottish oats
8 scoops of protein powder (could be vegan, but we usually have whey protein around)
1 cup (8 servings) chia seeds
1 cup (8 servings) flaxseed meal
1/2 cup (8 servings) psyllium husk powder
1 T cinnamon
pinch of salt
Stir together and cook in an Instant Pot on the "Rice" seeing. Makes 8 - 10 servings of goo.
After reading the article, spouse wants to try this as uncooked overnight oats rather than Instant Pot. Given the protein powder, it's going to have to be done in the refrigerator, which may take longer than overnight.
When I asked spouse for his goo formula, he asked, "Which goo?". I'm not sure whether this is charming or disturbing.
Not who you asked, but I make overnight oats quite a bit. I alternate between steel cut and rolled, with a preference for steel cut. However, steel cut takes longer to soften, so you need to give...
Not who you asked, but I make overnight oats quite a bit. I alternate between steel cut and rolled, with a preference for steel cut. However, steel cut takes longer to soften, so you need to give it a day or two extra to soak (in my experience) unless you are partially cooking it.
For rolled oats, soak water and oats in a container overnight in a 1:1 ratio.
For steel cut oats, soak water and oats in a container for 1-3 days in a 2:1 ratio.
That's it, really, the rest is flavoring to your preference. You can use milk or milk substitute instead of water if you prefer, and I recommend a pinch of salt with it to soak.
The rest is personal preference. I like adding natural peanut butter and raisins or fresh fruit. But many folks add chia or flax, jams, syrups, sugars, chocolate chips, etc. Just like regular oatmeal, it's a great carrier for other flavors.
I started a plant based diet when I was 14 years old. I've never been constipated since then. I understand it is a common affliction, at least in the U.S..
I started a plant based diet when I was 14 years old.
I've never been constipated since then. I understand it is a common affliction, at least in the U.S..
After about a year of being vegetarian my wife and decided to try to do a vegan diet for a month. It wasnt a huge jump but my body certainly thought so. I stopped after 2 weeks because I could...
After about a year of being vegetarian my wife and decided to try to do a vegan diet for a month. It wasnt a huge jump but my body certainly thought so. I stopped after 2 weeks because I could not. Stop. Pooping. My body did not appreciate it, I was pooping 4 times a day at least.
...so i've been vegetarian for about thirty-five years, flirted with veganism for a few years around the turn of the millenium, and: ever prepared for a colonoscopy?..that 'colon-blow' experience...
...so i've been vegetarian for about thirty-five years, flirted with veganism for a few years around the turn of the millenium, and: ever prepared for a colonoscopy?..that 'colon-blow' experience is just a routine morning for me, been purging my intestines that way every day for decades...
...my bowels are so disruptive that my wife and i were fully expecting bad news when i went in for my first colonoscopy at fifty years of age; the gastroenterologist instead said that i have the colon of someone half my age and he doesn't need to see me again for at least ten years...
...not sure exactly how to correlate cause and effect but apparently it's not entirely unhealthy...
Years ago my bandmate decided to switch from a stereotypical unhealthy "student diet" to a stereotypical uberhealthy diet - tons of vegetables, almost zero meat, fermented foods, sourdough bread,...
Years ago my bandmate decided to switch from a stereotypical unhealthy "student diet" to a stereotypical uberhealthy diet - tons of vegetables, almost zero meat, fermented foods, sourdough bread, legumes... It took almost a year of absolutely disgusting insufferable radioactive farts before his microbiome adapted. Now he's one of the healthiest people I know, though whether there's really a causative effect is impossible to say.
Yeah, a good diet shouldn’t need any supplementation. Living creatures on the earth have evolved to get everything they need from their food, short of some sort of medical condition....
Yeah, a good diet shouldn’t need any supplementation. Living creatures on the earth have evolved to get everything they need from their food, short of some sort of medical condition. Unfortunately, the food that we tend to eat today is of very questionable nutritional quality, and fiber in particular has been stripped from a lot of the food we eat. I’ve known a bunch of people who basically avoid vegetables like the plague (heck, I’m married to one), which is sad because vegetables are one of the best sources for fiber.
Counter point: some living creatures evolved to a state where they don't even have mouths, like giant silk months: Evolution doesn't care about our health at all, only that we live just long...
Living creatures on the earth have evolved to get everything they need from their food,
Counter point: some living creatures evolved to a state where they don't even have mouths, like giant silk months:
As with all giant silk moths, the adults only have vestigial mouthparts and no digestive system and therefore do not eat in their adult form
Evolution doesn't care about our health at all, only that we live just long enough to procreate. As a species that's now living easily four times longer than "evolutionarily necessary", I don't put a lot of stock in my body knowing what I need or how efficient it is with my food or anything really.
Put another way, you're completely right that a good diet doesn't need supplements, but the fact that I myself couldn't recognize a healthy diet from bad, is the main challenge, and why I wonder if supplements "can't hurt"
Another way to interpret your response is that we should all be having more sex. :P Supplements aren’t necessarily bad, of course, but keep in mind that your body is a complex ecosystem with...
Another way to interpret your response is that we should all be having more sex. :P
Supplements aren’t necessarily bad, of course, but keep in mind that your body is a complex ecosystem with countless variables, many of which we have yet to completely uncover. It is much better to get your nutritional needs from whole foods because they are generally not going to throw things too far off balance, assuming you eat a varied enough diet.
I used to be the avoider of vegetables. I didn’t touch anything green until I was about 19 years old and even then it was very selective until about 25. I don’t know about your partner but it’s...
I used to be the avoider of vegetables. I didn’t touch anything green until I was about 19 years old and even then it was very selective until about 25.
I don’t know about your partner but it’s always been a texture thing to me. I hated the “mushy” crunch that vegetables always seemed to have. That’s probably the best way I can explain it.
My wife’s strategy was to sneak things into recipes where I wouldn’t suspect there were vegetables. Even made a hot sauce with squash one time and I had no idea. Probably still the best hot sauce I’ve ever had.
I guess I’m saying all of this to try and give you hope that anyone can enjoy vegetables if you ease them in and get rid of as many pain points around them as possible.
Oh, he will eat vegetables on occasion. If it is less than 1/10th the meal, and it is integrated with something else and loaded with salt and sugar. Yesterday he had some with a large Yoshiniya...
Oh, he will eat vegetables on occasion. If it is less than 1/10th the meal, and it is integrated with something else and loaded with salt and sugar. Yesterday he had some with a large Yoshiniya beef and chicken bowl, where he gave me most of them - which made it something more like 1/100th of the dish.
He should really make an effort to adjust his pallet for his health, but he is older than me and I think he is at the point where he basically won’t change no matter what. But I’m worried about him; he’s probably been to the doctor 3 times in the decade or so that I’ve known him, and I think only one of them has been for a regular physical exam - which took me practically forcing him to do it.
I think supplements have a place. I have taken all kinds of supplements, but I never felt better than when I used cronometer.com and made it a game to get as close to 100% of my requirements as I...
Yeah, a good diet shouldn’t need any supplementation.
I think supplements have a place. I have taken all kinds of supplements, but I never felt better than when I used cronometer.com and made it a game to get as close to 100% of my requirements as I could from my food.
Oh sure. I guess I'm a little hypocritical on that front because the diet I have cuts out the most common source of B12 (meats and animal products), so I'm actually supplementing right now.
Oh sure. I guess I'm a little hypocritical on that front because the diet I have cuts out the most common source of B12 (meats and animal products), so I'm actually supplementing right now.
FWIW there are several supplements like vitamin d3, omega3s that most doctors are recommending for everyone. Included in that is the recommendation for b-12 supplements for people over 50....
FWIW there are several supplements like vitamin d3, omega3s that most doctors are recommending for everyone. Included in that is the recommendation for b-12 supplements for people over 50. Assimilating b-12 from animal products is hard to do, and it gets harder as life goes on.
B-12 supplements are almost natural. It is produced by growing bacteria in a vat which makes it.
I've heard some recommendation for D3 and Omega 3 fatty acids for vegan diets, but it's not quite at a majority opinion yet (I've never heard that from any of the doctors who worked with me on my...
I've heard some recommendation for D3 and Omega 3 fatty acids for vegan diets, but it's not quite at a majority opinion yet (I've never heard that from any of the doctors who worked with me on my diet), and I've certainly never heard of them being recommended to everyone.
Thanks for sharing this! I'll have to read it later. I've been trying to add more fiber to my diet. I read somewhere that fiber and probiotics work best in tandem, so I put bran buds (Kellogg's...
Thanks for sharing this! I'll have to read it later.
I've been trying to add more fiber to my diet. I read somewhere that fiber and probiotics work best in tandem, so I put bran buds (Kellogg's brand I believe) in my yogurt and when I finally poop I feel like I poop out a mold of my intestines and I feel weightless afterwards.
My best advice for parsing papers is to read the abstract, them the conclusion. Those are often more approachable. If you need more details, then you can dig into the body.
My best advice for parsing papers is to read the abstract, them the conclusion. Those are often more approachable. If you need more details, then you can dig into the body.
Anecdotally, I choked a little on pills with psyllium inside. Follow the directions carefully. Drink lots of liquid. https://www.nmhealth.org/publication/view/newsletter/3990/
Anecdotally, I choked a little on pills with psyllium inside.
Follow the directions carefully. Drink lots of liquid.
Muesli was invented by a Swiss doctor. There was an odd belief at the time that going to the bathroom too often was an unhealthy thing. Many of his patients "held it in" and became constipated....
Muesli was invented by a Swiss doctor. There was an odd belief at the time that going to the bathroom too often was an unhealthy thing. Many of his patients "held it in" and became constipated. Rather than arguing with them he created the original muesli recipe and prescribed it to them. You can easily mix your own if you don't want all of the sugar that comes with muesli from the store.
This was a fun read, thank you! I always enjoy a good meta analysis paper because they tend to really get at the important details rather than irrelevant factors.
I think the tl;dr version of this is that if you seek the health benefits associated with fiber, you need to make sure the fiber is a soluble, gel forming, non-fermenting variety, like psyllium, and hasn't been hydrolyzed or otherwise processed to prevent gelling.
If you seek the cholesterol reduction or glycemic benefits, then you need to eat the gelling fiber with, or before your meal. For glycemic control, the gel spreads out the time that compounds in the food are broken down so that nutrients are absorbed more slowly over the length of the small intestine as opposed to quickly in the first few feet.
For cholesterol control, the gel traps bile long enough that it can't be recycled, which lowers serum LDL cholesterol by triggering your body to produce more bile, which consumes LDL cholesterol, pulling it from your blood.
If you want more regular, comfortable bowel movements, then I don't suspect it matters if you take it with food exactly. The primary mechanism here is that if the gel is also non-fermenting, then it won't break down in the large intestine and will keep the moisture content and bulk of your stool at a healthy level.
So I suppose understand why you want to take fiber, and take it accordingly. Fortunately, the most effective types seem to be the cheapest and least processed varieties.
There is one important caveat that may not be obvious to some people: be aware that the study only focuses on specific functions of fiber.
The other function of fiber is to maintain a healthy gut microbiome. The metastudy did not look at this likely because it's difficult to impossible to clearly say that an effect is positive or negative (even with well known "useful" bacteria it's about balance). But there are now numerous studies on the topic of which specific kinds of fiber affect which bacteria negatively or positively, and the general conclusion supported by some evidence is that in order to maintain ideal health the average westerner should eat more fiber than they do now and mix different fibers from different foods.
That's a good point and probably a common misconception among some regarding scientific papers. Publications generally examine one or more specific claims. In this case, the impact of different fibers on modulating cholesterol, glycemic control, and regularity. Any other potential claims are (largely) unaddressed. So if there is some other claim about fermentable fibers, e g. promoting gut fauna for instance, that is unexamined in this analysis. So on the basis of this paper, nothing could be said about those other claims one way or the other.
This paper does briefly discuss prebiotic effects, and argues against the notion that well-fed colon bugs contribute to healthy poop (although not necessarily other health benefits).
For myself, what function do colon bugs serve? If it’s just Eatingg stuff, then feeding them more means just more bugs, and if the stuff we’re feeding them is preferred, maybe they won’t eat the other stuff we need them to?
The paper specifically discusses the probiotic effects within the context of promoting regularity and in lipid level mediation, and argues through the analysis that these claims aren't backed by the articles analyzed.
So, there may be some other claims or benefits with respect to prebiotic effects that do have supporting evidence, but those weren't analyzed here. I would have to do a careful literature review to find any high quality claims and evidence, since I'm not really familiar with the current state of this research area.
I do know that many aspects of gut health are being actively researched, including issues like leaky gut, etc, with respect to auto immune disease. But I suspect we are a ways off from seeing high quality meta analyses on those subjects.
Fair points all.
Questions about gut flora (3,000+ identified species and still counting) are incredibly complicated. We know there are overt disease states that can happen when the microbial population balance is disrupted by antibiotics, dietary imbalance, autoimmune disease, etc. We know that we depend on microbial processing for availability of nutrients from food, that some of the byproducts of microbial digestion can be toxic or immunogenic. Not everyone handles those byproducts well, depending on exogenous factors like diet, exercise, and genetics. [Good review paper here on microbial populations and metabolic health/diseases.]
There's suggestive research about what hunter-gatherer vs. modern agrarian vs. highly processed diets do to gut flora diversity. However, there's not enough good evidence about the overall health consequences of those differences, other than "highly processed = bad". We don't really know what a healthy intestinal ecosystem should look like, how best to cultivate it, how human genetic differences interact with the chemical outputs of all those critters, what trace antibiotic and biocide consumption does... Stay tuned for more research, and eat a varied, mainly unprocessed diet.
Without meaning to offend at all, I can't think of other label for this but "so ignorant it's unironically funny".
It's difficult to give you a real picture without writing out an entire lecture here, but the ultra-tl;dr is that the reason why we want to have a healthy and diverse microbiome is because bacteria create thousands of different metabolites that all have a role in various biochemical processes in our body. Some are directly related to nutrition - they can digest or synthesize vitamins or increase bioavailability of various minerals. Others affect various functions of the immune system, they may both attenuate or increase some types of inflammation. Some affect your mental health - this may sound improbable, but a common side effect of fecal microbiome transplants (FMT) is that people suddenly feel mentally great, and there are documented cases of successfully treating major depressive disorder with FMT. There are also numerous correlational studies, for example between the prevalence of specific gut bacteria and predicted symptom severity of covid.
The recommendation to eat more (and different kinds of) fiber is a result of all of that, from what we know it seems to lead to healthy patterns that promote the wanted parts of the above paragraph (and much more).
However it is a difficult area of study because the microbiome is incredibly complex and most prebiotics affect far more than one type of bacteria. So if you just take a group of people, feed them a specific type of fibre or placebo and watch whether symptom xx changes (this is what most studies referenced in this metastudy did), most of the time you won't get any conclusive data, or the results later won't reproduce when done in a different country (with different diets), because giving the same supplement to people with different starting microbiomes will lead to different results. The best way to get clearer data is to do microbiome sequencing and look at patterns there, which is done more and more often.
It feels like I'm seeing more meta-analyses these days. I don't know if it's because the public and press are more aware of them than we used to be, or if it's because they're actually being done more now than in decades past. Either way, it's good to see.
I had my gall bladder out a few years back because the bastard decided to figuratively kersplode on me. This is the first I'm hearing that bile production affects blood LDL levels. I wonder how the inability to store up bile affects this process?
With only a cursory look, there might be an association between gall bladder removal and lower LDL levels for a few days, but rebounds to normal levels. That makes sense, because rather than store up a reservoir of bile, it will continually release into your digestive system, where 90% is recycled. So having your gallbladder out doesn't prevent your body from recycling bile. That is caused by the gelling fiber binding the bile past the point of being recycled.
As far as the meta analysis, they've been popular for a while, but maybe science writers are starting to pick up on them more, hard to say. They've long been considered the gold standard, when there are enough studies to draw on.
TL;DR: psyllium makes for the best pooping overall.
I found this article because I was curious of the chemistry of stomach acid on fiber (still haven’t found that out).
I’m curious how much a “natural,” as defined by how we might have eaten prior to agriculture, diet would provide the kind of non-fermenting, gel-forming fiber the article suggests is necessary to good pooping.
The meta question is, what is the better existence, a “natural” diet without psyllium supplement, or an agro diet with it?
I’m also curious about how well people poop now, across lots of demographics, and how well different kinds of people pooped in the past. IN other words, I wonder, what is, in fact, a normal, healthy poop?
Edit: the articles framework is the dispelling of fiber myths. The current Mayo Clinic Health article on fiber is different, perpetuating the myths 8 years later:
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983#:~:text=Soluble%20fiber.,%2C%20carrots%2C%20barley%20and%20psyllium.
The natural diet is likely better. The paper questions that since it is difficult to establish causality in the context of natural fiber intake, but generally speaking it is commonly thought that a person’s diet should have a person eating food that fulfills all of their dietary needs.
I think you might be misunderstanding the audience for the two papers you linked to. The first is meant for researchers and doctors; people who need to know the fine details. The second is meant as more practical advice for everyday people. As such, it is not going to go into the fine details that this paper does. It may not be as accurate, but it is “good enough” and more importantly it has real actionable steps for a person to take.
It should also be noted that this analysis is necessarily limited in scope. There is a lot about digestion that we still do not fully understand. I was only really able to skim through it after about halfway through - it’s too early in the morning for this kind of thing - but it felt like fermentable soluble fibers got something of a bad rap. But those are important too, because those feed the bacteria in your guts, and that is a part of digestion that we understand the least right now.
Healthy bowel movements happen at least once a day - if not more - and produce smooth brown logs. If that’s not what it looks like, assuming no medical conditions or medications that would affect digestion, you are likely not eating enough fiber (the most likely thing in most Western / rich nations), not drinking enough water, or you have ate something you can’t digest properly.
Bad science reporting is a pet peeve of mine, especially in the context of offering guidance and advice. There's no reason the mayo clinic article can't be simple, actionable, and accurate.
For example, the article recommends "bran" containing cereal as a fiber source, but the journal article makes important distinctions regarding the benefits of bran, which, depending on form, can actually contribute to worse poops, and exacerbate IBS.
I'm also curious, and neither article really addresses this (although the mayo endorses it), whether and how whole grains contribute to healthiness. This goes to my pre-post agro civilization diets. Without doubt, a whole grain alternative is superior to its refined option. But I wonder if grains generally are actually good for us? I mean, there's the whole paleo movement that eschews grains for meat, but that's not really healthy either. Our early diet included lots of leaves, berries, seeds, bark, and roots, probably a lot more of those than meat. And the meat included all the animal except sinew and skin. While grains are seeds, technically, are they a suitable replacement for the other stuff?
I disagree with you about the writing in Mayo Clinic article. There is such a thing as too much information; when you get to that point then people miss important points and are for various reasons unable to create an active plan with the information provided. That would be very bad science reporting because the point of it is to make sure the audience understands. If anything, their article leans too far into detail; there is definitely an audience who will not be able to use this information effectively.
They did recommend cereals with bran, but that makes sense to me because they aren’t saying to only eat bran. They are saying to choose cereal that contains bran, which will likely contain other types of fiber and additional nutrients. Most popular breakfast cereals are stripped of all fibers!
It’s pretty well established that whole grains are overall pretty healthy for us. But the thing to be aware of is that like anything, you can over-consume it. Grains can have a lot of calories that are (relatively) easy to overeat because of the ways they are prepared. You should always have a well balanced diet.
I wouldn't read this paper as arguing against fermenting fibers. Rather, it is speaking narrowly within the context of specific benefits. And it is likely correct that fermenting fibers don't have those specific benefits, especially as relating to persisting through the large intestine.
But that doesn't preclude having both if fermenting fibers are associated with specific, different claims such as probiotic functions. But that would require enough other papers making those specific claims to be included in the meta-analysis.
Which makes sense to me. But according to my doctor, when asked about frequency, he said "anywhere from one to three days is normal" As an occasional three day pooper, I'd like to contest his theory cause I dont like looking like a semi-pregnant man and it doesn't feel very 'normal'
Ironically, the paper linked gives a very good definition for what constitutes healthy, not constipated poops, and it comes down to water content level. You might poop every three days with healthy water levels, and someone else might poop every day with unhealthy levels. And yes, you could have an unhealthy brown smooth log that's unpleasantly hard or otherwise difficult for the propagating pressure waves to propel
Yeah, skipping a day of dropping the kids off at the pool is one thing, but when it gets to three days it’s worrying. And if you are regularly having no-poo days you are likely to not track how often you are going, which can leave you blissfully ignorant until you have painful constipation, which is really fun if you aren’t prepared for it and don’t have any medicine for it.
USDA recommends something like 30g of fiber every day, and that’s actually a really conservative number. Which makes it all the more sad that so many people don’t even eat that much regularly. Which is probably why a physician would say that bowel movements once every 3 days is normal.
Eat veggies, folks. Your grandma was not kidding around.
Anecdotally, spouse makes a week's breakfasts worth of what he calls "goo": steel-cut oats, chia seeds, flaxseed meal, psyllium, and cinnamon, cooked together with just enough water that a spoon will still stand up in it when it's done. [Chia and flaxseed meal are also gel-forming, though the linked study doesn't mention any research on these ingredients.]
A cup of that every day does keep the trains running on time, but it's mighty boring without some preserves or dried fruit. He's fighting a family history of high cholesterol successfully (also takes a statin), and I'm not showing any signs of the family Type II diabetes tendency, so it's working?
We basically put together our mutual nutrition self-research and threw the kitchen sink at our respective ailments, present and potential, to come up with the recipe. No claims that it will cure cancer, arthritis, etc., but my skin and joints certainly aren't any worse for regular goo consumption.
That sounds interesting. Any chance of getting that recipe?
Following Instant Pot and package ratios for water (roughly 2 cups water per cup of ingredients, plus extra for desired consistency):
2 cups (8 servings) of steel-cut, rolled or Scottish oats
8 scoops of protein powder (could be vegan, but we usually have whey protein around)
1 cup (8 servings) chia seeds
1 cup (8 servings) flaxseed meal
1/2 cup (8 servings) psyllium husk powder
1 T cinnamon
pinch of salt
Stir together and cook in an Instant Pot on the "Rice" seeing. Makes 8 - 10 servings of goo.
After reading the article, spouse wants to try this as uncooked overnight oats rather than Instant Pot. Given the protein powder, it's going to have to be done in the refrigerator, which may take longer than overnight.
When I asked spouse for his goo formula, he asked, "Which goo?". I'm not sure whether this is charming or disturbing.
Awesome, thanks!
Not who you asked, but I make overnight oats quite a bit. I alternate between steel cut and rolled, with a preference for steel cut. However, steel cut takes longer to soften, so you need to give it a day or two extra to soak (in my experience) unless you are partially cooking it.
For rolled oats, soak water and oats in a container overnight in a 1:1 ratio.
For steel cut oats, soak water and oats in a container for 1-3 days in a 2:1 ratio.
That's it, really, the rest is flavoring to your preference. You can use milk or milk substitute instead of water if you prefer, and I recommend a pinch of salt with it to soak.
The rest is personal preference. I like adding natural peanut butter and raisins or fresh fruit. But many folks add chia or flax, jams, syrups, sugars, chocolate chips, etc. Just like regular oatmeal, it's a great carrier for other flavors.
I started a plant based diet when I was 14 years old.
I've never been constipated since then. I understand it is a common affliction, at least in the U.S..
After about a year of being vegetarian my wife and decided to try to do a vegan diet for a month. It wasnt a huge jump but my body certainly thought so. I stopped after 2 weeks because I could not. Stop. Pooping. My body did not appreciate it, I was pooping 4 times a day at least.
...so i've been vegetarian for about thirty-five years, flirted with veganism for a few years around the turn of the millenium, and: ever prepared for a colonoscopy?..that 'colon-blow' experience is just a routine morning for me, been purging my intestines that way every day for decades...
...my bowels are so disruptive that my wife and i were fully expecting bad news when i went in for my first colonoscopy at fifty years of age; the gastroenterologist instead said that i have the colon of someone half my age and he doesn't need to see me again for at least ten years...
...not sure exactly how to correlate cause and effect but apparently it's not entirely unhealthy...
I actually had a colonoscopy a couple years ago and they said the same thing about me. For the record I am about the same age. Good for us! Haha
That is something that can happen when you make dietary changes. It usually goes away after you get used to eating that way.
Years ago my bandmate decided to switch from a stereotypical unhealthy "student diet" to a stereotypical uberhealthy diet - tons of vegetables, almost zero meat, fermented foods, sourdough bread, legumes... It took almost a year of absolutely disgusting insufferable radioactive farts before his microbiome adapted. Now he's one of the healthiest people I know, though whether there's really a causative effect is impossible to say.
Yeah, a good diet shouldn’t need any supplementation. Living creatures on the earth have evolved to get everything they need from their food, short of some sort of medical condition. Unfortunately, the food that we tend to eat today is of very questionable nutritional quality, and fiber in particular has been stripped from a lot of the food we eat. I’ve known a bunch of people who basically avoid vegetables like the plague (heck, I’m married to one), which is sad because vegetables are one of the best sources for fiber.
Counter point: some living creatures evolved to a state where they don't even have mouths, like giant silk months:
Evolution doesn't care about our health at all, only that we live just long enough to procreate. As a species that's now living easily four times longer than "evolutionarily necessary", I don't put a lot of stock in my body knowing what I need or how efficient it is with my food or anything really.
Put another way, you're completely right that a good diet doesn't need supplements, but the fact that I myself couldn't recognize a healthy diet from bad, is the main challenge, and why I wonder if supplements "can't hurt"
Another way to interpret your response is that we should all be having more sex. :P
Supplements aren’t necessarily bad, of course, but keep in mind that your body is a complex ecosystem with countless variables, many of which we have yet to completely uncover. It is much better to get your nutritional needs from whole foods because they are generally not going to throw things too far off balance, assuming you eat a varied enough diet.
I used to be the avoider of vegetables. I didn’t touch anything green until I was about 19 years old and even then it was very selective until about 25.
I don’t know about your partner but it’s always been a texture thing to me. I hated the “mushy” crunch that vegetables always seemed to have. That’s probably the best way I can explain it.
My wife’s strategy was to sneak things into recipes where I wouldn’t suspect there were vegetables. Even made a hot sauce with squash one time and I had no idea. Probably still the best hot sauce I’ve ever had.
I guess I’m saying all of this to try and give you hope that anyone can enjoy vegetables if you ease them in and get rid of as many pain points around them as possible.
Oh, he will eat vegetables on occasion. If it is less than 1/10th the meal, and it is integrated with something else and loaded with salt and sugar. Yesterday he had some with a large Yoshiniya beef and chicken bowl, where he gave me most of them - which made it something more like 1/100th of the dish.
He should really make an effort to adjust his pallet for his health, but he is older than me and I think he is at the point where he basically won’t change no matter what. But I’m worried about him; he’s probably been to the doctor 3 times in the decade or so that I’ve known him, and I think only one of them has been for a regular physical exam - which took me practically forcing him to do it.
I think supplements have a place. I have taken all kinds of supplements, but I never felt better than when I used cronometer.com and made it a game to get as close to 100% of my requirements as I could from my food.
Oh sure. I guess I'm a little hypocritical on that front because the diet I have cuts out the most common source of B12 (meats and animal products), so I'm actually supplementing right now.
FWIW there are several supplements like vitamin d3, omega3s that most doctors are recommending for everyone. Included in that is the recommendation for b-12 supplements for people over 50. Assimilating b-12 from animal products is hard to do, and it gets harder as life goes on.
B-12 supplements are almost natural. It is produced by growing bacteria in a vat which makes it.
I've heard some recommendation for D3 and Omega 3 fatty acids for vegan diets, but it's not quite at a majority opinion yet (I've never heard that from any of the doctors who worked with me on my diet), and I've certainly never heard of them being recommended to everyone.
I read the news daily, and articles with those recommendations are often in the health section.
Thanks for sharing this! I'll have to read it later.
I've been trying to add more fiber to my diet. I read somewhere that fiber and probiotics work best in tandem, so I put bran buds (Kellogg's brand I believe) in my yogurt and when I finally poop I feel like I poop out a mold of my intestines and I feel weightless afterwards.
Oh boy, will this article have news for you!
I highly overestimate my ability to read these kinds of papers. Need to just keep my mouth shut next time
My best advice for parsing papers is to read the abstract, them the conclusion. Those are often more approachable. If you need more details, then you can dig into the body.
Sent this to 6 people I know!! Great addition. Cool insight about the different benefits.
Wow! I'm an influencer!
Anecdotally, I choked a little on pills with psyllium inside.
Follow the directions carefully. Drink lots of liquid.
https://www.nmhealth.org/publication/view/newsletter/3990/
Muesli was invented by a Swiss doctor. There was an odd belief at the time that going to the bathroom too often was an unhealthy thing. Many of his patients "held it in" and became constipated. Rather than arguing with them he created the original muesli recipe and prescribed it to them. You can easily mix your own if you don't want all of the sugar that comes with muesli from the store.