By Kim Buonomo, DPT, PHRC Lexington
What is fiber and why is it important to a pelvic floor physical therapist? The American Physical Therapy Association has stated that diet and nutrition are key components of many conditions managed by physical therapists. Nutrition can directly affect recovery and function while an individual is under a physical therapist’s care. Thus, PTs should be concerned with and address nutritional intake and eating patterns of their patients and clients. I argue that diet and nutrition are especially important to consider in the realm of pelvic floor PT and here at PHRC we are lucky to have access to great nutritional resources, especially our Integrative Functional Nutritionist, Jandra Mueller.
Since my personal passion is bowel function, I have done a good deal of research into dietary factors that affect the digestive tract. Before I tell you all about fiber: a pop quiz!
- Do you know how much fiber you should have per day?
- What does fiber do for you anyway?
- What foods are good sources of fiber?
- Can fiber help patients with irritable bowel syndrome or constipation?
By the end of the article, you should have all of these answers!
Fiber is a great way to help improve bowel function. Fiber is the indigestible part of plant foods that travels through our digestive system, absorbing water along the way and easing bowel movements. There are two types of fiber: soluble and insoluble.
Soluble fiber slows down the absorption of sugar and fats in the blood, which helps regulate blood sugar levels. This type of fiber binds with and removes cholesterol from the bloodstream, which helps lower LDL, or “bad” cholesterol.
Common Sources of soluble fiber include:
- Oat bran
- Dried beans
Insoluble fiber is described as roughage. This kind of fiber does not dissolve in water. It acts like a sponge. It is capable of absorbing up to 15 times its own weight in water and makes a person feel full longer. Insoluble fiber attaches to waste in the body, making it bulkier and easier to pass. Your intestines contract more when there is pressure on the inner wall of your colon. By bulking stool, it creates more pressure on the inner wall, or lumen, and facilitates contraction of your intestines to help “sweep” stool along.
Common Sources of insoluble fiber include:
- Fruits with skins
- Uncooked vegetables
- Brown rice
- Whole-grain flour
Fiber can be thought of as your body’s broom. It sweeps through your intestines to pick up unhealthy bacteria and excess waste and helps you eliminate it.
How fiber helps you:
- Protects against heart disease by reducing cholesterol levels.
- Slows the speed at which food passes from the stomach to the rest of the digestive system – this can make us feel full longer and can help with weight management and prevent blood sugar spikes in those with type 2 Diabetes.
- May have protective effects against breast cancer.
- Can lower the risk of prostate cancer progression. It does this by decreasing levels of testosterone, which helps decrease tumor growth.
- Fiber-rich foods help prevent diverticulosis by contributing bulk in the colon, so that less forceful contractions are needed to move things along.
- Fiber can reduce your risk of colorectal cancer.
- Fiber increases bulk in the intestinal tract and may help improve the frequency of bowel movements. It may also reduce the risk of developing colitis and hemorrhoids.
How much fiber to have:
The National Academy of Sciences’ Institute of Medicine recommends daily intake levels of 38 g of fiber for men and 25 g for women under the age of 50. For those over 50, the recommendations are 30 g for men and 21 g for women. On average, Americans consume 15 g or less of dietary fiber per day. This is less than half of the daily recommendation for men of any age, and six grams fewer than the minimum recommendation for ANY group.
But don’t go reaching for that Metamucil quite yet: too much fiber can cause negative health effects. For example, if a person eats too much fiber or increases too quickly (or doesn’t drink enough water as they are increasing their fiber), they can experience:
- abdominal pain
- loose stools or diarrhea
- temporary weight gain
- intestinal blockage in people with Crohn’s disease
- reduced blood sugar levels, which is important to know if you have diabetes
This can also interfere with your body’s absorption of other minerals. So be sure to increase your intake slowly and listen to your body, and if you have questions about specific nutritional choices for you, schedule a virtual integrative health and nutrition appointment today.
Appropriate fiber intake has tons of health benefits (as you should know by now) but if that’s not enough…
- High-fiber foods also happen to be major sources of important micronutrients. That’s why you want to concentrate on whole plant foods, not just fiber pills or supplements.
- If people who normally get little fiber suddenly doubled their intake through wiser food choices, they could lower their risk of colon cancer by 40%, according to research involving data collected from 10 European countries.
- Associated with weight loss and increased feelings of fullness.
- A study at the University of Cardiff in the United Kingdom found that people who had higher levels of fiber intake had higher feelings of well-being.
- Scientists show that those who eat the most fiber have significantly lower risk of dying of any cause. The National Cancer institute concludes that for every 10-gram increase in fiber intake, risk of death drops 15% in women and 10% in men.
- Reduced severity of sxs in patiests with IBS with increased fiber intake.
- Five RCTs looked at stool frequency and found either a trend or a significant decrease in favor of the treatment group, and increased number of stools compared with placebo
- 85% of patients with normal physiology improved or became symptom free with increased psyllium.
So by having good amounts of fiber, you’re going to lose weight, feel better, feel fuller longer, have a ton of health benefits and basically be a rock star. What’s not to love about that?
Now that you’re excited to get more fiber in your diet, how do you do it?
Here are some ways to increase your fiber intake:
- Eat Whole Grains
- Choose High-Fiber Breakfast Cereals
- Eat Beans a Few Times a Week
- Work in Fruits Whenever You Can
- Try to get several servings every day. Add fruit to your morning meal, enjoy it as a snack, and garnish your dinner plate with it. You can even have fruit with — or instead of — dessert!
- Work in Veggies Whenever You Can
- Include a vegetable with lunch, have raw vegetables as an afternoon snack or pre-dinner appetizer, and enjoy a big helping with dinner.
- Yes, there are plenty of over the counter fiber supplements you can take as well.
There are also plenty of websites that you can use to track your fiber intake. Again, aim for several servings every day. And make a point of having vegetarian entrees several times a week.
What did you learn about fiber today and how are you going to use this information to change your diet and improve your life? Let us know in the comments below!
Bijkerk, C., de Wit, N., Muris, J., Whorwell, P., Knottnerus, J., & Hoes, A. (2009). Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ, 339(aug27 2), b3154-b3154. doi: 10.1136/bmj.b3154
Portalatin, M., & Winstead, N. (2012). Medical Management of Constipation. Clinics In Colon And Rectal Surgery, 25(01), 012-019. doi: 10.1055/s-0032-1301754
Shariati, A., Maceda, J., & Hale, D. (2008). High-Fiber Diet for Treatment of Constipation in Women With Pelvic Floor Disorders. Obstetrics & Gynecology, 111(4), 908-913. doi: 10.1097/01.aog.0000308660.48204.7f
Yang, J. (2012). Effect of dietary fiber on constipation: A meta analysis. World Journal Of Gastroenterology, 18(48), 7378. doi: 10.3748/wjg.v18.i48.7378
Are you unable to come see us in person? We offer virtual physical therapy appointments too!
Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
PHRC is also offering individualized movement sessions, hosted by Karah Charette, DPT. Karah is a pelvic floor physical therapist at the Berkeley and San Francisco locations. She is certified in classical mat and reformer Pilates, as well as a registered 200 hour Ashtanga Vinyasa yoga teacher. There are 30 min and 60 min sessions options where you can: (1) Consult on what type of Pilates or yoga class would be appropriate to participate in (2) Review ways to modify poses to fit your individual needs and (3) Create a synthesis of your home exercise program into a movement flow. To schedule a 1-on-1 appointment call us at (510) 922-9836
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