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The Truth About Fiber

Fiber. It’s not a very…sexy topic. Just the word conjures up images of Metamucil commercials with the sandy-looking granules swirling in a glass and promises of being “regular.” But the benefits of a whole food, high fiber diet are many and certainly extend beyond the water closet.

Most Americans are fiber deficient—some experts in the functional medicine community claim that it’s the most clinically important dietary deficiency, a deficiency largely due to the Standard American Diet (SAD), which doesn’t favor whole, nutrient-dense foods like fruits and vegetables (complex carbs) and is chock full of sugar and processed carbohydrates in the form of “junk flour” (conventional bread, pasta, bagels, etc. (simple carbs)).

Unlike macronutrients (fat, protein, and carbohydrates) that our bodies break down and absorb, dietary fiber (also known as roughage or bulk) isn’t actually digested. It comes in two forms, soluble and insoluble; both are essential and can be obtained from a wide variety of delicious, high-fiber foods like true whole grains (vs. flour), fruits, vegetables, nuts, seeds, and legumes, which indeed, are mostly carbohydrates. (If you’re aghast at the suggestion to consider whole grains and/or legumes, you can read my prior post for Dr. Blum, In Defense of Grains and read my post[JG1] , In Defense of Legumes.)

Because of the common fiber-constipation association (you’re not allowed to laugh if you’ve never had it), many may not be aware of the many other benefits of adequate fiber intake:

  •       Promotes weight loss: What if I told you that fiber may be your best friend if you’re trying to lose weight? According to Monica Reinagle, licensed nutritionist, “Trying to lose weight on a low-fiber diet is like parallel parking without power steering.” Foods rich in fiber are filling, which means you eat less and stay fuller longer.
  •       Lowers risk of digestive conditions such as irritable bowel syndrome
  •       Lowers risk of heart disease by getting rid of digestive debris and environmental toxins and keeping bad cholesterol in check.
  •       Lowers risk of diabetes: Researchers are now finding that the fiber in grains specifically lowers the risk of diabetes. A September 2018 study from The Journal of Nutrition that followed 55,000 middle-aged women and men for 15 years discovered that those who consumed the most whole grains had the lowest risk of Type 2 diabetes.
  •       Lowers risk of stroke
  •       Provides fuel for the microbiome: You may be thinking…What?? I thought I was supposed to be low-carb to heal my gut and reverse my autoimmune condition. Read on!

Low Carb, Low Fiber?

We can’t discuss the important role of fiber and sidestep the carb conversation, given that so many gut-healing, immune modulatory diets eschew—or largely eschew—carbs and that fiber-rich foods are largely carbohydrates.

Fact: A low-carb diet, with its overreliance on fat and protein and under-reliance on complex carbs in the form of whole grains, legumes, and vegetables (including—and especially—starchy vegetables like sweet potatoes, yams, squash, carrots, etc.), tends to be low-fiber.

The importance of fiber in the diet is indisputable and has a profound impact on our digestive health and microbiome, our 100 trillion organism-strong “mini ecosystem” also known as “the forgotten organ.”

Justin Sonnenburg, PhD and Associate Professor of Microbiology and Immunology at Stanford, is the author of The Good Gut, co-authored by his wife, Erica Sonnenburg, PhD. The Sonnenburgs are considered some of today’s preeminent experts on digestive health and in the science of the fibers found in grains and their role in providing an important fuel source for the microbiome.

Justin says, “You have to ask the question of what it means when we’re consuming 15 grams of dietary fiber per day instead of 150—a 10-fold decrease in the foods that feed our gut microbe.”

In their book, The Good Gut, the Sonnenburgs state, “Increasing dietary fiber is essential to cultivating diversity in the microbiota. Microbes in the gut thrive on the complex carbohydrates that dietary fiber is primarily composed of. But rather than ‘dietary fiber,’ we prefer ‘microbiota accessible carbohydrates,’ or MACs. MACs are the components within dietary fiber that gut microbes feed on. Eating more MACs can provide more nourishment to the microbiota, help gut microbes thrive, and improve the diversity of this community. Our family eats what we jokingly refer to as a ‘Big MAC diet.’ This diet is rich in complex carbohydrates from fruit, vegetables, legumes, and unrefined whole grains, and is designed to create and maintain diversity within the gut microbiota.”

Dr. John Douillard states, “While fiber is linked to heart health, it is also critical for the protective health of the intestinal skin. If the intestinal skin breaks down, the beneficial gut microbes disappear.”

If you’re still unconvinced that grains and legumes can be part of a gut healing protocol, Dr. Susan Blum mentions quinoa, amaranth, millet, teff, buckwheat, various types of rice, and legumes in her book, The Immune System Recovery Plan, and incorporates these foods in several of her recipes. She calls them “foods to include” and states, “Fit lots of fiber onto your plate in the form of veggies, low sugar fruit like berries and apples, whole gluten-free grains, and legumes—to feed the good bacteria of the gut.”

It’s Easy to Get Enough

If you think you may be fiber deficient, slow and steady wins the race. Going overboard and increasing your intake with gusto can cause gut distress. And drink plenty of water.

Regardless of any deficiency, we all need regular fiber in our diet. At the end of the day, if you’re committed to a whole foods diet rich in color and variety, you’re likely getting the fiber that you need.

  •       Add nuts and seeds (especially flaxseeds and chia) to whole grain cereals, salads, soups, and smoothies
  •       Snack on raw veggies
  •       Legumes/beans play well with others; use them in soups, salads and many of your other favorite dishes
  •       Choose true whole grain foods vs. refined grains
  •       Eat fruit as a dessert or snack; the skin and/or seeds is where you’ll get the most fiber. Berries are a great choice, as they’re low on the glycemic index. Apples and pears are the best skin-on fruits.
  •       Incorporate all kinds of vegetables into every meal. In general, the darker the veggie, the higher the fiber. Get all that you can—it all counts!

 

Jill Grunewald, HNC, FMCHC, is the founder of Healthful Elements, an alopecia expert, and best selling author of The Essential Thyroid Cookbook.

 

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In Defense of Grains

If you’re reading this, you’ve likely been tuned into the integrative/functional health community for some time. And if you’ve suffered from an autoimmune condition, perhaps you’ve tried a Paleo (aka ancestral) or AIP (autoimmune protocol) diet, both of which eschew grains (and other whole foods).

Years before the popularity of these diets peaked, we’d been hit hard with the “low carb” craze. Carbohydrates come in many forms (grains, legumes, fruits, vegetables), but grains have gotten a particularly bad rap, primarily because a diet heavy in processed grains (flour-based products like conventional bread, crackers, muffins, etc.) can be kryptonite for blood sugar and inflammation management.

Indeed, for some, grains can cause brain fog, bloating, and digestive upset. I get it. But my feeling is that for many, the preexisting digestive imbalance is the reason for the intolerance, not the other way around. Until digestive function is optimized, many foods—not just whole grains—can cause issues.

I agree that, for some people, going grain-free can be helpful for managing autoimmunity. But I don’t believe that whole, gluten-free grains are categorically bad for everyone—even those looking to reverse their autoimmune condition.

Speaking of gluten, I do believe that it should be avoided, especially during a healing/immune modulatory phase. Gluten-containing grains include wheat (einkorn, durum, faro, graham, kamut, semolina, spelt), barley, rye, and triticale. Gluten-free grains include quinoa, amaranth, millet, teff, buckwheat, and various types of rice.

The case against grains is that they contain the anti-nutrients phytic acid and lectin, along with enzyme-inhibitors that inhibit mineral absorption. Yet these “anti-nutrients” are also found in vegetables like beets and dark leafy greens. Should we avoid these nutrient-rich foods too?

Grains are naturally high in vitamins and minerals (B vitamins, iron, manganese, magnesium, and zinc, to name a few) and the key is to properly prepare them to release these nutrients. See below for more information.

It’s only in the past century or so that we’ve largely stepped away from the traditional practices of leavening/fermentation, soaking, and sprouting (germinating), which “pre-digests” grains. Additionally, Vitamin A inhibits the potentially negative effects of phytic acid.

When traditionally prepared, grains are much easier to digest, we’re able to absorb their nutrition, and they help us produce serotonin, a neurotransmitter that brings about a sense of comfort and calm, which in itself is enough to consider whether grains should be avoided. In my work with “low carb refugees,” once these clients begin adding some complex carbs from whole grains (and other foods, especially starchy vegetables) back into their diets, the overall feedback is that they feel so much calmer and more grounded and centered. And they start sleeping better.

Dr. Susan Blum mentions quinoa, amaranth, millet, teff, buckwheat, various types of rice, and legumes in her book, The Immune System Recovery Plan, and incorporates these foods in several of her recipes. She calls them “foods to include.”

While being grain-free may be part and parcel of some of the popular diets today, it doesn’t mean it’s helpful or warranted for everyone. Moderate grain intake simply offers too many benefits—vitamins, minerals, and fiber and…calm and comfort in the form of serotonin production. So next time you’re inclined to take a “chill pill,” maybe reach for some millet instead.

The guide below was written by Lisa Markley, MS, RDN, and co-author of The Essential Thyroid Cookbook.

Purchasing
When purchasing whole grains, select intact gluten-free grains, such as brown rice, quinoa, certified gluten-free whole oat groats, steel cut or rolled oats, buckwheat, millet, and amaranth. When possible, opt for these grains in their sprouted form; your store may carry some sprouted whole grain options such as brown rice, oats, and quinoa in the aisle where you’d find other packaged grains. According to the Whole Grains Council, sprouting increases the grain’s antioxidant activity as well as many of the grains’ key nutrients, such as B vitamins, Vitamin C, folate, fiber, and essential amino acids, such as lysine. You can cook dried sprouted grains the same way you would regular grains, but follow the package for specific instructions, as cooking time may be less in some instances.

Rinsing
Certain grains should be rinsed before cooking to remove dust or other debris and to yield the best flavor. These include millet, quinoa, and rice. Quinoa has a bitter coating on the outside called saponin that will negatively impact flavor if not rinsed. Rinse the grains by placing in a fine mesh strainer and rinsing with warm water.

Soaking
If you’re unable to purchase sprouted grains, it’s generally recommended to pre-soak grains to enhance digestibility and break down phytic acid.  With the exception of quick-cooking grains like quinoa, millet, amaranth and teff, soak in their measured amount of water in a glass measuring cup for 12-24 hours on your kitchen counter. Add 1 tablespoon of raw apple cider vinegar or lemon juice per 1 cup of liquid, if desired. When ready to cook, note the water level of the soaked grain, drain off the soaking water, add fresh water to the measure you noted, and simmer on stove with a pinch of salt for recommended cooking time (see “Cooking” below). Note that soaking some grains reduces their overall cooking time by a few minutes, but the cooking time for pre-soaked steel cut or rolled oats is reduced by about half.

Sprouting
If you’d like to try your hand at sprouting your own grains, it’s fairly simple:

  1. Measure approximately ½ cup of an intact, unmilled whole grain such as brown rice, forbidden black rice, quinoa, millet, or certified gluten-free oat groats, place in a bowl, and cover with water. Soak the grains for 8-12 hours.
  2. Drain and rinse thoroughly, then place soaked grains in the bottom of a quart-sized mason jar. Cover jar with cheesecloth and hold in place with a rubber band or the metal ring from a screw lid. They also sell special sprouting lids/screens that are handy for this.
  3. Invert jar over a bowl and keep at room temperature, but out of direct sun.
  4. Rinse and strain grains thoroughly twice daily, then re-invert over bowl.
  5. Repeat step 6 every day for 1 to 5 days. You’ll know the grains have sprouted once a tail appears. You can continue sprouting/germination until tail is the length of the original grain.
  6. Enjoy them fresh, sprinkled on salads. Store the sprouted grains in the refrigerator for up to 3 days. Discard them if they begin to smell off or become slimy.
  7. The sprouted grains can also be dried by spreading evenly on a sheet pan and placing in at oven set to 150-200 for 8-12 hours. Or use a dehydrator, if you have one. Once the grains are dried thoroughly, you can store or cook as you would normal dried grains. They can also be ground into flour and used in baking.

Cooking
Place measured grain with water or stock and a pinch of sea salt in a pot, cover with a tight fitting lid, and bring to a boil. A 1-quart pot is best for cooking 1 cup of grain, a 2-quart pot for 2 cups of grain, and so on. Reduce heat and simmer for suggested cooking time, which will vary depending on grain. (See “Soaking” above about the reduction in cooking time for soaked grains.) Refrain from stirring the pot while the grains are cooking; this will disrupt the steam pockets that allow the top layer to cook as evenly as the bottom and cause some not to fully cook. To check if all of the water has been absorbed, simply tilt the pot to the side to see if there’s still water pooling at the bottom; if water is still present, continue to cook for a few additional minutes until it has all been absorbed.

Jill Grunewald, HNC, FMCHC, is the founder of Healthful Elements, an alopecia expert, and best selling author of The Essential Thyroid Cookbook.