Flashback Friday: The Five to One Fiber Rule

Flashback Friday: The Five to One Fiber Rule
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A guideline is suggested for how to read food labels for packaged grain products such as bread and breakfast cereals.

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When people think fiber, they think constipation. And it’s true, if we could get Americans to just eat the minimum recommended daily intake of fiber-containing foods, we could save our country 80 billion dollars —and that’s just from the effects on constipation alone. Accumulating evidence indicates that greater dietary fiber intake reduces risk for diabetes, heart disease, certain cancers, weight gain, obesity, and diverticular disease, as well as constipation. So, we need to eat more fiber rich foods, which means eating more whole grains, vegetables, fruits, and legumes (beans, peas, and lentils).

As fiber intake goes up, the risk of metabolic syndrome appears to go down: less inflammation and an apparent step-wise drop in obesity risk.

And so, no surprise, perhaps, that greater dietary fiber intake is associated with a lower risk of heart disease. A 9% lower risk for every additional 7 g/day of total fiber consumed. That’s just like some rice and beans or a few servings of fruits and vegetables.

How does fiber do its magic? What are the mechanisms by which dietary fiber may extend our lifespan? It helps get rid of excess bile, feeds our good bacteria, changes our gut hormones, which collectively helps control our cholesterol, and body weight, blood sugar, and blood pressure, which reduces the risk for cardiovascular disease. Reducing inflammation is a whole ‘nother mechanism by which fiber may help prevent chronic disease.

The accompanying editorial to the fiber and heart disease meta-analysis implored doctors to enthusiastically and skillfully recommend that patients consume more dietary fiber. That means a lot of whole plant foods. If we do buy something packaged, the first word in the ingredients list should be “whole,” but then, the rest of the ingredients could be junk; so, a second strategy is to look at the ratio of grams of carbohydrates to grams of dietary fiber. We’re looking for about five to one or less. So, for example, whole wheat Wonder Bread passes the first test: first word is whole, but then it’s like corn syrup and a chemistry set. Let’s see if it passes the five to one rule? What you do is divide the carbohydrates by the dietary fiber. 20 divided by 2.7 is about 7, that’s more than five, so goes back on the shelf. Better than white, though, which clocks in at over 18. Here’s one that makes the cut. 15 divided by three equals five.

You can do the same thing with breakfast cereal. Multi-Grain Cheerios. Sounds healthy, but has a ratio over 7. And then, it just goes downhill from there. Here’s an example of one that makes the cut though, sliding in under four.

The editorial concluded, the recommendation to consume diets with adequate amounts of dietary fiber may turn out to be the most important nutritional recommendation of all.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Farouq Taj via Flickr.

When people think fiber, they think constipation. And it’s true, if we could get Americans to just eat the minimum recommended daily intake of fiber-containing foods, we could save our country 80 billion dollars —and that’s just from the effects on constipation alone. Accumulating evidence indicates that greater dietary fiber intake reduces risk for diabetes, heart disease, certain cancers, weight gain, obesity, and diverticular disease, as well as constipation. So, we need to eat more fiber rich foods, which means eating more whole grains, vegetables, fruits, and legumes (beans, peas, and lentils).

As fiber intake goes up, the risk of metabolic syndrome appears to go down: less inflammation and an apparent step-wise drop in obesity risk.

And so, no surprise, perhaps, that greater dietary fiber intake is associated with a lower risk of heart disease. A 9% lower risk for every additional 7 g/day of total fiber consumed. That’s just like some rice and beans or a few servings of fruits and vegetables.

How does fiber do its magic? What are the mechanisms by which dietary fiber may extend our lifespan? It helps get rid of excess bile, feeds our good bacteria, changes our gut hormones, which collectively helps control our cholesterol, and body weight, blood sugar, and blood pressure, which reduces the risk for cardiovascular disease. Reducing inflammation is a whole ‘nother mechanism by which fiber may help prevent chronic disease.

The accompanying editorial to the fiber and heart disease meta-analysis implored doctors to enthusiastically and skillfully recommend that patients consume more dietary fiber. That means a lot of whole plant foods. If we do buy something packaged, the first word in the ingredients list should be “whole,” but then, the rest of the ingredients could be junk; so, a second strategy is to look at the ratio of grams of carbohydrates to grams of dietary fiber. We’re looking for about five to one or less. So, for example, whole wheat Wonder Bread passes the first test: first word is whole, but then it’s like corn syrup and a chemistry set. Let’s see if it passes the five to one rule? What you do is divide the carbohydrates by the dietary fiber. 20 divided by 2.7 is about 7, that’s more than five, so goes back on the shelf. Better than white, though, which clocks in at over 18. Here’s one that makes the cut. 15 divided by three equals five.

You can do the same thing with breakfast cereal. Multi-Grain Cheerios. Sounds healthy, but has a ratio over 7. And then, it just goes downhill from there. Here’s an example of one that makes the cut though, sliding in under four.

The editorial concluded, the recommendation to consume diets with adequate amounts of dietary fiber may turn out to be the most important nutritional recommendation of all.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Farouq Taj via Flickr.

Doctor's Note

I love doing these practical day-to-day decision type videos. If you go to the grocery store and find products that fit the 5 to 1 ratio rule, please share them in a comment below. They aren’t easy to find!

Eating fiber-rich foods is more than just avoiding constipation:

There’s this misconception that we can’t digest fiber. We can’t do it alone, but we can with a little help from our little gut flora friends. See Prebiotics: Tending Our Inner Garden.

But that’s not to downplay all the suffering caused by constipation. Feel free to check out How Many Bowel Movements Should You Have Every Day? and Should You Sit, Squat, or Lean During a Bowel Movement?

Isn’t this talk of fiber reductionistic? Good question! So good, in fact, that I did a whole video about it: Is the Fiber Theory Wrong? 

If you haven’t yet, you can subscribe to my videos for free by clicking here.

120 responses to “Flashback Friday: The Five to One Fiber Rule

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    1. I thought it was a good tip and I wanted to share it with my old mother who suffers from diabetes and vascular disease but when I looked at my buckwheat bread (only buckwheat flour, millet, ground flaxseed and buckwheat sourdough, no sugar) the nutrition facts label gives me Carbohydrate 23g fiber 4g =5.75…so close but no good(!?) Then I looked at my Integral sourdough bread ( only organic whole wheat stone-milled flour, water, organic sourdough, sea salt, yeast) and again Carbohydrate 24g fiber 3g=8…What??? So I looked at my whole grain quinoa (the real thing, just that) and it’s even worst! Carbohydrate 28g fiber 3g=9.3 . I won’t replace these food by those weird cereal with added sugar and fiber but can you help me understand how and with what we can use this rule. Thank you

      1. Julie,

        Maybe look at the whole meal and add some fiber-rich things to it.

        That is what I do. It actually makes the process simple.

        I think beans might be the highest and I do add them to every meal, which is Dr. Greger’s suggestion.

        Seeds, nuts, peas, artichokes, raspberries, dark greens, avocado…

        air popcorn as a snack

        I think even cacao has some.

        1. I found that it was too complicated for me in the beginning, but once you get the concept of which things add fiber, it gets easier.

          Also, if you still aren’t reaching it every meal, you can also do the resistant starch process.

          Cook things and cool them and re-cook them.

          1. Cooking and cooling does not work for building the starch resistance in all fiber foods, it does work great with potatoes though.

      2. Hi Julie, thanks for your question. Your bread with buckwheat sounds very good I actually make my own bread too!
        Please realize that this rule is mostly for more processed packaged foods with so many added ingredients that causes confusion for consumers. Your choices of whole grains are good.

      3. Julie Lefebvre, you raise a good point. I bake my own sourdough bread from whole grains that I grind at home, but I never thought to look at the carbohydrate to fiber ratio. (I will now.) However, I do know that “wheat flour” is not the same as “whole wheat flour” which is not the same thing as “whole grain flour.” Wheat flour is basically white four; it is the starchy endosperm only, and lacks the bran (or seed coat, which is a good source of fiber as well as other nutrients such as minerals, vitamins, and phytates) and the wheat germ, or baby plant. Whole wheat flour is reconstituted from wheat flour — the starchy endosperm — and bran — the seed coat; it lacks the germ or baby plant, which is a good source of protein and oil. And that’s why it’s not added back: The germ contains oil, which can go rancid with sufficient storage time. Whole grain flour is the whole grain ground up, usually with stone mills; it has the entire original grain in it: the endosperm, the bran, and the germ. And it also goes rancid with sufficient storage. Which is why it’s best to use this flour soon after grinding it (or to store it in a darkened container in the freezer, which slows down the oil degradation).

        Meanwhile, the endosperm consists primarily of starch with some protein (mostly gluten). Starch is carbohydrate, basically glucose linked together. The bran does have fiber, but not enough to give whole wheat flour a carbohydrate to fiber ratio of equal to or less than 5:1. I’m guessing that whole grain flour is similar, since the germ does not contain a lot of fiber, though it does contain some. And that would explain why quinoa has a carbohydrate to fiber ratio of greater than 5:1. Probably most grains do. But, they are packed with all sorts of nutrients, including fiber.

        The 5:1 ratio is meant for processed food, such as cookies, made with wheat flour, oil, and sugar. And the wheat flour is white flour, or basically starch with a little guten protein, with all the other nutrients stripped out. Which is why white or wheat flour is often “enriched,” by adding back some, but not nearly all, of those nutrients. Crazy, right?

      4. Dr. Greger,

        I tried to comment on the video with the 5 to 1 rule, but I could not leave a comment.

        I checked two whole grains that I often eat: rolled oats at 7:1, and brown rice 32:1.

        I also checked sweet potato at 6:1, and white potato at 9:1.

        I did find that Trader Joe’s Bran Flakes were slightly less than 5:1.

        Even the apple, which is often my primary source of diet fiber, does not make the cut.

        So, I question the practicality of this 5:1 rule for eating a whole-food, plant-based diet.

        Sincerely,

        Don Pitts

    2. Looking at Ezekiel bread by Food for Life Baking (organic sprouted whole grains low salt) : carb: 15 grams; fibre: 3g. Ratio: 5. Well this one is okay then…

    3. Fibre is supposed to help reduce LDL cholesterol. Yet my recent test results show my ldl to be 6% above normal and total cholesterol is 4% above normal.

      As of June 1st 2018 I am WFPB SOS-free, following daily dozen advice. Also added milled flax seeds (1-2 Tbs daily with steel cut oatmeal), 1 apple a day, blueberry powered tea (1tsp daily), amla powder prepared as tea (1-2 tsp daily). Reduced saturated fat next to nothing, cutting out chocolate.

      Running out of things to try. So will go back on Lipitor based on my physician’s advice.

      I will stay on the WFPB SOS-free diet, but will reintroduce a bit of chocolate and cut out yucky amla.

      1. WFPB may not be enough. There are many processed foods that qualify as WFPB (smoothies, breads, etc) that can increase serum lipids. If you want to try to improve your lipid profile without drugs, you can try eating unprocessed WFPB. This means fresh fruits and veggies: farm to mouth with no machinery in between. You may also need to avoid calorie dense foods like avocados, dates and nuts. If none of this works you may have a familial hypercholesterolemia which is not rare. Also, if you are overweight, you could have metabolic syndrome which would increase your serum lipids as well.

        Dr. Ben

    4. Am I doing something wrong? Or is there something I’m missing? According to the 5:1 rule, cooked barley doesn’t make the cut, nor does cooked teff, both of which are whole grains.

      1. You’ll see this explanation in several comments, but just to clarify: this rule is for packaged foods. Both Barley and Teff are good high-fiber foods. They may have a little more carbohydrate percentage than is healthy for more processed foods,they are well-designed for good human nutrition because with that little extra carb content comes lots of other healthy content in terms of phytonutrients. So enjoy and keep that fiber rule for packaged foods.

  1. There’s fiber, and then there’s fiber. NONE (or very few) of those crappy ingredients in that photo should we ever eat!

    The people who put that stuff together (what IS it?) hope their “Suitable for vegetarians” will rope in that crowd, at least.

    1. YR, I, too, got curious when I saw the lead-in picture. I put on my “detective” hat and did some web searching based on the portion of the label showing in the picture. The name looks like “Warburton”, and sure enough, there is a bakery company based in the UK with that name. Their website lists an “orange-wrappered Toastie loaf”! Could that be what we’re looking at in the picture? ;-)

      https://warburtons.co.uk/products/bread

      1. Good sleuthing, Hal.

        As most people at this site follow a WFPB diet, seems to me they wouldn’t even be eating processed garbage like whatever that stuff is in the pic above. :-/

        On the other hand, if they’re “vegan,” they very well might! :-)

  2. Love the advice but I may have missed something…exactly why is the 5:1 ratio important?

    The video seemed to jump from fibre studies/advice straight to telling us how to check labels for the 5:1 ratio….but no explanation of exactly why 5:1, or less is desirable – and why not 6:1, etc ?

    Apologies if I missed it but can anyone clarify?

    1. Hi David, thanks for your question. Basically Dr Greger is putting a rule of 5: 1 which would indicate 20% fiber content in a particular product which is a generous content of fiber in a product. In one of the studies that was referred to they indicated significantly lower CRP ( relative protein) Concentrations of 25-54% with increased DF consumption with dosages ranging between 3.3-7.8 g/MJ. So the more fiber in a product the better effect it will have on lowering C creative protein which is an indication of inflammation.

  3. Is this only for packaged foods with a long ingredient list? My steel-cut oats (that are only oats and I eat on a regular basis) don’t meet this standard. Neither does the puffed kaput that I enjoy, which has no other ingredients.

        1. This! He says-
          If we do buy something packaged,
          the first word in the ingredients list should be “whole,” but then, the rest of the ingredients could be junk; so, a second strategy is to look at the ratio of grams of carbohydrates to grams of dietary fiber.

    1. I have an unrelated question. I wanted to know if there is any legitimate information on human consumption of diatomaceous earth? (Food-grade) My sister claims it’s very healthy to consume. Thanks

    2. Hi Crystal, thanks for your question. Steal cut oats has a good source of soluble fiber. Steel cut oats provide 5g of fiber per 1/4 cup serving of dry oats, which is about double the amount of fiber you can get from rolled oats. So great job and enjoy your steal cut oats.

    3. Crystal,

      Yes, my steel cut oats don’t start off making the fiber rule, but an amazing thing happens, I add in my flaxseed and walnuts and suddenly they do meet it.

    4. From the responses above, it appears the 5:1 rule is for packaged/processed foods. So the answer to your question would be “yes”.

  4. “So, we need to eat more fiber rich foods, which means eating more whole grains, vegetables, fruits, and legumes (beans, peas, and lentils).

    When we eat fiber, we are feeding our gut bacteria. Their waste products are short chain fatty acids, which are absorbed through our one cell-thick gut lining and absorbed into the circulatory system. We are not made of what we eat, we are made of the WASTE from what our bacteria eat!

    Gluten (named for the Latin word for “glue”) interferes with that process. That means that our trillion microbial friends go hungry, and that our body is not utilizing all of those “fiber rich foods” that we are eating.

    Those gut bacteria not only digest our food, they also regulate our hormones. Take good care of them.

    1. Navy Corpsman, can you provide any evidence or references to support your statement:

      “Gluten (named for the Latin word for “glue”) interferes with that process [of feeding our gut bacteria]. That means that our trillion microbial friends go hungry, and that our body is not utilizing all of those “fiber rich foods” that we are eating.”

      Thanks.

      1. I suggest Dr. David Perlmutter’s three books, “Grain Brain,” The Better Brain Book,” and “Brain Maker.” (His emphasis is on prevention of dementia.)

        Also see “The Good Gut,” by Drs. Justin and Erica Sonnenburg.

      1. Linda, did Navy recommend Ezekiel? Yes, it does contain wheat, but it also contains gluten — which I think is what Navy was talking about more than anything. On my package of bread one of the ingredients is “organic wheat gluten.”

        https://draxe.com/ezekiel-bread/

        I also buy the FoodforLife sprouted grain tortillas, and there is no gluten in this product (or yeast).

        https://www.foodforlife.com/product/tortillas/ezekiel-49-sprouted-whole-grain-tortillas

        1. Which seems a little confusing to me. If both products contain a form of wheat (which is known to contain gluten), am wondering why gluten is not mentioned in their tortillas ingredients…..whereas it IS listed on the bread package.

    2. NC

      I am not aware of any evidence to support your claims. I did however find a study which showed EXACTLY THE OPPOSITE of what you say happens

      ‘ Celiac disease (CD) is an enteropathy caused by an aberrant immune response to cereal gluten proteins and the only therapy is the adherence to a gluten-free diet (GFD). In this context, a preliminary study was conducted to establish whether the GFD in itself could modify the composition and immune properties of the gut microbiota. The trial included 10 healthy subjects (30.3 years-old), which were submitted to a GFD over one month. Analysis of fecal microbiota and dietary intake indicated that numbers of healthy gut bacteria decreased, while numbers of unhealthy bacteria increased parallel to reductions in the intake of polysaccharides after following the GFD. Fecal samples of subjects under a GFD, which represent an altered microbiota, also exerted lower immune stimulatory effects on peripheral blood mononuclear cells than those of subjects on a regular gluten-containing diet. ‘
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3023594/

    1. An excellent illustration of the inherent limits of “rules.”

      I am all in favor of encouraging people to consume more fiber. I was at 60 grams a day until recently when I began an experiment (still ongoing) in which I have added another 30 grams a day, mostly in the form of prebiotics. So, I’m on board as far as the fiber train goes.

      But I think it’s too limiting to demand that every single grain-based product you purchase meets this rule. Better to think of the overall meal that product might be a part of, or how it plays into your diet for the day.

      So yes, more fiber, read labels, both good ideas. But a bowl of plain whole rolled oats is an excellent choice, enjoy them. Add some berries on the side, or have a salad later and consider yourself covered!

        1. Lida, I try to average 4 or 5 gm fiber for every 100 calories, so that even 1400 or 1500 calories will contain 60 to 75 gm fiber. I think WFPBRunner has me beat any day of the week.. she was saying some time ago she gets 90 or more gm fiber daily.

        2. It’s the kind of thing you work up to over time. Once your system has become adjusted to it, there really aren’t any obvious downsides and arguably quite a few upsides associated with it.

          It’s a fairly common amount for indigenous hunter-gatherer tribes (the handful that are still left) and so very well (still conjecture) may have been considered completely normal throughout much of human history.

    2. Hi Minnow9, thanks for your question. This is rule which can apply for more processed food and cereals to decrease confusion with products choice that have so many added ingredients. Rolled oat is good source of whole grain and as Dr Greger indicates in the cook book one can add flax seed, berries to increase the overall fiber content of a dish.

  5. If your bent on on buying processed packaged food, then following this rule may steer your choice from the horribly unhealthy to the slightly/moderately unhealthy. You cannot just blindly apply the 5:1 rule to everything – after all Halo Top Non Dairy deserts have an “impressive” carb/fiber ratio of 3.4 but we all know you can’t just eat of ton of this stuff without health consequences.

    As others probably noted, in the grand hierarchy of things, whole foods (in the closest to their natural form) should be at the top of the list and anything packaged/processed should be at the very bottom. So use this fiber ratio rule for the bottom dwellers of the list but do not forego something like oatmeal in favor of Halo Top because of the ratio ….

    1. Shhhh, don’t talk to me about Halo non-dairy ice cream.

      I only can have it once every few months on birthdays.

      That is the 4 out of 12 rule.

  6. So whole wheat bread, and oatmeal are not healthy since their carb to fiber ratios are not only greater than 5, they are greater than 6. It does not seem like adding more wheat bran is a natural way to raise the fiber. Or even adding spinich which has a ratio of 1/2, much lower than 5. So I think there is something wrong with the arbitrary ratio of 5 or less. It depends on the food. Should I stop eating bananas which have a carb to fiber ratio of over 10 !!! Bad science here.

    1. If you listen to what the good doctor is saying, you can hear him state that the “greater” amount of fiber you take in, the better. For every 7g of fiber, your risk of CVD goes down 9%. He also uses the phrase “minimum amount” and encourages the consumption of more whole foods such as fruits and vegetables as opposed to something sealed in a plastic bag and packaged in a cardboard box. The point is: If you are going to eat “food” out of a bag and box, make sure it has at least a 5 to 1 ratio of fiber to carbs. That’s it in a nutshell. (no pun intended)

    2. Not bad science, Thomas Spradley, but bad listening on your part. You need to watch the video again. You will hear that the 5:1 rule is for processed foods, not whole foods.

  7. I don’t think the ratio of 5.0 is bad science. Granted oatmeal has a ratio of around 7 and wouldn’t be recommended following this guideline. However if you add berries in right proportion you will easily meet the guideline. My recommendation would be to follow the rule for every meal taken as a whole. My two cents worth!

    1. Perhaps that is why the How Not to Die Cookbook has added flax and chia seeds, blueberries, and uses date sugar to my now favorite oatmeal recipe?

      1. Jimbo,

        I bought all of the ingredients but still haven’t had enough morning time to make it, but this weekend shall be my first.

        Whole Foods sells Just Date Syrup, which gives dates as its only ingredient. I am pondering that for a time saver, but I did already buy dates.

        1. Deb, that’s what I use for when I make Vegetater’s brownies. It’s definitely a time saver! Between my job & taking care of my mother, I don’t have a lot of time to cook.

          1. Thanks Nancy! That is helpful to me!

            I know that you are sacrificing. Caretaking takes a lot of mental, emotional and physical energy.

  8. Upon viewing this video at the time it first appeared, I discovered Uncle Sam cereal sitting on “my grocer’s” shelf, bought several boxes and have had a dose, with a kiwi or two, dried blue berries and unsweetened almond milk for breakfast almost daily, since then. I’ve even explained the 5:1 ratio test to wholly disinterested fellow shoppers, at my local Trader Joe’s. Dr. G., your efforts in making this video are much appreciated and have had a salubrious effect far beyond the average lecture. Thanks!

    1. Laughing.

      Yes, I have guessed wrong with a woman who was buying Brazil nuts, who started talking about the Selenium and I thought she was going to go into the 4 nuts cholesterol benefits, but she and another woman had a doctor saying, “one a day” and I am not sure which doctor that would be.

      I ended up liking them too much and need to buy them bulk so I can just buy 4.

    2. steve, I LOVE your comment : ” I’ve even explained the 5:1 ratio test to wholly disinterested fellow shoppers, at my local Trader Joe’s.” I have that problem, too: wanting to share nutrition information with “wholly disinterested shopper” at the grocery store. Thanks for the laugh!!

  9. So my organic oatmeal, that I always regarded as high in fibre, fails the test. 27g carbs with 4 g fibre. Any recommendations?

    1. Hi John, this recommendation is a way to evaluate processed foods such as breads and pastas. Whole grains are always good!

      1. Laughing, yes, that is the part some of us missed when this video first played.

        Oatmeal became my first creative fiber-adding assignment.

        That was good though because now I know how to add fiber.

  10. Dr Greger,
    I really like the test for packaged food, but it raised a question when it comes to cooked hulled Barley and Buckwheat. Both of them don’t meat the 5/1 ratio. I know they are good, they both have a good deal of protein also. Would appreciate knowing the why?
    Thanks
    Steve

    1. Glad the 5/1 Fiber rule is helpful to you. As referenced in other comments, this rule is for packaged foods. Both Barley and Buckwheat are good high-fiber foods. They may have a little more carbohydrate percentage than is healthy for more processed foods,they are well-designed for good human nutrition because with that little extra carb content comes lots of other healthy content in terms of phytonutrients. So enjoy and keep that fiber rule for packaged foods.

  11. Hey, anybody ’round these parts know of any published human studies on Eleutherococcus senticosus. I found it in my tea and, true to form, the interweb is cheerfully selling it on notions and tradition etc., but it appears there’s no real evidence of effects in humans at all.

    Just wondering and posted here because we used to have a few doctors and scientists and researchers participating in these comments sections.

    1. Here is a reliable comprehensive review of Eleutherococcus senticosus or Russian ginseng:
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991026/
      and two more research studies:
      http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000250/

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991026/
      Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress—Protective Activity
      There are some indications this substance may be helpful but as the last study concluded: “However, further research may be needed to evaluate the efficacy of adaptogens as geriatrics and to elucidate molecular mechanisms of action of these complex herbal extracts and their active principles.” I’m sure what yu saw on the web was gross exaggeration so you were right to be skeptical.

  12. Yeah, I have a bit of a problem with the 5:1 as well. I eat Bob’s Red Mill Organic Old Fashioned Rolled Oats which is whole grain. Total carbohydrate 32g and dietary fiber 5g which is over 6. My understanding is that this is an extremely nutritious and healthy food but it fails the test. Huh! Not going to stop me from continuing to eat it.

    1. I too eat Bob’s Red Mill food items, including the rolled oats. Am not about to sweat the small stuff and get out my calculator. Such angst!

      So many damn rules. :-(

    2. As you can see beneath the title of today’s video, it says the 5 to 1 rule is a guideline for reading labels of packaged bread and cereal products… not for whole grains like oats. It only is intended to keep folks on track when buying commercially made products.

      There are maybe half a dozen bread products that fit the rule in stores near us. Low fat, too, but bomb on the sodium rule. I think Dr J may have the right idea in making her own bread.

      1. My one slice of Ezekiel toast in the morning is enuf bread for me.

        I used to make my own whole-grain bread back in the day, every couple of weeks or so. Always did it the old-fashioned way, and all that kneading was good for the arm and hand muscles.

        Now they have these new-fangled bread machines on the market.

        https://www.consumersearch.com/bread-machines

        1. YR (Mostly WFPB), There are even newer fangled techniques these days, called No Knead bread: The long slow ferments take care of all that old beating the bread into submission. I do a slight variation when I make sourdough whole grain flour: mix the bread dough, do a few stretch and folds, and ferment for 2-4 hrs room T or overnight in the fridge. Shape the loaves, proof 1.5 – 4 hrs room T, then bake. No muscles involved at all. Well, other than the one between my ears.

          My loaves are made from whole grain flour (usually ancient or heritage wheats, and I now grind my own grains at home), water, flaxseed meal, and salt. (The starter culture, which I started myself over 5 years ago, is basically flour and water: the yeast and bacteria are all “wild.”) Sometimes I add seeds (sunflower, flax, chia, sesame) or dried fruit. The aroma of baking bread is divine, and the flavor fabulous!

          1. “The aroma of baking bread is divine, and the flavor fabulous!”
            – – – –

            How true, Dr. J! When I was young my mother used to bake bread with white flour (*groan* — who knew back then!) , and it always smelled soooooooo delicious! I was eager to cut into it before it even cooled thoroughly, and often did so. Had to smear on my trusty peanut butter, doncha know! Ate it still warm from the oven.

            Your recipe sounds delicious too. You say you grind your own grains, though, which sounds like more work than I’d want to put into it. Also, would need more info about getting a starter going. But maybe at some point I’ll sally forth with the idea. :-)

      2. Barb,

        if you ever want to start baking your own bread, the book “Josey Baker Bread” is one of the best I’ve come across; I’ve even recommended it to friends who have baked bread for years, and they’ve thanked me. It is simple, straightforward and clear; each chapter is a loaf of bread, starting with white flour no-knead bread, and proceeding up to sourdough whole grain bread with additives (seeds, dried fruit, etc), with new information presented in each chapter that builds upon the previous chapter. It’s a fairly quick read. There are other baked good recipes at the end, which I haven’t tried.

        Another good source is breadtopia.com, which is where I buy my grains, since I haven’t found good reliable organic ones locally (I’m still trying); his demo videos, explanations, and recipes are excellent.

        Any loaf of bread baked at home is better than anything I can buy. Even the “bricks” (this was before I discovered “Josey Baker Bread”) tasted good.

        1. Thank you Dr J! Great info! Your bread sounds wonderful – I had hesitated before because I have pain in my hands but the way you do it seems to be a lot easier. And of course, more delicious. It was my doctor that suggested I look into making bread when I mentioned difficulty finding great bread. I will check out the resources you mentioned, thanks!

  13. Dr. Greger asked for products that meet 5/1 rule. I have one, from Costco. Volupta Crunchy Dried Beet, beetroot is the only ingredient, they’re sliced into chips. Total Carbohydrate 23g, Dietary Fiber 7g, so the ratio is 3.28/1 “beat that” and I like em.

  14. I eat huge amounts of fruits, vegetables, beans, whole grains, nuts/seeds every day. The problem is that I am 20 lb underweight. Is it possible to eat too much fiber?

  15. I like the idea of a “high-fiber gauge” that tells me whether or not a food is “high-fiber.” I eat a lot of the same foods mentioned in the comments, steel-cut oats, Ezekiel bread, fruit, fibrous veggies, chia seeds (1-to1!) I’m wondering if I should have a fiber “macro” goal, and if so, how much is enough. Currently, I’m at 1600 kilocalories/day with 60% carbs and 15% fat. I’m within 200 kcal most days. Does 20% of my daily carb number of 240g, i.e., 48g of fiber/day make sense as a goal?

    1. Here is what Dr. Greger said in his blog on fiber:

      If you really don’t want a stroke, we should try to get 25 grams a day of soluble fiber (found concentrated in beans, oats, nuts, and berries) and 47 grams a day of insoluble fiber (concentrated in whole grains). One would have to eat an extraordinarily healthy diet to get that much, yet these cut-off values could be considered as the minimum recommended daily intake of soluble and insoluble fiber to prevent stroke.

  16. Dave’s Killer Bread, organic 21 Whole Grains and Seeds has a Carbohydrate (12g) to Fiber (3g) ratio of 4. That’s definitely good.

    1. I agree with Teeter, Dave’s Killer Bread, 21 Whole Grains and Seeds is a great product. My package states different nutritional values than her’s. My package states nutritional facts for one slice: Carbs = 22g; Dietary Fiber = 5g. That works out to 22g / 5g = 4.4 ratio

  17. One of the things I like about Flashback Fridays is that it causes me to wonder what information I missed or don’t remember well enough.

    I ended up watching the video on hibiscus tea eroding teeth. That could be my problem because I like hibiscus tea and drink it daily now.

    The thing I will say is that since I went back to flouride toothpaste, I haven’t noticed the same worsening as I had been noticing.

    That is the beginning of my teeth n of 1. I had a friend contact me that she needed two teeth removed today, so teeth were on my mind, but it had been a mystery because I wasn’t eating sugar or fats or citrus and my teeth seemed to be getting worse and that started before the hibiscus, but it probably got worse faster because of the hibiscus. I am so grateful I went back and looked it up. I don’t think I can drink the hot tea with a straw, but it tells me that I might need to alternate tea with water.

    1. The two will make beautiful children together, Deb. Or not. :-)

      I find I can’t drink green tea. It’s claimed the headache I get later is supposedly due to “releasing toxins” (handy phrase, overused IMO), but I don’t buy it. Nor literally, anymore.

      The green tea people also like to say it’s because we can’t handle the caffeine, but that’s got nothing to do with it. I’ve no trouble with a moderate amount of black tea or regular caffeinated (black, nothing added) coffee.

      1. YR,

        That is fascinating.

        I have had a green tea latte for breakfast for probably over a year.

        But the rest of the day, I drink other teas and sometimes water, but I, like Dr. Greger, started drinking hibiscus tea as if it were water.

        I still have been and the fluoride in the toothpaste seems to be working at stopping the erosion, but my teeth started having problems so quickly that I will be monitoring it carefully. Green tea is what we are supposed to gargle with, so maybe a scoop of green tea in my hibiscus will take away some of the acid?

        Or maybe I can heat up Essentia or another 9.5 PH water and use that to make the hibiscus tea to avoid some of the damage?

        Or just drink that directly after the tea? Though I love tea and do drink it back to back to back.

        Laughing, I could be a two-fisted drinker and have hibiscus on one side and Essentia on the other side and alternate sips?

        I will figure something out.

        I watched the toothpaste add about the toothpaste which puts minerals into the teeth. So that would be water with electrolytes? Or use that toothpaste for a while? Or the mouthwash which claims to do the same?

        I know that I really will figure something out. It just might take a process.

  18. If you look up many whole foods-such as apples or dates-the ratio of carbs to fiber is much higher than 5-so I don’t think this rule always applies.

  19. I guess oatmeal is not ok because it has a 7 to 1 ratio.

    I call BS on this. Where is the pubmed paper that says a 5 to 1 ratio carbs to fiber ratio cures anything?

    1. Mike,

      The rule is for processed food.

      Your oatmeal is okay if it is steel cut oats. Lots of people do instant oatmeal and that is what the rule is trying to discourage.

      It is a guideline to ensure that you get enough fiber throughout the day and it is easier to get it if you start at meal planning and the grocery store.

  20. Mike,

    Please see my response to Marcia…… Your correct that there is no ideal ratio for “cures”.

    As to higher fiber making major changes in numerous disorders, the amount of published literature is replete. Please see: https://www.ncbi.nlm.nih.gov/pubmed/29902436 (microbiome)(2018) https://www.ncbi.nlm.nih.gov/pubmed/3012064(1986 Cancer/CV/etc.) and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257631/ (metabolism changes 2010) The list is very lengthy and the association between fiber and disease well established..

    The idea of the 5:1 rule is to encourage people to not be had by thinking that a “whole” grain product is really a high fiber solution. As there are many cases where the amounts of fiber are not in significant quantities to make an impact but rather there as a branding claim, lacking healthy outcomes. Consumer education is the focus…. And the 5:1 rule is an easy metric.

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

  21. Once you get past the canned legumes, some frozen vegetables, and a precious few whole grain loaves of bread, it is difficult to find prepared foods that make the cut. The message is very clear. The easiest way to achieve the 5:1 rule is not using prepared foods.

  22. Alvin,

    You nailed it…….well done observation. Too bad most commercially prepared foods are less than optimal but that’s what’s on the shelves.

    I just had the experience of touring a food manufacturing plant, last week. Eye opening when you consider the balancing act between food costs, handling, personal, packaging and storage. Did you know that the a good margin in that industry is 7%. Think of the amount of volume you would need to move daily to maintain a plant….. and add in all the other factors including food spoilage and it’s amazing anything is on the shelf.

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

  23. Help! I ate ‘healthy’ my whole life, had a stroke so now ate WFPB for 6 weeks but now have had diahrrea for 3 weeks. Anyone else have that problem? I have GI appt. tomorrow.

  24. Jean,

    Kudos on your transformative WFPB diet change and I’m sorry to hear of your GI upset.

    With the increased fiber and potentially the amount of oil intake in the PBWF diet you will indeed often times see softer stools, and with an excessive amounts, frank diarrhea. Doing a food and stool diary and bringing it to your upcoming appointment will aid in pinpointing the problem.

    Consider any foods that you’ve introduced into your diet, especially but not exclusively 3 weeks ago as well as those that give you any GI reactions (gas/upset/etc.).

    By changing your intake slowly and observing the consistency, color, and odor you’ll be able to pinpoint the foods that make a change and get your stools back on track.

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

    1. Thank you for replying. Didn’t know if comments worked. Are lentils and beans difficult to digest if you’re not used to them?

      1. Jean, I tell my patients to start with 1/4 cup a day, every 2nd or 3rd day as part of a meal.
        Slowly increase amounts as you can. Beans and lentils are incredibly healthy foods, but your gut may take time to get used to digesting them.
        You can get them canned, rinse before using. Store rest in frig. Easy to have available that way,
        I also find that, in general, people do better starting with lentils, they seem to be easier to digest.
        Don’t get discouraged, this is one of the best choices you can make to improve your health.
        Best wishes to you!

      2. hi,

        yes they are, you should start eating them in small amounts first and then increase week by week.

        Another trick is to always soaked them for at least 8 hours and make sure you cook them enough time.

        I hope this helps

        Yared, Health Support Volunteer.

      3. Jean,

        When I was SAD diet, beans gave me gas, but it became a non-issue once I went off animal products.

        I suspect that there is a moment when the good gut bacteria win.

  25. When I learned how to use the concept of calorie density to reduce the calories I eat in a day, I realized that my virtual addiction to bread at ~1,400 calories / lb was a problem for me (one is allowed to eat foods with out restriction that are 600 Cal / lb or less… the less the better.) On a carb : fiber ratio basis, this bread comes in at 24:6 :: 6:1 ratio.

    Turns out, that I was raised in W. Germany for 6-7 years and ate the Danish-German rye rugbrøt growing up. I can get a bread from a brand called Mestermacher which makes a wonderful rye berry-oat groat-flax seed bread that comes in 760 Cal / lb. While not under the goal limit of 600 Cal / lb, it’s not much over that target and has 46% fewer calories than American Whole-grain breads.

    Another benefit is that this bread is so whole-grain you can actually see the grains in the bread… it looks like a block of whole rye and oat grains glued together by just enough flour to keep them together. This is whole-grain bread “on steroids” (figuratively – not literally).

    Because of the high whole-grain load, this digests much slower and a piece of this bread carries me through to lunch… a piece of American whole-grain bread only tides me over for an hour or two.

    I find that a thin schmere of tahini and a thin schmere of Polaner sugar-free preserves makes a good breakfast with an apple &/or orange and a mug of green or Darjeeling tea.

    1. Oops… the 24:6 ratio simplifies down to 4:1, NOT the 6:1 I typoed… I wish the website would allow one to edit entries to correct errors. Oh, well

  26. In Dr. Greger’s cookbook, How Not to Die, there is a recipe that calls for buckwheat soba noodles. I have not been able to find any brand that comes even close to this 5 to 1 ratio. Would appreciate it if anyone has identified a brand that does. Otherwise seems that regular whole wheat spaghetti might be the better choice.

  27. I’ve been paying more attention since I saw this video last week, I’ve been a little surprised by some of the whole food that don’t seem to conform to this guideline, like potatoes, or whole-wheat pasta.

  28. I’ve been eating a WFPB diet for a few years now, and I’m still not getting easy, daily bowel movements. I’m getting around 45-50 grams of fiber a day. Do I need to get even more? I drink 80 – 100 ozs of water daily, exercise, sleep well, maintain a low weight and eat no processed foods. My doctor offered stool softeners. I’m sure there’s a better solution, I just haven’t found it.

  29. I hope a smart scientist can help me out. In Norway (and maybe Europe overall?) the total carbohydrates are stated with a line under «of which sugars». Shouldnt we actually use sugars for this calculation and for that purpose bump the ratio down to 4 (ie., make it more strict)? There are some grains that have a lot of carbs, but hardly any sugars – this doesnt sound so bad to me?!

  30. I follow a WFPBD and I have a doctor friend who is an avid carnivore. He shuns all carbs and laughs at me. He sent me this study on how fiber does not help with constipation “Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms” by Kok-Sun Ho et. al. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/). I was wondering if anyone has read this study or has some comment on it? Thank you in advance.

    1. Dear Sonia, I am a WFPB doctor and a scientist.
      The article your friend shared has many limitations. Patient selection is not representative of entire population. It only has a bit more than 60 participants. It is further very strange that the authors are not surprised by their findings or conclusions (hence totally lacking insight), which contradict what is currently established medical knowledge on fiber. Please note that what you shared is a preliminary, not peer reviewed study. I have acted as a peer reviewer on a lot of articles and have tons of questions for these authors to answer. In science, only peer reviewed articles are accepted as “evidence”, although the system is far from perfect.

      I do not know if your friend has any scientific background, but this year, a respectful scientific journal Lancet published a study looking into thousands and thousands participants contributing many million years of observations. This study has way more weight than what you shared: “Carbohydrate quality and human health: a series of systematic reviews and meta-analyses” by Andrew Reynalds et al. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext

      It is important that you try to convince any healthcare professional about the benefits of WFPB. They influence other people. I appreciate your effort!

      1. Sonia,

        I’d like to amplify Pika’s response. My first read of the quoted study left me with a hair a scratching of who would publish such a poorly executed study. Using “idiopathic constipation” patients without more than a colonoscopy is fraught with error. Would you trust a mechanic who only looked at 2 out of 4 tires on your car and called it “acceptable” ?

        I would draw your attention to the second side of the experiment, with the return to prior diets, why would you expect a change ? Knowing the type and amount of fiber would be essential along with the need to know if any of these constipated individuals were allergy tested to any of the reintroduced “fibers” used, who filled the criteria of IBS or IBD, from a chemical basis and this only starts the conversation.

        One of the keys to determine if a study has merit is it’s design. If the outcome can’t be determined as clearly as possible, it’s not really good science, period.

        I would suggest that the doc using this study as his “go carnivore and ditch the fiber rational”, see a wide swatch of patients and do an in house bowel study with some serious evaluation methodologies. I’m referring to such tests at the CDSA (Genova) and others.

        Then consider an evaluation of the 5 RCT studies evaluated in this meta study done in 2012 a: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544045/. They too were constipated patients. The study conclusion: “Dietary fiber intake can obviously increase stool frequency in patients with constipation. ”

        It would have been a much more appropriate study if they had multiple indices of their patients with selection criteria to actually evaluate the underlying causes of their bowel issues. This is where the real rubber meets the road.

        Unfortunately science takes time and buying into a headline or abstract is just plain not adequate and often times misleading.

        Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

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