Most Americans get less than half the recommended minimum fiber intake a day and the benefits of fiber go way beyond bowel regularity.
Is Fiber an Effective Anti-Inflammatory?
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Hippocrates, the father of western medicine, believed that all disease begins in the gut.” Of course, he also thought women were hysterical because of their “wandering uterus.” So much for ancient medical wisdom.
But something like constipation can have a “major [negative] impact on physical, mental and social well-being.” Yet it’s “often overlooked in health care.” This may be because poop-talk is taboo, but it can have “a severe influence on…everyday living,” both psychologically and physically. Constipation can hurt, causing “abdominal discomfort and pain, straining, hard stool, infrequent bowel movements, bloating and nausea.”
No wonder “[l]axatives are among the most commonly used drugs. Most are safe when used judiciously [and] intermittently,” but because of the frequency of their use, they end up being one of the most common causes of adverse drug reactions. Perhaps “treatment should [instead] address the underlying problem,” such as lack of dietary fiber. You probably don’t need a meta-analysis to demonstrate that “dietary fiber can obviously increase stool frequency.”
“Populations in most Western countries must be considered by world standards to be almost universally constipated.” Here, it’s an epidemic among the elderly, but it’s simply not a problem among those centering their diets around fiber-rich foods. Where is fiber found? This patient summary in the AMA’s journal sums it up with an illustration: whole unrefined plant foods. Now for those of us smug in our intake of fruits and vegetables, we need to realize that “fruits and leafy vegetables are the poorest whole food sources of fiber.” Why? Because they’re 90 percent water. Root vegetables have more, but the fiber superstars are legumes, which means beans, split peas, chickpeas, and lentils, as well as whole grains. And gram for gram, fruit fiber doesn’t seem to have the same effect. It may take 25 grams of fruit fiber to double stool output, something just 10 grams of whole grain fiber or vegetable fiber can do.
And that’s not all fiber can do. If you eat some whole grain barley for supper, by the next morning your good gut bacteria are having it for breakfast, releasing butyrate into our bloodstream—a compound that seems to exert broad anti-inflammatory activities, which could help explain why significant decreases in the prevalence of inflammation are associated with increasing dietary fiber intakes. Check it out. And the highest group here was just getting the minimum recommended daily intake of fiber. So, what, if you have knee pain or something, you should eat more fiber-rich foods? We didn’t know…until now. “Dietary Fiber Intake in Relation to Knee Pain Trajectory.” Thousands of patients were followed and…”a high intake of dietary fiber,” which is to say just the minimum recommended intake, was “associated with a lower risk of developing moderate or severe knee pain over time.” And two Framingham studies found that higher fiber intake was related to a lower risk of having symptomatic osteoarthritis in the first place.
But wait; don’t a variety of diseases have an inflammatory component? How about fiber consumption and all-cause, cardiovascular, and cancer mortality? They found that, compared with those who consumed least fiber, those who consumed the most had 23 percent less cardiovascular disease mortality, 17 percent lower risk of dying from cancer, and 23 percent lower mortality from all causes put together. “Unfortunately, most persons in the United States consume less than half the recommended intake of dietary fiber daily.”
These researchers suggest all sorts of potential mechanisms for which fiber could be life-saving, from improving cholesterol, immune function, and blood sugar control, but there also may be more of a direct cause. If you ask people to bear down as if they’re straining on stool, you can get a rapid increase in intracranial pressure, pressure inside your skull, and indeed, if you look at trigger factors for the rupture of intracranial aneurysms, if you ask hundreds of people who had strokes—bleeds within their brains—one of the biggest trigger factors noted was straining for defecation, multiplying risk seven-fold.
Please consider volunteering to help out on the site.
- Vermorken AJ, Cui Y, Kleerebezem R, Andrès E. Bowel movement frequency and cardiovascular mortality, a matter of fibers and oxidative stress?. Atherosclerosis. 2016;253:278-280.
- Allison DB, Roberts MS. On constructing the disorder of hysteria. J Med Philos. 1994;19(3):239-59.
- Tvistholm N, Munch L, Danielsen AK. Constipation is casting a shadow over everyday life - a systematic review on older people's experience of living with constipation. J Clin Nurs. 2017;26(7-8):902-914.
- Burkitt DP, Meisner P. How to manage constipation with high-fiber diet. Geriatrics. 1979;34(2):33-5, 38-40.
- Burkitt D. Fiber as protective against gastrointestinal diseases. Am J Gastroenterol. 1984;79(4):249-52.
- Wald A. JAMA PATIENT PAGE. Constipation. JAMA. 2016;315(2):214.
- De vries J, Birkett A, Hulshof T, Verbeke K, Gibes K. Effects of Cereal, Fruit and Vegetable Fibers on Human Fecal Weight and Transit Time: A Comprehensive Review of Intervention Trials. Nutrients. 2016;8(3):130.
- Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum. 2001;44(8):1201-9.
- Sakuma M, Kanemoto Y, Furuse A, Bates DW, Morimoto T. Frequency and Severity of Adverse Drug Events by Medication Classes: The JADE Study. J Patient Saf. 2015;
- Leung FW. Etiologic factors of chronic constipation: review of the scientific evidence. Dig Dis Sci. 2007;52(2):313-6.
- Yang J, Wang HP, Zhou L, Xu CF. Effect of dietary fiber on constipation: a meta analysis. World J Gastroenterol. 2012;18(48):7378-83.
- Nilsson AC, Östman EM, Knudsen KE, Holst JJ, Björck IM. A cereal-based evening meal rich in indigestible carbohydrates increases plasma butyrate the next morning. J Nutr. 2010;140(11):1932-6.
- Meijer K, De vos P, Priebe MG. Butyrate and other short-chain fatty acids as modulators of immunity: what relevance for health?. Curr Opin Clin Nutr Metab Care. 2010;13(6):715-21.
- Grooms KN, Ommerborn MJ, Pham DQ, Djoussé L, Clark CR. Dietary fiber intake and cardiometabolic risks among US adults, NHANES 1999-2010. Am J Med. 2013;126(12):1059-67.e1-4.
- Dai Z, Lu N, Niu J, Felson DT, Zhang Y. Dietary Fiber Intake in Relation to Knee Pain Trajectory. Arthritis Care Res (Hoboken). 2017;69(9):1331-1339.
- Dai Z, Niu J, Zhang Y, Jacques P, Felson DT. Dietary intake of fibre and risk of knee osteoarthritis in two US prospective cohorts. Ann Rheum Dis. 2017;76(8):1411-1419.
- Liu L, Wang S, Liu J. Fiber consumption and all-cause, cardiovascular, and cancer mortalities: a systematic review and meta-analysis of cohort studies. Mol Nutr Food Res. 2015;59(1):139-46.
- Greenfield JC, Rembert JC, Tindall GT. Transient changes in cerebral vascular resistance during the Valsalva maneuver in man. Stroke. 1984;15(1):76-9.
- Vlak MH, Rinkel GJ, Greebe P, Van der bom JG, Algra A. Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case-crossover study. Stroke. 2011;42(7):1878-82.
Image credit: freegreatpicture via Maxpixel. Image has been modified.
Motion graphics by Avocado Video
- anti-inflammatory
- arthritis
- barley
- beans
- bloating
- blood sugar
- butyrate
- cardiovascular disease
- chickpeas
- cholesterol
- constipation
- fiber
- fruit
- grains
- gut flora
- heart disease
- immune function
- inflammation
- irritable bowel syndrome
- laxatives
- legumes
- lentils
- lifespan
- longevity
- microbiome
- mortality
- nausea
- osteoarthritis
- side effects
- split peas
- stroke
- vegetables
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Hippocrates, the father of western medicine, believed that all disease begins in the gut.” Of course, he also thought women were hysterical because of their “wandering uterus.” So much for ancient medical wisdom.
But something like constipation can have a “major [negative] impact on physical, mental and social well-being.” Yet it’s “often overlooked in health care.” This may be because poop-talk is taboo, but it can have “a severe influence on…everyday living,” both psychologically and physically. Constipation can hurt, causing “abdominal discomfort and pain, straining, hard stool, infrequent bowel movements, bloating and nausea.”
No wonder “[l]axatives are among the most commonly used drugs. Most are safe when used judiciously [and] intermittently,” but because of the frequency of their use, they end up being one of the most common causes of adverse drug reactions. Perhaps “treatment should [instead] address the underlying problem,” such as lack of dietary fiber. You probably don’t need a meta-analysis to demonstrate that “dietary fiber can obviously increase stool frequency.”
“Populations in most Western countries must be considered by world standards to be almost universally constipated.” Here, it’s an epidemic among the elderly, but it’s simply not a problem among those centering their diets around fiber-rich foods. Where is fiber found? This patient summary in the AMA’s journal sums it up with an illustration: whole unrefined plant foods. Now for those of us smug in our intake of fruits and vegetables, we need to realize that “fruits and leafy vegetables are the poorest whole food sources of fiber.” Why? Because they’re 90 percent water. Root vegetables have more, but the fiber superstars are legumes, which means beans, split peas, chickpeas, and lentils, as well as whole grains. And gram for gram, fruit fiber doesn’t seem to have the same effect. It may take 25 grams of fruit fiber to double stool output, something just 10 grams of whole grain fiber or vegetable fiber can do.
And that’s not all fiber can do. If you eat some whole grain barley for supper, by the next morning your good gut bacteria are having it for breakfast, releasing butyrate into our bloodstream—a compound that seems to exert broad anti-inflammatory activities, which could help explain why significant decreases in the prevalence of inflammation are associated with increasing dietary fiber intakes. Check it out. And the highest group here was just getting the minimum recommended daily intake of fiber. So, what, if you have knee pain or something, you should eat more fiber-rich foods? We didn’t know…until now. “Dietary Fiber Intake in Relation to Knee Pain Trajectory.” Thousands of patients were followed and…”a high intake of dietary fiber,” which is to say just the minimum recommended intake, was “associated with a lower risk of developing moderate or severe knee pain over time.” And two Framingham studies found that higher fiber intake was related to a lower risk of having symptomatic osteoarthritis in the first place.
But wait; don’t a variety of diseases have an inflammatory component? How about fiber consumption and all-cause, cardiovascular, and cancer mortality? They found that, compared with those who consumed least fiber, those who consumed the most had 23 percent less cardiovascular disease mortality, 17 percent lower risk of dying from cancer, and 23 percent lower mortality from all causes put together. “Unfortunately, most persons in the United States consume less than half the recommended intake of dietary fiber daily.”
These researchers suggest all sorts of potential mechanisms for which fiber could be life-saving, from improving cholesterol, immune function, and blood sugar control, but there also may be more of a direct cause. If you ask people to bear down as if they’re straining on stool, you can get a rapid increase in intracranial pressure, pressure inside your skull, and indeed, if you look at trigger factors for the rupture of intracranial aneurysms, if you ask hundreds of people who had strokes—bleeds within their brains—one of the biggest trigger factors noted was straining for defecation, multiplying risk seven-fold.
Please consider volunteering to help out on the site.
- Vermorken AJ, Cui Y, Kleerebezem R, Andrès E. Bowel movement frequency and cardiovascular mortality, a matter of fibers and oxidative stress?. Atherosclerosis. 2016;253:278-280.
- Allison DB, Roberts MS. On constructing the disorder of hysteria. J Med Philos. 1994;19(3):239-59.
- Tvistholm N, Munch L, Danielsen AK. Constipation is casting a shadow over everyday life - a systematic review on older people's experience of living with constipation. J Clin Nurs. 2017;26(7-8):902-914.
- Burkitt DP, Meisner P. How to manage constipation with high-fiber diet. Geriatrics. 1979;34(2):33-5, 38-40.
- Burkitt D. Fiber as protective against gastrointestinal diseases. Am J Gastroenterol. 1984;79(4):249-52.
- Wald A. JAMA PATIENT PAGE. Constipation. JAMA. 2016;315(2):214.
- De vries J, Birkett A, Hulshof T, Verbeke K, Gibes K. Effects of Cereal, Fruit and Vegetable Fibers on Human Fecal Weight and Transit Time: A Comprehensive Review of Intervention Trials. Nutrients. 2016;8(3):130.
- Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum. 2001;44(8):1201-9.
- Sakuma M, Kanemoto Y, Furuse A, Bates DW, Morimoto T. Frequency and Severity of Adverse Drug Events by Medication Classes: The JADE Study. J Patient Saf. 2015;
- Leung FW. Etiologic factors of chronic constipation: review of the scientific evidence. Dig Dis Sci. 2007;52(2):313-6.
- Yang J, Wang HP, Zhou L, Xu CF. Effect of dietary fiber on constipation: a meta analysis. World J Gastroenterol. 2012;18(48):7378-83.
- Nilsson AC, Östman EM, Knudsen KE, Holst JJ, Björck IM. A cereal-based evening meal rich in indigestible carbohydrates increases plasma butyrate the next morning. J Nutr. 2010;140(11):1932-6.
- Meijer K, De vos P, Priebe MG. Butyrate and other short-chain fatty acids as modulators of immunity: what relevance for health?. Curr Opin Clin Nutr Metab Care. 2010;13(6):715-21.
- Grooms KN, Ommerborn MJ, Pham DQ, Djoussé L, Clark CR. Dietary fiber intake and cardiometabolic risks among US adults, NHANES 1999-2010. Am J Med. 2013;126(12):1059-67.e1-4.
- Dai Z, Lu N, Niu J, Felson DT, Zhang Y. Dietary Fiber Intake in Relation to Knee Pain Trajectory. Arthritis Care Res (Hoboken). 2017;69(9):1331-1339.
- Dai Z, Niu J, Zhang Y, Jacques P, Felson DT. Dietary intake of fibre and risk of knee osteoarthritis in two US prospective cohorts. Ann Rheum Dis. 2017;76(8):1411-1419.
- Liu L, Wang S, Liu J. Fiber consumption and all-cause, cardiovascular, and cancer mortalities: a systematic review and meta-analysis of cohort studies. Mol Nutr Food Res. 2015;59(1):139-46.
- Greenfield JC, Rembert JC, Tindall GT. Transient changes in cerebral vascular resistance during the Valsalva maneuver in man. Stroke. 1984;15(1):76-9.
- Vlak MH, Rinkel GJ, Greebe P, Van der bom JG, Algra A. Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case-crossover study. Stroke. 2011;42(7):1878-82.
Image credit: freegreatpicture via Maxpixel. Image has been modified.
Motion graphics by Avocado Video
- anti-inflammatory
- arthritis
- barley
- beans
- bloating
- blood sugar
- butyrate
- cardiovascular disease
- chickpeas
- cholesterol
- constipation
- fiber
- fruit
- grains
- gut flora
- heart disease
- immune function
- inflammation
- irritable bowel syndrome
- laxatives
- legumes
- lentils
- lifespan
- longevity
- microbiome
- mortality
- nausea
- osteoarthritis
- side effects
- split peas
- stroke
- vegetables
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Is Fiber an Effective Anti-Inflammatory?
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Content URLDoctor's Note
This is one of the reasons legumes and whole grains are emphasized in my daily dozen checklist of all the healthiest of healthy foods to ideally fit into your daily routine. Available (for free of course!) as an app (Dr. Greger’s Daily Dozen) on iPhone and Android, and in my video Dr. Greger’s Daily Dozen Checklist.
Fiber does not work alone. Fiber acts as a prebiotic to feed our friendly gut flora. Check out, for example:
- Gut Dysbiosis – Starving Our Microbial Self
- Microbiome: We Are What They Eat
- Gut Microbiome – Strike It Rich with Whole Grains
If you’re a sucker for poop videos, you may also enjoy:
- How Many Bowel Movements Should You Have Every Day?
- Should You Sit, Squat, or Lean During a Bowel Movement?
- Paleopoo: What We Can Learn from Fossilized Feces
If you buy processed grain products how do you know if it has enough fiber? Check out The Five to One Fiber Rule.
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