Prunes vs. Metamucil vs. Vegan Diet

Prunes vs. Metamucil vs. Vegan Diet
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The average number of bowel movements a week is compared between those eating prunes, those taking a fiber supplement, and those eating a strictly plant-based diet.

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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.

Though there is an International Prune Association, keeping us all apprised of the latest prune news from around the world, in the U.S., the California prune board successfully pressured the FDA to change the name from prunes to “dried plums”—which evidently evokes more of a “positive ‘fresh fruit goodness’ image,” in hopes of attracting their “target audience, women.”  Of course, it might help if they actually included one or two on their board.  

The name change is in hopes of “de-emphasiz[ing] its connections to digestive regularity issues.” But, hey, why sell yourself short? Check this out: “Randomised clinical trial: prunes vs. [Metamucil, also known as] psyllium.” “Constipation is a common problem that affects up to [a fifth] of the world’s population. Nearly 60 million Americans suffer from chronic constipation;” particularly a problem in women and the elderly. A “pathological condition that is often severe enough to disrupt daily activities, derange quality of life, respond poorly to available medical remedies and [may] prompt sophisticated and potentially harmful surgical procedures.”

Despite all this, it is still frequently considered a trivial issue, and affected individuals tend to self-medicate either using OTC laxatives or ‘natural’ remedies, but none of these [have] been adequately investigated,” until now. Fiber supplements can be inconvenient, taste nasty, cause bloating—even choking.

So, we need “a food-based, natural, convenient…tasty alternative.” But, do prunes actually work? Here’s the study subjects at baseline. Each dot is a complete, spontaneous bowel movement. Note how many people had zero bowel movements per week, at baseline. About an average of 1.7 a week, which went up to 3.5 on prunes; a bowel movement every other day or so. Then, back to baseline, off of the prunes; then, on Metamucil, got up to 2.8; then, back down.

And, remember the Bristol stool scale? Significantly better stool consistency on the prunes, as well. The researchers conclude that “treatment with dried plums resulted in a greater improvement in constipation symptoms…[than the] commonly used fibre supplement, psyllium.”

So, “[g]iven their palatability, tolerability…availability, dried plums should be considered” as a first-line therapy for chronic constipation.

If this is what adding one plant can do—3.5 bowel movements a week—what if all you ate was plants? Where do vegans rate? Going, going, gone. Not 2, not 3, but 10.9 a week.

Please consider volunteering to help out on the site.

Images thanks to OliBac via flickr

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.

Though there is an International Prune Association, keeping us all apprised of the latest prune news from around the world, in the U.S., the California prune board successfully pressured the FDA to change the name from prunes to “dried plums”—which evidently evokes more of a “positive ‘fresh fruit goodness’ image,” in hopes of attracting their “target audience, women.”  Of course, it might help if they actually included one or two on their board.  

The name change is in hopes of “de-emphasiz[ing] its connections to digestive regularity issues.” But, hey, why sell yourself short? Check this out: “Randomised clinical trial: prunes vs. [Metamucil, also known as] psyllium.” “Constipation is a common problem that affects up to [a fifth] of the world’s population. Nearly 60 million Americans suffer from chronic constipation;” particularly a problem in women and the elderly. A “pathological condition that is often severe enough to disrupt daily activities, derange quality of life, respond poorly to available medical remedies and [may] prompt sophisticated and potentially harmful surgical procedures.”

Despite all this, it is still frequently considered a trivial issue, and affected individuals tend to self-medicate either using OTC laxatives or ‘natural’ remedies, but none of these [have] been adequately investigated,” until now. Fiber supplements can be inconvenient, taste nasty, cause bloating—even choking.

So, we need “a food-based, natural, convenient…tasty alternative.” But, do prunes actually work? Here’s the study subjects at baseline. Each dot is a complete, spontaneous bowel movement. Note how many people had zero bowel movements per week, at baseline. About an average of 1.7 a week, which went up to 3.5 on prunes; a bowel movement every other day or so. Then, back to baseline, off of the prunes; then, on Metamucil, got up to 2.8; then, back down.

And, remember the Bristol stool scale? Significantly better stool consistency on the prunes, as well. The researchers conclude that “treatment with dried plums resulted in a greater improvement in constipation symptoms…[than the] commonly used fibre supplement, psyllium.”

So, “[g]iven their palatability, tolerability…availability, dried plums should be considered” as a first-line therapy for chronic constipation.

If this is what adding one plant can do—3.5 bowel movements a week—what if all you ate was plants? Where do vegans rate? Going, going, gone. Not 2, not 3, but 10.9 a week.

Please consider volunteering to help out on the site.

Images thanks to OliBac via flickr

Doctor's Note

Who can forget the Bristol stool scale? Even if you’ve already seen it, you may want a refresher: Bristol Stool Scale. And while we’re on the topic, here are some other videos on optimizing bowel function:

Prunes may also help improve the health of our skin—see Beauty Is More Than Skin Deep.

In general, we should try to get our nutrients from whole food, not supplements (see Some Dietary Supplements May Be More Than a Waste of Money).

See my previous video, Dried Apples, Dates, Figs, or Prunes for Cholesterol? for a comparison of prunes to other dried fruit in terms of cholesterol-lowering capacity. And, if you’re worried dried fruit may be too calorically dense, my next video, Do Fruit & Nut Bars Cause Weight Gain? should help put your mind at ease.

For more context, you can refer to my associated blog posts: Best Dried Fruit For CholesterolBest Treatment for ConstipationRaisins vs. Energy Gels for Athletic Performance; and Flax Seeds for Diabetes.

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

74 responses to “Prunes vs. Metamucil vs. Vegan Diet

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  1. I have had IBS for over 40 years, I need the natural amount of crude fiber. I get that fiber from 1/4 cup/day Wheat Bran (AKA years ago Miller’s Bran)




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    1. Me, too.

      I used to think I needed dairy yogurt to stay regular, but that was because I did not eat enough fiber in beans and dark leafy greens.




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  2. Invegat……I also was a long time sufferer of IBS…..HIGHLY recommend the book Irritable Bowel Solutions by John Hunter, whose advice has solved my problems.




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  3. Since going vegan in July, I now have one very smooth, stress-free bowel movement every morning at about 7:30am. Also, thank you so much for these videos. They’ve helped a lot!




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  4. To quote Anthony Hopkins playing Kellogg in the film Road to Wellville, “They’re huge and smell no more than a hot muffin.” That’s what a plant diet has done for me.




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      1. From: Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. (see sources cited- links provided)
        Subjects were enrolled in an 8-week, single-blind, randomised cross-over study. Subjects received either dried plums (50 g b.d., fibre=6 gm/day) or psyllium (11 g b.d., fibre=6 gm/day) for 3 weeks each.




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  5. I’ve lived a life of struggling with off and on bad eating habits all while claiming to be a vegetarian. Finally, I made the decision to never eat anything except whole, high fiber foods. No more dairy or vegetarian junk. It’s taken a couple years to go all the way and start to heal a sick gut. It’s working…Yay, Vegan! Oh, and about the prunes. I’ll take them over all the horrible medications any day. Fresh is best.




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  6. Prunes can be effective for treating constipation but they are inferior to psyllium. Here’s why: (1)Prunes contain large amounts of the cancer-causing growth hormone, IGF-1. (2)Although eating prunes will cause less weight gain than the calories that they contain would predict, they are still extremely high in sugars, extremely high in calories, and prunes will cause weight GAIN, not weight loss. (3)Prunes are expensive compared to psyllium capsules or psyllium powder, which comes in cylindrical canisters. (4)Psyllium has been shown to cause substantial weight LOSS by feeding the good bacteria, reducing the absorption of calories from fats and sugars, and by speeding bowel transit time. (5)Psyllium has been shown to lower colorectal cancer risk in humans by about 20%. (6)Because psyllium is less fermented than other plant fibers, it causes less flatulence than other plant sugars, starches, and fibers. (7)Psyllium is sugar-free and has been shown to be heart-healthy. (8)Psyllium has been shown to work better than docusate sodium, which is what medical doctors still prescribe.
    http://www.ncbi.nlm.nih.gov/pubmed/19561384
    http://www.ncbi.nlm.nih.gov/pubmed/8287381
    http://www.ncbi.nlm.nih.gov/pubmed/10966900
    http://www.ncbi.nlm.nih.gov/pubmed/9663731
    http://www.ncbi.nlm.nih.gov/pubmed/17413119
    http://www.ncbi.nlm.nih.gov/pubmed/22863407

    Psyllium works faster for constipation than docusate sodium or prunes because soluble fiber can soften bowels that are already hard. If you need even quicker relief than psyllium, use gum arabic (a.k.a. Acacia Senegal or acacia gum), which is a less viscous soluble fiber than psyllium. However, for maximum weight loss benefit, use glucomannan soluble fiber (from shirataki noodles, konnyaku blocks, or sukiyaki) because it has a higher viscosity than mucilage soluble fiber (psyllium). Diarrhea washes away the weightloss-caising good bacteria and strengthens the weightgain-causing bad bacteria. Acacia gum can easily cause diarrhea. Glucomannan soluble fiber is the least likely to cause diarrhea. Mucilage soluble fiber (psyllium) can cause diarrhea but only if used in large quantities.




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      1. Is acrylamide an issue if the fruit is sun-dried, and not machine/oven-hot air dried?
        I doubt IGF issue with sun-dried dates and raisins. Maybe you know.




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  7. I’m a vegan and am chronically constipated!!! Eating prunes, kiwifruit, broccoli, and pears (I read these help.) What else can I do?




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    1. Do you consume whole unrefined plant foods or do you consume processed foods, such as white flour, mock meats, etc. Being constipated as a vegan is quite strange if your following a whole foods plant based diet.




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    2. Water is a major factor! Timing is very important too! Drink 10-16 ounces in the morning when you wake up before you eat anything!
      Your body needs to be rehydrated!
      stay hydrated throughout the day by continually drinking water.
      At night drink a glass of water before you go to bed (as much as you can without having to wake up in the middle of the night).
      Water recommendations: Take your body weight and divide it by 2

      Ex: A person weighing 200
      pounds should drink at least 100
      ounces of water each day.

      If overweight use your ideal body weight calculation found here: http://www.scymed.com/en/smnxpn/pndfc237.htm




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  8. I punch my daily food intake into Cronometer.com and it tells me I get right around 100 grams of fiber a day. I have at least 20 BMs a week. Been a vegan for just over a year and love everything about it.




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  9. I find that taking freshly ground flax seed, about 1 tablespoon in a small amount of fresh juice or water daily really helps me a lot, and also drinking lots of water. It also reduces appetite by making me feel fuller, so I eat less too!




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  10. aren’t psylium seeds a whole, plant-based food? I am not talking about the mucilage alone. I imagine the seeds are available and would contain significant amounts of protein, good oils and other nutrients as well as fiber, right?




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    1. I think so. psyllium husk is grown in farms and it grows in India (I get it in bulk). You can buy it in Indian grocery store. Add a small teaspoon with water and drink it immediately as it starts to bulk up within seconds…and becomes jello like, impossible to drink. One caceat, if you take psyllium husk, drink LOTS of water otherwise you may BECOME constipated because it will bulk up inside the gut and absorb all water like sponge. So any fiber you take (as supplement) drink water, water, water.




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  11. I am a 73 year old male, whom eats about 75 of my daily diet based on plants, and good fiber. On the BM daily scale of frequency I have spontaneous BM’s of 3-4 per day ! Never constipated. Eat plants and fiber, and never ever have a BM problem. Simple !




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  12. I always enjoy your sense of humor, and this video made me laugh. I’ll never forget one constipation episode that lasted a week. It felt as if I was having a baby. Since going on a whole food plant based diet in 2014, I am regular and so happy just knowing my body is functioning better than ever.




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  13. At age 18 I had a very painful hemorrhoid operation, and then rectal stretching. After I stopped screaming, I asked the doctor what do I do to prevent this from ever ever ever happening again. He said, you know what you have been eating, meat, fried foods and drinking soda. I said yes. He said well you know what you have not been eating, fruit, vegs, fiber. I said yes. He said reverse them ! I did. That was 55 years ago ! I eat 2+ pounds of fresh fruit and vegs, and natural fiber, every single day. Very little meat, some broiled wild fish, and lots of fresh home made soups. I have a BM 3-4 times per day, and have not had a problem going to the bathroom for a BM, ever since ! Simple solution. Listen to Dr. Greger, and you cannot go wrong. At age almost 74, I have no medical problems. Oh, and I go to the gym, 7 days per week, for a full hour, and I work out hard ! Of course I do not smoke, do drugs, or drink any alcohol, except a glass of dry red wine, only when I dine at night. Good nutrition, and exercise really works !




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  14. I am a 74 year old white male. I eat 2-3 pounds of raw fruits and vegs per day, plus lots of fiber supplements. Broiled fish 2-3 times per week. Don’t smoke, don’t drink hard liquor. I do have a glass of dry red wine with my dinner nightly. On the subject of BM. I have 3-4 good BMs per day. Have not been constipated in probably 40 years. I do go to the gym every day for one hour and I work out hard. Dr. Greger’s recommendations for a healthy life works 100 % of the time, all of the time. Do it and have a great life !




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  15. I’ve got a question: Is it harmful or helpful to take daily a soup spoon full of psyllium? I have had a discussion with my wife. We are both on a whole, plant-based, low fat diet. My wife likes to take daily a soup spoon of psyllium in addition – I argue it is not necessary because we get enough fiber by eating whole (grain) food, lentils, beans etc. The finally question for us is: Can we get to much psyllium fiber? Are there any scientific trials?




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    1. Hi, Steffen Jurisch. I am Christine, a NF volunteer moderator. Assuming adequate water intake, psyllium husks should be safe for most people. Inhaling the dust can be detrimental, some people are allergic to psyllium, and I found one case study in which psyllium caused adverse effects in a person with adrenal insufficiency. Barring those circumstances, I am unaware of adverse effects from psyllium husk consumption. I hope that helps!




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      1. Christine,

        I am curious and can’t seems to find the answer. I went plante base 6 years ago and mostly because of hemorrhoids and realized I needed more fiber. I had surgery 10 years ago and going back again next week. It seems that my stool is to loose now. I am trying to add psyllium and slippery helm to help. AsI said I am a full plante based following all the recommendation of Dr greger and Dr Esselstyn. My total cholesterol is down to 115 to 140 from 200. Any recommendation on how to get my stool a little firmer or what i could be doing wrong?

        Thank you




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  16. Jean Marc,
    Hello! I am a family physician in private practice, and a volunteer moderator for this website. Also, I’ve been eating vegan since 9/2015. My own experience, plus that of my patients who have switched to vegan diets, is that bowel movements always become looser and more frequent. But that is a GOOD thing! Here is a great video by Dr. G. on what is “normal” for frequency of BMs: http://nutritionfacts.org/video/how-many-bowel-movements-should-you-have-every-day/

    The alternative to loose stools — and what most of us used to experience on meat-eating diets — is periodic constipation and slow transit of stool through the body, which increases risk of colon cancer, hiatal hernia, diverticulitis, hemorrhoids, and many other problems. Also, the composition of your gut flora on a vegan diet is much healthier than on animal foods. Dr. G has many videos on this; here is a great one: http://nutritionfacts.org/video/prebiotics-tending-our-inner-garden .

    OK, sorry if you already knew all that, and still just want some way to make your stools more firm. There are certain foods which can trigger diarrhea (e.g. black cherries), and that seems to vary from person to person. So you might want to try to figure out if one of the foods you’re eating is particularly bad in terms of loose stools.

    I hope this helps some.




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    1. Dr Jon,

      Thank you for your answer. I also volunteer as a translator :) …
      I will try to figure out what food triggers my extra loose stool. I wonder if it could be to many raw vegetable/fruits and maybe should eat more starches ( sweet potato, rice). I already have plenty of beans and lentils.

      Thank you again. Jean-Marc




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  17. I don’t understand. I drink green smoothies several times a week, eat dark leafy greens for at least 1 meal a day, consume oats and brown rice and drink plenty of fluids, but I still struggle with daily bowel movements.




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  18. All these extra stool events sound like a good thing… UNTIL… it isn’t.

    That is, butts have to be wiped. Toilet paper is made from wood. Wood comes from trees (mostly.) Trees sequester CO2. More fiber causes more methane (which is more destructive to the stratosphere than CO2 actually.

    So it follows: MORE STOOLS ARE CAUSING MORE GLOBAL WARMING!!!

    P.S. Not to mention the extra water used to flush with… the more chemicals etc. used to treat the waste… etc. etc. ad infinitum




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      1. ‘-)

        Butt in all seriousness, I do eat from 3 to 6 prunes + a tsp of almond butter and a tsp of peanut butter a day. Prunes are a great protector of osteocast activity (bone loss) meaning less osteoblast activity (bone remodeling) required.

        The peanut butter and almond butter are for other things… obviously not for memory because I can’t remember what purpose I eat them for. ‘-)




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  19. I can’t even imagine not pooping twice a day. How could one possibly poop as little as 3 times per week? I’m averaging two to three per day now that I am eating high fiber foods all the time.




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