A guideline is suggested for how to read food labels for grain products such as bread and breakfast cereals.
The Five-to-One Fiber Rule
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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.
- K N Grooms, M J Ommerborn, D Q Pham, L Djousse, C R Clark. Dietary fiber intake and cardiometabolic risks among US adults, NHANES 1999-2010. Am J Med. 2013 Dec;126(12):1059-67.e1-4.
- J K Schmier, P E Miller, J A Levine, V Perez, K C Maki, T M Rains, L Devareddy, L M Sanders, D D Alexander. Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model. BMC Public Health. 2014 Apr 17;14:374.
- D E Threapleton, D C Greenwood C E Evans, C L Cleghorn, C Nykjaer, C Woodhead, J E Cade, C P Gale, V J Burley. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013 Dec 19;347:f6879.
- R B Baron. Eat more fibre. BMJ 2013; 347.
- A Satija, F B Hu. Cardiovascular benefits of dietary fiber. Curr Atheroscler Rep. 2012 Dec;14(6):505-14.
- R Landberg. Dietary fiber and mortality: convincing observations that call for mechanistic investigations. Am J Clin Nutr. 2012 Jul;96(1):3-4.
- C J North, C S Venter, J C Jerling. The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease. Eur J Clin Nutr. 2009 Aug;63(8):921-33.
Images thanks to Farouq Taj via Flickr.
- beans
- blood pressure
- blood sugar
- bread
- breakfast cereal
- cancer
- cardiovascular disease
- Cheerios
- chronic diseases
- constipation
- diabetes
- diverticulitis
- fiber
- fruit
- grains
- gut flora
- heart disease
- high blood pressure
- hypertension
- inflammation
- legumes
- lentils
- metabolic syndrome
- microbiome
- obesity
- peas
- rice
- vegetables
- weight gain
- weight loss
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.
- K N Grooms, M J Ommerborn, D Q Pham, L Djousse, C R Clark. Dietary fiber intake and cardiometabolic risks among US adults, NHANES 1999-2010. Am J Med. 2013 Dec;126(12):1059-67.e1-4.
- J K Schmier, P E Miller, J A Levine, V Perez, K C Maki, T M Rains, L Devareddy, L M Sanders, D D Alexander. Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model. BMC Public Health. 2014 Apr 17;14:374.
- D E Threapleton, D C Greenwood C E Evans, C L Cleghorn, C Nykjaer, C Woodhead, J E Cade, C P Gale, V J Burley. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013 Dec 19;347:f6879.
- R B Baron. Eat more fibre. BMJ 2013; 347.
- A Satija, F B Hu. Cardiovascular benefits of dietary fiber. Curr Atheroscler Rep. 2012 Dec;14(6):505-14.
- R Landberg. Dietary fiber and mortality: convincing observations that call for mechanistic investigations. Am J Clin Nutr. 2012 Jul;96(1):3-4.
- C J North, C S Venter, J C Jerling. The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease. Eur J Clin Nutr. 2009 Aug;63(8):921-33.
Images thanks to Farouq Taj via Flickr.
- beans
- blood pressure
- blood sugar
- bread
- breakfast cereal
- cancer
- cardiovascular disease
- Cheerios
- chronic diseases
- constipation
- diabetes
- diverticulitis
- fiber
- fruit
- grains
- gut flora
- heart disease
- high blood pressure
- hypertension
- inflammation
- legumes
- lentils
- metabolic syndrome
- microbiome
- obesity
- peas
- rice
- vegetables
- weight gain
- weight loss
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Title
The Five-to-One Fiber Rule
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor'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 five-to-one 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. For example, watch my videos Fiber vs. Breast Cancer and How to Prevent a Stroke.
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? is queued up next.
2019 Update: Check out my new video on fiber, Is Fiber an Effective Anti-Inflammatory? and all my fiber videos here.
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