A number of patients have been coming into the office suffering from a variety of symptoms, all of which can be traced to a lack of fibre intake. Most were eating plenty of whole grains: bread, cereal and rice, but no one was eating enough fibre. What kinds of symptoms result from eating too little fibre?

Most commonly I see constipation, acne, elevated cholesterol levels, headaches, haemorrhoids, chronically elevated liver enzyme systems, PMS and irritable bowel syndrome. You might ask how a lack of fibre intake can cause this wide array of symptoms. To understand the importance of this macronutrient, you first need to understand that there are two very different types of fibre.

The first type of fibre that comes to mind is the 'insoluble type'. This fibre, found in whole grains and vegetables, helps keep us regular and reduces the risk for colon problems from constipation and irritable bowel syndrome to colon cancer. This is the type of fibre your mother may have called 'roughage'. Water insoluble fibre is critical for the proper functioning of the colon. It ensures that the undigested and indigestible food moves quickly through the small and large intestines and does not stay in any one spot too long where it may irritate the lining of the intestines. It also binds up bile from the liver and gall bladder which contains oil soluble wastes such as excess hormones and pesticides residues. These need to be removed from the body through the bowels quickly or they will be reabsorbed and circulate through the body again before again being removed by the liver. The increase in body toxin levels can cause headaches and fatigue. The attempt by the body to remove excess levels of unwanted chemicals through the skin can cause acne and aggravate eczema. Since excess hormone levels are thought to be one factor in PMS and acne, as well as migraine headaches, these types of problems may be caused by a lack of insoluble fibre. Insoluble fibre is also important in treating any type of liver trouble from elevated enzyme levels to hepatitis.

The second type of fibre is called 'water soluble' fibre and is found in oats, beans and certain fruit, especially apples. This is the type of fibre that binds up cholesterol and removes it from the body. It can help lower total cholesterol levels, reducing your risk for heart disease and it will reduce your risk for gallstones. Many nutrition experts believe that this may be the meaning behind the saying 'an apple a day keeps the doctor away'. Although not a cure for the flu, eating an apple a day may well prevent a visit to the cardiologist.

A separate type of water soluble fibre called 'lignan' is now being studied because of its effect in lowering women's risk for breast cancer. The highest food source for lignan is flax seed meal. Whereas flax seed oil contains a full range of essential fatty acids which can help reduce allergy related problems and inflammations as well as reducing the risk for heart disease, it contains no fibre, or lignan. This lignan is the part that seems to be able to prevent breast cancer as well as reduce the risk for recurrence in breast cancer survivors. One theory about how lignans work is that they bind oestrogen, helping to reduce circulating oestrogen levels in a women's body. But, more than other fibres, lignans can also be changed by gut bacteria, absorbed into the body and affect cancer cells in a way that makes them less able to multiply. While the exact mechanism for this action is still being elucidated, taking some flax seed meal (ground whole flax seeds) in a bowl of oatmeal in the morning seems worthwhile for those with an elevated risk for breast cancer, along with proper diet and nutritional supplements.

Total fibre intake is also important. A high fibre intake insures an even blood sugar level helping to prevent hypoglycaemia and evening out blood sugar levels in diabetics. A high fibre intake also helps you to feel full longer on fewer calories, helping to maintain a healthy body weight.

Heart disease, colon cancer, breast cancer. Diseases affecting 30% of all Americans over age 50 which can be linked to a 'fast food' or 'westernised' diet. All are linked in one way or another to low fibre intake.

The easy solution to all these problems is to eat more fibre. Ideally, you should try to get at least two servings of both water soluble and water insoluble fibre daily. This translates for most people into eating vegetables at both lunch and dinner every day, as well as having a snack of an apple and replacing sugary cereal with oat bran or oatmeal. It is also important to choose whole grain foods rather than breads and pasta made of white flour. For those with specific diseases, higher levels of intake are needed. And remember, to prevent fibre from becoming like cement in your gut, you must drink 8 glasses of water each day. Supplements (such as psyllium seeds which contain both water soluble and insoluble fibre) are available, but food sources are the best choice for long term health.

Dr. Jennifer Brett
Dr. Brett is a naturopathic physician with offices in Stratford and Stamford, CT