Today I want to make fiber practical. On a GLP-1 fiber, it can help you feel satisfied longer and have less constipation. It can also cause you to bloat more and, if you get too vigorous, feel like you need a Lamaze coach when on the toilet.
Those fibers that need gentle introduction to your body, those are the fermentable fibers. And your gut will ultimately get used to them, like them, but before that happens, let me tell you a story.
I used to have breakfast with one of my favorite GI doctors. Wanting to leave a good impression on her, I ordered the steel cut oatmeal. The first day, I felt a bit of rumbling. The second day, which was a surgery day, I had a lot of gas. The third day, while in clinic, I lit a candle on my office desk while answering the phone, and opened the window. Answering a phone call, I turned around, and then noticed smoke. The papers had crossed over the candle, set the desk on fire, and I had to stop the call, put out the fire. For the many years I owned that desk, the burn mark gave me a vivid reminder of what happens when you introduce certain fibers too soon. My week of breakfast meetings ended with eggs. She didn’t have a sense of humor when I related that story to her. She asked me why it took me many years to get that kind of fiber in my diet. Alas, some GI doctors have no sense of humor.
Why did a perfectly respectable bowl of steel-cut oatmeal cause so much trouble, and how do we introduce fiber without repeating that experiment?
Half of the steel cut oatmeal’s fiber is soluble, it doesn’t get broken down, and then it reaches the colon, intact. It then becomes powerful, and I mean a powerful source of food for the bacteria in the colon.
The bacteria ferment the fiber. Instead of saying they digest the fiber, we use the word “fermentation.” Fermentation is the name of the digestion, where bacteria consume food and grow in an oxygen free environment, like your colon or a champagne bottle. That is how I want you to think about it. You eat oatmeal, it ferments in the colon, and like champagne, it pops out. I know, it is odd to think of our gut as fermenting and causing us distress, but that is what is happening. Hence, fiber that reaches the gut, and these bacteria consume it. That is fermentable fiber. Or champagne fiber. And the gas pops out.
The gases produced include carbon dioxide, methane, hydrogen sulfide and others.
There is a war in your colon, and bacteria are competing for space. Trillions of them. There is also some yeast in that microbiome. The bacteria who win the war are the ones who eat well. It turns out the more efficient the bacteria are at fermentation, the less gas they create.
Start feeding your gut more oatmeal, and those efficient bacteria multiply. Over time, eat enough steel cut oatmeal, and your gut microbiome will have the bacteria that produce less gas. Here is the good news: the bacteria that love fiber are the bacteria associated with less heart disease, less cancer, and better health.
A Grizzly Bear and Constipation
Before a grizzly hibernates, it begins to consume fibrous material. Things like sticks. Lots of it, and so much so that it forms a plug in its colon, so that when it sleeps, it does not need to move its bowels. The material is in the colon and not going anywhere. At least that is the story we were told.
Bears develop fecal plugs during hibernation. The traditional story is that they eat roughage, leaves, and other fibrous material to plug themselves up. Nice story, but in reality, during hibernation, the fecal material sits in the colon, while the colon continues to absorb water. That is one of the main functions of the colon, to absorb water from stool.
For the Grizzly, that fecal material becomes a plug, hard and dry. Hair and plant debris can be present, but the plug isn't simply made of sticks and berries. You wonder why when bears wake up, they are grumpy. That has to be one tough time. But there is a similarity to a GLP-1 patient.
On a GLP-1, the colon doesn’t move as fast as it once did. Because fecal material sits longer in the colon, and the colon still absorbs water, and fecal material becomes more of a plug. Yes, Lamaze might help, but seriously, it can be a problem.
What about fiber to help move things along?
Metamucil is one of the more common fibers commercially available. It is made from a seed husk (psyllium) and is part soluble. Metamucil absorbs water and holds onto it. So the colon doesn’t absorb that bulk. This allows Metamucil to help move things along. It is not very fermentable, would not make good champagne. About 1/3 of it is fermentable, leading to far less gas. Most who get bloated with Metamucil are because they did not drink enough water with it. Keeping hydrated is one of the cornerstones in avoiding constipation.
When dealing with fiber, we have to have hydration. Without hydration, you become a grizzly bear. Without the winter sleep. Adding more fiber to a slow moving colon that absorbs the water from stool can make one miserable.
So why do we say more fiber is needed? This sounds like a trap. Too much champagne and you have misery. Too much grizzly fiber and you are stuck.
Then there are the studies. People who have fiber in their diet have less heart disease, less colon and rectal cancer, and longer lives. Best of all, you will have less constipation and enjoy a wider variety of foods.
The best diet for people on a GLP-1 is the Mediterranean diet. Its benefits aren’t solely due to fiber, but fiber is part of the package, or it might be the package.
For paid subscribers, we’ll get practical. And of course, a recipe.
There is a way to enjoy the champagne without becoming a bear.
Here are the keys: There are two reasons fiber will give you an issue. One is that you have fermentable fiber, and your colon isn’t used to it yet. The second is that you have a fiber not accompanied by enough water or other liquid. Fixing those issues is not difficult, but now you know a bit more about fiber.
