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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Tuesday, April 14, 2015

FOCUS ON FIBER FOR BETTER HEALTH

Fiber is the indigestible part of plant foods -- whole grains, beans, nuts/seeds, fruits and vegetables. Fiber has many health benefits including improving regularity, lowering blood cholesterol, stabilizing blood glucose, and  supporting weight loss.  However, the typical diet is dominated by animal proteins which naturally have no fiber and refined grains (white bread, pasta, & rice) from which the fiber is removed.  It is estimated only 5% of Americans get the recommended 25-35 grams of daily fiber with most getting less than half that. 

An intriguing recent study illustrates the power of fiber.  Researchers advised 240 obese patients with metabolic syndrome to follow one of two diets for 1 year.  One group was assigned to eat at least 30g of fiber daily.  The other was assigned the American Heart Association's (AHA) detailed dietary guidelines which contains 13 components including eating more fruits and veggies, reducing sugar & salt, choosing lean proteins, limiting alcohol, and balancing intake of protein, fats and carbohydrates. Researchers found simply having individuals increase their fiber intake was equally effective for weight loss and heart health risk factors as following the AHA's detailed dietary guidelines.  So, keep it simple.  Eat more fiber!

What Are the Health Benefits of Fiber?
Fiber content is listed under "Total Carbohydrates" on the Nutrition Facts label.  Fiber is classified into insoluble and soluble.  Soluble fiber is especially helpful with increasing fullness, moderating blood sugar, and decreasing blood cholesterol.  Oats, apples, citrus, barley, beans and many seeds are good sources.  Insoluble fiber, while also contributing to fullness and GI health,  is most important in softening and adding bulk to the stool.  It is found in the bran of whole grains as well as many crunchy fruits and vegetables. 

Eating the right amount of fiber has been shown to have a wide range of health benefits.  Eating the right amount of fiber has been shown to have a wide range of health benefits including:

·         Aids in weight control by increasing fullness without adding calories 
·         Aids digestion and supports healthy gut bacteria
·         Prevents constipation, diverticulosis, hemorrhoids
·         Lowers blood cholesterol
·         Improves blood sugar control
·         Improves irritable bowel syndrome, and inflammatory bowel disease
·         Prevents kidney and gallstone formation
·         Reduces systemic inflammation
·         May reduce blood pressure and stroke risk
·         May reduce colon and some other types of cancer risk


Here's some more details on how fiber improves health... 

Intestinal health: Since your body cannot digest it, fiber travels through the intestine attracting water along the way. This causes the stool to enlarge and soften, which enhances your body's natural process of elimination. If you eat too little fiber, the result can be constipation, diverticulosis (in which pouches develop in GI that food can get trapped in causing infections) and hemorrhoids. High fiber diets are estimated to reduce the risk of diverticulosis by 40%.   Higher fiber diets can also relieve symptoms of irritable bowel syndrome and inflammatory bowel disease.  Fiber fuels healthy intestinal bacteria.  It is increasingly being recognized that maintaining healthy gut bacteria populations has profound effects on immune function, inflammation, and chronic disease risk.

Cardiovascular health:  An inverse association has been found between fiber intake and heart attack, and research shows that those eating a high-fiber diet have a 40% lower risk of heart disease.  A diet high in soluble fiber, like that found in oats and oat bran, can help reduce cholesterol levels and promote cardiovascular health. As soluble fiber passes through the digestive system, it binds to bile acids and removes them from the body.  The liver makes bile acids from cholesterol so when bile is excreted, the liver synthesizes additional bile by using cholesterol from the bloodstream, thereby lowering the blood cholesterol. Soluble fiber can also bind to unhealthy dietary fats in the GI, preventing them from being digested.  Higher fiber diets also appear to improve blood pressure.  Researchers have found that for every additional 7g of daily fiber, stroke decreases by 7%.  Because fiber slows digestion and blunts blood sugar rise after a meal, it also helps to control blood sugar levels.  Keeping blood sugar in check reduces heart health risk, especially among diabetics who are at high risk for cardiovascular problems.  

Metabolic & endocrine health:  Fiber, especially soluble fiber, helps to slow digestion of carbohydrates and reduce the post-meal rise in blood sugar.   By increasing feelings of fullness and preventing blood sugar swings, fiber has been found to decrease caloric intake.  Also, fiber-rich foods such as vegetables are low in calories and help to displace intake of other less healthy, higher calorie options. and improve weight loss.  A high-fiber diet also helps to reduce the risk of gallstones and kidney stones, likely because of its ability to help regulate blood sugar.

How can I increase my fiber intake?

Start slowly.  When you first add fiber to your diet you may notice bloating, cramping or gas. Add fiber gradually to minimize these symptoms. Be sure to drink plenty of water. Liquids help your body move fiber through the GI. Having high fiber foods or supplements can decrease the absorption of certain medications such as thyroid medicine.  Discuss how fiber may influence your medications with your provider. 

Whole grains and beans are the richest natural sources of fiber.  The fiber content among different fruits and vegetables varies considerably.  Some of the fruits highest in fiber include pears, berries, apples, kiwis, and oranges.  Veggies especially high include artichokes, sweet potatoes, green peas, broccoli, green beans, peppers, and asparagus.

Go for whole foods.  Choose breads, crackers and grains made from 100% whole grains such as whole wheat, brown rice, rolled oats.  Refined grains are stripped of most of their fiber.  Similarly, removing the skin from fruits and vegetables or juicing them decreases their fiber content. It’s better to eat an apple than to drink apple juice.

Experiment & try new options.  Try brown instead of white rice.  Many find quinoa or quinoa-corn pasta to be more palatable than whole-wheat.   Bulgur, quinoa and barley are good side dishes or chilled in salads. Add fresh or frozen vegetables to soups, sauces.  Try adding wheat bran, oat bran, flax, and/or chia seeds to yogurt, oatmeal, smoothies, cereals, and baked goods.

Eat more beans, nuts, and seeds.  Use beans in place of animal proteins at some meals.  Tuck beans into whole-grain tortillas or pita bread. Add them to soups, salads, and pasta dishes. Toss beans into sautéed veggies or mix them with cooked greens and garlic.  Nuts and seeds are versatile heart healthy options. Nuts are a great stand alone snack or use them on yogurt, salads, and stir-fries.  Chia and flax seeds can be sprinkled into dressings, yogurt, and smoothies. 

Consider a supplement.  Fiber supplements, while not taking the place of a high fiber diet, can be helpful.  Because the soluble fiber in foods is more limited, taking a supplement rich in soluble fiber is often advised. Aim for up to 12g of fiber per day from supplements with doses dispersed throughout the day.   Psyllium seeds/husks, found in Metamucil, Fiberall, and Konsyl, are a fantastic source of soluble fiber.  Still always best to get your fiber from foods. 

The following lists a number of specific suggestions on how to increase fiber intake.

High-Fiber Breakfast Foods
         Whole grain hot cereals, such as oats (2g fiber per 1/2 cup) with fruit and seeds/nuts added
         100% whole-grain cereal, All Bran (10g per 1/2 cup), Fiber One (14g per 1/2 cup), Kashi Go Lean (10g per 1 cup)
         100% whole-grain bread, Ezekiel Sprouted Grain (3g per slice), 100% whole rye e.g. Mestemacher (6g per slice)
         100% whole-grain bagels, English muffins, waffles, e.g. Eggo FiberPlus Waffles (4.5g each), Orowheat Double Fiber English Muffins (8g each)
         High-fiber fruits, e.g. raspberries (4g per 1/2 cup), blueberries (4g per 1/2 cup) added to smoothies, yogurt
         Add nuts & seeds, almonds (4 g fiber per 1 oz.), flaxseed (8 g fiber per 1 oz.), to cereals, yogurt, & smoothies

High-Fiber Lunch Foods
         Sandwiches made with 100% whole grain/whole wheat and/or high-fiber breads with high fiber veggies
         Sliced tomatoes (2g fiber per small tomato) & other high fiber veggies in sandwiches, salads
         Fresh vegetables, baby carrots (2g fiber per 3 oz. serving) and snow peas (3g fiber per 1 cup)
         Bean, lentil, or veggie-rich soups, such as Progresso High Fiber Minestrone (7g per 1 cup)
         Add microwaved high-fiber veggies to frozen meals, leftovers, or prepared soups
         Cooked beans or lentils added to soups, wraps, or salads, such as kidney beans (7g fiber per 1/2 cup)
         Fresh fruit, bananas (3g fiber per small banana), apples (4 g fiber per small apple), strawberries (3g per 1 cup)
         Nut butter on whole grain bread or crackers, such as peanut butter (2g fiber per 2 Tablespoons)

High-Fiber Dinner Foods
         Whole grains, e.g. whole-grain spaghetti (3g per 1/2 cup), bulgur (4g per 1/2 cup), & quinoa (3g per 1/2 cup)
         Bean sides & mains, e.g. white beans (6g per 1/2 cup), lentils (8g per 1/2 cup), & chickpeas (6g per 1/2 cup)
         Fresh or cooked veggies, artichokes (7g per 1/2 cup), mixed veggies (4g per 1/2 cup), broccoli (3g per 1/2 c.)
         Baked potatoes with skin (5g fiber per medium potato)
         Whole grain and/or high-fiber rolls & crackers, such as Wasa Fiber Crispbread (6g fiber per 3 slices)

 High-Fiber Snack Foods
         Fresh fruit, pears (5g per small pear), oranges (4g per orange), can be added to cottage cheese, yogurt
         Dried fruit, such as dates (7g fiber per 1/2 cup) and figs (4g fiber per 2 dried figs)
         Veggies, e.g. bell peppers (3g per 1 cup), celery (2g per 4 oz. serving) with hummus (2g per 2 tablespoons) 
         Nuts and seeds, such as walnuts (2 g fiber per 1 oz.) and sunflower seeds (2 g fiber per 1 oz.)
         100% whole-grain & high-fiber granola or nutrition bars, e.g. Fiber One bars (9g), Kellogg’s FiberPlus bars (9g)
         Whole grain and/or high-fiber crackers, RyKrisp (6g fper 4 crackers), Mary's Gone Crackers (3g per 13 crackers) with hummus (2g per 2 tablespoons) or black bean spread/dip (2g per 2 tablespoons)


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