On Health with Houston Methodist

Fiber: Should You Be ‘Fibermaxxing’?

• Houston Methodist • Season 9 • Episode 7

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Move over, protein: Fiber is the newest macronutrient darling of the food world. Content creators promoting optimal digestion suggest we maximize fiber intake — “fibermaxxing” — by eating fiber-rich foods with every meal and snack as well as using fiber supplements as needed. The fibermaxxing crowd claims the approach can help with everything from gut health to improved cholesterol and blood sugar levels and may even aid in cancer prevention. Can increased fiber intake and other digestion-related trends, such as the dense bean salad and post-meal walks, really deliver better overall health?

Expert: Dr. Michael Allen, primary care physician

Notable topics:

  • What is fiber, and what role does it play in our diet?
  • How much fiber you need in a day (you’re probably not getting enough)
  • Who needs more fiber, and who needs to moderate their intake?
  • How the body reacts when you have too little or too much fiber in your diet 
  • Is fibermaxxing a safe trend?
  • The role hydration plays when increasing fiber intake
  • Dense bean salad: Is it a healthy option?
  • Can taking a walk after eating really help with your digestion and blood sugar levels? 
  • How to safely start increasing your fiber intake


If you enjoy these kinds of conversations, be sure to subscribe. And for more topics like this, visit our blog at houstonmethodist.org/blog.

ZACH MOORE:

Welcome to On Health with Houston Methodist. I'm Zach Moore, I'm a photographer and editor here, and I'm also a long-time podcaster.

KIM RIVERA HUSTON-WEBER:

I'm Kim Rivera Huston-Weber, and I'm a copywriter here at Houston Methodist.

ZACH:

And Kim, do you have a high fiber diet?

KIM:

You know, I would say yes now more than I have probably ever in my life --

ZACH:

And is that intentional?

KIM:

Yes, I wanna say it's more intentional just because I think I've gotten a little older and so I'm trying to be more mindful about my diet.

ZACH:

Mm-hmm. KIM: But yeah. No, there were certainly times in my life where I was getting nowhere near enough fiber. What about you? ZACH: I guess. I mean, I don't really track… KIM: That's fair. My fiber intake. Maybe I should. But again, I don't have any -- I've mentioned this in other conversations we've had. I'm very fortunate where I don't have any health issues right now or health challenges… KIM: Mm-hmm. That would necessitate me doing that. Now, if one were to arise, yeah, I'd start, you know, food journaling and all that stuff. But I feel like just, like, always trying to eat healthy, sometimes succeeding, sometimes not. But by trying, a lot of that's gonna take care of itself.

KIM:

For sure. And you know, I think if you're aiming to eat mostly whole foods like fruits and vegetables, whole grains, and just kind of generally doing that more often than you're not, I think we talked about it in our moderation podcast this season, you're gonna get there with your fiber and all of your macronutrients.

ZACH:

Seems like the general understanding of, like, when you get the most fiber's like breakfast, right? With the, you know, the cereals, and your whole grains, and your breads, and that sort of thing.

KIM:

Mm-hmm.

ZACH:

Like, you see all the cereal boxes, you know, they advertise how much fiber they have. And I guess that's when we're quote unquote "supposed" to get the most amount of fiber at least.

KIM:

I mean, we'll find out in our episode. I felt like our expert was really helpful in helping us understand like when we should be eating fiber and what that looks like for us in everyday life.

ZACH:

Absolutely. And who did we talk to about fiber?

KIM:

Sure. We spoke with Dr. Michael Allen, he is a primary care physician here at Houston Methodist.♪ ♪Thank you so much for being with us today, Dr. Allen.

Dr. MICHAEL ALLEN:

Yeah, I'm more than happy to be here.

KIM:

So, it seems that we really go through this cycle where a certain macronutrient or ingredient in our food becomes widely popular. I think we all know that protein's really caught the world's attention the past ten, fifteen years. But I'd say that there's another macronutrient that's, kind of, on the rise, and that's fiber. And unlike protein, I think most Americans are getting nowhere near the recommended daily amount. So, to start, what is fiber and why should we be thinking of it in our diet?

DR. ALLEN:

Yeah, absolutely. I mean, it's a good question. And you are right that the vast majority of Americans do not get enough fiber. So, what fiber is, it's actually a carbohydrate but not in the same sense that we usually consider carbohydrates or like sugars and things. Fiber, unlike other carbs, is not digested or absorbed in the body or the small intestine. Instead, it pretty much passes relatively intact to the large intestine where then it plays a role in a number of things. And I even wrote some down here to make sure I remember. But of course, you know, you have two main types of fiber. You got your soluble fiber and your insoluble fiber. Soluble fiber, this is the fiber that will form, essentially, like a gel-like substance when you ingest it, and this one is the main one that's gonna help lowering blood cholesterol levels, blood glucose levels. You'll see it in foods like oats, or beans, apples. That's the kind of main fiber that a lot of folks are going for. And then you have your insoluble fiber. That's the one that doesn't dissolve in water, and that's the stool bulking type of fiber. So, this one helps the stool and the food to, kinda, pass more quickly through the large intestines. And that you'll find it in, like -- that's the Bran Flakes, right? Gotta have my morning bran or whole wheats and a lot of vegetables you'll see that soluble fiber.

KIM:

So, you kinda touched on it about lowering cholesterol. Why is fiber so important for our bodies and what are some of the health benefits of making sure we have a diet rich in fiber?

DR. ALLEN:

There's a number of benefits that we can achieve by that. Really depends on the type of fiber you're looking for. But I think to, kinda, go back, we should talk about does it matter how you get your fiber in?'Cause it can. They both have different health benefits for you. So, you've got your whole food fiber which is gonna come from foods and then your synthetic fibers and that's a lot of the supplements that people will take. Ideally you wanna get whole food fiber 'cause that's gonna have a mix of the soluble and insolubles. Most of the isolated or synthetics you can have soluble fibers like the psyllium husk or Metamucil. That's a common one that people like to use. So, when we talk about fiber, there's a number of things it does, especially soluble fiber. It will slow down the absorption of carbohydrates that your body can more better manage it. It can also bind up some other things too. But the other big benefit is the microbiome of the gut. These fibers, some of them can be fermentable, so the gut microbiome will use them as nutrients, and we definitely want a healthy gut microbiome'cause it has a lot downstream effects. I mean, you could probably do a whole podcast over the gut microbiome too if you're not already thinking of doing that. But I think as we go on, I'll kinda go more about it in terms of what are the more unique benefits for it. But the, kinda, bottom line for those are cholesterol and glucose, but then also weight loss, right?'Cause you're gonna feel full longer and quicker because it slows down gastric emptying, you're gonna feel more satisfied too. You'll have a lot of energy,'cause the problem is if you have a low fiber diet, when you do eat, your glucose can shoot up pretty quickly and then it will crash back down. And that's that carb crash that people can feel where they feel very fatigued throughout the day and then get hungry again pretty quickly so they tend to eat more. And then if you're eating more, you're gonna gain more weight. So those are just to name a few of the benefits of the fiber.

KIM:

You had mentioned synthetic and so, you know, I know protein's been a big deal in the food industry the past ten, fifteen years. Now that fiber is getting noticed, food and supplement companies are now starting to tout the fiber in their products. And you know, as you mentioned, I think we're all kind of coming to know the gut microbiome is probably a little bit more important than we've given it credit for in the past. And so, we're seeing all of these specialty processed foods and supplements crop up to help us meet our fiber intake. So, should we opt for some fiber sources over others and kinda of why or why not? DR. ALLEN: Great question. Yeah, this is something that I do have patients ask me more often now. Kind of bottom line is whole food sources of fiber should be your foundation. You should be getting it from food and whole foods and use supplements to bridge the gap, right? So, if you're not gonna meet your fiber requirement that day, then a supplement is fine. You know, there's a lot of these, kinda, trendy fiber blends coming out or gut health powders. They might not be harmful and they might help, but they're definitely not magic and they are expensive. You don't need some magic powder thing to give you the fiber that you need. What you really need is whole foods, and then picking a reliable supplement fiber if you want like a well-studied like psyllium husk. That's the most studied in terms of benefit and that's a soluble. Or one of my favorites which is methyl cellulose or Citrucel. That's a good kinda beginner level fiber to get in with supplements 'cause it's very well tolerated and doesn't make you gassy and bloaty. Supplements are good but they shouldn't be the only place you get your fiber from. It should be mostly from your food. Well -- and I think these powders are becoming a lot more trendier than they used to be. Like, the marketing's definitely gotten a little bit better'cause I definitely remember, you know, the kind of stodgy looking canister that my grandparents would keep around the house so I think we're living in an era where it's not your grandparents --

DR. ALLEN:

Grandpa had to have his Bran Flakes, right? Now it's the trendy gut powder health things that we have.

KIM:

Oh yeah. And so, it's interesting. So, supplements are okay but it shouldn't be what we focus on the most. I definitely wanna talk about more trends but would love to get an understanding of the basics. So, when we're thinking about how much fiber we should be consuming and knowing if we may need to bridge that gap, how much fiber should we be taking in each day?

DR. ALLEN:

It's a little different for men and women. So, for women, that's gonna be 25 grams of fiber a day and then for men, you're looking at 38 grams. Or if you're looking if you're kind of a calorie counter, if you're really down to get the macros and calories, 14 grams for every thousand calories consumed is what you're going for. Most Americans get 15 grams or less. There's definitely some populations that are more at risk of not getting enough fiber in as well.

KIM:

Yeah. Would love to talk about that. So, are there populations that are more fiber deficient than others? And like, who might need to think about, like, upping their intake?

DR. ALLEN:

We could probably guess who it's gonna be. Men, for one, they eat less fruits, and vegetables, and legumes than women do. Women tend to eat a little better than guys. Young adults as well. Young adults eat a lot of processed foods. It can either be 'cause they're working so much it's easy to grab something from the vending machine or they're getting these meals that are sent, they're premade. So, lots of processed foods among younger adults. Low income as well. Low income people can't afford these whole foods, fruits, and vegetables. They really rely on a lot of processed foods and frozen things that are unfortunately pretty devoid of fiber a lot of the time. And then older adults too. Mostly either because appetite's not there, right? They just don't eat as much or they might have, like, teeth problems or denture problems so it's just harder to get their nutrition in. Those are gonna be your main ones. I find that men especially just don't get enough fiber and that's quite common.

KIM:

It, kinda, makes sense to me. I've had to pester my husband to eat better. And so, I'd like to understand, when we're not getting enough fiber, what are we gonna notice in our body when we're just deficient in fiber?

DR. ALLEN:

That's a really great question 'cause you know, your body tells you a lot. I think that's probably why women are a little better'cause they're -- I find they're a little more in tune with what their body's telling them 'cause they're -- that just seems to be how it goes. But things that you'll feel if you're not getting enough fiber in, constipation or irregular bowel movements. Most folks if you got good fiber, you'll go at the same time about every day and it won't be a struggle. There's the classic meme of, you know, dad's on the toilet for like half an hour or 45 minutes, right? And you know, maybe they're just playing on the phone but maybe it's 'cause it's just taking longer to get the job done. But you'll have those big sugar highs and crashes. So eating and then feeling very tired not long afterwards'cause your sugar is crashing down. Also feeling hungry quickly after meals. I, kinda, mentioned that earlier. Patients saying,"I'm always hungry," it's usually 'cause they not getting enough fiber in. And then cholesterol will slowly go up over time. Fiber plays a big role in that. A part of the way we get rid of cholesterol is you have to eliminate it, and the way you eliminate it is through your stool. And then the gut microbiome is gonna be weaker and then you'll see a multitude of downstream effects from that. I mean, microbiome can affect weight, and mood, and fatigue, and sleep and all these things. So, all that combination you'll start to see. The biggest one, the kind of biggest tell is being hungry all the time and those crashes after you eat. Like, "Oh, I eat and I just want to take a nap." Like, shouldn't be happening. KIM: No, that's interesting. It sounds like most of us are eating nowhere near enough. But are there certain populations that need to maybe moderate their fiber intake or lower it for any reason? Most people benefit from increasing their fiber but there are some exceptions and often it relies like what's the type of fiber that they're having. And so very common like IBS or irritable bowel syndrome. Some fibers, especially fermentable ones like inulin will create gas, and then that's gonna cause pain, and that will make IBS worse. Those people benefit more from like a low FODMAP diet. And then of course if you have either active inflammatory bowel disease, like during a flare, you don't wanna irritate the gut so you wanna do low residue, low fiber, let the gut, kind of, rest. Fiber is like a work out for your gut, right? So, it makes it work, which is what you wanna do. But if your gut is sick or inflamed, it needs to rest. And so, you don't wanna give it fiber, you don't wanna have it go exercise. And then folks with diverticulitis, now a lot of folks will confuse diverticulosis and diverticulitis. Diverticulitis is the inflammation that occurs from people that have diverticulosis. During the inflammatory phase, which is diverticulitis, then you don't wanna give more fiber'cause it's gonna irritate, you wanna rest it. But when you're in the stable phase, then you want high fiber to not get constipated, not let the stool accumulate which can then cause the flare. If you have diverticulosis, it should be high, if you're in a flare, you wanna back off.

KIM:

Another population, and it's getting to be more and more popular, folks taking GLP-1 medications. I know I have a few friends that have taken them, and so, like, they've gotten into fiber supplements of course. Is it true that using fiber supplements while you're taking a GLP-1, does that, kind of, help with any of the side effects that you might have with taking that medication?

DR. ALLEN:

Absolutely, yeah. GLPs, they are very popular, right? And then I wonder if that has to do with why fiber is getting so popular now too is because I feel like everyone's either trying to get it compounded, which I don't recommend, or you know, getting a script from their doc. But, you know, GLP-1's common side effects is gonna be constipation, nausea, and then early satiety and reduced food intake. And that's part of how it works, the latter, not the constipation and nausea. Fiber will counteract those things such as relieving the constipation. Of course, you wanna, kinda, gradually increase your fiber, you just don't wanna go straight to it. Stabilizing the blood sugar, which is good 'cause if you're eating less overall, you wanna have more stable glucose levels. You don't want them getting too low, you'll feel fatigued. And then again, the gut health, right? GLPs change the way that your gut processes food. It slows down absorption, it slows down where certain nutrients, kinda, get to in your digestive tract, so they will affect your gut microbiome too. Fibers are gonna help to more stabilize your microbiome. I always recommend for any of my patients taking a GLP if they're not getting enough fiber in, which sometimes they're not 'cause they eat less, they can benefit to take a supplement to, kinda, get the rest of the way there or be very cautious about getting enough fiber in.♪ ♪

KIM:

Up after the break, more digestion tips and tricks with Dr. Allen.♪ ♪

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KIM:

Something that has become trendy on social media is fibermaxxing. Folks are now sharing tricks and tips to -- basically to maximize their fiber intake and they're loading up each meal, each snack with foods rich in fiber and then there are also sometimes using supplements so they're sharing about supplements. And, you know, they're just trying to support their goals whether it's gut health, cholesterol, blood sugar, it goes, kind of, on and on. Is fibermaxxing a good idea? And, you know, when we're thinking of adding more fiber to our diet, does timing matter at all?

DR. ALLEN:

Another great question. I like the term fibermaxxing. It, kinda, makes something that was -- like you said,"the old people thing" or not as trendy sound cool, right? So, I'm fibermaxxing. In theory, yes. I mean, the average American should be consuming double the fiber they're already doing 'cause they're not getting enough. You know, 15 grams is what most people are doing. You need more than that. So it's a great goal. Can you do it wrong? Yeah. So, you know, if you're gonna do fibermaxxing, it's just like going to the gym. You wanna do it gradually and mindfully, right? You're not gonna go to the gym if you haven't been in years and try to bench press 200 pounds just like you shouldn't start slamming down as much fiber as you can 'cause it's not going to go well for you. So, does timing matter? It does. So, you really wanna spread it out throughout the day. That's gonna prevent bloating'cause if you do it all at once, definitely you're gonna get some bloating and then keeping the blood sugar stable. So, it's throughout the day, you know, two to three times, and ideally with every meal is best. And then starting low and going slow. So, if you're normally eating only, like, ten to fifteen grams, don't go straight to forty. You're not gonna have a very good time. It won't be very fun. And then pairing it with water. Of course, that's key. And then some kind of a fat or a protein as well so we, kinda, get that longer satiety to slow the digestion and then aid in that nutrient absorption. So, timing very much does matter. You wanna, kinda, spread it out and not do it all at once.

KIM:

Yeah, I've seen a couple videos where someone has gone from zero to ten thousand in terms of their fiber intake. Just for our listeners who might be encouraged and might try to go too fast too soon, how would you know if you're maybe overdoing it?

DR. ALLEN:

Yeah, again it's going back to listening to your body, right? So, surprising enough, you'll start getting the same effects as you would if you were not having enough fiber. So, constipation surprisingly enough and often, especially if you're not getting enough water in, gas, bloating, abdominal cramping, that very tightness in the belly. And then you might even, if too much fiber, you won't absorb nutrients effectively. So, you might not be getting enough vitamins, other minerals, or even carbohydrates absorbed in the first place. If you have too much, it can block the absorption and then you could suffer the effects of that. Low vitamin D causing fatigue low carbohydrates causing low energy. There's a multitude that we can go over. But yeah, those are some of the ones you see. And especially if you pick ones that are highly fermentable and then you're really looking at having a lot of bloating and gas, and that microbiome -- the microbiome's gonna be happy about it, but you won't be very happy about it. So, you'll see those effects if you do too much all at once.

KIM:

And you, kind of, keyed in on it just then but how important is hydration when we're slowly adding it? How should we be thinking about how much water we're taking in?

DR. ALLEN:

Oh yeah. It is crucial, if not nonnegotiable, right? You have to have water if you're gonna take in fiber. You know, some of the things I mentioned that will happen if you don't take in enough water with fiber is the constipation, the bloating, and then the feeling, the sluggish feeling, the tired and sluggishness. A good, kind rule of thumb is for every five grams of added fiber, a glass of water, eight ounces of water. It's a good rule of thumb for that. Maintaining hydration throughout the day, you know, it kinda rule say "Oh, 64 ounces of water a day is pretty good." But yeah, if you're kinda pairing your fiber intake with water, five grams to eight ounces.

KIM:

So, another popular thing that I've been seeing is the dense bean salad. If you haven't seen it, I'll send you the videos. The recipes look good. I haven't made one yet -- Yeah, the DBS. The salad usually contains anywhere between two to three types of beans. There's usually vegetables, a protein, and some kind of dressing that they'll make. And it's meant to be mixed all together and it's something you can, kinda, consume during the week for your lunch. Would making a DBS every week be enough for us to meet our daily or weekly fiber goals?

DR. ALLEN:

DBS, finally it's one of those trends that's actually backed by, like, solid, nutritional science. So, it's one that I can definitely be on board with. Beans especially are just an absolute fiber powerhouse. And then combining them with vegetables and a vinaigrette makes it nutrient dense, filling, and gut friendly. So, wins all across the board. The question is is it enough, right? It can, it can get you there, right? But there's a few considerations. Most people with DBS, let's say if you make a DBS or dense bean salad and you have a cup and a half to two cups, that's gonna give you about 15-25 grams of fiber. For women daily it's 25 and 38, so either meeting it or pretty close. So, almost the whole day in one sitting, which is good. But if you remember, earlier I mentioned it's better to spread it out throughout the day than taking your fiber all in at once. So, fiber works best when you spread it throughout the day and, like I said, not kinda slammed in all at once. It avoids the bloating and then facilitates the gut microbiome. It can definitely -- I like to describe DBS could be your fiber anchor so it's like,"All right, I'mma do this. That's, kinda, my anchor and then through the rest of my day, make sure I'm getting in other fiber sources and maybe even the supplement, but I would consider DBS as almost like a supplement. Like, I'm gonna use this as my anchor to bridge and then get the rest with my diet throughout the day. So, I think it's great and they do look really delicious, yeah.

KIM:

Yeah. DR. ALLEN: I might make one later this week too. KIM: Sounds so good. I like seeing when they, like, put 'em in wraps or --'cause you know, the reason why I haven't tried it is, is it just gonna be, like, eating a bunch of beans all at once? But…[Laughing]

DR. ALLEN:

It has the word salad in it, so you know. KIM: Yeah, yeah. Just supplement with all those veggies. Just to circle back really quick. So, we talked about supplements and also getting our fiber from whole foods. Are all fiber sources created equal or should we prioritize one over the other? You know, we kind of mentioned it's basically whole food fiber versus the synthetic. Whole food fiber is ideal. And you can get it from tons of sources. And really, there's no wrong source to get it from. Fruits, and vegetables, and beans. Especially fruits too 'cause they come with other nutrients that work synergistically with fiber. So, it's not just the fiber that you're getting when you're having it from whole foods. You're getting everything else that comes with the whole foods that work in concert with the fiber. It's by design almost, right? Whereas the synthetic fiber, you're not getting all those things. All you're getting is the fiber component. You're not getting the vitamins or the other chitins of things that can come with it. So really, there's no, like, perfect food and we know some are stronger and better than others in terms of their content of fiber. But ideally, a variety is what's best. You don't wanna be like,"Okay, I'm just gonna only do beans and have that be my only source of fiber." You want a little bit from everything, and some of the foods I mentioned earlier, and then you can always look up online 'cause you know the apple's not coming with a food label. But you wanna get it from a variety. So, there's no all star whole food to get it from. And then of course using the synthetics as your bridge.

KIM:

We've kind of, been circling the whole topic of digestion, and another trend that's become really popular with the fibermaxxing crowd. And please excuse the language but it's called fart walks. It's basically, you know, you've finished your meal and you are gonna go outside, maybe walk around the block is kind of the general idea. Are there any actual health benefits to taking a stroll after a meal, whether it's for digestion or otherwise?

DR. ALLEN:

Fart walks are legit. I mean, they definitely have benefit. It's one of the simplest and most effective things that you can build into your day to get a multitude of benefits, and I'll kinda go through some and address ones you asked. So, digestion, right? So, we know that gentle motion -- and really, you know, this walk, you only need ten to fifteen minutes of a light walk. It doesn't have to be high intensity after a meal. You usually wanna try to go on the walk within 30-60 minutes after you complete it. But it'll support digestion. The gentle movement stimulates what we call peristalsis, which is the wave-like muscle contractions that help move food and gas through your intestines. That'll help to relief bloating and reduce gas build up, hence fart walks, right? So, you're walking and then it's gotta go somewhere. And then promoting the more regular bowel movements. But not only that, you're gonna get better control of your blood sugars. Post meal walks have shown to blunt sugar spikes because what happens is when you start walking and exercising, a very unique thing occurs that doesn't happen if you're not moving, and that's your muscles. Insulin is slow, right? So, when you're exercising, it's too slow to get the sugar into your muscles, so what happens is your muscles actually open up these channels and then suck up sugar from the blood. So, they stop these big spikes that you can get, and thus an insulin spike, which then can create more fat cells because whatever is not used, it's gonna get stored. Your body doesn't wanna waste things. So, you can reduce those sugar spikes, and especially helpful for those that might have insulin resistance or type two diabetes. We know for the next 24 hours after going on a ten to fifteen minute walk, your body's gonna be more sensitized to insulin, meaning your pancreas won't work so hard and your sugars won't get so high. And those are the effects it'll have on that. Of course, for heart and metabolic health, it improves cholesterol, reduces blood pressure. And they really do add up throughout the day too. Ultimately, our goal is 150 minutes of moderate intensity exercise per week. So just getting in this ten to fifteen, kinda, helps you to get to that goal. And then lastly is, you know, I think the big reason is the gas, hence the name, right? So, if you're getting new to starting fiber or you're, kinda, working on upping it, if you really wanna alleviate that bloating and gas that can sometimes occur, this is a great way to do that versus just, kinda, sitting and suffering in it. So yeah, I definitely am all for fart walks.

KIM:

We've, kind of, mentioned that everything that's, kind of old is becoming new again, but just with better marketing. So, in addition to fart walk, I've seen the same creator, what they've done is -- so, they'll take high fiber cereal and they melt chocolate and they mix it together and it becomes a dessert. So, when we're thinking about, like, kind of these ways to add more fiber into our day, and I know 'cause we've talked about it many times on the podcast. You know, we're trying to lower the amount of ultra processed foods that we're taking into our diet, but are these kind of little cheats that we might take to get to fiber. Are those okay to try?

DR. ALLEN:

I'd say so. You know, especially if you're having trouble getting your fiber in, right? You know, some people, they're just -- even if they want to, they just don't really like vegetables, or they can't afford them or can't afford fruit, but they can definitely afford a big bag of cereal that has high fiber in it. So, you know, it's a risk benefit thing. If the alternative is you're not gonna get enough fiber in for your day, then I'd rather you mix it with the chocolate and have it as a dessert, right? Granted, yes, it's processed and we, you know, kinda pick the least processed version of it. But yeah, like I said, if the alternative is just having none at all, I'd rather you get it in.

KIM:

We've kind of talked about all of these various trends, and if we're trying to come up with a regimen that is a combination of any of these things, you know what would you recommend, like, how we should start out maybe?

DR. ALLEN:

Slow is the way to go. Remember it's like taking your gut to the gym. You're not gonna go and just start trying to bench press as much as you can. You're gonna hurt yourself. A good way to start, it depends, you know? I would also -- I would definitely talk to your doctor, right? Kinda get advice there. So, those other populations I talked about, like IBS or inflammatory bowel disease. Probably might wanna start with my beginner fiber, which I talked was like Citrucel. That one is not fermentable. Guts can't -- biome cannot digest it, so. But it can aid with constipation and keeping the gut moving, but don't really get the gut biome. But it's a good kinda intro starter to get into it. Psyllium is the best. Generally what I recommend is you're gonna wanna increase, let's say if you're having none now, you're not doing any kind of supplement or adding, or if you're looking at increasing your fiber, start with five grams for a week, and then after that we can increase it by another five and gradually increase it as you move forward until you hit your goal, whatever that might be. Either if it's your daily recommended or if you're trying to do more than that. But kinda -- a week is about enough time to get into that. First couple days you might do some adjusting but once you feel like your gut's adjusted and you're feeling good, then it'll be time to move to the next one. So, three to five grams a week until you get to your goal is a good approach. KIM: Awesome. Is there anything that we haven't talked about that you might talk to your patients about with fiber? Anything that, you know, you really think that listeners should understand? I think we've hit a lot of it right, and it's good to see that there's finally a trend, like, a food trend that is real and does have a lot of benefit and is really overlooked. I mean we've known people have problems fiber for years and years and years. So, we've known it for a very long time, it's just how do we make fiber and pooping cool, right? It's kind of tough to do. Somehow they managed to do it right. But I think that's just people being more conscientious of the inner workings of how our bodies operate and they really -- you know our bodies aren't just a bunch of individual pieces, it's all together and works in concert with itself. So, fiber is important, protein's important, carbohydrate's important. Where you get it from also really matters and I think that's another thing people are realizing is where is it coming from? So, I think if I wanna leave one thing with folks is whole foods is the best thing to do. And honestly if you can grow it yourself, that's even better, right?'Cause now you're not worried about the pesticides and other type of GMOs that can have effects. But whole foods is where you want it, you want to spread it throughout the day and give yourself a variety. And if you're looking at achieving those goals, set a plan and, kinda, gradually work your way up to there just like if you're starting an exercise program, it's the same thing for your gut. And then hopefully your doctor or whoever you're seeing can provide some guidance on it too.

KIM:

I love the idea of it's exercising your gut 'cause, you know, I think we all like to think of ourselves as getting in enough movement. But to get movement -- sorry excuse the pun but I had to do it.

DR. ALLEN:

It was right there in front of you, you had to take it. KIM: Yeah. Well, thank you so much. This has been such a great conversation and I hope our listeners can really have some actionable bits to take on. I'm glad as well and hopefully somebody learned something from this, and if anything go for a fart walk.

KIM:

Definitely. I don't know, maybe I'll -- after lunch.[Laughing]

DR. ALLEN:

Perfect. KIM: Thank you. Thank you.

ZACH:

Okay Kim, looks like that you shouldn't stock pile your fiber at the start of the day. I don't know how I got this idea. Again, I blame the cereal companies and all the labels for advertising fiber on their cereal boxes, right? You guys even talk about that a little bit.

KIM:

Well, and I think as more people become conscious about how much fiber they're taking in, like if you go to -- now that you're aware of it and you go grocery shopping, you're going to see all the boxes are like ten grams of fiber, three grams of fiber. It's everywhere on the front of packaging now, which is good. People should be conscious about fiber. I mean, 'cause I think we've been so in love with protein but… ZACH: Yeah. It's really fiber the one you should be worried about.

ZACH:

Now, you guys talk about this bean salad.

KIM:

Yes. ZACH: I haven't done that. I've done the, like, the high protein, high fiber, like, bean chili. Mm-hmm.

ZACH:

So, it's like a cousin of that it sounds like. It's like without the salad dressing, but it's like just the beans, and like the vegetables. And so, I've had good experiences with that, what about you?

KIM:

I still haven't tried the dense bean salad yet but I do follow the particular creator who is the originator of the dense bean salad. And every time I see one of those recipes, I'm like, "I really should make that."

ZACH:

It looks good. KIM: It really looks good. And I like the idea that it's -- you make it on Sunday or Monday and that's your lunch for the week. Yeah, see as someone who is always struggling with meal planning, right? And like, "Oh, we should be healthy and eat this all week." It's a struggle. But something like that... In the past, I've like, okay, divvy all this out into, like, this container, and that container, that container, and these are your, you know fo -- let's be realistic, right? You're gonna, like, go out for lunch at least once a week. So, you know, four. Four containers of this salad or chili, whatever that ends up being, it helps you across the board, really.'Cause it helps you health wise… KIM: Yeah. Because it's the healthy thing to eat. And also, you know, save a little money.

KIM:

Save a little money and, you know, it's about that consistency right?

ZACH:

Yes.

KIM:

So, just making sure you're being better more often than you're not. ZACH: Yeah, yeah.'Cause you feel bad if you have something in the refrigerator and then you just leave it there and go spend money on lunch, right? KIM: Yeah. There's nothing worse than the look of shame that your produce gives you when it's, like, wilting there in the crisper… ZACH: Yeah. As you put out food delivery on the table.

ZACH:

Yes, yes.

KIM:

Another trend that I talked about with Dr. Allen. I mean, I don't know if we can really say it on the podcast, but I'm just gonna say it anyway. Zach, have you ever gone on a fart walk?

ZACH:

You know, it's good to know that there's an official designation for this now. I mean, honestly, we all gotta pass gas sometimes, right? And at some point in my life, I found am I gonna have an upset stomach… KIM: Mm-hmm. And be uncomfortable, or just go pass gas somewhere?

KIM:

Yeah.

ZACH:

Maybe more than one somewhere. Maybe many somewheres.[Laughter] So yes, in my own way, I have done this. I guess we all have, but now we have something to call it, right? KIM: Yeah.'Cause the more fiber you eat, the more gas you gotta pass. That just goes with the territory.

KIM:

For sure. Especially, you know, when you start exploring adding more to your diet, I think that's when Dr. Allen said that we are more likely to experience those challenges of having more fiber. What I think was so interesting about, like, going for a digestion walk or going for a walk after a meal is he said it helped with your blood sugar levels. And, you know, I think that's a great reason for all of us just to, you know, after you eat dinner to go take a stroll around the block or something like that.

ZACH:

Yeah, it's a nice after dinner activity, and it has health benefits as well. So, if nothing else, just park a little further away from the restaurant, right?

KIM:

Park a little further away from the restaurant, maybe just after you finish the meal, like take a little stroll around the block and come back home.

ZACH:

Do some window shopping. KIM: Yeah, that's right. I love tips like that where it's just so easy to just incorporate into your day 'cause sometimes I feel like we think about these changes that we might want to make for our health as being, like, these big, like, insurmountable things. Yeah, but if you slowly incorporate, like Dr. Allen said, about having more fiber with each meal and kind of following it, going slow to start I think is great advice for anything you wanna do when you're trying to change your health. ZACH: Absolutely. And we've had many conversations on this podcast about that. Making those micro changes, that's the way to go.

KIM:

Mm-hmm.

ZACH:

Because if you just make some sudden pendulum shift to the other side, that's unsustainable, right? And it's not gonna stick. KIM: Yeah. I think the big changes that are overnight changes, I think those are the ones that, kinda, lead into the crash outs. ZACH: Absolutely. So, you worried about your fiber intake now or do you feel pretty confident in it?

KIM:

You know I feel pretty confident in, kind of, how I've been approaching things'cause I don't really count macronutrients but I'm making sure that there's vegetables on my plate with every meal so I know I'm getting fiber. And, you know, I take a little, like, gummy supplement and hopefully I'm there. ZACH: Absolutely. Alright, well that's gonna do it for this episode of On Health with Houston Methodist. Be sure to share, like, and subscribe wherever you get your podcasts. We drop episodes Tuesday mornings. So until next time, stay tuned and stay healthy.