Three White Coats
Diet For Constipation Prevention and Relief
Inadequate diet significantly contributes to constipation. For example, Western diet - a term relating to a calorie-dense diet high in red and processed meat, refined grains, sweets, and dairy - has long been directly associated with many disorders, including constipation. On the other hand, a well balanced, healthy diet, rich in whole foods - fruits, vegetables, grains, nuts, and seeds - lowers the risk of a number of common ailments, from hypertension to diabetes. Dietary changes offer a safe, efficient and inexpensive way to improve symptoms of constipation. Although it may not be immediately effective, adopting a healthy diet will be a long lasting solution. Importantly, it will minimize the need for laxatives, which offer a quick fix but also bring about the risk of dependency.
Increased intake of dietary fiber and fluids is the advice most commonly given to people with chronic constipation.
Fiber
Dietary fiber is abundant in plant food and has numerous health benefits. Depending on the type, fiber helps with constipation in different ways. There are many different types of fiber, but for the sake of simplicity we will group them into only two broad categories: soluble and insoluble.
Soluble fiber has the ability to form a viscous gel with water, which helps soften the stool, making it easier to pass. Additionally, by increasing the fecal bulk, some soluble fiber can also improve the stool frequency.
Insoluble fiber provides bulk necessary to move the waste down the digestive system, and can reduce the intestinal transit time.
Whole Grains. In a grain, the highest amount of fiber is found in its outer shell, the bran. Unfortunately, in the refinement process, the bran, the germ (the embryo of the grain), and the important nutrients they contain, are all removed from the grain. This is why the refined grains and the products made from them (white/enriched bread, white rice, wheat flour) contain significantly lower amounts of fiber than the whole grains (whole wheat, brown rice, quinoa, oats, rye, popcorn). An easy way to introduce more fiber into your diet is to replace the refined grains with the whole ones.
Whole grains differ in the amounts of fiber they provide. Barley, bulgur wheat, oats, whole wheat and their products, are all excellent sources that provide 2-6 grams of fiber per serving. Wheat bran is also available as a supplement that can be added to smoothies, breads, and baked goods. However, in clinical trials, wheat bran did not show a clear benefit for constipation relief.
Bread made from whole grain rye, a cereal grain similar to
wheat, was found to significantly relieve symptoms of constipation. Consumption of yogurt, containing Lactobacillus rhamnosus strain, alongside rye bread, was found to alleviate gastrointestinal symptoms (gas, bloating) that are sometimes associated with high fiber diets.
Fruits and vegetables. Cellulose, an insoluble fiber, is found in all plants. It is a very close relative of methylcellulose (in fact, methylcellulose is derived from cellulose), an active ingredient in the commonly used laxative, Citrucel. Fruits and vegetables also have varying amounts of other insoluble and soluble fiber. Consuming the recommended five to nine servings of fruits and vegetables a day, will provide a variety of fiber that will help improve many symptoms of constipation, from infrequent stools to stool consistency.
Flaxseeds. Seeds of the plant used to make linen fabric, flaxseeds, have traditionally been used for constipation relief. Flaxseeds contain a large amount of mucilage (soluble fiber) and lignin (insoluble fiber) that help with stool bulking and softening. Flaxseeds can be added to your favorite baked goods or eaten with the morning cereal. To get the most out of the many nutrients that flaxseeds contain (polyunsaturated fatty acids, fiber, proteins), grind the seeds before you use them. The hulls of flaxseeds are so hard that if eaten whole, flaxseeds will not be digested at all. Flaxseeds are best stored in the freezer to preserve polyunsaturated fatty acids that they are perhaps most known for. It is worth noting that flaxseeds also contain materials that can potentially be toxic. For this reason, keep your daily consumption of flaxseeds below 30g per day.
Fluid intake
Fiber needs water if it is to properly function and provide the bulk and stool consistency needed for constipation relief. In fact, adding fiber to your diet without adequate hydration can cause constipation - not improve it. In a clinical study, the simultaneous increase in fiber and water intake showed greater benefit for functional constipation than did high-fiber diet alone. A large study in Japan found that water from food is particularly important in preventing constipation.
If your health allows, increase your fluid intake by sipping water throughout the day, or by including fruits and vegetables with high water content in your diet.
Beyond Fiber and Fluid
Prunes. Dried plums have been used as a natural laxative for a long time. Besides fiber, prunes contain a large amount of sorbitol, a sugar substitute with a known laxative action. A high content of sorbitol helps explain why prune juice (almost devoid of fiber) has a similar effect on constipation as do prunes themselves. Various preparations of prunes – plain, jam, in combination with yogurt, etc.- have all been clinically proven effective in relieving constipation.
Many fruits contain sorbitol, but dried fruits are an especially good source. Fruit juice, particularly made from apple, pear, and aronia, is also high in sorbitol. Dried dates, apples, apricots and peaches make for a delicious desert; an occasional glass of juice (with no added sugar, of course!) is also a refreshing treat.
Magnesium. In the first report of its kind, a large epidemiological study found low magnesium intake to be associated with a higher incidence of constipation. In addition, mineral water rich in magnesium sulfate was found to be beneficial for constipation relief. These results are perhaps not surprising considering the fact that magnesium products (citrate, sulfate, hydroxide) are well-known laxatives.
Sufficient magnesium levels are important not only for constipation but for one’s overall health. To increase your intake, include ample amounts of magnesium-rich food in your diet. The best sources of magnesium are dark leafy greens (Swiss chard, spinach), legumes, whole grains, nuts (almond, cashew, peanuts), seeds (pumpkin) and fish (halibut, mackerel).
Fats. Recently, a large study found a link between the high intake of saturated fats (found in meats and dairy) and constipation. On the other hand, no such link was shown to exist between the consumption of unsaturated fats and constipation. To lower your risk of constipation, replace saturated fats (butter, cheese, cream, meat, fast food) with the healthy ones (olive oil, avocado, oily fish and nut oils).
Precautions
Sudden increase in fiber can lead to side effects such as cramping, bloating and gas. For this reason, it is important to go slowly when introducing high fiber foods into your diet. Add a serving of vegetables or fruits and pay attention to their effects. If you see that you are tolerating it well, go ahead and introduce another high-fiber item.
On the other hand, if you experience uncomfortable gastrointestinal probelms, pause for a day and try some other food the next day. The goal is to find both the right amount and the type of fiber that will work specifically for you.
Fruits, starchy vegetables. and whole grain products can contain a substantial amount of carbohydrates. Accordingly, it is important that prediabetic and diabetic patients consume these foods in moderate amounts.
To summarize:
Last updated: November 16, 2016