The Ultimate Guide to: Your Poop
Despite what the USDA food pyramid may be telling you – eating a LOW fiber diet saved my life, and it might save yours.
In 2009, out of the blue I started experiencing weird bowel and GI issues. I noticed that I was bloated everyday, began having abdominal pain, and suddenly was finding myself chronically constipated (as you can tell, this is going to be a fun story).
As a person who ate healthy my entire life – who ate lots of fruits, vegetables, whole grains, lean meats – I was pretty perplexed – I mean, my diet was perfect, so what was going on?
After consulting with nutritionists, doctors, GI specialists, and many alternative practitioners (that didn’t work), I learned an interesting truth: particularly for those with bowel issues, much of what we’re taught about fiber is un-true. What’s more, many of the claims about lowering disease or colon cancer risk aren’t true.
Why The Advice We’re Getting is All Wrong
I was perplexed.
I ate a “perfect” diet by objective standards, since everyone knew me as a healthy guy. Nonetheless, I didn’t feel right. Something was up.
First stop? The general practitioner.
“Well, can you tell me about your poo?” he said bluntly. “Are you clogging the toilet? Does it smell weird?”
(This was fun, I assure you).
“Errrrr….” I slightly replied.
“Could be a lot of things! I’m going to refer you to a nutritionist friend I have, she’s a doll.”
Second stop? The nutritionist.
The nutritionist was a pretty nice woman who knew her stuff.
“We’re going to get some blood work done, and then a complete dietary check.”
* Two weeks later *
Nutritionist: “Wow, your blood is purer than the Virgin Mary.”
Me: “Really? So what’s going on?”
And from there, the story is the same – she gave me the universal mainstream prescription for constipation: “Add fiber and drink more water.”
So we tried this for a month or two. I bought bran meal, added it to my morning oatmeal, added some more fiber throughout the day, and then was eating 30-50 grams of fiber a day.
… And I was promptly in the worst pain of my life, and so painfully bloated that I couldn’t even sleep. Oh, and I still was corked up tighter than the gates of Troy.
“I’m going to pass you to a GI doctor.”
Third stop? The GI doctor.
After spending a grand total of 90 seconds with me, he said “Sounds like IBS, let’s give you a colonoscopy.”
After the GI doc’s “thorough” analysis, I decided that it was time to go old-fashioned: DIY Time.
Fourth Stop? Poo-testing 101
After the GI doctor, someone mentioned that, being an avid traveler, I might’ve caught something on a recent trip to a third world country.
Having recently been in India, I mailed away for a home test stool sample kit, spent three incredibly fun days hand scooping fecal matter into test tubes, and then mailed it back to the lab.
How Do Eskimos on a No Fiber Diet Not Get Constipated?
After I began questioning conventional advice, I found some interesting questions:
A. Why do Eskimos in northern latitudes, who typically eat a no fiber diet, have no constipation issues?
B. Why do people who fast, and don’t eat solid foods for weeks, still have bowel movements?
C. Breast milk has no fiber, so how come babies who are only consuming breast-milk still have multiple bowel movements per day?
In my quest to answer some of these perplexing questions, I ended up finding out three truths about fiber that dramatically improved my health problem (when everything else failed).
A: Fiber is Making Your Constipation Worse
Fiber Constipates You
For some people (the lucky few), consuming more fiber will do exactly what you think – increase more bulk and help pass things through the intestines quicker.
But for people who already have constipation issues or IBS, fiber not only doesn’t help, it makes things worse. I learned this first hand after dealing with the nutritionist. If things are already not moving, adding more bulk just makes that worse… because nothing is moving!
Reducing your fiber will dramatically reduce your symptoms and get the… ahem… good stuff going. Again, this is specifically for people who already tend to have constipation or IBS-like issues.
A 2012 study showed that stopping or reducing dietary fiber intake reduces constipation and it’s associated symptoms. (for people who are regularly constipated for “no reason”, aka idiopathic constipation)
People who reduced their fiber completely went from having 1 bowel movement every 3.75 days, to one bowel movement every day.
People who reduced their fiber intake a bit went from having 1 bowel movement ever 4.19 days, to one bowel movement every 1.9 days.
For no fiber, reduced fiber and high fiber groups, respectively, symptoms of bloating were present in 0%, 31.3% and 100% and straining to pass stools occurred in 0%, 43.8% and 100%.
Higher fiber = high bloating and pain for many of us.
Another study done in Brazil found no association between low fiber and constipation in kids.
Fortunately I can confirm from years of personal experience – by far the best thing I did was reduce my fiber as low as possible, which meant eliminating all grains, white breads, wheats, etc.
B. Fiber Does Not Lower the Risk of Colon Cancer
Does fiber actually reduce colon cancer risk? NOPE.
Straight from Harvard:
For years, Americans have been told to consume a high-fiber diet to lower the risk of colon cancer—mainly on the basis of results from relatively small studies. Larger and better-designed studies have largely failed to show a link between fiber and colon cancer. One of these—a Harvard study that followed over 80,000 female nurses for 16 years—found that dietary fiber was not strongly associated with a reduced risk for either colon cancer or polyps (a precursor to colon cancer). More recently, researchers combined the results of the Harvard study with those of several other large studies that followed more than 700,000 men and women, some for up to 20 years. After accounting for differences in participants’ red meat and alcohol intake, as well as other factors that could increase colon cancer risk, high intake of fiber was not found to protect against colorectal cancer.
And from the FDA:
“Based on its review of the scientific evidence, FDA finds that (1) the most directly relevant, scientifically probative, and therefore most persuasive evidence (i.e., randomized, controlled clinical trials with fiber as a test substance) consistently finds that dietary fiber has no effect on incidence of adenomatous polyps, a precursor of and surrogate marker for colorectal cancer; and (2) other available human evidence does not adequately differentiate dietary fiber from other components of diets rich in foods of plant origin, and thus is inconclusive as to whether diet-disease associations can be directly attributed to dietary fiber. FDA has concluded from this review that the totality of the publicly available scientific evidence not only demonstrates lack of significant scientific agreement as to the validity of a relationship between dietary fiber and colorectal cancer, but also provides strong evidence that such a relationship does not exist.”
It’s notoriously hard to say “colon cancer risk was reduced because of dietary fiber intake” because there’s often many variables involved and factors that need to be accounted for.
I just wish my morning Wheaties would remove the big heart that says “Fiber helps reduce the risk of colon cancer!”
C. Does Fiber Actually Reduce Heart Disease Risk?
Does more fiber actually lower heart disease? Technically, yes… but that’s not really the whole story.
This is a typical story: A 2004 study compared people that were measured for 5-10 years in a long-term study. After adjusting for demographics, BMI, and lifestyle factors, each 10g increment of dietary fiber was associated with a 14% decrease in risk of all coronary events and a 27% reduced risk of coronary death.
The researchers’ conclusion? Increased dietary fiber from cereals and fruits is inversely related to coronary heart disease.
You could end right there and think ‘Oh! Time to eat more fiber! Let’s start shoveling in some extra bran into my oatmeal in the morning!”
But it doesn’t say whether that decreased risk was due to the high fruit and vegetable intake (which we know reduces disease risk), or if it was actually due to the fiber.
Also – what kind of fiber? Soluble or insoluble? IN other words, getting all your fiber from vegetables and fruits is way different than getting it all from increasing your grain consumption.
This 2008 study found similar things – increase fiber decreased the chances of heart disease. But was it the fiber, or the fact that if you’re eating 30g of fiber, you’re eating a hell of a lot more plants and fruits than other people?
We know that fruits and vegetables have hundreds of protective and preventative effects on the body, so is it actually more fiber protecting us, or more of the right foods?
… So Why Don’t Eskimos Get Constipated?
… Because you don’t need fiber to poop.
Remember: babies drinking breast milk, eskimos eating no fiber, and fasters drinking only liquids still have bowel movements.
People often think that feces, is well, food – and that you require fiber in order to make them.
So the logic often goes like this: “If fiber makes good stools… and people are having bowel issues, let’s add more fiber and push it all through!”
In reality, proteins, fats, carbohydrates and even fiber are usually digested completely – if they aren’t (and they come out intact) it’s because the body couldn’t digest them.
Feces are actually made up of bacteria (anywhere from 30%-70%), water, mineral salts and some traces of fat (source).
It’s a myth that you somehow need fiber and bulk to poop.
So If I’m Repeatedly Constipated or Have IBS… What SHOULD I Do?
SO what does work? I can confirm this both from the research and from entirely too much personal experience:
A. Gradually lower your fiber intake. How: Remove whole grains, pasta, wheat, bread, bran, etc. Leave the fiber you find naturally in fruits and vegetables. Lower your fiber intake slowly – because of the now decreased stool size, it’s possible to become constipated because your body has a harder time registering the smaller stool (common side effect of the Atkins diet – when people go low carb, they also dramatically reduce fiber intake).
B. Dietary fat, not protein, not carbs, and not meal volume help stimulate bowel movements. When you want to try and establish a daily ritual of going to the bathroom, consume a high fat meal the same time every day – for example, add half an avocado or a tablespoon or two of peanut butter after a meal, and relax for a few minutes. If you haven’t, you can create a morning routine by drinking a warm beverage first thing in the morning, sitting, and relaxing for 10 minutes.
C. Don’t over drink water. Drinking more water does not help moisten stools more. You shouldn’t be forcing yourself to drink extra water.
D. Do the 3rd world squat. Virtually everywhere in the underdeveloped world, squatting is common to go to the bathroom. Without a toilet it’s just the most convenient way to go to the bathroom, but as it turns out, there’s lots of evidence showing that it’s a better way to go to the bathroom, and is much easier to have bowel movements. Studies have tested and compared squatting versus seated positions and found that squatters had quicker bowel movements, less strain, and reported less subjective pressure and discomfort.
Fiber – Pain, Bloating, And Gas – Anyone?
My point is not to make fiber out as the enemy for everyone – my point is that, in a smaller subgroup of people who already have bowel issues, fiber is absolutely the enemy, and it is being pushed on us left and right despite the fact that it doesn’t work.
30% of people have chronic constipation, and virtually 100% have short term constipation at some point.
This makes me begin to wonder if we are maybe in a GI and digestive health epidemic.
It seems like every day I hear about a new person with IBS or some kind of chronic bowel/digestive issue, and I’m terrified at the prospect of them downing 30g of fiber.
Definitely make sure to check out the incredible book Fiber Menace: The Truth About the Leading Role of Fiber in Diet Failure, Constipation, Hemorrhoids, Irritable Bowel Syndrome, Ulcerative Colitis, Crohn’s Disease, and Colon Cancer.
Some select quotes and references have been adapted from here, but this book was (flat out) the most useful book in my own personal vendetta against IBS and all symptoms related to it.
Bottom line: So what am I supposed to do? Count my fiber? Count my calories? Calculate food ratios? No…
The prescription for “what to eat” is the same that I always suggest – the same one that has dramatically improved my health. Just eat real food. Incase you forgot what that was, read this.
When you want to reduce your fiber to fix a slow GI, the first things you should remove are grains, wheat, breads, etc. Constipation will clear up, GI problems will ease, and you’ll probably also end up losing some weight.
P.S. Add Modern Health Monk on Facebook – I post lots of cool health experiments and articles you won’t find here on the site.