online version Dietary Fibre Patient Information for the Gloucestershire Health Community GHPI0811_08_07 Author: Continence Review due: August 2010

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1 GHPI0811_08_07 Author: Continence Review due: August 2010 Patient Information for the Gloucestershire Health Community Dietary Fibre

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3 Notes Introduction Fibre is an extremely important component of a balanced, healthy diet. Its main role is to keep the digestive system healthy, but it has other functions within the body including; Controlling blood glucose levels Decreasing cholesterol levels Improving the absorption of nutrients Controlling appetite Preventing bowel disease (Irritable Bowel Disease, Diverticulitis and Bowel Cancer) In relation to problems of bowel control, fibre can improve stool consistency, promote bowel regularity and control symptoms of bowel frequency and urgency. What is Fibre? Fibre is made up of the indigestible parts of plants, which pass relatively unchanged through the stomach and intestines. There are two types of fibre, soluble and insoluble Soluble fibre is broken down in the colon (large bowel) by bacteria. Stools become bulky, because of the increased bacterial mass of the stool. This type of fibre also forms a gel like substance which can bind to other substances in the gut. Again causing, the stool to be more bulky and thicker in consistency. Insoluble fibre is less easily degraded by colonic bacteria, but it holds water very effectively, thus increasing stool weight. This increase in stool weight improves the movement of nutrients and waste products through the digestive tract. 8 1

4 How much should I eat? To promote health and well-being, a balance of both forms of fibre should be included in your diet (see the fibre table to see which type of fibre is predominant in particular foods). The recommended average daily intake of fibre is 18g per day for an adult, which to be effective, must be consumed with 6-8 glasses of water per day.. A sudden increase in fibre can have 'explosive' effects. A sudden switch from a low fibre diet to a high fibre diet can cause abdominal pain, increased flatulence and bowel urgency. If you have to increase your fibre intake to reach the optimum level, then do so, on a gradual basis, say a few grams every few days, so as not to over burden the digestive system. Be aware that too much fibre in your diet can hinder the absorption of certain minerals including zinc, calcium and iron. You should, therefore, avoid eating more than 35g per day. How can fibre help with bowel control? If you have a tendency to suffer from constipation or diarrhoea, increasing or restricting the amount and type of fibre in your diet may help. If stools are too hard and infrequent, the aim of treatment should be to soften them to produce a stool that is easier to pass, when defecation is attempted. Increasing the amount of fibre in the diet can help achieve this aim. In particular, increasing the amount of insoluble fibre (which increases the absorption of fluid in to the stool) will make it softer and bulkier. On the other hand, if you suffer from diarrhoea or bowel urgency, reducing the amount of fibre in your diet might help. 2 Sweetcorn 85g 1.2 Brussel sprouts 90g 2.4 Peas 70g 3.6 Pulses Cooked Weights Split peas 30g 2.8 Baked Beans 30g 5 Butter Beans 30g 2.8 Chickpeas 30g 3.4 Boiled Beans 30g 4 7

5 Predominantly Soluble Fibre Fruit Apple with peel 1 (100g) 1.8 Apricots (dried) Banana 1 (100g) 1.1 Grapes 100g 0.7 Nectarine 1 (150g) 1.7 Peaches 1 (110g) 1.4 Oranges 1 (160g) 2.7 Pears 1 (150g) 3 Prunes Sultanas 1tbs 0.6 Dates (dried) 15g 0.6 Fruit (Cooked) Blackcurrants 140g 3.9 Goosberries 140g 2.7 Plums 140g 1.7 Rhubarb 140g 1.7 Avacado 1/2 small pear 3.4 Vegetables medium portion Jacket potato (with 180g 4.9 skin) New Potatoes 175g 2.6 French Beans 90g 3.7 Cauliflower 90g 1.4 Brocoli 85g 2 Carrots 80g 2 Spinach 90g 1.9 Tomatoes 85g Experimenting with the fibre in your diet will enable you to see which foods make your bowel control better or worse. This is very individual. Our bodies do not react the same, and it is a case of trial and error to see which foods, if any, cause problems for you. Increasing you Dietary Fibre Make it easier to include fibre in your diet by stocking up your cupboards with staples made from whole grains such as cereals, oats, brown rice, rye and whole wheat crackers and breads. Gradually increase your intake of fibre over a 3-5 day period. Ensure you also increase your fluid intake to 6-8 glasses per day. Make your own muesli by mixing oats, all bran flakes (or your favourite bran cereal), sesame seeds, sunflower seeds, nuts and assorted chopped dried fruits. For something a little crunchier, toss the mixture lightly in oil, add honey and bake in an oven for 45 minutes. Add dried fruit and nuts last. Start the day with your homemade muesli, or a high fibre cereal, and try to include wholemeal or wholegrain breads as part of your breakfast routine. When making casseroles, stews or soups, add lentils, pearl barley, brown rice or cracked wheat, all of which are good sources of fibre and add flavour to any dish. Finish a meal off with some citrus fruit, or include this as part of your mid- morning snack or lunch. Try to cut down on your use of white bread. Choose breads that contain wholegrain kernels. Pumpernickel and seed loaves have the highest fibre and nutrient content. Oats contain both soluble and insoluble fibre. They are cheap, easy to prepare and delicious. Try them with freshly 3

6 sliced banana and maple syrup. Remember the way the body reacts to dietary fibre is very individual. It may take you some time to find an acceptable diet that improves the function of your bowel. The tables below will help you decide which foods to include. Dietary Fibre Content Tables Predominantly Insoluble Fibre Breakfast Cereals Cornflakes 30g 0.3 Weetabix 2 Biscuits 4.4 All Bran 40g 10 Muesli 40g 3 Ready Break 160g 2.2 Porridge 160g 1.3 Bran Flakes 30g 5.2 Fruit & Fibre 40g 2.8 Sultana Bran 40g 4 Special K 30g 0.5 Shredded Wheat 2 biscuits 6.1 Bread White Bread 2 slices 1.5 Brown Bread 2 slices 2.8 Wholemeal 2 slices 4.5 Wheatgerm 2 slices 2.6 High bran 1 small 3 Pitta Bread 1 1 Granary 2 slices 2.6 Oatcakes Wholemeal 3 1 Crackers Ryvita Digestives Pasta & Rice Cooked Weights Whole wheat/ 220g 8 brown pasta White Pasta 220g 2.6 White Rice 180g 0.2 Brown Rice 180g 1.4 Nuts Coconut 25g 1.8 Hazlenuts 25g 1.6 Peanuts 25g 1.6 Peanut Butter 25g 1.4 Brazil 25g 1.1 Walnuts 25g 0.9 Almonds 25g

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