Talking with Patients about Fiber and their Health

While trending diets and eating recommendations seem to be focused on elimination of specific foods or food components, it is important to advise patients on foods and ingredients they should consume – fiber being one of them. For example, numerous studies have shown fiber intake is associated with several positive health outcomes including reduced risk for cardiovascular disease (CVD), type 2 diabetes, and cancer. Research also shows improved digestive health and body weight outcomes related to fiber intake. In 2015, the Academy of Nutrition and Dietetics published a position on the health implications of dietary fiber.

The benefits of fiber are also acknowledged in numerous public health and dietary recommendations including:

• 2015-2020 Dietary Guidelines for Americans
• Eatwell Guide developed by Public Health England
• Australian Dietary Guidelines

The Motivation for Patients

Patients interested in reducing their risk of certain chronic diseases may be motivated by understanding the benefits of consuming sufficient dietary fiber. Other patients may want to know the risks of not consuming enough. In a 2016 Global Burden of Disease study, the low intake of fiber was related to death and disability in adjusted life years due to ischemic heart disease, colon cancer, and rectal cancer. Estimates show dietary fiber intake is insufficient in most countries, and thus, many individuals you counsel may benefit from including more fiber in their diet.

During a 2014 Food & Fiber Summit, strategies for healthcare providers to use when discussing fiber with patients were identified. These strategies include communicating the benefits of fiber by focusing on food and flavor while addressing misperceptions using short, specific and simple recommendations.

The Opportunity for Added Fiber

Healthcare professionals may be familiar with suggestions for individuals to consume more whole grains, whole fruits, vegetables, legumes and nuts. However, a variety of foods and beverages also contain added fibers that provide health benefits and may be more appealing to individuals making changes to their dietary patterns. A 2017 review provides a summary table of fibers found in various packaged foods and health benefits that can be claimed in several countries. Providing recommendations based on food preferences can include simple substitutions that may be viewed as more achievable than drastic changes. Some examples of simple substitutions to discuss with patients include:

• Choosing cereals and cereal bars that contain added fibers such as inulin, digestion resistant maltodextrin, and rice fiber.
• Drinking dairy products and beverages that contain beta-glucan, oligosaccharides, polydextrose, and xanthan gum.
• Eating pasta that is either whole grain or contains added fiber such as psyllium, resistant starch, and konjac glucommanan.
• Selecting desserts also contain a variety of added fibers from ice cream and baked goods to fruit snacks, and confectionery products including chocolate.

Educating your patients and clients on choosing foods high in fiber by reading food labels and knowing what ingredients are sources of dietary fiber can broaden the option of fiber-containing foods they enjoy consuming.

Additional resources that may be helpful for healthcare professionals and consumers are regularly updated and available here.

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