Fiber - The ins and outs

The results of a study in teenagers were recently reported in the American Journal of Clinical Nutrition: Over the two-year study period, about half of the participants had decreased their consumption of fiber by an average of about 6 grams per day, while the remainder increased their fiber intake by a similar amount. The investigators were looking at belly fat, which is the most dangerous type of fat; fatter waistlines increase the risk of diabetes and heart disease. Belly fat increased 21 percent for the study participants who were eating less fiber, but the adolescents who upped their fiber intake had a 4 percent reduction in belly fat.

Separately, it was earlier reported at the University of Leeds that pre-menopausal women who eat 30 grams or more of fiber a day cut their risk of breast cancer by 52 percent. This study involved nearly 36,000 women and lasted over eight years.
I found these conclusions outstanding! So what's going on with fiber and our health? Exactly what is fiber anyway? What are the best sources of fiber and what are its health benefits?

Officially, fiber is a type of carbohydrate that the body can't digest. Great sources are whole fruits and vegetables, whole grain breads and breakfast cereals, and all manner of beans. The daily amount of fiber that is currently recommended depends on the number of calories that you consume each day. Most adult women should shoot for over 20 grams of fiber a day; teens and men should aim for over 30 grams.

Before discussing fiber's health benefits, let's first bust two myths:
1. All fiber is created equal. Not true. There are two basic types of fiber, with different functions. Insoluble fiber is found in wheat bran, nuts and many vegetables. Its structure is thick and rough, and it won't dissolve in water, so it zips through your digestive tract. Conversely, soluble fiber is found in oats, beans, barley and some fruits. It dissolves in water to form a gel-like material in your digestive tract. This allows it to slow the absorption of sugar into your bloodstream.
2. Fiber has no calories. Not true. Your small intestine can't break down soluble or insoluble fiber; both types just go right through you. That's why some experts say fiber doesn't provide any calories. However, this claim isn't entirely accurate. In your large intestine, soluble fiber's molecules are converted to short-chain fatty acids, which do provide four calories per gram, as with all carbohydrates. (Insoluble fiber has essentially zero calories.)

Finally, let's review a short list of fiber's health benefits and discuss the reasons for these benefits.

• Avoiding and relieving constipation. Fiber can absorb large amounts of water in the bowels, and this makes stools softer and easier to pass.
• Heart disease. Foods containing soluble fiber can have a positive influence on cholesterol, triglycerides, and other particles in the blood that affect the development of heart disease.
• Gallstones and kidney stones. Rapid digestion leads to a rapid release of glucose (sugar) into the bloodstream. To cope with this, the body has to release large amounts of insulin into the bloodstream, and this can make a person more likely to develop gallstones and kidney stones (in addition to diabetes and high cholesterol).
• Keeping Weight Under Control. Foods containing plenty of fiber have more bulk than low-fiber foods. Therefore, fiber can sometimes slow the onset of hunger because the contents of the stomach are bulkier and are retained longer. Here's a tip: avoid foods that have been made easier to eat by the removal of fiber, such as fruit juices. You would be far better off to eat an apple and then drink a glass of water, rather than having a glass of apple juice (which contains no fiber).

Indeed, the list of the health benefits of dietary fiber is much longer. It is safe to conclude that paying more attention to fiber may go a long way to improving your health and avoiding disease.

Obesity drugs -- panacea or fool's paradise

Despite years of research effort, the pharmaceutical industry has not made meaningful progress in combating obesity, arguably one of Canada's biggest and costliest health problems. The two existing obesity drugs, Meridia and Xenical have had limited success, with combined worldwide sales of under one billion dollars. Compare this with the annual sales of the statin drug, Lipitor, at 13 billion dollars.

Obesity in Canada is a growing health concern as it is one of the leading causes of preventable deaths. Canada ranks 35th on a 2008 list of fattest countries with a percentage of 61% of its citizens with an unhealthy weight.

In the last few weeks, three small American companies have completed clinical trials of the next wave of obesity drugs and will be considered for approval by the U.S. Food and Drug Administration. If approved, Canada will surely follow. These new drugs are called Contrave, Iorcaserin and Qnexa. In the last wave, when fen-phen drugs hit the market in 1994, prescriptions soared to 20 million in the U.S. alone, but by 1997 deadly side effects (to the heart) surfaced and the drugs were retired by their manufacturers in the face of huge lawsuits.

Clearly, both Canadians and Americans want a quick fix for losing weight. Is this possible? Will there soon be a free lunch?
Here's my take: The human body has evolved over hundreds of thousands of years in an environment somewhat different from the one in which we live today. Up until a hundred years ago, with the exception of pharaohs and kings, humans have had no alternative but to be physically active on a daily basis, just to survive. More recently, on the whole, we have become much more sedentary, and therefore many of us have thus become overweight, or so the statistics inform us.

But here's the problem with all drugs, including past obesity drugs and future ones, too. They introduce chemical formulations into the body that are foreign to us. Did you ever wonder why all drugs have side effects? It is because our bodies are very finely tuned organisms. While that foreign substance wrapped in a pill may result in one positive effect that we seek, it will surely affect something else inside us that may be dangerous or at least disruptive to our good health.

Let's look at the situation another way. After thousands of generations of unmitigated success as a species, our bodies expect the following ingredients to remain healthy, be strong to fight off germs and live a long life: Fresh air, pure water, natural fruits and vegetables, whole grains and nuts, and cooked fish, poultry and meat. Most everything else has the opposite effect: Robbing us of our good health and destroying our immune system.

In conclusion... there is no free lunch. Next month I will discuss a recent study which has surprising and counterintuitive conclusions that support my own beliefs: The only successful formula for losing weight and regaining strength is a change in lifestyle which promotes healthy habits, including physical activities, a proper diet and a positive mental attitude.