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The Wellness Blueprint: With Dr. Caleb Davis
Welcome to The Wellness Blueprint with Dr. Caleb Davis, where we uncover the secrets to living a long, active, and pain-free life. Hosted by Dr. Caleb Davis, an orthopedic surgeon and fitness enthusiast, this podcast is your ultimate guide to musculoskeletal health, injury prevention, and wellness.
Dr. Davis combines his expertise as a shoulder and elbow specialist with a passion for empowering people to take charge of their health. From deep dives into cutting-edge restorative medicine to practical tips on avoiding surgery and optimizing recovery, The Wellness Blueprint offers valuable insights for anyone seeking to preserve their body and thrive at every stage of life.
Join us each week for professional guidance, fascinating medical discussions, and actionable strategies that help you move better, feel stronger, and stay functional for years to come. Whether you're an athlete, a weekend warrior, or someone looking to age gracefully, The Wellness Blueprint provides the tools to design a healthier you.
The Wellness Blueprint: With Dr. Caleb Davis
Episode 26: Gut Check: How fiber impacts your health, not just your colon
In this episode of The Wellness Blueprint, Dr. Caleb Davis and Nicole Davis delve into the importance of fiber. They explore why this often-overlooked nutrient is one of the biggest game changers for long-term health.
From soluble vs. insoluble fiber to where you can actually find them in your diet, they break down how fiber supports everything from gut health and heart function to muscle strength and joint longevity. They uncover research showing that fiber-rich diets help reduce the risk of diabetes, colorectal cancer, and even osteoarthritis, all while keeping you feeling stronger and more energized.
You’ll also hear their best real-world tips for increasing fiber without digestive backlash — and a few words of caution for those tempted to go overboard. It’s an episode packed with practical insight, humor, and an empowering message: what you eat today builds the foundation for your future health.
If you want to understand how a simple dietary shift can improve nearly every system in your body, this is the episode to tune into.
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Hey everybody and welcome back to the Wellness Blueprint Podcast. I'm your host, Dr. Caleb Davis, and as usual, I'm joined by my lovely co-host Nicole Davis.
SPEAKER_02:Hey everybody.
SPEAKER_00:We are excited to get back into the groove of things. We're still getting used to this new parenthood thing. We are going to be trying a couple new tweaks with our setup. We are back on camera. We'll see how long that lasts.
SPEAKER_02:That was a sad, sad day for me.
SPEAKER_00:We actually were just starting to record this episode when our daughter woke up again. So we are trying again. Yeah. Take two. Take two. Today's topic was suggested by my good friend Dr. Kelly, who has her own podcast, Life Rounds, with Dr. Kelly. Dr. Kelly suggested this next topic for us several months ago. This was before Elena was born, and I've neglected to get to it until now. So she may not.
SPEAKER_02:We've got the new baby excuse.
SPEAKER_00:Oh, that's a built-in excuse for a while.
SPEAKER_02:Yeah, I'm gonna milk that for all it's worth.
SPEAKER_00:I'm not sure if Dr. Kelly even remembers suggesting this to us, but we'll see. But we want to give her a shout-out and thank you for the suggestion.
SPEAKER_02:And check out her podcast too.
SPEAKER_00:Check out Life Rhines with Dr. Kelly. It's a great podcast, always a fun listen. She's got a good variety of topics on medicine, being a physician, being a med student, and anything you can think of medically related. Nicole, tell us what today's topic is.
SPEAKER_02:It's about fiber.
SPEAKER_00:I feel like fiber was a really hot topic in the 90s and early 2000s. I heard about it all the time. Fiber's important for you.
SPEAKER_02:Yeah, everything has like added fiber materials and whatnot.
SPEAKER_00:I don't know about you, but I feel like people don't talk about fiber that much anymore.
SPEAKER_02:You know, not as opposed to cholesterol or I don't know, other stuff. Right. Fats, bad fats.
SPEAKER_00:Artificial sweeteners, yeah. Food dyes, uh seed oils, right? There's all uh all the buzzwords we're thinking about these days. But I wanted to delve into a little bit more what fiber is and what it does and why it's important, maybe some of the misconceptions. Um, and as always, my litmus test, if you will, for what people think about fiber or what what people think about things or what people understand about things, is I asked Nicole. So Nicole, well, this should what's fiber?
SPEAKER_02:This should give you a good indication. This big brainy doctor over here said litmus test. So that's why he needs a regular person like me.
SPEAKER_00:All right, how about my my death death gauge? With that, I don't know. My yardstick.
SPEAKER_02:Um, yeah, so my understanding of fiber is that it's something that you can eat, particularly beans and leafy green vegetables, and it helps your intestines flush out all the stuff so you can poop better.
SPEAKER_00:It always comes down to poop, right? Sure does. I think most people probably think when they think fiber is poop better. I think that's a good summation. Yeah. And you listed some of the things where we find fiber, but we haven't exactly talked about what fiber is. So today we'll do our best to cover what dietary fiber is, why fiber matters beyond simply keeping yourself regular. When I say regular, I do mean pooping. What happens if you get too little? What happens in your gut, but your entire body? Uh, understand. We'll talk about whether or not you can have too much fiber, and we'll also talk about some of the diets that typical diets or maybe trend diets or popular different trends that maybe don't have enough fiber, and we'll talk about that as well. And we'll try to wrap up with some practical take-home tips for how to optimize your fiber in your diet. So we'll start with what is fiber? Nicole's already given us a good start. We talk about dietary fiber, we're talking about carbohydrates, usually related to plants that are not digested. So when we think about digestible carbohydrates, probably most people think of sugar and grain, but there's portions of that that your body can't truly digest and break down into its constituent elements and use for fuel. So we refer to these carbohydrates as dietary fiber. And that breaks down even further into soluble and insoluble fiber, which if you look at a nutrition facts on any kind of packaged food, it'll usually break that down for you. Soluble fiber dissolves and it becomes almost like a gel in your intestines. When it combines with water, it becomes this gel-like substance. And it has a go undergoes a partial fermentation in the gut. You know, Nicole, I know you're gonna be all over this. Think about beans, think about fermentation, think about what that might do to you.
SPEAKER_01:Oh, yeah. Well, beans, beans are good for the heart. The more you eat them, the more you fart.
SPEAKER_00:Class act, I've always I'm really setting setting you up today.
SPEAKER_01:Yeah, no, this is great.
SPEAKER_00:Insoluble fiber does not dissolve in water, or at least only minimally dissolves in water. It passes through your body largely intact. Again, think popcorn, you know, corn kernels, things like that.
SPEAKER_02:You're attacking me. I love my popcorn.
SPEAKER_00:Yeah.
SPEAKER_02:What about broccoli?
SPEAKER_00:Broccoli has components, both soluble and insoluble, but broccoli does have a lot of fiber.
SPEAKER_02:Yeah. I'm just trying to think of things that I see largely intact, you know, when you stare into the that toilet bowl.
SPEAKER_00:Yeah. Are you staring in the toilet bowl a lot?
SPEAKER_02:Well, yeah. I mean, I have to assess my health.
SPEAKER_00:Is that how you do it? Yeah. Yeah. Is it like a daily examination?
SPEAKER_02:No, no, I don't know.
SPEAKER_00:Okay.
SPEAKER_02:Yeah. Julie, if it felt if it felt different.
SPEAKER_00:Yeah.
SPEAKER_02:Yeah. It's like, uh uh, I better check that out. Send Dr. Caleb a picture.
SPEAKER_00:Yeah, thanks a lot for that, by the way. I think we've we've we've said too much. So just to break this down into Nicole terms, think of soluble fiber like a sponge that absorbs water and it can help slow down your digestion a little bit, help absorb some more nutrients. Maybe that fermentation can help feed friendly gut bacteria. And think of an insoluble fiber more like a scrub brush. It's adding bulk, it's kind of like helping move things along and it supports gut motility, meaning you're able to move more frequently, more regularly in a healthy manner. So I think that'd be a good breakdown. So, where do we find fiber? I think most people have a decent idea about this. Typically, fruits, vegetables, whole grains, and legumes. Nicole.
SPEAKER_02:Legumes.
SPEAKER_00:Do you know what a legume is?
SPEAKER_02:It's like a bean, like a kidney bean.
SPEAKER_00:Beans, lentils, things like that. Yeah. Nuts and seeds are also good sources of fiber. And as you mentioned before, some foods are reinforced with fiber. Whole grain cereals, you can find breads that are higher fiber.
SPEAKER_02:You can also just find fiber additives, you just add to a glass of water, right?
SPEAKER_00:Correct. There are supplements for people to take that can dissolve in water if they want to try to boost their fiber intake. Now, if you think about, you know, whole grain bread versus like a white bread, a lot of that fiber is being removed. So the more processed, the more white, the more fine something is in a processed food, probably the more fiber's been taken out of it. So that's another good rule of thumb.
SPEAKER_02:So we do need to drink a lot of water if we're eating a lot of things like beans and vegetables in order to help that fiber pass through your system.
SPEAKER_00:Yep. And we're gonna get into that as well. I was gonna cover that, but you're absolutely right. If fiber wants to do its job, you can eat tons of fiber, but if you're not hydrated, you're gonna have a pretty bad time, actually. You're adding all this bulk to your diet and you don't have water to help move things along, it's actually can be counterproductive. That's a good point, good takeaway. So, how much fiber is enough? A lot of people shoot for 25 grams a day. There's been plenty of research to show that that's adequate for normal bowel movements. While if you have an increase over 25, that's been shown to actually be cardioprotective, meaning reduce your risks of a heart disease and even type 2 diabetes.
SPEAKER_02:Question.
SPEAKER_00:Yes.
SPEAKER_02:You say 25 grams, what does that mean to a normal person?
SPEAKER_00:Well, I think the best take home for that would be to look at the food that you're eating, and it'll show you in grams how much fiber insoluble and soluble fiber is on an FDA nutrition facts.
SPEAKER_02:Okay, but when I talk to most women my age, they're making crock pot meals for their families, Instant Pot meals, whatever. They're dumping in a can of kidney beans and they're dumping in uh, you know, can of vegetables and meat and stuff, and then you dish it out into a bowl. It's not like you have macro data to look at.
SPEAKER_00:You know, that's a great, great question. Back in the day when I used to be religious about my macros and tracking all my calories and my fiber, my protein, my carbs, and my fats, I actually would actually calculate how much is in each dish that I made, and I actually recorded it and figured it out. I don't expect most people to do that.
SPEAKER_01:Right.
SPEAKER_00:The beauty of it is unless you're unless you're pro-athlete, pro-bodybuilder, and you really have to just nail those numbers perfectly, in this day and age with AI, you can get a rough idea of what your fiber is in your diet. If you can keep a food log, you know, I'd love to talk about food diaries and food logs on this podcast. If you can keep a log of what you're eating and say, this is what I ate, breakfast, lunch, dinner, snack, in rough proportions, you could ask an AI large language model, give me an estimate of how much fiber I'm having or what else I could eat, and it could do it, at least roughly. So I, you know, back in the days when I was doing this, I didn't have that resource. I did it all manually by hand and actually measured out my food. It's kind of a crazy person, a little neurotic, right? Uh yeah.
SPEAKER_02:Well, people who are ultra into fitness and macros and stuff are a little bit neurotic.
SPEAKER_00:But they're pretty simple and easy and free tools that will at least get you in the ballpark of how to calculate what your nutritional status is with fiber. So with that being in mind, as long as you use it and know that that's a resource, I think you can get pretty close.
SPEAKER_02:By the way, I don't want to throw shade at people who are super into fitness and macros and tracking all that stuff. You're neurotic, but I appreciate neuroticism. I too am neurotic on different levels.
SPEAKER_00:Yeah, hence looking at your toilet. So let's talk about some of the big picture health benefits. I know I've talked about already motility, meaning, you know, good bowel habits, talked about cardiovascular health and diabetes, but let's break it down.
SPEAKER_02:I want to actually did we talk about cardiovascular health and diabetes? I kind of cut you off.
SPEAKER_00:Well, you're not listening. She's out of practice. She's got a little baby brain going on. No, I only I mentioned it briefly. We're gonna get into it, Nicole. Oh, sorry. We're gonna get into it right now.
SPEAKER_02:Uh all right. I need some fiber, sorry.
SPEAKER_00:So we're gonna talk about a study that was written in 2023 in the Journal of Nutrition and Metabolism entitled High Dietary Fiber Intake is Strongly Associated with Low Risk, all-cause mortality, cardiovascular disease, and cancer. Scientists do not know how to name journals.
SPEAKER_02:Yeah. It's a lot of keywords in there.
SPEAKER_00:The articles are a mouthful. And as someone who has written scientific papers, I'm guilty of this too, by the way.
SPEAKER_03:Yeah.
SPEAKER_00:So, but this was written in 2023. So, what did it look at? It's a meta-analysis of a prospective cohort study examining fiber intake and all-cause mortality. When we talk about all-cause mortality, that means every reason that somebody died, put bluntly. Cardiovascular disease, cancer, anything you can think of which caused death.
SPEAKER_02:Vehicles?
SPEAKER_00:Well, I mean, it's tracking large populations over a period of time. So, yes, I mean, it could even be a trauma, something like that. So, this is a large population study, multiple cohorts. A meta-analysis means it looks at multiple studies together. So we're talking about pooling tens of thousands of people's data. The finding was that people with the highest fiber intake had a 23% reduction of all-cause mortality, meaning they had a 23, 23% chance of dying, less of dying than the next person with low fiber of all causes, whether that be cancer, diabetes, heart attack, and then a 26% lower risk of cardiovascular disease death specifically, and also a 22% lower risk of dying from cancer. So these are pretty big numbers. If you look at things that are above 20%, that's that's actually very significant. I'm sorry, I'm sorry, 2017. We left Chattanooga in 2017.
SPEAKER_02:Okay. So I got to rewind all the way back to 2016, 2017. Okay. I remember I got into a phase where I was super interested in plants. And there was now? No, I mean I still love how love me a good plant.
SPEAKER_00:I know you do.
SPEAKER_02:Yeah, like eating it. Like I can't take care of plants very well. Look at our our deceased bonsai trees. But say in Chattanooga, I read this this controversial book. And of course I can't think of it right now, but it's about this guy who who did like a study of Asian countries and found that a study? I think so.
SPEAKER_00:Yeah, something like that. He was a big vegan guy, right?
SPEAKER_02:Yeah.
SPEAKER_00:Yeah.
SPEAKER_02:Yeah, yeah, yeah. Like well, a plantitarian or something. Like I feel like they called it that. Pretty much as as solely based on plants as possible. And he, I think he was like a cardiologist or something, and he was trying to help his patients who were gonna die of heart disease, and basically encouraged them to eat solely plant-based things and basically go on a vegan or highly vegetarian diet. And those people found a remarkable reduction in their bad numbers of cholesterol and the plaque buildup and all this stuff. So I remember being into that and thinking, yeah, that's awesome. And I remember you thinking, that's not a very good study, Nicole.
SPEAKER_00:Well, in my notes here, we have weaknesses of the study that we're gonna go over.
SPEAKER_02:Oh, you actually have that study listed?
SPEAKER_00:Oh, no, no, just the study that I'm talking about in particular. I want to talk about a weakness of the study. So I think you've already brought up a great point. When you look at large population studies, you're not looking at an intervention. You're not saying we're gonna take someone in the lab, we're gonna look at these three factors and we're gonna isolate them. That's how a prospective double-blinded study would be done. We want to take this, try to make things all equal, and do one intervention. And when we say that, we're gonna change one thing. These people are, we're looking at tens of thousands of people over 20 years. All their habits are different. You know, they're from different populations, they have different lifestyles, their exercise, the other things they do, you know, we're but this is just looking at fiber. So those are what we call confounding factors. There's lots of different things that could be affecting their mortality, cancer risk, other than fiber, that this study can't control for. Sure. That's all terminology that we use when we're writing these scientific papers. So knowing that though, we can see these differences, but we can't nef necessarily associate causality, meaning if you and I were to change nothing else in our life except just eat a ton of fiber, that we would have a higher chance of living and not dying of a heart attack or cancer, necessarily. Does that make sense?
SPEAKER_02:Yes, but say it again with less words.
SPEAKER_00:Okay.
SPEAKER_02:I feel like Mac from Sunny in Philadelphia.
SPEAKER_00:Explain it to me like I'm three. The essentially we see that people who have high fiber intakes tend to be healthier and live longer. However, there could be other things that people who do that sort of thing also would be doing that may cause those effects. Meaning, Nicole, you're a vegan, you eat lots and lots of plants, so you have lots of fiber, but you also don't smoke, don't drink, don't party and do cocaine at clubs on the weekends, like all of these other things.
SPEAKER_02:And you're showing how not cool I am. I don't appreciate it.
SPEAKER_00:I think you're pretty cool. I I I I love how regular you are. Take that however you will. So that's the only thing when you take these large population studies. It's hard to take a study where you take one person and another person. The only thing you do is change fiber over 20 years and then see what the outcome is. You know, that's not really a realistic thing that you can do. But I think it still points to the fact that people who probably eat a lot of plants in their diet and abstain from other unhealthy things have a compounding effect to live to a higher quality of life and longer lifespan. That's what I take away from this study. Well, you have the benefit of having read papers like this in the past. So we've talked about some of the benefits of fiber in terms of diabetes, cardiovascular disease, all-cause mortality, and cancer. Uh, another study published in 2021, I'm trying to keep more modern studies for this. High dietary fiber intakes are associated with improved skeletal muscle strength and function. This was another observational cross-sectional study, as most dietary studies are. And the key findings were that high fiber intake was linked with a higher measure of muscle strength just across the board. Now, again, we can't say that just eating fiber increases muscle strength. However, there is a proposed mechanism that it offers better absorption of nutrients in the bloodstream when you have high fiber, and that may help feed muscles better and recover better from exercise.
SPEAKER_02:And why it's because things have fiber, like plants have a lot of micronutrients.
SPEAKER_00:That'd be another good theory. And would be another interesting point of discussion is if you just supplement like a fiber powder, is that going to be as good as getting fiber from whole plant food sources? And I think the answer, of course, is no, it's not. If you're looking just to get more fiber and bulk in your stool, maybe that's the short-term answer. But as most things are in life, it's better to get it from the whole food source. It's better to get protein from whole food rather than powder. It's better to get vitamins and minerals from whole food rather than pills. Although in a pinch, if that's what you gotta do, then that's what you gotta do. So, of course, as an orthopedic surgeon, I wanted to pick this next study because there's also an increased association with, or I should say, there's a decreased association with osteoarthritis and high fiber intake. Osteoarthritis meaning the wearing down of cartilage and joints, which is one of the main reasons I have to replace people's hips and knees and shoulders with trying to put yourself out of a job. You know, if if I can get everyone to to poop and have good joints, and I don't have to operate on them anymore, that's fine with me. So this study looked at 30,000 people, and the people with the highest fiber intake showed a 27% lower odds of developing painful or severe osteoarthritis compared to the rest of the study group. Again, you can only take these studies with a grain of salt because there could be other factors. These people may exercise more regularly, have lower inflammatory diets, stay better hydrated. But again, if you tend to have a whole food diet filled with plants, nuts, and seeds and things like that, you're probably less likely to eat junk food. You probably have a higher satiety, meaning you're not hungry and craving things all the time. And some people believe that all this fiber has a lower inflammation, has an anti-inflammatory effect systemically, which may lead to lower joint inflammation causing osteoarthritis. Another study in 2023 in the Journal of Nutrition showed that diets low in fiber are convincingly associated with increased risk of diabetes and colorectal cancer. My take on this is likely the mechanism there is again, if you're eating more processed foods, higher glycemic foods, causing higher blood sugar spikes, and you're having less satiety, you're more likely to eat this type of food, which could make you more prone to developing diabetes. Again, systemic inflammation is also a breeding ground for different types of cancer, and that may be the increased risk of developing colon cancer as well due to low fiber intakes. You want to add anything to that?
SPEAKER_02:No, it's all pretty fascinating.
SPEAKER_00:Yeah. Are you fascinated?
SPEAKER_02:Yeah, I'm just thinking about certain people in my life who really have no understanding of this.
SPEAKER_00:Well, I'm doing my very best to break it down and make it easy to understand.
SPEAKER_02:Yeah.
SPEAKER_00:You know, we found some good studies here for you. Accompanying me to try to explain it to people and tell me what I'm getting to in the weeds. It's always very helpful. So, what are some of the proposed mechanisms of why fiber helps with all of these different things? I already touched on a little bit, but when fiber is fermented by gut bacteria, it's fermented down into short chain fatty acids that have a systemic anti-inflammatory effect. And that's one of the reasons people believe that it may be having a reduction in ostearthritis and cancer. High fiber leads to improved satiety, which means you have lower energy dense diets, which leads to less fat mass, which, if you have lower weight, that also may lead to less load on your joints, causing less rates of osteoarthritis as well. I can tell you though, if you're carrying a lot of excess weight, it does put a lot of strain on your joints and leads to earlier rates of osteohritis.
SPEAKER_02:Well, what's considered a lot, Caleb? Because when you and I watch a TV show from the early 2000s, their idea of obesity was our idea of normal in this day and age.
SPEAKER_00:That's hard to say. You know, BMI used to be the gold standard. A lot of people wanted to have a BMI of under 25. BMI, you know, has been widely criticized for not being the most accurate measure. So some people take body fat percentage. Men tend to have a lower threshold than women. We're not going to get too much into that today, but I'd have a conversation with your primary care doctor to see what they think a healthy weight range might be for you so you can decide what the good goal for you would be. So, what other diseases might be associated with a lower fiber intake? As you may imagine, low fiber intake is strongly tied to poor bowel function, constipation, slower, slower transitive bowels, higher risk of colorectal cancer. And that's been shown in population studies as well. Again, whenever you look at these sorts of intake of nutrients, these are pretty much the few models that we have as to look at these large population studies. But these are all things that we see in low fiber intake. Now, I think the one that people don't think about a lot is probably cardiovascular disease. I think colon cancer and constipation, that that makes sense. Yeah. I think that's sort of intuitive. But I don't think people think about cardiovascular disease. So there's one study that showed for every additional seven grams of fiber a day was associated with a 9% reduction of cardiovascular disease.
SPEAKER_02:Sounds a lot like what that guy was saying with the China study. The more plants you eat, the less heart attacks you'll have.
SPEAKER_00:And I think there's probably something to that, but I think that this particular study also tried to correlate if you eat meat, it's also going to kill you. I think he was a proponent of a completely vegan or completely plant-based diet. There's confounding factors to that too. You know, people who tend to eat a lot of red meat, maybe also eat more bread, maybe smoke more cigarettes, drink more alcohol, all these associations have been played out, so you have to take into account those confounding factors. If you eat healthy, lean beef and also plants, there's probably something to that. Those diets have not been as well studied where you have actually a healthy balance of plants and meat and animal products without eating tons of processed garbage. You're really pushing to become a plant-based person, huh? Yeah. Well, you eat all the plants you want, just eat a steak every now and then.
SPEAKER_02:If you cook it for me, then I'll eat it.
SPEAKER_00:Do we up a nice lean fillet, you know, it's good for you.
unknown:Yeah.
SPEAKER_00:At least that's my contention. Now, obviously, the benefit of the seven increase seven grams of fiber decreases your chances of heart disease. There's a cap on that, right? I mean, you can't eat 100,000 grams of fiber and have a negative 100% chance of developing a heart attack. You know, there's a threshold, and I think some people have have thought that that's probably between 35. You know, it cuts off. You can't just continue eating fiber. Um, so keep that in mind. Don't just try to like take the entire bottle of metamulcil and have one bottle of metamucil every day.
SPEAKER_02:You did mention that it could have the opposite desired effect if you have too much fiber. That's right. But what do you mean? Like you're just gonna be like, you know, dying of dysentery or what? Like you're on the organ trick.
SPEAKER_00:If you have too much?
SPEAKER_02:Yeah.
SPEAKER_00:Well, if you increase your fiber intake way too rapidly, first of all, you're gonna have cramps and you actually could have uh counterintuitive, you can have constipation. And if you're gonna be increasing your fiber intake, you better drink lots of water while you do it as well. But if you're not used to having a ton of fiber or a couple other conditions, if you have irritable bowel syndrome or an inflammatory bowel syndrome like ulcerative colitis or Crohn's disease, that actually could have a pretty negative effect. So if you're being treated for one of those conditions, you may want to consider seeing your specialist first before you rapidly start increasing your fiber intake. That's a great thing to focus on for this episode is if you're considering really dramatically increasing your fiber intake, do it slow and drink water while you do it. Don't try to do it all at once.
SPEAKER_02:Otherwise, you're gonna curse our names.
SPEAKER_00:Yeah, you're gonna have a little bit of a tough time. And I've seen this in the bodybuilding world where these bodybuilding guys eat nothing but chicken, broccoli, and rice. And they'll eat like, you know, four bags of broccoli and they just get bloating and gas and cramping, and and it's just not pleasant. Now, fortunately, they tend to drink a lot of water too. So I think that gets them through it. But you know, you gotta be careful with this, you gotta be slow. So, one of the things that I wanted to ask when I was researching this was what about the ever so popular meat diets like carnivore diet or keto. Is that one? Paleo Paleo was a trendy diet a while ago. I don't hear people talk about paleo much anymore, but I was thinking keto.
SPEAKER_02:Oh, keto.
SPEAKER_00:Yeah.
SPEAKER_02:Okay. Yeah. Well, so for paleo, I'm pretty sure the rules were you're allowed to eat leafy greens, but I don't think you could eat beans.
SPEAKER_00:Or like sweet potatoes or corn, starchy things, I think they wanted you to avoid.
SPEAKER_02:But then there was also the whole 30 diet. That was big a while ago.
SPEAKER_00:Yeah, and you can eat leafy greens, but they didn't have you eating any grains or nuts, I think.
SPEAKER_01:Right.
SPEAKER_00:Well, don't quote me on that. The ones that I was focusing on was keto and carnivore.
SPEAKER_02:Okay.
SPEAKER_00:And I've I've tried almost every diet in the book. You know, I've I've tried them all just to see you, yeah.
SPEAKER_02:You did like a vegan diet in college for a year. You lost like all of your body fat, and it was a sad day for Nicole.
SPEAKER_00:And I was just too thin for you, huh?
SPEAKER_02:Yeah. I don't think many women want to marry a guy with a waist smaller than hers. I don't know. That could just be me.
SPEAKER_00:Well, I can tell you vegan diets, I think, have changed a lot since then. I mean, that was like 15 years ago. Yeah, because we're old. Yeah. These days there's so much processed food that's marketed as a vegan diet. When I did a vegan diet, I drank like tons of water and green tea. That was my thing. And I just ate beans and vegetables and put them in this soup, and I'd eat this, you know, this giant pot of soup, but I'd eat it three times a day, and that's all I ate. Nowadays you get all this pre-made food, and it's filled with additives and carbohydrates. Because if you look at the ingredients of an Oreo, an Oreo is vegan. You know, so not only was I very strict on a vegan diet, but I didn't eat processed foods, I didn't eat anything that was pre-prepared. I was also a broke college student, so I couldn't afford to eat all this expensive pre-made vegan stuff. So I it was a very successful diet for me, but I think you could really get pulled into a trap by eating all this marketed pre-made vegan stuff.
SPEAKER_02:I think you said you went regularly like three times a day, something.
SPEAKER_00:Nicole, not all of us are as comfortable sharing our toilet habits as you are to the world. But thanks for sharing that now to me. Yes, I was very regular on that diet. But no crank there.
SPEAKER_02:Well, there you go.
SPEAKER_00:So here's the thing: the keto diet, the carnivore diet are really interesting because they cut out a lot of inflammatory foods like processed grains and sugar. So this is exactly the kind of diet you would be thinking is this would be really interesting to see if they had a high fiber intake along with the diet, what would that look like? Because they are eating a lot of meat.
SPEAKER_01:Yeah.
SPEAKER_00:But we don't have I don't I couldn't find any long-term studies on this. Interesting. On what is a carnivore diet or a keto diet. They're short-term. People who go on a carnivore or keto diet do tend to have an increase in their LDL and HDL cholesterol. Although some people will level out over time, you will usually see an increase.
SPEAKER_02:Is it bad?
SPEAKER_00:Well, traditionally, that'd be the traditional way of thinking about it. If you're having a spike in your cholesterol, that something bad's happening. Although some people have noted that their long-term levels do level out a little bit if they stay on the diet long term with a strict adherence. I do know anecdotally that a lot of people do report early constipation with both these diets.
SPEAKER_02:Okay. So just remind me, keto is when you eat a lot of meat and meat and fat. And fat.
SPEAKER_00:Mm-hmm. And you have very, very low carbohydrate diet, usually less than 30 grams a day, and you go to one banana. Yeah. I mean it's low.
SPEAKER_02:It's not a diet for Nicole.
SPEAKER_00:It's not a diet for Nicole.
SPEAKER_02:But it's also one of those diets where like you can't like cheat.
unknown:Right.
SPEAKER_02:That's why it's not a diet for it.
SPEAKER_00:It's this whole idea that you're going into ketogenesis where you're making energy sources from other foods rather than sugar or carbohydrates. And so you have to be very strict about it. It was super popular for a long time. I don't know how popular it is anymore. I don't hear people talk about it much anymore. I do hear people talk about the carnivore diet, but I imagine that's a trend that'll go away as well.
SPEAKER_02:Well, especially as prices of meat continue to go up.
SPEAKER_00:Sure.
SPEAKER_02:But my my question was with uh keto, wasn't that primarily used for seizure patients?
SPEAKER_00:There's some epilepsy, yeah. There's some data back from the 40s and 50s of the ketogenesis diet actually causing a lot of patients epilepsy to go into remission or at least a much more controllable state. And that's been shown to be an effective treatment for some patients. I can't speak to that broadly. I know that some people still recommend it if patients are failing to respond to typical anti-epileptic drugs. Again, a little bit out of my wheelhouse these days. I don't remember, I've forgotten more about neurology than I know now, you know. But that that's it, that is where a lot of this research originally came from. You're absolutely right. But what I can say about keto and carnivore, I'm not gonna tell you not to do it. Just understand that you may lose some motility in terms of your bowel habits. And I would tell you that it's important to still stay hydrated if you're gonna have less fiber. So whether you have a lot of fiber, whether you have a little fiber, drink lots of water. Some people find that their bowel habits do sort of regulate, the body finds a way, but that is something that you may experience if you try either one of those diets. So let's summarize. We talked about what fiber is and why it's important. So let's talk about some practical tips for how you can get more fiber in your diet. So we're gonna aim for 25 to 30 grams of dietary fiber a day for adults. And this is backed up by all the studies that we've talked about so far. So, what are some of our sources for fiber? Whole grains, legumes, a wide array of less starchy vegetables, leafy greens, uh, whole fruit, not just the fleshy part of the fruit, but appealing if you can tolerate that.
SPEAKER_02:Like an apple?
SPEAKER_00:Yeah?
SPEAKER_02:Yeah, like apple skins.
SPEAKER_00:Do you eat the uh do you eat the uh banana skin?
SPEAKER_02:I I can't say that I have, but you eat the sweet potato skin. I do, yeah. Who doesn't?
SPEAKER_00:I don't. No, I do sometimes. What about the kiwi skin? Do you eat that?
SPEAKER_02:That the furry stuff?
SPEAKER_00:Yeah.
SPEAKER_02:Oh no. Okay, no. No.
SPEAKER_00:What about avocado?
SPEAKER_02:No, not avocado skin. I also don't really eat orange peels. Sometimes I'll grate the orange peel into a dish.
SPEAKER_00:It's pretty good. I think out of all the people I know, you are the most tolerant of most roughage. I've seen Nicole. I've just I've seen Technical walk through a garden and just start picking leaves and just eating them.
SPEAKER_02:I I had I had a consent to do that. Let me just put that out there.
SPEAKER_00:Yeah, your permission. Yeah, you had permission. I'm just saying you just pick up these big leafy greens and eat them, and you're like, oh, that's delicious. And I'd be you know barfing.
SPEAKER_02:Oh, like I love to eat, I love to eat beets just like raw.
SPEAKER_00:Like dwight fruit, just like an apple.
SPEAKER_02:Well, it's really hard. It's tough to do that.
SPEAKER_00:Do you peel it? That's like a big dirty.
SPEAKER_02:No, I don't I don't peel beets.
SPEAKER_00:That's wild. You're like a real-life dwight fruit.
SPEAKER_01:Bears, beets, battlestar galactica.
SPEAKER_00:And last but not least, nuts and seeds, which is probably my favorite source of fiber, because the nuts are filled with healthy fats. It's filled with protein and they're very satiating. So as long as you're not talking about adding a ton of dried fruit and sugar and MMs to your nuts, it's a good snack that's high in energy. It's very satisfying. So it'll fill you up.
SPEAKER_02:They're very calorie dense, aren't they? Right.
SPEAKER_00:Yeah. When I say high in energy, that's exactly what I mean.
SPEAKER_02:Oh, okay.
SPEAKER_00:Yeah, exactly. And they can be dried and stored and they're easy and they're mobile. So in my line of work as a busy physician, it's a good snack for me. I'm going to harp on that one more time about the whole fruit thing. If you're juicing, you're getting less fiber. Even if you're doing a smoothie, you're still getting some fiber, but you're still not getting as much as you would in the whole fruit form. Also, if you eat a whole fruit, it takes longer to eat and digest and makes you more full for longer rather than drinking it, which can it's believe it or not, it's a sneaky way to get lots of calories easily is by drinking fruit juice and fruit smoothies. A little counterintuitive. You're getting micronutrients and vitamins for sure, but it's better to eat the whole fruit, just like most things in life.
SPEAKER_02:Yeah, we're but it also the carbohydrates break down into sugar faster or something when you juice it or there's even even the act of mastication, chewing.
SPEAKER_00:Sorry. Whoa, whoa. Sorry.
SPEAKER_01:Okay.
SPEAKER_00:Even the act of chewing your food helps break down the food in your mouth. It causes hunger signals to change as you're chewing them rather than just drinking them. It's all it's all this very complex satiety feedback cycle of chewing and swallowing and letting it digest in your stomach makes you full faster rather than just drinking fruit juice or smoothie. I think that's a fascinating part of human physiology. But then anytime I get to use the word mastication, you know, it's a good day. As part of our useful tips, remember increase your fiber gradually. Don't try to get 25 grams a day if you're only getting five grams a day right now. By the way, five to ten grams a day is not unusual for an American adult. I believe up to 90% of adults in the United States have been estimated to have dramatically too low of a fiber intake. I mean, this is an epidemic problem.
SPEAKER_02:This is what I want to talk about. Like if you add an apple as a snack, and if you add a handful of nuts or something.
SPEAKER_00:Well, that's exactly what we're talking about.
SPEAKER_02:Yeah, but it's like it's little things. It's not like you have to eat an entire salad. Yeah. You can just add these things little by little to every meal or snack.
SPEAKER_00:Don't try to get all your fiber in one meal. That's going to lead to discomfort. You know, have something with fiber in breakfast, lunch, dinner, and with snacks. And nuts make a great snack. Maybe have a whole fruit in the morning, have leafy green vegetables at night, you know, and have variety. You want to have it from different varieties of food sources because you'll also be getting a different mix-up of your micronutrients and the macronutrients as well if you do that. You know, and if you really need to, if you're having a really hard time, you can consider doing like a psyllium husk or metamucil would be a brand name. You know, these powders that are dissolvable in water that you can drink. I don't think that's a long-term solution. It shouldn't be a permanent solution. But if you're having some issues and you need to increase your fiber intake and you're having a hard time, that is always an option. Although I'd recommend that you try to go for the whole food route.
SPEAKER_02:Yeah. Well, Caleb, we haven't talked about one of the most important things, one of the most life-changing things for me.
SPEAKER_00:Hit it. Hit me.
SPEAKER_02:Which is the Bane Outtakes video by the Oral Nots. Okay. Who's seen that? Raise your hand if you've seen that.
SPEAKER_00:I've seen it. I love it. I knew this was going to come up. This is a deep cut. I don't know if people are going to understand or know what this is.
SPEAKER_02:Like if they've ever seen anything, like even Honey Badger. Okay. Like, whatever. All right.
SPEAKER_00:Well, take it away. Tell me what you're talking about.
SPEAKER_02:Okay, yeah. So, like in that video, there's it's a cut of Batman, the Dark Knight, right?
SPEAKER_00:Dark Knight Rises.
SPEAKER_02:Dark Knight Rises with Bane. Yeah, with Bane. That's my name. It's like a seven-minute clip, and this guy's doing a voiceover imitating you know the Bane voice.
SPEAKER_00:And he's talking about I've always said the Bane voice was like a mixture of Sean Connery and Darth Vader. Yeah, a little bit. It was really weird. I know people love that movie. Everyone loves that movie, but I I just thought it was a weird choice. Anyway, anyway, back to go ahead.
SPEAKER_02:Love the after though. Yes. Yeah. And he does jujitsu.
SPEAKER_00:Tom Hardy, I think, is a purple or brown belt jujitsu. Yeah.
SPEAKER_02:It's pretty awesome.
SPEAKER_00:Yeah.
SPEAKER_02:Anyway, so the Bain voice, they're basically saying that Bain is very insistent that everybody get their daily fiber intake. So if you have not seen this clip, you need to. It's pretty fantastic.
SPEAKER_00:That video you're talking about actually has one of my favorite lines ever. It's like, you are what you eat. It's like, what did you eat? A frowdy biscuit?
SPEAKER_02:Yeah, which is why we call our daughter a frowny biscuit a lot of times if she's unhappy.
SPEAKER_00:She's unhappy, yeah. What did you have to eat a frowty biscuit? But yeah, maybe we'll clip little parts down this episode if that I gotta figure out how copyrights work on YouTube. And what did you eat? A frowdy biscuit. Anyway, Nicole, we've actually been talking for a while on fiber, and we've always said the word poop once or twice. I think that's pretty good.
SPEAKER_02:I tried to restrain myself.
SPEAKER_00:I thought you did a pretty good job.
SPEAKER_02:Thank you.
SPEAKER_00:I see you straining over there. I don't think you have a fiber problem at all.
SPEAKER_02:No, no, and then like I remember one time we went to Iceland and we solely subsisted off of pizza and gas station hot dogs and whey protein powder.
SPEAKER_03:Do you know what happens to your body without fiber? This is your body without fiber.
SPEAKER_02:Right? Yep. And that was the horrible double time for my digestive system. And I was constipated for like three days. And I remember begging you to take me to your grocery store, and I basically just bought a can of beans and some olive oil.
SPEAKER_00:You know, it takes a really courageous woman to bear her bowel history online like this. I'm proud of you. I'm real proud of you. But yeah, you don't get a lot of don't get a lot of fiber when you're living that kind of diet.
SPEAKER_02:Yeah.
SPEAKER_00:But again, we were in Iceland and we were we were broke. We're like really broken.
SPEAKER_02:This is our first time in Iceland.
SPEAKER_00:And we could, that's all we could afford to eat. Yeah. So it definitely took its toll. Is there anything else you want to add about fiber before I sum it up and wrap up the podcast?
SPEAKER_02:Oh man, I think so. We did a pretty good job covering it.
SPEAKER_00:Yeah. Awesome. Awesome. Well, let's sum it up. Dietary fiber, not just for bowel movements, it's got a wide range of health effects, including cardiovascular health protective benefits, metabolic health, like your diabetes, and muscle and joint health. We talked about soluble and insoluble, both are important. So you want to get a variety and diversity of the source matters. Again, if you want to think about what you're eating and what you could add, use something like Perplexy or ChatGPT or Grok if you want ideas of how you can improve your fiber intake or get an idea of how much you're getting if you type in your foods. There's all sorts of tools out that out there for this sort of thing. High fiber intake is associated with a 20 to 30% lower risk of mortality across the board and also things like cardiovascular disease and cancer.
SPEAKER_02:So I feel like what you're saying is pooping will save your life.
SPEAKER_00:I mean, if you don't poop, that's that's trouble. I mean that is trouble. I think you'll die pretty quick, actually.
SPEAKER_02:Yeah. But if you poop too much, you'll die also. So you might be able to do that.
SPEAKER_00:There's a healthy balance. Inadequate fiber take, inadequate fiber intake is quite common. Lack of fiber is tied to increased risk of lots of different diseases. Too much fiber. While rare in well-nourished people, if you have a rapid increase, it can cause trouble. So increase slowly and carefully. Diets that minimize plant foods like keto and carnivore, you're gonna have a hard time keeping up your fiber intake. So just be aware of that if you're trying these diets. And it's important to have a strategy, you know, good diverse food sources and portion out during the day rather than trying to get it all at once is an important strategy. And we've kind of talked about some of the foods that you may want to consider adding to your diet. All of this is just part of the tools in your toolbox to keep healthy. Nothing replaces a well-balanced diet and healthy lifestyle that takes a lot of different things like meditation, gratefulness, sleep, low stress, because surrounding yourself by good people and good community.
SPEAKER_02:All of these basically are taking all the things out from new parenthood.
SPEAKER_00:Yeah. Yeah. We're getting the hang of it though.
SPEAKER_02:Except for this six-month sleep regression thing.
SPEAKER_00:I'm drinking more, I'm exercising more, and I'm sleeping more now. We're getting the hang of it. We're getting the hang of it. Now, just remember, if you have a condition like irritable bowel syndrome or inflammatory bowel syndrome, or maybe a slow gastric emptying, what they call gastroparesis, consult with a physician before you radically change your fiber intake or your diet. And remember, nothing you've heard on this podcast will replace a good in-depth consultation with a physician about your dietary needs or with a registered dietitian. So consider that as well before making any radical changes to your diet. I'm so glad to be back and doing these podcasts again. You can reach out to us on Instagram, on TikTok. We have a link tree on our Instagram on WellnessPluberin Podcast. Check us out there, send us a message if you have anything that you'd like to talk about or hear on the podcast. I'd love to hear it. And another shout out to Dr. Kelly for the topic today. Hopefully, she gets a chance to check it out. And we'll see you all next time.
SPEAKER_02:Hope you poop well.
SPEAKER_00:Happy pooping, everybody. Remember, be happy, be humble, be healthy. We'll see you next time.
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