I really don’t like talking about constipation, since it makes me wonder whether I’m starting down that inevitable decline towards the day when all I want to talk about is having a “good bowel movement.”
But the C word–constipation–continues to come up regularly when people go wheatless and grainless. “Won’t I lack fiber?” many ask. For example, in response to the Wheat Belly Blog post, The Wheat-free “Movement,” Janne posted this comment:
I am very happy on a no-wheat regimen but I wish I knew what I should do to add enough fiber to my diet. I am not quite on the verge of constipation. When I ate lots of whole grains (I haven’t touched refined grains in years), I would have easy daily bowel movements. I am still going daily but it’s not as ‘easy.’ I eat lots of vegetables. What am I doing wrong?
Granted: Wheat products are a convenient source of indigestible fiber. But the idea that you must have whole grains from wheat to obtain sufficient fiber is pure fiction. There are plenty of other foods that are rich in fiber. The “fiber for bowel health and regularity” is really a message that has been hijacked by the grain industry. The original observations and science that demonstrated the benefits of fiber focused on the fibers from vegetables, fruit, non-grain seeds, nuts, and legumes–not the cellulose fiber of grains. The original observations on the health benefits of fiber were made by Dr. Dennis Burkitt in the 1970s while in Africa. He noticed that native Africans, who relied on large intakes of plant matter (but not grains), had voluminous bowel movements, while Europeans had small, rabbit pellet BMs and ate refined flour products. Native Africans had virtually no constipation, hemorrhoids, colon cancer and other intestinal struggles, while these conditions were rampant among Europeans. Such observations were, over time, subverted by the grain industry into their use, promoting bran cereals and other products as sources of fiber. But there is no intrinsic human need for the cellulose fibers from grains, not to mention the huge number of gastrointestinal problems caused by wheat and grains, from acid reflux to ulcerative colitis.
Here are some better ways to regulate regularity in our wheat/grain-free lifestyle with none of the downsides:
1) A probiotic to help your poor wheat/grain-damaged intestine to recover. Wheat and grain consumption changes the bacterial composition of your intestinal tract. Taking a probiotic for a few weeks can provide organisms like lactobacillus and bifidobacterium that help regain normal bacterial populations. Look for probiotics that provide at least 50 billion CFUs (colony forming units, a bacterial count) per day with a dozen or more different species. If there are no gastrointestinal diseases or antibiotics, taking for a finite period, e.g., 8 week, is all you need to do. (People with inflammatory gastrointestinal conditions, such as ulcerative colitis or celiac disease, would be better served by taking a probiotic for longer periods, perhaps years, to allow full healing.)
2) Cultivate beneficial bacterial species with prebiotic fibers/resistant starches–I hate to admit it, but there is actually a beneficial fiber in wheat and grains called arabinoxylan. Remove all grains and you lose the 3-4 gram per day intake of prebiotic fibers like arabinoxylan that nourish bowel flora. But you can easily make up for that loss and more by incorporating sources of prebiotic fibers. We try to obtain 20 grams per day of prebiotic fibers from such sources as raw potatoes, green unripe bananas, small servings of starchy legumes, inulin and fructooligosaccharide powders, as well as some convenient commercial sources. This very powerful strategy for bowel–and overall–health is often neglected, but is very important for long-term health success. Not only does cultivation of bowel flora with prebiotic fibers ensure bowel regularity, it also reduces the likelihood of diverticular disease and colon cancer, while also helping reduce insulin and blood sugar, reduces blood pressure, reduces total and LDL cholesterol values, improves mood and deepens sleep since healthy bowel flora produce a number of neurochemicals
3) Supplement magnesium–Magnesium provides an osmotic effect that increases stool moisture content. This is why many laxatives contain magnesium, like Milk of Magnesia (magnesium hydroxide). The majority of people are deficient in magnesium anyway, since modern water purification removes all mangesium and modern farming methods fail to mobilize soil magnesium. The form of magnesium to choose depends on what you are trying to achieve. Strictly for purposes of regularity, magnesium citrate, 400 mg twice per day, will provide a modest boost. Those of you desiring better absorption of magnesium and less bowel softening should look for magnesium malate, 1200 mg twice per day (or 180 mg twice per day of “elemental” magnesium, i.e., the weight of magnesium minus the malate).
4) Add more raw nuts and seeds, more nut meals, including the recipes in the Wheat Belly book and here in this blog. It means that even treats like chocolate almond biscotti are rich in fiber.
5) Hydrate–A helpful habit is to drink two 8 ounce glasses of water immediately upon awakening when you are substantially dehydrated from lying supine for 8 or so hours. Do the same several more times per day and be sure that, whenever you urinate, urine is only lightly yellow, almost clear, never dark and concentrated.
If you still feel you must add more fibers beyond prebiotic fibers, then safe non-grain sources low in carbohydrates are flaxseed, chia, and psyllium. These are easy to sprinkle on foods, mix in with your wheat-free baked dishes, mix in with wheat-free granola. They do not have any effect on blood sugar.
So going wheat- and grain-free does not mean a lifetime of pushing and straining, then calling your surgeon to clip the hemorrhoids. For some, it can even mean reversal of incapacitating constipation to new-found regularity. It means intestinal health that is improved because it now avoids the most destructive of diet ingredients, wheat and other closely-related seeds of grasses.
Cardiologist Dr. William Davis is a New York Times #1 Best Selling author and the Medical Director of the Wheat Belly Lifestyle Institute and the Cureality.com program.