Abstract
Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder occurring in people <45 years. Diverticular disease is among the most clinically and economically significant gastroenterological conditions in people ≥65 years of age. Having a history of IBS appears to increase the risk of diverticular disease in older age. IBS, previously called colitis, does not generally show visible structural or anatomic abnormalities, but is characterized by abdominal pain, bloating, distension, and changes in bowel habits. Celiac disease may be confounding and difficult to distinguish from IBS symptoms. Diverticular disease may evolve from colonic diverticulae (herniate pouches) potentially caused by high colonic intraluminal pressure which occurs in most people with aging but only approximately 20% of individuals with diverticulae develop abdominal symptoms (symptomatic uncomplicated diverticular disease). A smaller percentage of older individuals eventually develop complications such as severe bouts of diverticulitis or bleeding that may lead to sepsis and death. Healthy dietary patterns and low intake of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) may help to lower the risk and alleviate symptoms associated with IBS and diverticular disease. For IBS, psyllium is the fiber source most consistently found to help provide moderate relief of symptoms. For uncomplicated diverticular disease, fiber-rich healthy diets and low red or processed meat consumption decrease the risk, and fiber-rich diets, and foods or supplements containing wheat bran, psyllium or methylcellulose may help to alleviate diverticular disease symptoms and/or improve bowel function. Fiber related mechanisms that may help reduce risk or manage symptoms of IBS or uncomplicated diverticular disease are related to: (1) improved colonic health by promoting better laxation and stool bulk, and a healthier microbiota ecosystem with higher fecal ratio of probiotic to pathogenic bacteria and higher butyrate concentrations associated with lower colonic inflammation and improved colonocyte structure and function; and (2) reduced risk or rate of annual body weight and central abdominal fat gains (or promotion of a gradual lowering of body weight and waist size in overweight or obese individuals).
Keywords
- Irritable bowel syndrome
- Diverticular disease
- Colon microbiota
- Dietary fiber
- Western dietary pattern
- Healthy dietary pattern
- Low FODMAP diets
- Butyrate
- Psyllium
- Wheat bran
- Celiac disease
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Appendix A:
Appendix A:
Fifty high fiber whole or minimally processed plant foods ranked by amount of fiber per standard food portion size
Food | Standard portion size | Dietary fiber (g) | Calories (kcal) | Energy density (calories/g) |
|---|---|---|---|---|
High fiber bran ready-to-eat-cereal | 1/3–3/4 cup (30 g) | 9.1–14.3 | 60–80 | 2.0–2.6 |
Navy beans, cooked | 1/2 cup cooked (90 g) | 9.6 | 127 | 1.4 |
Small white beans, cooked | 1/2 cup (90 g) | 9.3 | 127 | 1.4 |
Shredded wheat ready-to-eat cereal | 1–1 1/4 cup (50–60 g) | 5.0–9.0 | 155–220 | 3.2–3.7 |
Black bean soup, canned | 1/2 cup (130 g) | 8.8 | 117 | 0.9 |
French beans, cooked | 1/2 cup (90 g) | 8.3 | 114 | 1.3 |
Split peas, cooked | 1/2 cup (100 g) | 8.2 | 114 | 1.1 |
Chickpeas (Garbanzo) beans, canned | 1/2 cup (120 g) | 8.1 | 176 | 1.4 |
Lentils, cooked | 1/2 cup (100 g) | 7.8 | 115 | 1.2 |
Pinto beans, cooked | 1/2 cup (90 g) | 7.7 | 122 | 1.4 |
Black beans, cooked | 1/2 cup (90 g) | 7.5 | 114 | 1.3 |
Artichoke, global or French, cooked | 1/2 cup (84 g) | 7.2 | 45 | 0.5 |
Lima beans, cooked | 1/2 cup (90 g) | 6.6 | 108 | 1.2 |
White beans, canned | 1/2 cup (130 g) | 6.3 | 149 | 1.1 |
Wheat bran flakes ready-to-eat cereal | 3/4 cup (30 g) | 4.9–5.5 | 90–98 | 3.0–3.3 |
Pear with skin | 1 medium (180 g) | 5.5 | 100 | 0.6 |
Pumpkin seeds. Whole, roasted | 1 ounce (about 28 g) | 5.3 | 126 | 4.5 |
Baked beans, canned, plain | 1/2 cup (125 g) | 5.2 | 120 | 0.9 |
Soybeans, cooked | 1/2 cup (90 g) | 5.2 | 150 | 1.7 |
Plain rye wafer crackers | 2 wafers (22 g) | 5.0 | 73 | 3.3 |
Avocado, Hass | 1/2 fruit (68 g) | 4.6 | 114 | 1.7 |
Apple, with skin | 1 medium (180 g) | 4.4 | 95 | 0.5 |
Green peas, cooked (fresh, frozen, canned) | 1/2 cup (80 g) | 3.5–4.4 | 59–67 | 0.7–0.8 |
Refried beans, canned | 1/2 cup (120 g) | 4.4 | 107 | 0.9 |
Mixed vegetables, cooked from frozen | 1/2 cup (45 g) | 4.0 | 59 | 1.3 |
Raspberries | 1/2 cup (65 g) | 3.8 | 32 | 0.5 |
Blackberries | 1/2 cup (65 g) | 3.8 | 31 | 0.4 |
Collards, cooked | 1/2 cup (95 g) | 3.8 | 32 | 0.3 |
Soybeans, green, cooked | 1/2 cup (75 g) | 3.8 | 127 | 1.4 |
Prunes, pitted, stewed | 1/2 cup (125 g) | 3.8 | 133 | 1.1 |
Sweet potato, baked | 1 medium (114 g) | 3.8 | 103 | 0.9 |
Multi-grain bread | 2 slices regular (52 g) | 3.8 | 140 | 2.7 |
Figs, dried | 1/4 cup (about 38 g) | 3.7 | 93 | 2.5 |
Potato baked, with skin | 1 medium (173 g) | 3.6 | 163 | 0.9 |
Popcorn, air-popped | 3 cups (24 g) | 3.5 | 93 | 3.9 |
Almonds | 1 ounce (about 28 g) | 3.5 | 164 | 5.8 |
Whole wheat spaghetti, cooked | 1/2 cup (70 g) | 3.2 | 87 | 1.2 |
Sunflower seed kernels, dry roasted | 1 ounce (about 28 g) | 3.1 | 165 | 5.8 |
Orange | 1 medium (130 g) | 3.1 | 69 | 0.5 |
Banana | 1 medium (118 g) | 3.1 | 105 | 0.9 |
Oat bran muffin | 1 small (66 g) | 3.0 | 178 | 2.7 |
Vegetable soup | 1 cup (245 g) | 2.9 | 91 | 0.4 |
Dates | 1/4 cup (about 38 g) | 2.9 | 104 | 2.8 |
Pistachios, dry roasted | 1 ounce (about 28 g) | 2.8 | 161 | 5.7 |
Hazelnuts or filberts | 1 ounce (about 28 g) | 2.7 | 178 | 6.3 |
Peanuts, oil roasted | 1 ounce (about 28 g) | 2.7 | 170 | 6.0 |
Quinoa, cooked | 1/2 cup (90 g) | 2.7 | 92 | 1.0 |
Broccoli, cooked | 1/2 cup (78 g) | 2.6 | 27 | 0.3 |
Potato baked, without skin | 1 medium (145 g) | 2.3 | 145 | 1.0 |
Baby spinach leaves | 3 ounces (90 g) | 2.1 | 20 | 0.2 |
Blueberries | 1/2 cup (74 g) | 1.8 | 42 | 0.6 |
Carrot, raw or cooked | 1 medium (60 g) | 1.7 | 25 | 0.4 |
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Dreher, M.L. (2018). Dietary Patterns, Foods and Fiber in Irritable Bowel Syndrome and Diverticular Disease. In: Dietary Patterns and Whole Plant Foods in Aging and Disease. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-59180-3_6
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