Many individuals find it difficult to obtain an adequate amount of fiber from food sources alone. Eating fiber-rich foods such as fruits, vegetables, whole grains, and legumes is considered the optimal approach for individuals to obtain their recommended daily fiber intake. However, many individuals may find it difficult to obtain an adequate amount of fiber from food sources alone. In the United States, the average dietary fiber intake for children and adults is less than half of the recommended daily amounts. As a result, some individuals elect to use the various fiber supplements on the market to maintain normal bowel function and prevent or decrease constipation.
What is Fiber?
Fiber is the general name for certain carbohydrates -- usually parts of vegetables, plants, and grains -- that the body can't fully digest. Dietary fiber generally refers to the indigestible carbohydrates that are naturally present in fruits, vegetables, nuts and grains. While fiber isn't broken down and absorbed like nutrients, it still plays a key role in good health. There are two main types of fiber: soluble fiber (which dissolves in water) and insoluble fiber (which does not). Combined, they're called total fiber.
Recommended Daily Intake
The American Heart Association recommends that at least half of an individual’s daily grain intake come from whole grain sources. The number of servings per day depends on the age, gender, and caloric needs of the individual. The Institute of Medicine has set an adequate intake (AI) for total fiber, which includes all sources. Getting this amount of fiber should be enough to stay healthy. Doctors may recommend higher doses of fiber.
- Children:
- 1-3 years: 19 g/day
- 4-8 years: 25 g/day
- Females:
- 9-18 years: 26 g/day
- 19-50 years: 25 g/day
- 51 years and up: 21 g/day
- Pregnant: 28 g/day
- Breastfeeding: 29 g/day
- Males:
- 9-13 years: 31 g/day
- 14-50 years: 38 g/day
- 51 years and up: 30 g/day
Health Benefits of Fiber
Studies have investigated the possible health benefits of fiber, which include laxative effects, normalization of blood lipid levels, and attenuation of the blood glucose response. A number of studies have found that a high intake of total fiber, from foods and supplements, lowers the risk of heart disease. High-fiber diets have also been associated with a reduced risk of type 2 diabetes.
- Insoluble fiber adds bulk to stools. It helps treat constipation and diverticular disease and may benefit people with some types of IBS (irritable bowel syndrome). Recent research has shown that increased fiber is also linked to increased survival in people with colon cancer.
- Soluble fiber seems to lower cholesterol levels. It binds with cholesterol in the intestines and prevents it from being absorbed. Soluble fiber may also be useful in treating diabetes and insulin resistance (prediabetes). It can slow the absorption of carbohydrates, helping to improve blood sugar levels.
- Since fiber is filling and has very few calories, high-fiber foods may also help with weight loss.
- According to a study published in 2009, viscous soluble fibers were associated with acute and long-term metabolic improvements in patients with type 2 diabetes mellitus via reductions in glycated hemoglobin, fasting and postprandial glycemia, insulinemia, and cardiovascular risk factors.
- Studies have reported that individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing congestive heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal disorders.
- Increasing fiber intake may decrease blood pressure and serum cholesterol levels.
- Increased intake of soluble fiber may improve glycemia and insulin sensitivity in nondiabetic and diabetic individuals.
- Fiber supplementation in obese individuals significantly enhances weight loss.
- Increased fiber intake improves several gastrointestinal disorders, such as gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids.
Sources of Fiber
The best way to get fiber is from food, like a variety of fruits, vegetables, and grains. Fiber that comes from whole foods is called dietary fiber. Fiber that's sold in supplements, or added to fortified foods, is called functional fiber.
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Some good sources of soluble fiber include:
- Oatmeal and oat bran
- Apples, citrus fruits, and strawberries
- Beans, peas, and lentils
- Barley
- Rice bran
And some sources of insoluble fiber are:
- Cereal brans
- Whole grains, like barley
- Whole-wheat breads, wheat cereals, and wheat bran
- Vegetables like carrots, cabbage, beets, and cauliflower
Some foods, like nuts, contain both soluble and insoluble fiber.
Fiber Supplements
Fiber supplements are available in formulations that may contain wheat dextrin, methylcellulose, psyllium husk, inulin, or calcium polycarbophil. Dosage forms include sugar-free products, caplets, chewable tablets, capsules, wafers, and dissolvable powders in flavorless versions or various fruit flavors. The fruit-flavored gummy formulation is new and very popular. Some fiber supplements contain vitamins and/or minerals, such as calcium. Selection of fiber supplements may be based on patient preference, dosage form, cost, tolerability, and effectiveness.
Examples of Available Fiber Supplements:
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- Benefiber products (wheat dextrin): Benefiber Fiber Caplets, Benefiber Plus Heart Health Powder, Benefiber Chewable Tablets, Benefiber Powder, Benefiber for Children, Benefiber Powder Plus Calcium (300 mg calcium), Benefiber Stick Packets
- Citrucel products (methylcellulose)
- Fiber Choice (inulin): Fiber Choice Chewable Tablets, Fiber Choice Sugar-Free Tablets, Fiber Choice Weight Management Tablets (contains chromium and picolinic acid), Fiber Choice Plus Calcium (contains 500 mg and 200 IU of vitamin D), Fiber Choice Plus Antioxidants, Fiber Choice Fruity Bites
- FiberCon Caplets (calcium polycarbophil)
- Hydrocil (psyllium)
- Metamucil Clear and Natural (inulin)
- Konsyl products (psyllium hydrophilic mucilloid): Konsyl Fiber Caplets, Konsyl Original, Konsyl Easy Mix, Konsyl Fiber Easy to Swallow Capsules
- L’il Critters Fiber Gummy Bears
- Little Remedies Fiber Gummies
- Metamucil (psyllium husk): Metamucil Original, Metamucil Fiber Powder Drink Mixes, Metamucil Fiber MultiGrain Wafers, Metamucil Fiber MultiHealth Capsules, Metamucil Fiber Singles
- Phillips Fiber Good Gummies
- UniFiber (powdered cellulose)
- Vitafusion Fiber Well Gummies
- Vitafusion Fiber Well Weight Management Gummies
Psyllium
Psyllium may support digestion and heart health. It works by increasing the bulk of your stool. This increases pressure, which helps the muscles in your intestine move stool. It also reduces the amount of cholesterol your body absorbs from food. Psyllium, one type of bulk-forming laxative, has also been used along with a proper diet to treat high cholesterol.
How to use Fiber Supplement 100 % Oral Powder:
Take this medication by mouth as directed by your doctor. If you are self-treating, follow all directions on the product package. If you have any questions, ask your doctor or pharmacist. To prevent choking from this medication, take it with a full glass of water or other liquid (8 ounces/240 milliliters). If you are taking the wafers, chew them thoroughly before swallowing.
For powder forms of this medication, measure each dose according to the directions on the product label. Mix in a full glass of water or other liquid (8 ounces/240 milliliters), stir completely, and drink right away. You may add more liquid to the mixture if it becomes too thick. When preparing the medication, be careful not to breathe in the powder since it may rarely cause an allergic reaction.
Dosage is based on your age, medical condition, and response to treatment. Do not increase your dose or take this drug more often than directed.
This product may decrease the absorption of other medications you may be taking. Take this product at least 2 hours from your other medications. Ask your doctor or pharmacist for more information or if you have any questions.
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It may take 1 to 3 days before this medication starts working. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day. Do not take this medication for more than 7 days unless directed by your doctor.
Tell your doctor if your condition lasts or gets worse, or if bleeding from the rectum occurs. If you think you may have a serious medical problem, get medical help right away.
Potential Side Effects
Fiber does not have serious side effects. At high levels, it can cause bloating, cramping, gas, and perhaps worsening constipation. Drinking more water -- 2 liters a day -- may help. When patients begin using fiber supplements or increase dietary fiber intake, they should always gradually increase their intake over a few weeks to avoid or reduce adverse effects such as intestinal flatulence, bloating, diarrhea, and cramping. Adequate intake of water is advisable because inadequate fluid intake can reduce the effectiveness of a product and may cause intestinal or esophageal obstruction. To avoid choking in patients, many fiber supplement labels recommend taking the supplements with 8 oz of water.
Side effects that you should report to your care team as soon as possible:
- Allergic reactions-skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Choking-chest pain, trouble swallowing or breathing, vomiting
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Bloating
- Diarrhea
- Gas
- Nausea
- Stomach pain
Precautions and Interactions
If you take any regular medications, talk to a doctor before you start using a fiber supplement. It may block the absorption of some drugs. Therefore, patients should always be advised not to take supplements within 2 hours of taking other medications, and patients should express any concerns to their primary health care provider. This product may decrease the absorption of other medications you may be taking. Take this product at least 2 hours from your other medications. Ask your doctor or pharmacist for more information or if you have any questions.
Patients with preexisting medical conditions, such as those who must restrict fluid intake (eg, patients with significant renal dysfunction or with congestive heart failure), and patients currently taking any medications should discuss the use of fiber supplements with their primary health care provider prior to use in order to ensure appropriateness. Patients with intestinal ulcerations, stenosis, or disabling adhesions should avoid fiber supplements because of the possibility of fecal impaction or intestinal obstruction. The sugar and salt in some supplements, particularly powders, might be risky for people with diabetes or high blood pressure. People with diabetes may want to choose a sugar-free powder or another form of fiber.
Before taking this bulk-forming laxative, tell your doctor or pharmacist if you are allergic it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestinal blockage, difficulty swallowing, appendicitis or symptoms of appendicitis (such as nausea/vomiting, sudden or unexplained stomach/abdominal pain), a sudden change in bowel habits that lasts for longer than 2 weeks, bleeding from the rectum.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Some products may contain sugar and/or aspartame. Caution is advised if you have diabetes, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.
Tell your doctor if you are pregnant before using this medication.
It is unknown if this medication passes into breast milk. Consult your doctor before breastfeeding.
Important Considerations
Patients, especially those with preexisting medical conditions, should be encouraged to discuss the need to increase fiber intake with their primary health care provider. It is recommended that individuals primarily increase their fiber intake by dietary means first because few extensive studies on fiber supplements have been conducted. If dietary modifications are not effective, supplements may be incorporated into the diet when appropriate.
Patients should be reminded to eat a healthy and balanced diet to obtain most of their daily fiber and to use fiber supplements as adjunctive therapy as warranted.