FiberDiverticular Disease

Eat to Beat It

The colon is the Rodney Dangerfield of bodily organs: It doesn’t get the respect it deserves.

Shaped like an inverted U, the colon is part of the large intestine and functions predominantly to maintain fluid balance, aid in the absorption of certain vitamins, and remove waste from the body, the latter being essential to help expel the environmental toxins we’re exposed to each day that can sour our health. So when trouble brews in the colon, it’s important to take notice.

Two conditions comprise diverticular disease: diverticulosis and diverticulitis. Diverticulosis is the development of pouches (diverticula) in the colon or bowel walls. Most people don’t experience symptoms of this condition, which is usually only spotted during a colonoscopy. Diverticulitis occurs if the pouches become inflamed and rupture,which can trigger a range of odious symptoms,including intense abdominal pain, fever, chills,diarrhea, bloody stools, and vomiting. Complications can include the formation of abscesses and fistulas, intestinal rupture, peritonitis and, in rare cases, death.

Medical experts have yet to pinpoint the cause of diverticular disease. However, many believe that diet is a major culprit in the malady’s progression. It’s been noted that diverticular disease is much more prevalent in Western industrialized countries than in underdeveloped nations. The theory is that the modern Western diet that is super-sized in processed, fast food is not friendly to the colon. This theory is supported by the fact that when countries such as China and Japan adopt a more Western lifestyle, the prevalence of diverticulosis often rises.

Thankfully, by tweaking your diet, it’s possible to keep diverticular disease at bay and your colon in fine working order.

A high-fiber eating plan is the diet therapy for diverticulosis,according to Tamara Duker Freuman, MS, RD,CDN, a registered dietitian in New York City who specializes in digestive disorders and food intolerances. “Because a key contributor to the development of diverticula is straining to pass stools,a high-fiber diet is prescribed to add bulk to the stool and make it easier to pass,” she notes.

After years of straining due to the chronically low-fiber diet that has largely become the norm in the United States, the colon can become a little bit stretched, Freuman explains. “A looser colon will require an even bulkier stool to make contact with the surface of the contracting colon to help move things along easily,” she says.

Among nearly 45,000 male health professionals who participated in a long-term study published in the Journal of Nutrition, eating a diet rich in fiber was associated with about a 40% lower risk of diverticular disease.

By helping fill you up, a highfiber diet has been shown to aid in weight loss, which indirectly can help in the fight against diverticular disease. A study published this year in The American Journal of Gastroenterology found that women who were overweight or physically inactive were more likely to develop diverticular disease requiring hospitalization.

Current recommendations indicate that women should eat 25 grams of fiber each day, while men are advised to shoot for as much as 38 grams daily. Yet the average American eats only about 15 grams of fiber each day. “The trick is to include high-fiber foods at each meal and for snacks,” Freuman says. She suggests eating plenty of whole grains, such as oatmeal, barley,and whole wheat bread, as well as beans, lentils, fruits, and vegetables to get your fill of fiber. “Dried fruits are a terrific source of fiber and make a good snack option,” she adds.

In other words, a whole-foods diet, as opposed to one replete with processed items such as white bread and white rice, is the ticket to meeting your daily fiber quota.

Freuman says both soluble and insoluble fiber are important for different reasons. “Insoluble fiber, like the type found in peels of fruits and vegetables or in seeds, adds bulk to the stool and makes it pass more quickly and with less effort.” On the other hand, she says, soluble fiber, such as that found in oatmeal,barley, and the flesh of some fruits like apples,draws water into the stool where it is then retained,helping to keep it soft and therefore easier to pass.

Freuman notes some old-school doctors still tell patients with diverticulosis to avoid nuts, seeds, and popcorn for fear that these foods will get stuck in the diverticula and cause an infection. “But the evidence simply does not support this recommendation and,in fact, these foods are excellent sources of fiber that make convenient and healthy snacks,” she says.

It’s a good idea to trade in your steak for tofu more often. According to a recent report in BMJ involving more than 47,000 men and women, vegetarians had a 31% lower risk of developing diverticular disease compared with meat eaters. It’s believed that’s due to the additional fiber in a vegetarian diet. The scientists also hypothesized that a meat-heavy diet may negatively impact the bacteria in the colon,resulting in a weaker colon wall.

“Drinking sufficient liquids on a high-fiber diet is important to prevent the fiber from causing an obstruction, but once fluid levels are adequate,more liquid does not provide a greater benefit,” Freuman says. When boosting your fiber intake, aim to imbibe plenty of calorie-free liquids such as water and tea.

The colon plays host to a zoo of bacteria, and a proper balance of healthy bacteria must be maintained inside the colon for optimal digestive health. It’s believed that foods high in probiotics, such as those found in yogurt and miso, can help in the battle against diverticular disease.

A recent study by Italian researchers discovered that patients with symptomatic diverticular disease who consumed a probiotic supplement as part of a high-fiber diet experienced less abdominal bloating and pain. Still, it remains to be proven that the amount of bacteria in yogurt and other fermented foods can have a tangible impact, particularly if dietary fiber is lacking.