Fiber rich plates and smaller stomachs?

Okay, the title is sensational.  I wanted to get people's attention.  Fiber rich plates might actually bloat your stomach, and yet, still be good for you.  My blog post is not about using fiber to lose weight, its just about fiber. 
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My diet is naturally high in fiber.  By naturally, I mean that my daily plate is plant based and contains many vegetables and whole grains, foods that are high in both soluble and insoluble fibers.  I started increasing my fiber intake after learning from nutritionist/researcher Barbara Rolls, PhD that one could have a full plate of food, feel satiated and stay nourished, by choosing foods (and creating meals) low in energy density (~ 2001).  

Energy density, the calories per gram of food, has been the subject of many of my past posts and I have a You Tube channel primarily dedicated to demonstrating how to prepare low energy dense meals.  

Many foods that are low in energy density are also high in fiber.  A body of literature suggests that eating fibrous foods is health promoting and disease preventing.  For an overview of these benefits and the studies that support them, see the Dietary Guidelines for Americans, and the Nutrition Source at Harvard’s School of Public Health.

One of the benefits associated with diets high in fiber is weight control.  It makes sense that a diet high in fiber would lead us to eat less if we feel full sooner, or with fewer overall calories.  I think, based on my personal experience, that being able to eat more food per calorie is a main mechanism of effect for weight control (aesthetically, emotionally and digestively, we are more satisfied with a fuller plate).  Experimental studies show that certain digestive actions, including the release of certain hormones, are what cause a person to feel full and eat less (see e.g., Pereira and Ludwig, 2001).  A recent study on mice found that hormones are not just acting in the gut, but in the brain as well. The study:  Frost, G., Sleeth, M. L., Sahuri-Arisoylu, M., Lizarbe, B., Cerdan, S., Brody, L., & Bell, J. D. (2014). The short-chain fatty acid acetate reduces appetite via a central homeostatic mechanism. Nature Communications, 5, can be viewed for free here.

In the Frost et al study, researchers fed some mice a high fiber diet while feeding other mice normally.  The mice on the higher fiber diet did end up weighing less than the other mice (on average). A scientist who did not participate in this study, but who also does this kind of work was interviewed by blogger/reporter Brian Owens.  He, the other scientist, made some interesting comments that I wanted to share with you.  To paraphrase William Colmers (in Brian Owens article), in order for the researchers to track the fiber and its metabolites through the mice bodies, the mice were fed a lot of fiber.  Dr. Colmers said that it is possible that the appetite regulation seen in the lab study was not a chemical reaction in the brain - but a consequence of the mice feeling “uncomfortable.”  Dr. Colmers also pointed out that the lab was likely filled with “mouse farts.”  I will let you consider the same scenario for a lab experiment with people.

In fact, the next step is to do a fiber feed in human volunteers, but in order to get the level high enough, they will probably be given some form of fiber in a pill.  I understand that as a first step, it makes sense to see what is happening by using something artificial or modified, but what we really want to know is what happens when people eat foods that are high in fiber. I don’t know how a study using an extracted form of fiber is going to answer that question.

Here is a link to the piece Brian Owens wrote for Nature.

Get Your Fiber - from food

This quick post regarding dietary fiber is my reaction to a commercial for a supplement called Benefiber.  
It is true that most Americans need more fiber in their diets, and it is true that a diet high in fiber is associated with improved health.  
The Dietary Guidelines for Americans list fiber as a nutrient to increase and on page 88, the Guidelines  present a table of foods that are good sources of fiber. The best way to obtain fiber is from food, in fact, there is little, if any, evidence to suggest any benefit from a fiber supplement. Just like any other nutrient, the best place to get it is from your plate.  Choose foods that are naturally high in fiber instead of fiber pills - no matter what the commercial tells you.  The Guidelines do not recommend pills except under the rarest of circumstances, for example, if food is not available.

Notice the many fiber rich foods on the cover - these are the foods we should eat, within our own caloric limits.  The body needs food.

The Power of Oatmeal

No not as a miracle cure for weight loss... surely by now you know that I don't endorse such nonsense.
I mean the power of oatmeal (oat bran for me) to satiate.  To leave you with a feeling of fullness which lasts for hours.  
I knew that my oat bran with almond milk breakfast was very filling, but now there is research to support this personal experience and to explain why it occurs.

The researchers in this study collected information on how the participants were feeling, e.g., if they 'felt full,' 'were hungry' and what was happening to the oatmeal and the comparison food - ready to eat cold cereal - in the body, i.e., how it was being digested.  The participants reported their feelings at several different time points up to four hours after they ate their assigned breakfast.

It is important to note that the participants each ate both meals, but in random order and about a week apart.  The meals were 1) Quaker oatmeal and 2) Honey Nut Cheerios.  The meals were served with the same amounts of skim milk and had the same amount of total calories.  I do not eat Quaker Oatmeal - but I think they used the kind that you cook with hot water.   I use oat bran which I cook with water and eat with low cal almond milk (+aspartame).  I can say with certainty that if I had equal calories of cheerios and oat bran the cheerios would be half the volume of my oat bran.   And I believe that what you see has an effect on your feelings of satisfaction and fullness.

Anyway,  the study was well done.  The lead author/researcher is Candida Rebello - a nutritionist.  You can read the summary abstract here.

Putting the reports from the participants together with the lab results, the researchers could assert that the oatmeal breaks down more slowly, is thicker going through the small intestine, among other things and is more satiating than the cereal.  There are a lot of details in the article that I am not taking the time to explain, and some I could not explain even if I had the time.  But I think I have shared enough to give you the evidenced based take home message.  Choose oatmeal over cold cereal.

As for myself, I never eat cold cereal as a breakfast.  I believe that it offers too many calories per ounce (it is energy dense) and as this research suggests, doesn't stay with you very long.  I do sometimes have a taste of it as part of my discretionary (treat) calories.

Weekly w/ Video

The News:

The American Heart Association: I hope that this volunteer health agency which is comprised of both medical and non medical volunteers is one that you trust. It has been in existence since 1924 and facilitates research into the prevention and treatment of heart disease. Their mission includes reducing deaths from heart attack and stroke by 25%. Research is published in peer reviewed journals and is used to create evidence based guidelines for health care professionals. The AHA recently spoke to Congress and shared concerns that the gains that have been made in reducing the above mentioned deaths will soon be lost due to increasing numbers of heart disease. A major concern is obesity and the Association is urging the government to increase funding for prevention in the schools and community. They are also very clear regarding the consequences of tobacco use and support FDA regulation of tobacco products which would limit if not prohibit some of the marketing and advertising by tobacco companies. The main risk factors for heart disease include: unhealthy weight, poor diet, smoking, and diabetes (type 2). These are modifiable risk factors, in other words, you can control them.
Carcinogens in Products: I am going to start sounding like a broken record but I cannot help but point out this type of discrepancy when I see it. An American consumer interest group had made claims that some Johnson and Johnson baby shampoo and lotions have two chemicals that are known to cause cancer at some level. They are formaldehyde and 1,4 dioxane. I have not researched this myself I only point out that the organization has gotten the attention of the Chinese government where these products are sold. They are also sold here but the FDA is not yet investigating. There is no report of death or illness at this time. This is of note because cigarette smoke contains at least those two chemicals and over 40 more carcinogens. These “cigarettes” are responsible for millions of deaths a year worldwide… so uh, where is the outrage? [post note: this issue has been cleared by China's state food and drug agency]
Pretending to Smoke: What an odd little “game” the children have created. From A WSJ article I learned that kids can crush up certain candies, sort of inhale the dust and then blow out smoke. They even practice blowing smoke rings. All I am saying, kids really need to get out and play more
PSA Testing: I recall talking about this test for prostate cancer when my newsletter was first being published. In the early 2000s then, the concern was whether to test and then whether to treat because this cancer, though the second cancer killer for men, was a slow killer and often the men could live the rest of their lives without much decline in quality of life and likely die of something else before the cancer killed them. [probably they will die from heart disease, no?]. The testing or screening can lead to biopsies and treatment that is rife with side effects. The treatment can be debilitating and or embarrassing. Two very large research studies, studies lasting 15 years, do not offer a disposition. Over 240,000 men were studied. The results were a very slight benefit in one study, but with significant side effect costs and the other found no benefit at all. This is exactly the kind of reporting I want to see on medical devices, tests and treatments. Not that they do not work, but whether or not they work and what the risk to benefit is.
Number One Cancer Killer?: Good question. Though men suffer from prostate cancer and women from breast, the number one killer of both men and women is lung cancer. There may be a higher prevalence of the other cancers, including colorectal, but those with lung cancer generally die from it, while the other cancers have better survival rates.
HDL: The Good Guy: A reader and friend recently asked me to tell him a way to raise his good cholesterol that he didn’t already know. Certainly he knows what most of you know, you raise it through exercise (though not exponentially) but more often those with high HDL have a gene that promotes it. I did take his challenge however and read what I could about the issue from sources that I consider valid or research based. I.e. you are NOT going to hear me recommend a supplement to increase your HDL. What you will get from me is a practical application of what I have vetted. Here it is then. The mayo clinic among others, notes that oils with mono unsaturated fats, like olive and peanut, enhance the anti-inflammatory properties of the HDL. So though you may not be able to change your number you may be able to increase the impact of that number, in my opinion. I strongly suggest that you follow my example from the cooking demos and do not cook in the oils but add limited amounts to your already cooked veggies or to a salad. A teaspoon for example, or even a tablespoon spread throughout the day. It is also true that HDL works in keeping you healthy by carrying out excess bad cholesterol. It is known that certain fibers can also aid in ridding the body of bad cholesterol so again I recommend something like my cereal bars. Lastly, do not smoke. Smoking lowers HDL. Some research supports that red wine may have an HDL promoting effect but not enough to make a standard recommendation for anyone to add wine if they do not currently drink it.

That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar. Today’s show is peanut butter cookies which in fact, are HIGH in fiber… and the peanut butter is a source of monounsaturated fats. These are not your mother’s PB cookies, nor my mom’s which are fantastic.. but this blog is about health not decadence.

Ingredients include:

Smucker’s All Natural Peanut Butter
(do not use jiff, peter pan, etc- for numerous reasons)
Splenda or Altern
Kellog’s All Bran Original
Loose Oat Bran
WATER
Non fat cook spray (butter)
Cookie Sheets
Large microwaveable bowl… glass is best
Heat oven to 375*
I forgot to say this in the video but cook the cookies for 20 minutes and then check them, move pans around, check every five or ten minutes, you will get the idea in time.

This is the original recipe from a cook book I made a long time ago, but it is hard to explain what I mean, thus the video!

4 Tbls smucker’s all natural peanut butter
water
2 c All Bran original
¼ cup loose oat bran
¼ to ½ c loose Splenda

In microwave if available, heat the peanut butter with about 1 ½ c or more water for about 2 minutes, then use beaters to mix this until it is peanut butter colored water mixture, also mix in the sweetener. Then add the cereals, set aside until moist. Mix this again adding some water until it is moister than other cookie dough. I use a scoop to make two trays with 20 cookies on each. Bake at 375, twenty or so minutes until done. More water and less cooking makes them seem moister. It is good to experiment until you like them!! Made my way, each has about 20 calories.

Serving size: 3 cookies
Amount per serving: calories: 60; fiber: 3g; protein: 2g; fat: 2g.

Wellness Weekly with video recipe

Most of the articles that caught my eye this week, or my ire, as it were, appeared in the Wall St Journal or on My Yahoo homepage. Interestingly, I emailed the reporter for one of the stories so I could have more information for my readers. I will hit a few highlights, but I also want to provide a little history about this blog site and newsletter.
I began writing a weekly email newsletter in 2000 and it was first for the Social Work / Case Management Dept at WFUBMC. I was the department’s appointed wellness ambassador for our Action Health (employee wellness) program. Things rather cascaded from there. I received some fitness and nutrition certifications (nothing gold standard) and the newsletter went out to a lot more people and was also at one time posted at two Fitness Centers, in NC. Originally it ended with a recipe. I put many recipes together into a small cook book as well. At the time I was a social worker doing some personal training and catering on the side. In 2004 I went back to college, to grad school and received the Public Health master’s and the credential of Certified Health Education Specialist. This blog came about because many people wanted to keep getting their “News” even as I moved to FL and my web page attempt was tedious.. My goal has been the same for four or five years now, and is the premise of the blog. I want only to prevent disease or progression of disease in myself and the people I know and the people with whom I share this world. My next goal is to have this influence as an “expert” but for now, I do it as I can and as a layperson. Many times I share my ideas about food with my friends, coworkers and family. I have a gift.. I am sure that I do. I can revise any recipe and make it healthier. I have learned tricks on the preparation and the selection of foods. I believe 100% in the Volumetrics concept of Dr. B. Rolls and not at all in any dieting. My cooking tricks, techniques and ideas are hard to put in writing and for some time I have considered video taping my cooking. If you checked in lately, you can see that I have taken a stab or two at doing just that. As I work to make this better I do have to wonder about the balance between the news and the cooking.. or I might find a way to compartmentalize. Bear with me as once again the Weekly News, now nine years old, gets a makeover. Today’s column will end with my most famous and historic recipe, Cereal Bars, with a demo video.

The News:

Treating Stroke: Tom Burton of the Wall St Journal described an interesting debate regarding what is the best treatment for preventing a stroke. This is timely as we hear talk about effective treatment and comparative research. Tom noted a study that compared surgery to stenting but which does not answer the question about drug therapy as the third option. In the article, Tom explains the stenting. This is to insert a small metal tube in the neck to open the blocked artery. We have spoken of stents a lot so you know the risks with them. This is also known as something that is noninvasive, but to me, a tube in my arteries IS invasive. The surgery has been around a long time and is considered effective for clearing clogged arteries. [just writing this scares hell out of me and is exactly why I eat the way I do] The surgery is referred to as a carotid endarterectomy and Tom says that this cutting open the artery and then cutting away the fatty plaque is “pretty routine”. A third option is the use of medication. There is some evidence that drugs like statins can keep the plaque from building up more and in some cases may even reduce it. The next step would be in evaluating if the drugs, the endarterectomy or the stents prevent the most strokes and of course, which have the highest adverse outcomes. Now if this doesn’t make you want to avoid high fat foods I don’t know what will. And that would be the fourth option, preventing plaque buildup in the first place.

Knees and Knee Parts: I am sure that there are people who receive knee replacements and have an improved quality of life, I haven’t met them. Research comparing physical therapy to arthroscopic knee surgery, for instance, did not show a better outcome for surgery. I have said this before but here again… some people choose surgery over physical therapy HOWEVER<>

Speak Up: This week also brought an article that encourages the recipients of health care, you and me, to speak up about the quality even to a white coat. Yes, it is okay to say, gee Doc could you wash your hands please? In reading this article I recalled one time that I did not speak up and wished I had and others where I do speak up but have a hard time being heard. The first was ten or more years ago when my Dad was in the hospital and had to have his blood taken. The phlebotomist (I think that is the term) did not wear gloves. I remember thinking that he must think my dad is a safe stick, because he is 70ish etc, but that doesn’t mean the person drawing the blood was “safe”. More personally, because I am a health educator and study this stuff, I know that to get a good blood pressure read, the patient should be seated for several minutes and their arm should be at a 90 degree angle. How many times do you walk in and right away the cuff is placed for the BP?

Colds: I like oh so much to be right, so let me share some info from Melinda Beck’s Health Journal from Tuesday. Basically, it is ok, even beneficial, to work out when you have a cold, she said swim or run. It is not helpful to take those supplements and herbals that claim to protect you from getting colds or shorten their duration. Research supports that getting plenty of exercise, sleep and vitamin D (some from sunlight for sure) is protective for preventing colds or minimizing symptoms and duration. To ease symptoms these three things were suggested, decongestant sprays, hot beverages and acetaminophen. The researcher stated that there was no evidence to support use of antihistamines or cough medicines. True that.

Ok that is enough news.

Here is the recipe. These cereal bars are, in my opinion, wonder bars. They keep you feeling full, they level your blood sugar, they assist in the removal of LDL cholesterol and they keep you regular, which would intuitively also protect against colon cancer and a cranky mood. [omg, I crack myself up]. Let me add a disclosure, what I mean to say is that the ingredients in these bars will do the above, the bars themselves have not been used in a research study… yet.

Cereal Bars

1 ¾ c Kashi Good Friends Cereal (in red box) or Kashi Go Lean

3 c All Bran original

½ c loose oat bran (buy at a whole foods store)

1/4 c skim milk plus 1+ cup water

¼ c Waldon Farms sugar and calorie free syrup

1/4 c apple sauce(no sugar added)

1 tsp cinnamon

1/8 c egg substitute

mix all together in a bowl and pour into 8 ½ by 11 inch pan that has been thoroughly sprayed with butter flavored non-fat cooking spray. Bake at 375 about 40 / 45 min, if spring to touch they are done. When completely cooled, place on cutting board, cut in half and then each half into 12 bars, will have Approx. 40 calories each and about 4 g of fiber. (I use a brown glass dish and I cool over night in the fridge for easier cutting. These are small, cut into twelve pieces for 80 cals each).

Very important note, before you add the milk/water mixture (last) have the oven heated and the pan sprayed so that as soon as you stir it you fold it into the pan and place in oven, otherwise, the water is quickly absorbed by the cereals and it’ll dry out. The mixture should be wet, but not too loose. It’ll be trial and error. I use almost 2 cups of milk/water mix.