Fiber Is the New Sexy

What could be more sexy than a beautiful gut? All glistening and shiny, doing it's job just right, not inflamed, not allergic, just all happy? Fiber takes you there: removes toxins, keeps things moving, gives you a sense of satiety. Most important? Fiber protects your gut from injury and disease. Let's get some.

My Fave Fiber-Rich Foods

Bran, Baby. Bran, or at least raw bran from corn, rice and wheat, counters constipation because it is rich in insoluble fiber. Oat bran, lowers bad cholesterol (LDL). Bran can be sprinkled into your favorite foods—from hot cereal (I favor oat groats, quinoa flakes) to yogurt. And for those of you still eating cereal and bars (you mean I haven't convinced you not to?!), I've included some of the popular high-fiber choices.

Food  |  Portion  |  Amount of Fiber
Oat bran, raw - 1 ounce - 12 g
Corn bran, raw - 1 ounce - 22 g
Fiber One Bran Cereal - 1/2 cup - 14 g
All-Bran Cereal - 1/2 cup - 10 g

Beantown. Beans are some of the most naturally-rich sources of fiber. Many indigenous diets include a bean or two in the mix. Some folks experience gas as they amp up bean intake, so they may be better off slowly working beans into their diet. I cook mine in the slow cooker, after an overnight soak, and have zero problems with gas. Try a variety of beans as a replacement for animal protein in soups, salads, and dips.

Adzuki beans, cooked - 1 cup - 17 g    
Fava beans, cooked - 1 cup -  9 g
Black beans, cooked  - 1 cup - 15 g
Garbanzo beans, cooked - 1 cup - 12 g
Lentils, cooked  - 1 cup - 16 g

Berrylicious. We love berries for their superfood antioxidant status, but let's keep their fiber in mind. I eat berries every morning on my oat groats. I buy mine frozen and organic from the local store during the winter.

Raspberries, raw - 1 cup - 8 g
Blueberries, raw - 1 cup -  4 g
Strawberries, raw  - 1 cup  - 3 g
Boysenberries, frozen - 1 cup  - 7 g
Blackberries, raw - 1 cup - 8 g

Put Your Hands in the Air for Whole Grains. Not my first choice, but whole grains get you dense nutrients the less process they are. But aim for smaller quantities, particularly at lunch and dinner if you're trying to lose weight. Think of it more as a condiment.

Barley, pearled, cooked - 1 cup - 6 g
Oats (old fashioned), dry - 1/2 cup -  4 g
Quinoa, cooked - 1 cup  -  5 g
Wheat berries, dry  - 1/4 cup -  5 g
Brown rice, cooked  - 1 cup  -  4 g
Spaghetti (whole wheat), cooked - 1 cup -  6 g

Crazy Sexy Peas. Peas are crazy full of fiber. Not just for New Years Day! I love BEPs in more ways than you know!

Blackeyed peas, cooked - 1 cup - 11 g
Peas, split, cooked - 1 cup  - 16 g
Peas, green, frozen - 1 cup - 14 g

Imma be the Queen of Greens. There are 1000+ plant species with edible leaves, so you can truly go wild in this category. I toss many of them chopped in a salad, or saute them in coconut oil with Meyer lemon and shallots. Delish.


Beet greens, cooked - 1 cup - 4 g
Mustard greens, cooked - 1 cup  - 5 g
Collard greens, cooked - 1 cup -  5 g
Spinach, cooked  - 1 cup  -  4 g
Swiss chard, cooked -  1 cup -  4 g

Hormone Therapy Lowers Colon Cancer 25-36%

Here's another post from North American Menopause Society. Seems cyclic progesterone was associated with the greatest risk reduction of colon cancer. Check it out.

Does hormone therapy decrease colorectal cancer risk?

Johnson JR, Lacey JV Jr, Lazovich D, et al. Menopausal
hormone therapy and risk of colorectal cancer. Cancer
Epidemiol Biomarkers Prev 2009;18:196-203.

We evaluated colorectal cancer risk associated
with the duration and recency of specific
menopausal hormone therapy formulations (ie,
unopposed estrogen versus estrogen plus
progestin) and regimens (ie, sequential versus
continuous estrogen plus progestin use) among
56,733 postmenopausal women participating in
the Breast Cancer Detection Demonstration
Project follow-up study. Hormone therapy use
and other risk factors were ascertained through
telephone interviews and mailed questionnaires
from 1979 to 1998. The final cancer group
included 960 women who were identified from
self-report, medical records, state registry data,
and the National Death Index. Poisson regression
was used to generate multivariable rate ratios
(RR) and 95% confidence intervals (95% CI).
We observed a decreased risk of colorectal
cancer among ever users of unopposed estrogen
therapy (RR, 0.83; 95% CI, 0.70-0.99). Among
estrogen users, the largest reduced risk was
observed for current users (RR, 0.75; 95% CI,
0.54-1.05) and users of ≥ten years duration
(RR, 0.74; 95% CI, 0.56-0.96). We found a
reduced risk among users of estrogen plus
progestin therapy (RR, 0.78; 95% CI, 0.60-
1.02), with sequential regimen users (progestin
<15 days per cycle) having the largest risk
reduction (RR, 0.64; 95% CI, 0.43-0.95). Past
users of ≥5 years ago (RR, 0.55; 95% CI, 0.32-
0.98) had the largest risk reduction. In this
study, estrogen plus progestin use, especially
sequential regimen use, was associated with the
largest overall reduction of colorectal cancer
risk.

Comment. This is a retrospective study, the
stated purpose of which was to identify
separate risk estimates for colon cancer
according to menopausal hormone form-
ulations. A paper published 9 years earlier1
from the same database found a suggested
inverse relationship between the use of HT and
colon cancer. The current paper analyzed
postmenopausal women divided into groups of
never users, those who had ever used estrogen,
and those who had ever used estrogen plus
progestogen (EPT), and then further divided
them by sequential hormone use and length of
time exposed to HT. What the current authors
found was that those who had ever used
unopposed estrogen had a decreased risk of
colon cancer. Those who had used sequential
EPT had the largest risk reduction. What does
this information add to our knowledge of this
topic?

Estrogen receptors have been detected on colonic
cells, with estrogen-receptor β being over-
expressed in healthy colon cells and reduced in
colon cancer cells. This overexpression, coupled
with negligible expression of estrogen-receptor α,
is thought to provide protection by HT against
colon cancer. What is also known is that
prescribing patterns for HT vary among race,
with African-American, Asian, and Latina
women receiving less treatment than Caucasian
women. An evaluation of how many women
were represented in each group rather than a
designation of “nonwhite” and a designation of
“person-years” only would have been
informative. It would also have been beneficial if
the groups had been matched by age, ethnicity,
and HT use (perhaps this is a paper that will be
published later).

African-American women have the highest risk
for colon cancer, higher even than white males;
and colon cancer in these women is often
detected at a more advanced stage. If HT really
does reduce the risk of colon cancer, all women
should have a discussion with their healthcare
provider about the potential benefits of HT for
them. A prospective study of matched groups of
women would be very informative regarding risk
reduction across ethnic groups in which there is a
dearth of comparative information available.
Women who use HT are more likely to have
mammograms, as well as Pap smears and
colonoscopies. Colonoscopy, however, is still at
the bottom of the list even for women who
regularly undergo other types of health screening.
It would be helpful if healthcare providers
encouraged women to have a colonoscopy. It has
been shown that if a healthcare provider strongly
recommends a test, a patient will often agree.

As March is National Colon Cancer Awareness
Month, this might be a good time to consider a
large-scale prospective randomized trial of HT
use with timed colon cancer screening across
ethnic groups by those in this field.
Michelle Inkster, MD, PhD
Department of Gastroenterology and Hepatology
Cleveland Clinic
Cleveland, OH

Reference:
1. Troisi R, Schairer C, Chow WH, et al. A prospective
study of menopausal hormones and risk of colorectal
cancer (United States). Cancer Causes Control 1997;