May 2023 – Steven Piriano, MD

Got Fiber?

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In my last post, I wrote about fiber and its many health benefits. I mentioned that it lowers cholesterol and triglycerides. I also stated that it reduces the risk of developing chronic diseases such as diabetes, heart disease, and several types of cancer. As an added bonus, it makes you feel fuller sooner and without increasing your caloric intake.

I stated how many different types of fiber are the food of choice for the 39 trillion bacteria living in our gut—our gut microbiome. Moreover, a thriving gut microbiome is responsible for many of the health benefits of fiber. When the bacteria in our gut are presented with different types of fiber, they produce small molecules called short-chain fatty acids (SCFAs). Aside from providing several of the health miracles described earlier, SCFAs also provide 70% of the energy needed by the cells of our colon, which will keep them functioning well.

To digress for a moment, have you ever heard of leaky gut syndrome? I certainly have. Over the years, I’ve had many patients who have told me they have this condition. But what exactly is a leaky gut? I mean, how does one’s gut leak? Well, it all comes down to the health of our colon cells. These cells are held closely together by molecules called tight junctions. If these junctions work normally, the colon cells will be held closely together. If these junctions are not operating as they should, the colon cells will separate, and there will now be spaces between cells. Substances within the gut, such as bacteria, bacterial toxins, and molecules from food, can now move through these openings and find themselves outside the gut. This, my friends, is a leaky gut.

You may wonder why it is such a problem if these things “leak” out of your gut. Well, the fact that 70% of your immune system lives just outside the gut is one big reason. When your immune system encounters these things, it can lead to allergies, excessive inflammation, and even autoimmunity. Furthermore, the muscles and nerves within the gut can be adversely affected, leading to distressing symptoms such as constipation, diarrhea, bloating, and abdominal pain.

Once again, I’d like to point out that you can lower the risk of developing many diseases and also allow yourself the opportunity to feel fantastic through the simple act of eating whole, healthy foods.

Thank you for taking the time to read this post. I hope you enjoyed it and found it informative. If so, please feel free to share it.

What’s All the Fuss About Fiber?

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What do foods such as broccoli, peppers, bananas, and apples have in common? Sure, they are loaded with vitamins, minerals, and antioxidants, which are essential to good health. The other indispensable component that they have is fiber.

I’m sure you’ve heard a lot about fiber. But, why is fiber so important for good health? What IS all the fuss about fiber? That is a terrific question, and I’m glad you asked.

Books can and have been written about the benefits of fiber. In this post and the next, I will distill down a few of the critical points.

You’ve probably heard that fiber can help you poop regularly. That’s true, and that is an important benefit of fiber. However, there is so much more to fiber than just helping to keep us pooping regularly.

First, it’s important to understand that our bodies cannot digest fiber, and we get no calories directly from fiber. Having said that, one of the things that fiber does is that it increases satiety. That’s right; it makes us feel full without increasing our caloric intake. That is a great thing in and of itself. Fiber also increases insulin sensitivity, which decreases the risk of diabetes. It lowers cholesterol and triglycerides. It also reduces the risk of heart disease as well as several cancers, such as colon cancer.

Now, if we can’t digest fiber, how does it work its miracles within us? Another great question—you’re on a roll. Fiber is actually the food of choice for the 39 trillion bacteria that live in our guts, also called our gut microbiome. Further discussion on that in my next post. Fun fact: 39 trillion microbes are living in our guts. Do you know how many human cells your body is made up of? About 30 trillion—give or take a trillion. Think about that—your body is likely composed of more bacterial than human cells. Amazing, right?

Moreover, we have an important relationship with these gut bacteria, and they are vital for good health. Thus, it would behoove us to give our gut bacteria what they need to thrive. And as mentioned earlier, their food of choice is fiber—many different fiber types.

Where do we get lots of different kinds of fiber? It comes from eating a variety of plant-based foods, especially whole plant-based foods such as fruits, vegetables, beans, lentils, oatmeal, flaxseed, and whole wheat pasta. Fiber is only found in plant foods. Animal foods have zero fiber.

One last thing: if you currently don’t eat many fiber-containing foods and want to start, that is fantastic. However, there is an important warning. Let’s say that your only source of fiber is something like a banana a day. If you go directly from that to eating five or six servings of fiber-containing foods the next day, you will likely feel pretty bad. You may experience abdominal pain, bloating, and feel gassy. The best way to increase your fiber intake is to do it slowly. If you’re starting low, then please go slow.

Solely by the simple act of eating whole, healthy foods, we can help improve and maintain excellent health.

Next time: Fiber part II.

I hope you enjoyed this post and found it informative. If you did, please feel free to share it.

Failures are Good

Back in high school, I eagerly anticipated acquiring my driver’s license. I vividly remember the day of my road test. While backing up during my parallel park, the tires kept hitting the curb. I just couldn’t seem to get the angle right. When I signaled my intention to pull out so I could try again, the windshield wipers turned on. It felt like I was fumbling with the controls for an eternity, trying to figure out how to turn them off. All the while, my examiner stared at me—it was a bit humiliating. When I finally figured it out and pulled out, my examiner instructed me to return to the location where the test began. I was angry and upset. I wasn’t being given another chance at the parallel park. I knew I had failed.

As I signaled to make my final left turn, the car suddenly jerked to a halt. Thankfully, my examiner had hit the brakes. It took me a moment to realize that I was about to turn into oncoming traffic. I had been so upset that I was not paying attention to the road. I left the test feeling disappointed in myself. However, reflecting back, I realized that this experience taught me two essential lessons. First, never make a left turn into oncoming traffic. Second, always pay close attention to the road because there can be serious consequences for not doing so.

Flash forward about a decade, and I was about to sit for my oral board exam in Emergency Medicine. I had done well on the written boards, but the oral boards were an entirely different animal. In this exam, a seasoned physician asks you questions about how you would care for multiple patients at once. It was intimidating. A few weeks later, my score report arrived in the mail. As I read the letter, I was disappointed. I had failed—not by much, but I had failed.

I studied diligently and scheduled a retake of the test. I am happy to say that I passed the second time. Contemplating this experience, I realized that although I failed, I had gained a lot. While studying for my retake, I became much better at organizing my thoughts in order to be more efficient when caring for multiple patients simultaneously. I also learned a lot more about medicine that I know also allowed me to provide better care to my patients.

I hope these stories demonstrate that failures—as long as you learn something from them—are good. Of course, you are likely to be disappointed if you fail, which is normal. However, if you take something away from your failures and learn how to do something better, then failure is great. Failures are how we learn and improve. They can be thought of as stepping stones or springboards to success. In fact, I’ve heard that the most successful people in life are also the people that have experienced the greatest number of failures.

If you experience a failure, learn something from it and move on.

Please feel free to share this post with anyone who might find it helpful.

Don’t go on a Diet

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I know—that sounds like an unusual statement from someone passionate about healthy lifestyles.

But I’ll state it again: Don’t go on a diet.

I make this statement because, although well-intentioned, if you go on a diet, it implies that at some point in time, you are going to come off the diet. Thus, any health improvements that occurred while on the diet will likely be lost when you are off the diet.

What I propose instead of “going on a diet” is to state that you are going to change your lifestyle. You are going to change the way you eat. You are going to commit to eating healthier foods. This is a much more powerful way to state your intention. You are expressing your resolution to a lifelong change rather than a temporary fix. This will help ensure that you achieve your health goals and enjoy years of good health and vitality.

If you know of anyone who would benefit from this post, please feel free to share it. Thank you.