Patient Information Advice for patients following a high fibre diet The information contained within this diet sheet is intended to be used alongside the tailored dietary advice provided by your dietitian Author: Dietetics and Nutrition Produced and designed by the Communications Team Issue date Jan 2016 - Review date Jan 2019 - Expiry date Jan 2020 Version 2 Ref no. PILCOM1721
Fibre is important for general good health but particularly for the normal functioning of the bowel. In particular fi bre can help to: increase stool bulk increase gastric transit soften stool consistency In turn, this can help regulate bowel habits. A high fibre diet is often used to help with irritable bowel syndrome, constipation, diverticular disease and haemorrhoids. You have been advised to follow a high fibre diet to help improve your symptoms. While following this diet ensure that you: Eat regularly and try to include fibre rich foods at each meal. Spread your intake of fi brecontaining foods evenly throughout the day. Drink a minimum of 8 half-pint (250ml) glasses of fl uid per day. What is dietary fibre? Dietary fibre is obtained from plant foods and unlike other nutrients; it is not absorbed across the gut wall. Fibre is often classifi ed as soluble or insoluble: Insoluble fibre adds some bulk to the stool. It is often fermented by gut bacteria but the structure remains largely unchanged as it transits through the gut. Diets high in insoluble fi bre help promote the growth of bacteria, which is thought to be benefi cial for the overall health of the gut. Examples of insoluble fi bre sources include; whole-grain cereals, vegetables, nuts and seeds and skins from fruit. Soluble fibre absorbs water and becomes bulky and heavy. This additional bulk can help encourage a regular bowel habit. Examples of soluble fi bre sources include; vegetables, fruits, oats, barley and pulses. Both types of fi bre are important for a healthy gut and to promote a regular bowel habit and need to be included in your diet. How much fibre should I have in a day? It is recommended that you consume 24g of fi bre per day. Do not exceed 32g of fi bre per day. The fi bre content of some common foods can be found on pages 6 to 8 of this booklet. 2
What is considered a normal frequency of bowel movement? There is no offi cial defi nition but a normal bowel habit is often considered as opening the bowels from three times in a week to three times in a day. Fibre facts The average intake of fi bre in the UK is 14g per day 10% of the population suffer with constipation 8/10 people in the UK don t eat sufficient fi bre Fibre can help regulate bowel habits prevent or treat constipation help reduce cholesterol levels add bulk to the diet which helps control overeating Dietary sources of fibre Bread 100% wholemeal/whole-wheat is the best, otherwise try granary breads. Breakfast cereals Breakfast cereals are an excellent way to increase your fibre intake easily. Use wholegrain or oat based breakfast cereals (e.g. Weetabix, Shredded Wheat, muesli, porridge, Branfl akes, Fruit and Fibre, Oatibix, All bran, Ready Brek). Flour/wheat Use 25 50% wholemeal flour to replace white fl our in home baking and cooking. (You may need to add extra fl uid in your recipes when using wholemeal fl our). Biscuits and crackers Use wholegrain biscuits and crackers e.g. Ryvita, oatcakes, bran biscuits or digestive biscuits. Vegetables, pulses and barley All vegetables and salad are good sources of fi bre and can be included at main meals. Tinned or frozen products contain as much fi bre as fresh. Pulses are easy to add to salads, stews and soups. Pearl barley is a good addition for soups, stews, hot pots and casseroles. N.B: Dried beans must be soaked overnight, boiled rapidly for at least 15 minutes and then cooked for the specifi ed cooking time. Tinned beans are a suitable more convenient alternative. 3
Fruit All fruits, fresh, frozen, dried or tinned (preferably in natural juice) are good sources of fi bre and are easy snacks and pudding options. N.B. You should aim to have fi ve portions of fruits and vegetables in a day. Always eat the skins of fruit and vegetables where possible to maximise the fi bre content e.g. jacket potato, apple. Nuts and seeds Nuts and seeds can be used as snacks instead of sweets and crisps. They can also be used in baking and cooking with main course meals and salads. Nuts and seeds are also a tasty addition to breakfast cereals. Oats Oats are an excellent source of fibre and can be eaten cooked or raw. Use at breakfast as a porridge or mix some oats in with yoghurts or fruit crumble toppings. Oatcakes or fl apjacks are a high fi bre snacks for in between meals. There are also an increasing number of commercial oat based breakfast cereals. Other fibre sources Quorn is a meat replacement often used by vegetarians. It is high in protein and fi bre and comes as imitation mince or chicken pieces. It can be used in stews, bolognaise sauce, stir fries and most other recipes that require mince meat or chicken. Bulgur wheat or cracked wheat is a grain that is used in Middle Eastern style cooking (tabbouleh is the most common dish it is used for). It is a higher fi bre alternative for white rice and cous cous (a white pasta based grain) and is excellent in soups, and salads. Buckwheat is a grain similar in appearance to bulgur wheat (but is not a wheat) and is related to the rhubarb family. It can be used in a similar way to Bulgur wheat or cracked wheat. Quinoa is a grain like crop grown for its edible seeds which can be used as a higher fi bre alternative for rice and couscous similar to bulgur wheat. 4
Soya beans and edamame (an oriental bean snack) are rich in fibre. Soya products such as tofu and soya milk are not as rich a source of fi bre as the beans but do contain small amounts. Linseeds or flaxseeds If you remain constipated or struggle to increase your fi bre intake then you can try up to one tablespoon of linseeds per day which can be mixed with cereals, yoghurts, sauces and baking. Make sure you drink plenty fluids when you have linseeds. It doesn t matter if you use whole or ground or brown or golden. 5
The following table gives a guide to the fi bre content of some foods: Fibre content of foods Food group Cereals, grains and bread g fibre per portion 1 Weetabix 2 Branfl akes (1 bowl or 30g) 5 Fruit & Fibre (1 bowl or 30g) 3 All Bran (1 bowl or 40g) 11 Ready Brek (1 bowl or 30g) 2.5 Granola (1 bowl or 40g) 2 Porridge oats (30g uncooked) 3 1 x Shredded Wheat 2 1 x slice white bread 1 1 x slice wholemeal bread 2 1 x slice granary bread 1.5 1 white pitta bread 2 1 wholemeal pitta bread 4 1 medium chapatti 2 150g naan bread 3 180g brown rice (cooked) 5 180g white rice (cooked) 1.5 75g uncooked wholemeal pasta 6 75g uncooked white pasta 1 6
g fibre Food group per portion Fruit 1 banana 2.5 1 apple 2 1 orange 3 1 peach 2 peaches canned in juice (100g) 1 1 pear 3 6 prunes 4 3 fi gs 3.5 4 dates 4 140g rhubarb 3 1 kiwi 1 Vegetables 4 broccoli fl orets 2 90g caulifl ower 2 65g peas 3 2 tbsp sweet corn 3 60g carrots 2 90g runner beans 3 90g cabbage 2 75g mange tout 3 Potatoes 1 medium jacket potato 4 180g boiled potatoes 2 50g plantain 3 130g sweet potatoes 3 Lentils and 120g lentils (cooked) 4 pulses 200g chick peas (cooked) 10 200g kidney beans (cooked) 17 135g baked beans (cooked) 9 7
g fibre Food group per portion Other 100g quorn 5.5 80g pearl barley (cooked) 3 180g cooked bulgur wheat 6 180g cooked buckwheat 5 180g quinoa (cooked) 5 50g mixed nuts 4 20g popcorn 2.5 100g tofu 1 100ml soya milk 0.5 25g peanut butter 2 Reading labels Reading labels is a good way to identify if a food is high in fi bre. A food product is considered high in fibre if it contains 6g (or more) per 100g / ml of the food. A food product is considered as a source of fi bre if it contains 3g per100g / ml of the food. Tips for increasing dietary fibre Increase your fi bre intake gradually. Count roughly how much fibre you are having currently and increase it by 4g every 2-3 days providing you feel comfortable. Keep a food and symptom diary so you can work out how much fi bre is right for you. Some people who are unused to fi bre complain of bloating, wind and abdominal discomfort. This can often settle after 2-3 weeks so bear this in mind as you increase the fi bre in your diet. As you increase your fi bre intake, make sure you are drinking at least 8-10 glasses of fl uid each day. 8
Suitable alternatives for a high fi bre diet Low fibre choices Higher fibre choices Breakfast Light meals Cornfl akes, sugared fl akes, puffed rice White bread or toast Fruit juice Cooked breakfasts: Bacon, egg, sausages and white bread Sandwiches made with white bread / pitta Pasta rice or couscous salads Cheese on white toast 9 Wholegrain cereals (e.g. branfl akes, shredded wheat) or oat based cereals (e.g. porridge) Wholemeal bread or toast Fresh fruit or fruit smoothie Use wholemeal bread, baked beans, mushrooms, grilled tomatoes as higher fibre additions Sandwiches made with wholemeal bread / pitta (Higher fi bre additional sandwich fi llers include hummus, mashed banana, peanut butter, quorn and mixed salad items) Wholemeal pasta, brown rice, bulgur wheat, buckwheat salads with added lentils beans and pulses Baked beans on wholemeal toast or in jacket potato
Low fibre choices Higher fibre choices Main meals Peeled boiled, roasted, mashed or chipped potatoes White pasta, white rice, couscous Unpeeled boiled, roasted, mashed, chipped potatoes or jacket potatoes Wholemeal pasta, brown rice, quinoa, bulgur wheat, cracked wheat Add fresh, tinned or frozen vegetables or salad to all main meals Add beans, lentils, nuts or pearl barley to stews, salads, soups, hot pots and casseroles Add nuts or seeds to salads Desserts Apple crumble Apple crumble with wholemeal fl our and oats topping Yoghurt Yoghurt with handful of oats/nuts/dried fruit Fresh fruit salad Biscuits, cakes, chocolate Wholemeal scone, fruit, ryvita, cereal bars, digestives fl ap- jacks, fresh fruit Remember to drink plenty fluid during the day 10
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Not to be photocopied Contact details If you require further information, please contact the Nutrition and Dietetic Department at Basildon University Hospital on 01268 593957 or btu-tr.btuhdietetics@nhs.net Basildon University Hospital Nethermayne Basildon Essex SS16 5NL 01268 524900 Minicom 01268 593190 Patient Advice and Liaison Service (PALS) 01268 394440 E pals@btuh.nhs.uk W www.basildonandthurrock.nhs.uk The Trust will not tolerate aggression, intimidation or violence directed towards its staff. This is a smokefree Trust. Smoking is not allowed in any of our hospital buildings or grounds. This information can be provided in a different language or format (for example, large print or audio version) on request.