I’ve written too much about politics in the last couple of weeks. I’m off to Labour conference tomorrow and may have more to say next week. So this week I’ve returned to a regular topic of national and international importance - how not to get constipated on a keto diet!
Navigating a Low Carb Lifestyle 🥦
How do you maintain a fibre-rich diet on a low carb regime? Even with the gradual re-introduction of carbs into my life, my diet largely remains low carb. Though there are caveats - the occasional scoffing a whole loaf of sourdough being the primary one.
On a strict keto diet, finding fibre can be a challenge. In my book, Lose Weight for Life, I emphasise making broccoli your friend. While many keto enthusiasts eat cauliflower rice and courgette spaghetti too, supplementing with psyllium husk is often necessity. I’ve read the limited research on psyullim husk so that you don’t have to.
The need for fibre to maintain a healthy digestive system is undeniable, though. I constantly remind myself to maintain a fibre rich diet and you should too.
The Gut-Brain Axis: A New Avenue for Combatting Depression 🧠🔄🦠
In recent years, the gut-brain axis has emerged as a focal point of scientific inquiry. The bi-directional communication channel between our brain and digestive system suggests a remarkable influence our gut, often dubbed the 'second brain', could have on our mood and mental well-being. Nurturing the gut, therefore, may unlock new methods to alleviate conditions like depression.
Definitions: Prebiotics, Probiotics, and Synbiotics 🌿
Prebiotics are fibrous substances in foods like garlic and asparagus, serving as nourishment for beneficial gut bacteria.
Probiotics are live beneficial bacteria from certain foods or supplements, like yogurt and kefir.
Synbiotics are a fusion, including both live beneficial bacteria and the sustenance to foster their growth.
A recent meta-analysis delved into the potential of prebiotics, probiotics, and synbiotics in managing depression. The findings revealed promising potential, especially with probiotics, in offering significant antidepressant effects. However, more research is needed to confirm the effectiveness of prebiotics and synbiotics.
Personalised Approaches and the Future 🔄🌱
The study underscores the nuanced interplay of biological sex in how we respond to these treatments, hinting at more personalised approaches in leveraging the gut-brain axis for depression management. Moreover, a balanced representation of sex and age in future trials was highlighted, indicating these factors could significantly impact the effects of prebiotics, probiotics, and synbiotics. While we're on the brink of personalised approaches to combat depression, the journey of exploring the trinity of dietary choices, gut health, and mental well-being, continues.
As we navigate through middle age striving to keep away the blues, harmonising our gut-brain axis by embracing the benefits of prebiotics and probiotics is worth spending time thinking about.
A Gentle Boost of Fibre: My Life with Psyllium Husk
Before you read on remember that I am absolutely not advising you what to eat. I’m not qualified for that. I can only tell you what I do, which may be wrong.
Over the past six years of embracing a low-carb lifestyle, I have occasionally turned to psyllium husk for a gentle fibre supplement. Derived from psyllium (plantago psyllium) - it’s a plant native to Northern India, has been a reliable companion to me, especially during my keto phases.
While many consider it a herb, psyllium is more closely related to the common plantain, rather than the banana. The plant yields thousands of tiny seeds enveloped in a robust husk. When immersed in water, a clear gel-like mucilage encases the husks, which, upon consumption, make their journey through the digestive tract as a bulky mass, untouched by the digestive enzymes. This process naturally softens and enlarges the stools, making them easier to pass.
Available in husk or powdered form, psyllium is a gentle laxative, unlike its stronger counterparts like caffeine, with the added benefit of not causing excessive flatulence.
The Fibre Dilemma in Low-Carb Diets
Embarking on a keto journey often means bidding farewell to multigrain bread, starchy vegetables, and high sugar fruits – a harsh goodbye to essential sources of roughage. The result can be constipation, defined by the NHS as having fewer than three bowel movements a week, straining excessively during these movements, or passing dry/hard stools.
The discomfort of bloating and being unable to relieve oneself is just the tip of the iceberg. Over time, a fibre-deficient diet can herald heart issues and bowel cancer. Hence, the need for alternative fibre sources like psyllium husk.
Unlocking the Benefits of Psyllium Husk
Cholesterol Management - Psyllium husk has a knack for binding to dietary fatty acids and cholesterol. A comprehensive review (1) underscores its potential in mitigating cardiovascular disease risks by significantly lowering LDL cholesterol levels with a dose of 10.2g.
Blood Glucose Regulation - A meta-analysis (2) spotlighted the favourable impact of dietary fibre, including psyllium, on blood glucose levels over 2 to 3 months in individuals with type 2 diabetes.
Digestive Health - Research (3) confirms psyllium's high water-holding capacity as a boon for normalising stools, be it softening hard stool in constipation or firming loose stool in cases of diarrhoea and IBS.
Anti-Inflammatory Properties - A study (4) involving 35 participants revealed that a daily fibre intake of about 30g, either from natural sources or supplements like psyllium, could reduce C-reactive protein (CRP) levels, a crucial inflammation marker.
Gut Microbiota Balance - There’s evidence (5) suggesting that psyllium supplementation can foster a healthier gut bacteria balance, besides alleviating chronic constipation.
Appetite Control - Feeling fuller for longer is another feather in psyllium’s cap. A particular study (6) demonstrated decreased hunger levels and a heightened sense of fullness after psyllium supplementation.
Keto Constipation: what to do?
The NHS recommends for adults and children aged 13 years and over to take 1 sachet of Fybogel granules twice a day for constipation relief.
Separately, Examine.com suggests that if using psyllium for its fecal forming properties, a daily dose of 15g (three times daily dosing of 5g) is a good starting point, and the dose can be adjusted depending on its effects on fecal formation.
Conclusion
Whether you opt for Plantago psyllium, plantago ovata, or ispaghula plantago, the benefits remain. The choice between powder or entire husks and between brands like Metamucil and Fybogel (which houses 3.5g ispaghula husk alongside other ingredients) boils down to personal preference. Psyllium husk stands as a gentle, effective solution to the fibre dilemma many low-carb dieters face.
Footnotes:
Jovanovski E, Yashpal S, Komishon A, Zurbau A, Blanco Mejia S et al. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2018 Nov 1;108(5):922-932. doi: 10.1093/ajcn/nqy115. PMID: 30239559.
McRae MP. Dietary Fiber Intake and Type 2 Diabetes Mellitus: An Umbrella Review of Meta-analyses. J Chiropr Med. 2018 Mar;17(1):44-53. doi: 10.1016/j.jcm.2017.11.002. Epub 2018 Mar 1. PMID: 29628808; PMCID: PMC5883628.
Lambeau KV, McRorie JW Jr. Fiber supplements and clinically proven health benefits: How to recognize and recommend an effective fiber therapy. J Am Assoc Nurse Pract. 2017 Apr;29(4):216-223. doi: 10.1002/2327-6924.12447. Epub 2017 Mar 2. PMID: 28252255; PMCID: PMC5413815.
King DE, Egan BM, Woolson RF, Mainous AG 3rd, Al-Solaiman Y, Jesri A. Effect of a high-fiber diet vs a fiber-supplemented diet on C-reactive protein level. Arch Intern Med. 2007 Mar 12;167(5):502-6. doi: 10.1001/archinte.167.5.502. PMID: 17353499.
Yang C, Liu S, Li H, Bai X, Shan S, Gao P, Dong X. The effects of psyllium husk on gut microbiota composition and function in chronically constipated women of reproductive age using 16S rRNA gene sequencing analysis. Aging (Albany NY). 2021 Jun 3;13(11):15366-15383. doi: 10.18632/aging.203095. Epub 2021 Jun 3. Erratum in: Aging (Albany NY). 2022 Mar 30;14(6):2923. PMID: 34081625; PMCID: PMC8221300.
Brum JM, Gibb RD, Peters JC and Mattes RD. Satiety effects of psyllium in healthy volunteers. Appetite 2016; volume 105; 27-36; https://doi.org/10.1016/j.appet.2016.04.041.
Watching
Hurray, Lupin in back on Netflix. I like this show but more importantly, I love the dog, J’Accuse. I mean, absolutely love J’Accuse. He looks younger in Series Three though. Does he have a stand in?
He looks younger in Series Three though. Does he have a stand in?
Red Door
How did I miss the Red Door on Channel Four? I’ve binged watched the first series in three days. Think Randall and Hopkirk meets the Sweeney, in Italian. Sort of.
Reading
The Clash of Civilisations, Samuel Huntingdon.
My undergraduate son’s reading list has been distracting me all week! It’s 30 years since Huntingdon argued that in the post-cold war world, cultural and religious differences and not ideology will be the fault line of world affairs.
It’s such an alluring idea to explain why the world is more fragile today than at any point since Gordievsky averted a nuclear war with the Soviet Union, when the Soviets misinterpreted the NATO exercise Able Archer 83 as a potential first strike.
Still, here’s why his theory was over-simplistic in Huntingdon own words in 1993:
While there has been serious fighting between Muslims and Christians elsewhere in the former Soviet Union and much tension and some fighting between Western and Orthodox Christians in the Baltic States, there has been virtually no violence between Russians and Ukranians.
It just goes to show that you have to have an open mind in politics!