>> Dr. Terry Simpson: M Today, we're going to talk about poop. Keep your

poop in a group. Get your together. All right,

we're going to talk about fiber. And before you

turn this off, a fair warning. There will be a few

dad jokes today, because every dad needs a dad

joke or two. And if you can't laugh while learning

about digestion, you're taking life and yourself a

little too seriously. Now, fiber is about poop,

but it's also about a lot more than poop. It's

about lowering your risk of colon cancer. It's

about smoothing glucose spikes. It's about

avoiding hemorrhoids, diverticulosis,

diverticulitis, and spending less time in the

bathroom wondering if the phone is about to fall

into the toilet. I know you've had it happen. I

saw. And by the way, that's not a productivity

issue. It's a fiber issue. When I run into the

true carnivores and they always identify

themselves immediately, they are very eager to

tell me fiber is not an essential nutrient. And

technically, they are correct. There is no classic

fiber deficiency disease, no scurvy of spinach, no

berry berry of bran. But medicine isn't just about

what kills you quickly. It is about what breaks

systems down slowly. And here is the part that

never gets mentioned. I hear influencer after

influencer obsess about protein, protein goals,

protein timing, protein powders with names that

sound like Marvel villains. And yet true protein

deficiency in the United States, even among

bariatric surgery patients, is rare. But 92% of

Americans do not get enough fiber. 92%. And that

lack of fiber is exactly why some people are stuck

on the toilet with the latest squatty, potty

scrolling, waiting, hoping, maybe even listening

to my podcast, but quietly increasing their risk

of rupturing a diverticulum or developing worse

hemorrhoids. So today on 4Q, we are going to make

sense of the madness of fiber. I am your Chief

Medical Explanationist, Dr. Terry Simpson, and

this is 4Q Fork University, where we bust a few

myths, make sense of the madness, and teach you a

little bit about food and medicine. Let me tell

you a story about oats. Everyone except a few

rubbish people agree that oats are healthy. The

vast majority of literature shows that people who

eat oats have less obesity, less diabetes, smaller

circumference of their waistline. And everybody

knows that oats have fiber. And steel cut oats

probably have the most fiber. Well, groats have

the most fiber, goes groats, steel cut oats,

rolled oats, instant oats. But so One week, I

decided to be very responsible and increase my

morning fiber. Now, this was many years ago when

I, um, was not so sophisticated about all this

stuff. And I was in meetings all that week with

colleagues. And every morning there was coffee and

steel cut oatmeal. And they made it deliciously

steel cut. It was nutty. It was delicious. So I

joined in. Day one, fine. Day two, my bowels

started getting the message. I was full. I was a

little bloated. I was a little m expressive. By

the time I got back to my office, this was no

longer subtle. So I did what any reasonable

physician would do. I opened a window and I lit a

candle. I had one of those big old school desks,

papers everywhere, large oak frame. And then I got

a phone call. And I turned my back on the desk

while I was answering the phone call. When I

turned around, some papers were on fire and I had

to put it out. And for years, that dark scorch

mark on my desk reminded me of a very important

lesson. Do not jump from low fiber to high fiber

overnight. Your gut needs time to adapt. And yes,

my desk paid the price for my confidence. That's

why it's called a trial by fiber.

>> Dr. Terry Simpson: Hi, it's producer Ivo jumping in here, saying I

had no advance warning of any of this.

>> Dr. Terry Simpson: All right, so what does fiber actually do? Or as

some might say, what does fiber does? Fiber is a

carbohydrate that humans don't digest. So you

would never count it as a part of the fiber if

you're counting carbs, which you shouldn't be, but

you would never count it for added sugar. But

there are different types of fiber. Okay, so we're

going to go over this. It's not that boring, I

promise. I want you to think of soluble fiber like

the oats that I had. Barley beans, psyllium. And

they form a gel in your gut. This gel slows

absorption, which means that the glucose isn't

absorbed as rapidly, so the glucose doesn't spike.

And because your liver makes cholesterol, how it

gets your cholesterol into your bloodstream is it

dumps the cholesterol into your bile, which goes

into your small bowel.

>> Dr. Terry Simpson: And.

>> Dr. Terry Simpson: And when you have fiber, it absorbs some of that

cholesterol, which is why fiber lowers your low

density lipoprotein cholesterol. And that, by the

way, is why psyllium shows up in all the clinical

guidelines. Now, insoluble fiber is simpler. This

is what. Well, we'll call it the make your poop

better fiber. It adds bulk, it speeds transit, and

it makes things predictable. It also does the

opposite. So if you have really loose stools,

let's say you ate something you shouldn't have or

have a little bit of distress fiber will actually

help you. People who have problems with bile,

salt, diarrhea, we put them on a higher fiber

diet. People who have fatty diarrhea or other

things, we put them on a higher fiber diet. But

here's the thing. If you're on a GLP1, I am, for

example, and you're constipated, I am not. You

need to have fiber in your diet. Magnesium gummies

are not a long term bowel plan. They're a side

hustle. Insoluble fiber is the plumbing that you

need. So I want you to realize that fiber just

keeps things moving forward. All right, I'll see

myself out.

>> Dr. Terry Simpson: Yeah. If you honestly believe he's through, you're

fooling yourself or haven't listened to these long

enough. Okay, let's go, doc.

>> Dr. Terry Simpson: Here's the other part that gives some people

trouble. It's called fermentable fiber. This is

things like beans, onions, garlic, asparagus,

resistant starches. This is the fiber that feeds

your gut bacteria. And when you feed the so called

good bacteria, the part of your microbiome that

you want, those microbiome tend to grow better and

they will crowd out, uh, those bacteria that don't

like fiber as much. And those good bacteria, they

produce short chain fatty acids. This isn't fat.

These are short chain fatty acids that your body

uses for basic building blocks. And the most

important one they make is butyrate. Which brings

me to one of my favorite Internet myths. I've had

carnivore people tell me very confidently that

butyrate comes from butter. That butter is called

butter because it contains butyrate. No, butter is

called butter because the word comes from the

Latin and the Greek, meaning cow cheese. Now,

butyric acid was named because it was first

isolated from a rancid butter, but not because

butter is a good way to get it. The butyrate that

matters is made in your colon by bacteria from

fermentable fiber. Dietary butyrate from butter is

absorbed in the small intestine and disappears. I

mean, if butter were good colon therapy,

gastroenterologists would prescribe croissants.

And sadly, they do not. I mean, if croissants

fixed your gut, Paris would be the healthiest city

on, on earth. Now, let's talk about fiber

supplements. And there are a lot of them out

There. Benefiber, psyllium, husk, metamucil,

citrusyl, others. And most of them will give you 4

to 5 grams of fiber. That's about 10% of what you

should get in a day. Helpful? Yes. Enough, No. I

personally like a fiber supplement called Loam L O

A M M which gives you about 12 grams of mixed

fiber. And I use it in my morning smoothie. Now

that's a bridge. It's not a replacement. But if

your entire fiber strategy fits in a scoop, you're

missing the point. Let's talk about irritable

bowel syndrome or ibs. These people are the ones

that'll say fiber makes them feel worse. Sometimes

at first they're right. Because fermentable fiber

produces gas and IBS guts are sensitive to gas.

We're all sensitive to gas. Some clinicians use

what's called the fodmap diet as a temporary

elimination tool to identify the triggers. But we

don't live there. We use a Mediterranean style

diet, which in recent series has been shown more

important to identify problems and reintroduce

foods. Now, I've heard some of the paleo ancestral

diet people say, oh, use the whole 30. It's an

elimination diet. It's not. It's low carb cosplay.

We eliminate to learn, not to live. Afraid of

food. Now people ask, what does eating enough

fiber actually look like? Because you want to do

this without thinking about it. And if you want, I

have a three day Mediterranean diet that's free on

terrysimpson.com but let me walk you through a

simple day. In my morning, I have oats, berries, a

little bit of nuts, maybe some chia seeds. In my

smoothie that's a combination of soluble and

insoluble fibers and some polyphenols. For lunch,

I'll have some vegetables, carrots, some beans or

lentils. I'll have some whole grains, like maybe

a, uh, sandwich. And this is where the microbiome

starts smiling. For snack, I'll have a stone

fruit, maybe some nuts. I don't have a protein

bar. Most of those kind of have the texture of

drywall and the taste close to what I would

imagine drywall would taste like. And dinner is

pretty simple. I have some vegetables and I have

whole grains like farro and some fish or poultry.

Now, this kind of eating routinely delivers about

25 to 40 grams of fiber. No spreadsheets, no apps,

no drama. And with my loam, I'm getting in at

least 37 to 50 grams of fiber easily. So if you're

part of that 92%. And if you're listening to this,

you probably are that are not getting enough

fiber. Go slow, increase gradually. Make sure

you're well hydrated. Remember my desk. And

remember this. You're not fragile, but you might

be flammable. Now, fiber isn't magic. It's not

trendy. It doesn't have any influencers. It needs

forks. And if you're bringing your phone into the

bathroom just in case, that's not aging, that's

fiber deficiency. Please see the blog associated

with this@yourdoctorsorders.com and and check out

my substack@drsimpson.com the podcast was

researched and written by me, Dr. Terry Simpson.

And while I am a board certified physician, I am

not your physician. And before making any changes

to your diet, please talk with your board

certified physician and a registered dietitian.

Don't talk to a chiropractor or some functional

medicine witch doctor guru. All things audio are

done by my friends at Simpler media. And the pod

got himself Mr. Evo 2 Tara. And producer girl

Productions is responsible for making me more

interesting than I am. Have a good week,

everybody. Hey, Evo, what's your favorite fiber?

And keep candles away from the oats, buddy.

>> Dr. Terry Simpson: Yeah, I'm pretty sure the problem was really more

about the methane, uh, than the oats themselves.