Today I've got another tip for those of you with digestive issues, including IBS, constipation, diarrhea and acid reflux: eat fewer vegetables.
Yep, that's right. Fewer vegetables.
Vegetables (as well as some fruits) are often high in insoluble fiber. While soluble fiber can be soothing for the gut, consuming large amounts of insoluble fiber when your gut is inflamed is a little bit like rubbing a wire brush against an open wound. Ouch.
Vegetables that are high in insoluble fiber include:
- Greens (spinach, lettuce, kale, mesclun, collards, arugula, watercress, etc.)
- Whole peas, snow peas, snap peas, pea pods
- Green beans
- Kernel corn
- Bell peppers
- Onions, shallots, leeks, scallions, garlic
- Cabbage, bok choy, Brussels sprouts
- Winter squash
- Summer squash (especially peeled)
- Starchy tubers (yams, sweet potatoes, potatoes)
But won't I become deficient in nutrients if I don't eat tons of veggies?
First of all, I'm not suggesting that you don't eat these foods at all if you have digestive problems. I'm simply suggesting that you limit them. There are also steps you can take to make these foods more digestible and less likely to cause problems. They include:
- Never eat insoluble fiber foods on an empty stomach. Always eat them with other foods that contain soluble fiber.
- Remove the stems and peels (i.e. from broccoli, cauliflower and winter greens) from veggies (and fruits) high in insoluble fiber.
- Dice, mash, chop, grate or blend high-insoluble fiber foods to make them easier to break down.
- Insoluble fiber foods are best eaten well-cooked: steamed thoroughly, boiled in soup, braised, etc; avoid consuming them in stir-fries and if you do eat them raw, prepare them as described in #3 above.
I have nothing against vegetables. In fact, I like them quite a bit and I do think they're beneficial. But the advice to eat 6-8 servings a day is not based on solid scientific evidence, and may cause unnecessary distress in people with gut problems.
Fermented vegetables: a better alternative?
Fermented vegetables like sauerkraut, kim chi, sauerruben and cortido are excellent alternatives for people with gut issues. First, the fermentation process "pre-digests" the vegetables and makes them easier to absorb. Second, fermented veggies contain probiotic microorganisms that help heal the gut.
Although sauerkraut and kim chi contain cabbage, which is high in insoluble fiber (and a FODMAP to boot), I've found that many patients with gut problems can tolerate it quite well. FODMAPs are sugars and sugar alcohols, and fermentation breaks down sugars. This is probably why fermented FODMAPs are better tolerated than non-fermented FODMAPs.
If you're new to fermented vegetables, you have two options:
- Make them yourself. Check out this page for a great primer. It's really quite easy, and cheap.
- You can buy them at a health food store. Make sure that it says "raw" on the jar, and they're in the refrigerated section. The sauerkraut you can buy in the condiments section has been pasteurized and won't have the same beneficial effect.
P.S. Next week I'll be presenting at the Ancestral Health Symposium in Boston, and thus may not be able to post an article to the blog. I look forward to meeting those of you that will be there.