Marvin is a 29-year old accountant with a very stressful job, working long hours and then commuting home on a train which is often packed with commuters. He suffers from chronic constipation which he manages by taking laxatives. He is aware that his constipation is exacerbated by his stress levels and lack of physical activity.
Martin’s 5-day food diary revealed that his diet is a typical Western diet high in refined carbohydrates and saturated fats, and alcohol, while lacking in dietary fibre, fruit or vegetables. Marvin does not drink any water either; his only fluid intake is from coffee and a glass of orange juice in the morning.
During his first nutrition consultation the focus was on a dietary strategy to help alleviate his constipation.
Marvin was advised to AVOID the following:
Refined carbohydrates such as cakes, biscuits, pastries, white bread, white rice,, as these foods are stripped of dietary fibre during the refining process. As dietary fibre increases gt motility by adding bulk to the faeces, it helps the food products pass more quickly through the large intestine.
Marvin was advised to increase dietary fibre intake to approx. 28 g /day by introducing fibre-rich foods such as wholegrains (e.g. brown rice, wholemeal bread, rye bread, oat cakes, etc.) and have cakes and chocolate occasionally only as a treat. He was also advised to increase his fluid intake to around 2 litres per day, as fibre without adequate fluid intake hardens stool consistency and can exacerbate constipation.
Excess alcohol – as alcoholic is a diuretic it therefore increases dehydration contributing to hardened, difficult to pass stools
Marvin was advised not to drink more than 14 units per week, in accordance with the UK’s Chief Medical Officer recommendations. He was also advised to spread the 14 units per week evenly across the wee
Stressful situations – studies suggested that failure to cope with stressful situations can result in constipation, as stress internalization, which in turn inhibits colonic motility, prolongs colonic transit time – i.e.
Marvin was advised to consider mindfulness meditation, as research shows it could be a potential remedy to stress (his main trigger for constipation) by helping with relaxation and reducing anxiety.
Sedentary lifestyle – studies show that lack of exercise / sedentary lifestyle is more common in constipated people. This may be due to physical activity promoting bowel movements by improving bowel activity in the large intestine.
Marvin was advised to aim to exercise regularly as per WHO (2010) recommendations that all adults should aim for 30 minutes of moderate activity daily on at least five days over a one-week period.
Therapeutic foods for constipation
Marvin was also advised to introduce a few therapeutic foods, known to help manage constipation:
Beans – e.g. aduki beans, red kidney beans, broad beans, etc.
Beans are beneficial for constipation as they are excellent sources of dietary fibre. Studies have shown that individuals who did not regularly consume beans were more prone to constipation.
Marvin was advised to aim for a portion of beans daily, in a form of a bean salad, hummus on oatcakes, bean soup, chilli con carne etc.
Rye bread is also an excellent source of fibre and therefore beneficial for constipation. A small Finnish study showed that rye bread consumption increased faecal mass by retaining water, which eased defecation and improved mild constipation.
Marvin was advised to consume 40g of rye bread a day (approx. 2 slices of flat rye bread).
Flax seeds / linseeds
Soaked or ground flax seeds have been traditionally used to treat constipation. As flax seeds act as swelling, bulk-forming agents, they have a stimulating effect on bowel movement and are therefore beneficial for constipation.
Marvin was advised to have at least 1 tablespoon of flaxseeds per day.
The laxative effect of the kiwi fruit may be due to dietary fibre and certain enzymes that stimulate colon motility. Studies have shown that a 4-week consumption of 2 ripe kiwi fruits per day improved bowel function in constipated subjects.
Marvin was advised to aim for 2 ripe kiwis daily
Part 2 (2nd visit) to follow in a few weeks time