“This girl is on FIBER!”

-Alicia Keys, Metamucil Remix Edition

“Eat more fiber” is often hailed as a dietary axiom…but fiber is actually a rather complicated topic.  Because there is insoluble and soluble fiber…and then there are viscous and non-viscous soluble fibers…and there are fermentable and non-fermentable viscous fibers…and all of these fiber types have different functions and stimulate different responses within the gastrointestinal tract.  Studying fiber makes you yearn for simpler times when all you knew is that fiber helps you poop!

This meta-analysis would suggest that higher fiber intake makes you virtually invincible…well, at least 18 to 25% or so less likely to die than you are at baseline!  Seems a little too good to be true, but in general, fiber seems to have some benefit for both blood sugars and lipid levels.  It can help lower the glycemic index of a meal, which results in less blood sugar and insulin spikes. Viscous fiber can function sort of like a hybrid bile acid sequestrant/ezetimibe combo that can have some modest benefit on LDL cholesterol levels.

But not everyone has a positive response to fiber; a minority of people see a spike in inflammation levels with increased fiber ingestion, and it can worsen symptoms in certain people with ulcerative colitis and inflammatory bowel disease.

So let’s talk about one specific type of soluble viscous fiber, the Popular Princess of Roughage Royalty and a staple of every grandmother’s kitchen cupboard…PSYLLIUM, better known as Metamucil.  Overall, psyllium lowers total cholesterol 4% and reduces LDL-C 5-9%.  Some people might argue that those numbers add up over time…but if your Metamucil is keeping you on the can instead of out on the pickle ball court, I’m not sure it’s worth it. (I’m sure the False Dichotomy police are already gearing up to slap some handcuffs on me, but I hope that we can all be friends while discussing opinions surrounding Effect Sizes of one isolated component in a dietary pattern).  In this case, I’m personally underwhelmed; I think it’s rather PSILLY to bank on PSYLLIUM for meaningfully reducing your cardiovascular risk and/or modifying the denizens of your Lipid Neighborhood.  But I guess they have gummies now as an option instead of the powder, so maybe that’s a win.

So where does that leave us?  Well, I end up landing back at “Prioritize Protein, Eat Real Food.” Because generally you’ll get a reasonable amount of fiber with that approach. And then you can tailor your additional (or subtractional) fiber intake on your individual preferences from there😊