I’m reading Fiber Menance by Konstantin Monastyrsky.  I first read Monastyrsky’s views at Mark’s Daily Apple:  Dietary Fiber Is Bad for Sex – That’s the Only Claim About It That Isn’t a Myth.  Monastyrsky argues that fiber is not the miracle panacea for bowel problems but instead the cause of the Western epidemic of constipation, diverticulosis, irritable bowel syndrome, Crohn’s Disease, hemorrhoid disease, and even colorectal cancer.  Monastyrsky has convinced me.  Of course, it helps that I’ve also read Gary Taubes’ famous chapter on fiber in Good Calories Bad Calories which blows the bad science of fiber out of the water.  Monastyrsky’s case seems unassailable to me: fiber is indigestible and bulks up stools. So if you eat too much of it, in the long run your stools will become bulky, hard to pass and will begin to create bowel problems–such as the creation of inflamed hemorrhoids and diverticula.  Add to that that whole grain proteins can also cause gut inflammation in many people, and we have a strong case against grain-based fibers, which are the highest, most concentrated source of dietary fiber in the Standard Western Diet.  Doctors and nutritionists that recommend to their patients with bowel problems to eat more fiber and drink more water are exacerbating the problem.  It is an egregious example of nutritional iatrogenesis–i.e., doctors are making their patients sick.

On drinking too much water, I agree with Monastyrsky as well.  He says that drinking the recommended eight glasses of water will only deplete one’s bodily minerals, especially potassium, and will exacerbate the problems of constipation.  I have had over-hydration leading to constipation, so that I learned experientially that he’s right on this point.  While in Africa, I was drinking several liters of water because of the heat and humidity.  I started having abdominal cramps and would sit on the toilet hoping that something would come out.  Finally, I asked the school nurse if he could help me, and he said that I needed to take salt. The over-hydration and perspiration had depleted my body of essential minerals.  I started adding generous sprinklings of table salt on everything I ate, and it greatly improved my condition within a couple days.

So here is what I’ve gleaned from Fiber Menance as the best way to have good poop:

1. Reduce fiber to what is available in green vegetables.  Avoid grain-based fibers.  When starting a lower fiber regimen, reduce fiber gradually.
2. Eat more fat:  Fat is not a dietary demon but will make stools easier to pass (though it is also good to avoid trans-fats and too much Omega6).
3. Make sure you have adequate probiotics:  good poop consists ca. 75% bacteria (dry weight).  Soft easy to pass stools contain little fiber.  This makes a strong case for Korean Paleo (kimchee) or German Paleo (sauerkraut) or just plain probiotic yoghurt.  There are also probiotic supplements.
4. Don’t over-hydrate.  Drink adequate water to remain well, yet do not drink water as a cure.  It can destroy your electrolyte balance and even be fatal.
5. Make sure you have adequate minerals in your diet: esp. salt, potassium (and don’t forget magnesium).  Doctors have also demonized salt and this too is iatrogenic.
6. It may also be necessary to eliminate grains entirely.  Cf. Wheat Belly.

Monastyrsky says that ideally poop should appear as 4-5 in the Bristol Stool chart and one should have a bowel movement at least once a day, preferably two or three times.  Paleo people will find Fiber Menance comforting, since they necessarily have reduced their fiber intake by eliminating grains and often legumes from their diet.  But what will happen eventually is that their stools will begin to soften and pass more easily, provided that there are adequate probiotics in their gut.  Monastyrsky is uncharitable towards Robert Atkins, because often low-carb dieters suffer from constipation.  But this is not so much Atkins fault–in this case Atkins followed the standard advice and told his followers to take a fiber supplement.  The better solution is to add a probiotics, like kimchee, into the diet, and then all will come to pass.