Constipation can occur in any age group, but it tends to become more of a problem as you get older, with 30% to 40% of adults over the age of 65 citing constipation as a problem.
It may seem like a minor annoyance, but chronic constipation can come with some pretty serious health consequences, including fatigue, anxiety, depression and significantly higher colorectal cancer risk.
There are a lot of things that are believed to cause constipation, such as a low-fiber diet, lack of fluid intake, abuse of caffeine or alcohol, certain medications and a sedentary lifestyle.
But research is uncovering new information about constipation every day — like this one…
Throw what you think about fiber out the window and learn the truth about how to keep the modern scourge of chronic constipation from ever developing…
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The fiber fallacy: it’s not the constipation fix we thought
A team of researchers at Mass General Brigham monitored more than 96,000 middle- and older-age participants for several years to see how long-term eating habits influenced the likelihood of developing chronic constipation, defined as symptoms lasting at least 12 weeks within a year.
The study focused on five widely followed diets: the Mediterranean diet (MED), a plant-based diet, a low-carb diet, the Western diet and an inflammatory diet.
Perhaps unsurprisingly, the analysis found people who routinely ate a MED or plant-based diet experienced a lower incidence of constipation.
On the flip side, participants who consistently consumed a Western or inflammatory diet were more likely to develop chronic constipation. A low-carb diet did not have a strong effect on constipation risk.
But here is where it gets interesting…
“We have always assumed that the benefits of eating a healthy diet would be driven by fiber, but our analyses showed the benefit of these healthy diets on constipation were independent of fiber intake,” says senior author Dr. Kyle Staller of Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system.
So, if fiber wasn’t the reason for the MED or plant-based diet’s effectiveness, what was? The researchers had a few theories…
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Inflammation: a missing piece of the puzzle
Constipation is often accompanied by low-grade inflammation and increased oxidative stress. Higher consumption of ultra-processed foods, which are low in antioxidants that help reduce oxidative stress and inflammation, may negatively affect gut microbiota, increase gut inflammation, and elevate the risk of constipation.
The anti-inflammatory, antioxidant-rich nature of plant-based or MED diets could explain why these diets prevent constipation from developing.
Contrary to popular belief, the researchers also found that alcohol intake, especially wine, did not increase risk for constipation. This connection, as supported by a few cross-sectional studies and a mouse model study, may be explained by wine’s polyphenol-rich nature. These polyphenols have anti-inflammatory properties and can benefit the gut microbiome.
Another interesting point was that although several trials have implicated the beneficial effects of fruits such as kiwi or prunes on constipation, the researchers didn’t observe any link between total fruit intake and constipation risk.
Instead, vegetable consumption — particularly tomatoes, cruciferous vegetables, leafy green vegetables and dark yellow vegetables — appeared to be the components driving the protective associations between the MED and plant-based diets and constipation. The researchers say these findings are consistent with several cross-sectional studies and one randomized, controlled trial.
The study emphasizes how the quality of diet influences gut health well beyond traditional advice. For example, beyond fiber, the type of foods in the MED and plant-based diet help the gut produce short-chain fatty acids (SCFAs). SCFAs may ameliorate constipation by regulating inflammatory response, gut motility, colonic fluid and sodium absorption.
“Chronic constipation affects millions of people and can significantly impact a patient’s quality of life,” Staller says. “Our findings suggest a diet rich in vegetables, nuts and healthy fats may help prevent chronic constipation in middle- and older-age adults.”
So, if you’re looking to protect yourself against constipation as you get older, adopting a plant-based or Mediterranean diet may be a good idea. Make sure your diet includes plenty of the aforementioned vegetables and possibly even a nightly glass of red wine — for the polyphenols, of course.
Sources:
What 96,000 adults taught scientists about preventing constipation — ScienceDaily
Dietary Patterns and Incident Chronic Constipation in Three Prospective Cohorts of Middle- and Older-Aged Adults — Gastroenterology
Constipation — National Library of Medicine
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