The world is not in shortage of advertisements for high-fiber biscuits, cereals and other foods to warm people to the idea of a healthy body by gaining access to their heart. Nutrients can be macro- and micronutrients. We are all too familiar with the macronutrients that include carbohydrates, fats and proteins and the micronutrients such as vitamins, iron and zinc but what many of us don’t know is that fiber is a type of carbohydrates that the body cannot digest. It is a good carb that is essential for the body to help it with numerous processes. While most carbs are broken down into sugars and converted into energy fiber passes through the body in an undigested form. Each of us need daily consumption of dietary fiber to prevent individuals from getting hungry sooner, increase satiety levels and regulate blood sugar levels.
Kids and adults alike are becoming victims to obesity and overweight. Obesity epidemic in adults is bad but the same in children is worse as it lays the foundation for a future that’s occupied by unhealthy and diseased citizens. We are familiar with obesity and diabetes as serious risk factors for ill health in kids but there does exist a huge gap regarding fiber intake and health in kids resulting in serious constipation problems and digestion issues. These problems affect the day-to-day functioning of the kid affecting his/her quality of life and ruining her/her competency in studies and other streams. It is indeed surprising to know that such constipation problems affect the individual’s well-being even more than those kids with gastric reflux or inflammatory bowel disease. While children and adults need around 15 to 30 grams of fiber per day for good health it is a sad fact that most of us get between 10 and 15 grams only through various sources. The dietary fiber recommendations for children are extrapolated from adult data and there is a serious lack of coherence between intake recommendations and the regular fiber intake levels are fall below recommended ranges. Fiber is classified as dietary and functional fiber-dietary fiber includes nondigestible carbs and lignin that are intrinsic and intact in plants whereas functional fiber includes isolated or purified carbs that are nondigestible, absorbed in the small intestine and have physiological advantages on the individual. Vegetables, whole grains, fruits and legumes are excellent sources of dietary fiber while functional fiber is found in cereals, soups, frozen foods, etc. There are certain whole grains such as wheat and barley that increase dietary fiber consumption levels in children but these are also the foods that are not well-accepted by many kids. It has been seen that children get much of their dietary fiber from foods that are low in fiber density but the good thing is that they consume huge quantities of these foods. It was also seen that kids who eat cereal for breakfast consumed only 1 g of fiber more than kids and teens who skipped breakfast or ate other foods for breakfast.
Increased Fiber Intake to Reduce Constipation Rate
Increased dietary fiber (DF) was one of the main objectives of American Dietary Guidelines in 2010 but still intake levels remained below recommendations. Such decreased intake is greatly associated with poor diet outcomes and is a serious risk factor for constipation. We might seem to be relieved on reading that the side effects are only as trivial as constipation but what we fail to notice is that functional constipation has a worldwide prevalence between 7 and 30% and comes with painful symptoms that debilitates the life of the kid. While reduced fiber intake remains a risk factor for constipation children suffering from it have lower fiber intake than healthy kids. We do have evidences linking the benefits of consuming fiber on constipation problems in kids making it one of the best solutions and finest treatment options.
Intake of DF foods such as veggies, fruits and whole grains is linked to better diet quality that’s high in nutritive value in younger kids while the same is linked to reduced fat consumption in older kids. Hence, it is clear that there is a need for increasing DF intake to reduce the risk of constipation. A study was conducted on the same to check the effectiveness of DF intake with the help of introducing two high-fiber snacks per day on gastrointestinal function and nutrient intake in kids aged 7-11 years.
Randomized Controlled Study
The study on 7-11-year-old kids was conducted for 8 weeks in an elementary school on children whose teachers granted permission. 11 teachers granted permission for the study on their kids but it was seen that children with digestive disorders, food restrictions and food allergies were not included in the study. During the intervention period the participants were asked to consume two high-fiber snacks per day (all 7 days of the week) and the control group continued consuming their regular snacks irrespective of whether or not the snacks contained any fiber. All the participants were collected information on their gastrointestinal function and regular dietary pattern at the start of the study, again another set of details were collected midway through the study (4th week) and finally, a third set of data was collected after the eighth week of study.
Each child in the intervention group was given 2 high-fiber snacks which were selected based on their fiber and energy content such that the snacks fulfilled 10-12 g and also with the goal of increasing the consumption by 8 g per day. Every child who consumes both the snacks consumed around 314 kcal and 10.2 g of fiber per day. Along with the snack, all the kids were provided with a 30-ml glass of slim milk to avoid any GI distress. The beverage was included during each snack as too much of fiber intake too suddenly can cause constipation, gas and bloating and the person can relieve this discomfort by consuming fluids. Fiber is required for solid bowel movements but too much of it can cause constipation as well. All of the snacks were deprived of its original packaging, repacked by the team and served. Each of the kid’s consumption was marked as ‘none’, ‘one-quarter’, ‘one-half’, ‘three-quarters’ or ‘all’. The snacks offered included:
Kellogg’s Frosted Mini-Wheats Little Bites Chocolate®
Kellogg’s FiberPlus Cinnamon Oat Crunch®
Kellogg’s Frosted Mini-Wheats Little Bites Original®
Kellogg’s Cracklin Oat Bran®
Kellogg’s Frosted Mini-Wheats Bite Size Blueberry Muffin®
Kellogg’s FiberPlus Berry Yogurt Crunch®
Kellogg’s NutriGrain Bar®
Kellogg’s Frosted Mini-Wheats Big Bite®
Kellogg’s Frosted Mini-Wheats Blueberry®
Kellogg’s Frosted Mini-Wheats Strawberry®
Kellogg’s Frosted Mini-Wheats Touch of Fruit in the Middle Mixed Berry®
Kellogg’s Special K Snack Crackers - Savory Herb®
Kellogg’s Special K Crackers Multigrain®
Kellogg’s All-Bran Crackers Multi Grain®
Sara Lee Soft and Smooth White Bread with Whole Wheat®
Sara Lee Soft and Smooth 100% White bread with Ca/Vit D®
Pepperidge Farm Deli Flats (Whole Grain White)®
Thomas 100% Whole Wheat Bagel Thins®
Pepperidge Farm Stone Ground Whole Grain Bread®
Thomas 100% Whole Wheat Mini Bagel®
Arnold Whole Wheat Bread®
Arnold Sandwich Thins®
Thomas Light Multi-Grain English Muffin®
Thomas Plain Bagel Thins®
Snacks were given at a time convenient for both teachers and students but there were occasions during which the snacks could not be served twice a day at school. During such occasions, the snacks were given home and the same protocol as the one followed during weekends was put into practice. All the kids were given a paper bag with two options for each snack occasion and were instructed to return the empty or full snack bag after the weekend to the research staff in the school. The parents and the kids were requested to fill an 8-question Questionnaire on the child’s digestive health. Two recalls were taken-one between Monday and Thursday and another one between Friday and Sunday via telephone. The average of the two recalls were used to jot down regular intake and total energy intakes below 500 kcal or above 3500 kcal were ignored for the study.
A total of 80 kids participated in the study and initially there was no difference in energy intake between the intervention and the control group.
Constipation is characterized by infrequent bowel movement, difficult stool passage and unsatisfactory defecation. A community-based study in Hong Kong on 3-5-year-old kids found that 30% suffered from constipation and so did close to one-third of kids in United Kingdom. Both the studies showed that kids who ate a high-fiber diet did not suffer from constipation and so did an Irish study on 5-8-year-old kids proved that constipation rates were almost double in those kids who failed to eat a high-fiber diet compared to those who had sufficient fiber intake. There are several studies showing that increasing fiber intake is the best first step to decrease the effect of chronic constipation in otherwise healthy children.
Different fibers have different effects on the body and by examining isolated fibers the effect of each on constipation could be analyzed in detail. In one study, children were given bran fiber and it was shown that those kids who showed improvements in constipation had higher fiber and bran intake than kid whose constipation did not improve or worsen too. In another study, children with chronic idiopathic constipation were given cocoa husk that resulted in less hard stools compared to those kids who received a placebo. Glucomannan, a special fiber, was given to kids with chronic functional constipation which improved stool consistency in almost 62% of these kids and also in 23% in the control group. Researchers found that giving fiber-rich foods to kids improved constipation levels according to both parents (68 vs. 13%) and kids (42 vs, 13%). There are numerous clinical studies available presently that support the importance of fiber intake on bowel function but sadly, caretakers including parents, grandparents and even healthcare providers are not ready guide their children’s fiber intake. Though fiber affects a person’s health in the same way as sugar or salt, fiber has not been able to reach people in the same vigor as the other two. Making people aware of the health benefits of consuming fiber will help in promoting and increasing fiber intake.
The Effect of Providing High-fiber Snacks on Digestive Function & Diet Quality in a Sample of School-age Children: https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-12-153
What do we Know about Dietary Fiber Intake in Children & Health? https://academic.oup.com/advances/article/3/1/47/4557086
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Dr. Nafeesa Imteyaz of First Eat Right clinic, is the Best Dietitian Nutritionist in Bangalore. Best Dietitian Nutritionist in Pune. Best Dietitian Nutritionist in Hyderabad. Best Dietitian Nutritionist in Chennai. Best Dietitian Nutritionist in Mumbai. Best Dietitian Nutritionist in Delhi. Best Dietitian Nutritionist in Kolkata.