Answers from Dr. Greene

QUESTION:

As a person with diabetes, do I need to worry about fiber and if so, how much should I get each day?

Thanks for your help - Tom S.

DR. ALAN GREENE:

Fiber is a complex carbohydrate. It is found in vegetables, fruit, whole grains, nuts, seeds and legumes.

There are 2 kinds of fiber: soluble and insoluble. Soluble fiber is found in oats, beans, fruits, vegetables and psyllium (for example, Metamucil). Insoluble fiber is found mainly in whole grains and wheat bran as well as in nuts, fruits, vegetables and legumes.

Most people do not get enough fiber in their diets. The American Heart Association recommends increasing dietary fiber to help control both blood glucose levels and improve the lipid profile (cholesterol levels) of people with diabetes.

Studies are inconclusive about how much fiber is needed to improve blood sugar control. However, a large study in the American Journal of Clinical Nutrition showed that fewer women got diabetes if they followed a high fiber diet. Additionally, populations with a high rate of diabetes tend to eat a diet that is low in fiber. In the Nurses Health Study and the Iowa Health Study higher intakes of fiber showed significant decreases in the rates of type 2 diabetes.

To increase your intake of fiber:

• Choose cereals, breads and pasta with the word whole as the first ingredient.
• Eat fruits and vegetables daily.
• Include nuts and seeds.
• Eat soups and stews containing beans, brown rice, barley and legumes.

Water helps to digest fiber. Increase fiber intake gradually and drink more water to avoid discomfort.

For a more complete list of fiber sources, check out our calorie and fiber charts.

Alan Greene, M.D. earned a Bachelor's degree from Princeton University and graduated from medical school at University of California at San Francisco. Upon completion of his pediatric residency program at Children's Hospital Medical Center of Northern California in 1993, he served as Chief Resident. During his Chief year, Dr. Greene passed the pediatric boards in the top 5 percent of the nation.

Dr. Greene entered primary care pediatrics in January 1993. He is on the Clinical Faculty at Stanford University School of Medicine where he sees patients and teaches Residents. He serves as the Chief Medical Officer of A.D.A.M., Inc., a leading provider of consumer health information, and helps direct A.D.AM.'s editorial process. As A.D.A.M.'s CMO, he served as a founding member of Hi-Ethics (Health Internet Ethics) and helped URAC develop its standards for eHealth accreditation. He is also the Founder & CEO of DrGreene.com. Dr. Greene was also named Intel's Internet Health Hero for children's health. He is an author, medical expert, and a media personality.

He is the author of The Parent's Complete Guide to Ear Infections (People's Medical Society, 1997). Dr. Greene has appeared in numerous publications including the Wall Street Journal, Parenting, Parent, Child, American Baby, Baby Talk, Working Mother, Better Home's & Gardens, and Reader's Digest. He also appears frequently on television and radio shows as a medical expert.

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