Take care with fiber supplements

For most of the 4 million Americans suffering from frequent constipation, the simple fix -- exercise, eat more fiber and drink more water -- is anything but simple to achieve.

As Americans, we have a particular struggle with getting enough fiber in our diets. And when efforts to eat more fiber-filled foods fail, some people look for what they need from a capsule, jar or wafer.

Are such fiber supplements OK? Maybe.

First, it's important to understand some basic facts about fiber and the role it plays in our diet.

Fiber comes from parts of plants that we eat but don't fully digest. There's fiber in all fruits, vegetables, beans, grains, seeds and nuts. There's no fiber at all in dairy products and meats. The richest sources of fiber include dried beans and peas, wheat bran and dried fruits, such as prunes.

Foods contain a mix of different forms of fiber. Water soluble fiber helps lower blood cholesterol levels and control blood sugar levels. Water insoluble fiber primarily adds bulk to our stools. Get enough total fiber and you'll not only have less constipation, you'll lower your risk for coronary artery disease, diverticulosis, hemorrhoids, obesity and diabetes, too.

Unfortunately, we need a whole lot more than most of us get.

Women and men under the age of 50 need 25 to 38 grams of total fiber each day, according to the Institute of Medicine; 21 to 30 grams per day for women and men over the age of 50. One cup of raisin bran cereal contains 8 grams of fiber; a medium apple gives you 6. There's 15 grams of fiber in a good-sized bean burrito.

If we all ate whole grain cereals for breakfast and heaping helpings of fruits and vegetables for lunch and dinner, we'd be in good shape. The reality, though, is that most of us are doing well to get half the amount of fiber we need.

If you're one of the millions who are fiber challenged, a supplement may be worth considering. While they don't carry all of the health-supporting vitamins and minerals of whole foods, they can be effective at softening stools and easing constipation. Some may help to lower blood cholesterol levels, too.

Fiber supplements have a natural laxative effect. Brands such as Metamucil, Citrucel and Konsyl are made with chopped or ground psyllium seed husks or methylcellulose. These ingredients absorb fluid and take on a gel-like consistency, adding bulk and softening stools, making them easier to pass. The supplements can be packaged as gel caps, mixed into crackerlike wafers, or powdered for mixing with a water or juice. They're generally safe to use on a daily basis, with some caveats:

* Any bulk-forming fiber supplement can cause problems if you don't drink enough fluids. Stay well-hydrated so that there's enough fluid for the fiber to absorb.

* Check with your health care provider or pharmacist if you take medications. Fiber supplements may interfere with certain drugs or affect the dosage you need.

* If you have a gastrointestinal disease or condition, get your doctor's approval before taking a fiber supplement. You need individualized advice that only your health care provider can give.

* Go slowly. If you do add a fiber supplement to your diet, take a little at a time until you are up to a full dose. Adding a concentrated dose of fiber to your diet overnight could cause gas, bloating or cramps. Give your body time to adjust.

And never give up on whole food sources of fiber. No supplement will ever replace the beneficial vitamins, minerals and phytochemicals packaged with the fiber in fresh fruits, vegetables and other wholesome foods.