Constipation is characterised by infrequent bowel movements or difficulty in passing stools.
Most people may suffer occasionally from constipation but with time and changes in the daily diet this normally resolves itself. Although uncomfortable, it is usually not dangerous. However, constipation can lead to other health problems such as haemorrhoids or it can be the first sign of an underlying health condition.
With a well-balanced diet which includes fibre-rich foods, drinking plenty of fluids and regular exercise, intestinal activity is stimulated, becoming regular.
One of the most important aspects in controlling bowel movements and avoiding constipation is to slowly increase the intake of dietary fibre. Fibre cannot be digested and is present in some foodstuffs, adding bulk and softness to the stools.
There are two types of fibre: soluble and insoluble fibre. Soluble fibre absorbs liquids and binds with fatty acids, forming a gel-like substance that keeps stools soft. At the same time this fibre helps to control sugar and fat levels, preventing Type II Diabetes and high cholesterol.
Insoluble fibre does not dissolve in water, thus providing bulk and moisture to the stools. Generally both types are found in all fruits and vegetables, it is therefore important to eat a wide variety of fruits, vegetables, nuts, legumes, unprocessed bran and whole grains. In order to prevent constipation, the daily intake of 25 to 30 grams of fibre is recommended.
There are some strategies that one can follow in order to increase the intake of fibre in the diet:
▪ Choose wholegrain bread or cereals for breakfast and all other meals (some with 100% whole wheat, oats, barley or rye).
▪ When buying bread or cereals read the labels. Use whole wheat flour for baking cakes or pancakes;
▪ With main meals, include unpeeled fresh fruits, instead of fruit juices. E.g. for dessert, a fresh fruit salad using orange, kiwi, pineapple, pear, papaya, figs… Add berries to your oat porridge or cereal (strawberries, raspberries or blueberries). For lunch or dinner add fruit to a cold salad (chicken salad with pineapple or peach).
▪ Add a tablespoon milled flaxseed to your cereal, salad or vegetable soup. They provide a wonderful mix of soluble and insoluble fibre. Flaxseed is also an excellent source of omega-3 fatty acids, which reduce inflammation and prevent high cholesterol levels.
▪ Choose wholegrain brown rice instead of white rice and sweet potatoes instead of white potatoes.
▪ Eat vegetables in soups for lunch and dinner. For the main course, half your plate should be made up of salads or cooked vegetables. A large variety is important as it means a larger mix of soluble and insoluble fibres. E.g. broccoli, zucchini, cabbage, cauliflower, pumpkin, turnip, leeks, artichokes, chard, lettuce, green beans, spinach and asparagus.
▪ For breakfast or an afternoon snack, add a slice of tomato or cucumber to your sandwich. If you are hungry in between meals, eat a raw carrot.
▪ Dried fruit and nuts are also a good source of fibre; e.g. add prunes, dates, raisins, almonds or peanuts to your breakfast cereals or to a hot meal or salad. Nuts are very rich in “good fats”, which will help to control cholesterol levels. Eating a handful of peanuts or almonds every day is a good way of controlling your appetite between meals.
▪ Introduce legumes daily: beans, lentils, chickpeas, peas or broad beans are a very good source of fibre, vitamins, minerals, proteins and carbohydrates, and should be eaten every day in soups, salads or casseroles; try also tuna fish salad with beans and tomato, stewed chicken with chickpeas or a lentil soup with pumpkin.
▪ Avoid eating large quantities of chocolate, dairy products and fatty food, especially if you have a tendency to suffer from constipation. These food groups should not be eaten in excess, as they form gasses and irritate the bowel.
▪ Drink at least nine cups of water a day (1 ½ litres). Fluids help your body process fibre. If you increase the intake of fibre without increasing the amount of fluid intake, constipation will aggravate. Herbal tea, water with mint leaves or lemonade without sugar, cucumber or puréed strawberries will help to increase your fluid intake during the day.
Example of a daily menu (approximately 30g fibre)
Oat porridge (4 tablespoons)
1 coffee spoon cinnamon
1 pear unpeeled
1 cup of tea
4 whole wheat crackers
1 glass of water
Vegetable soup (sweet potatoes + leeks + broccoli + garlic + pumpkin + unpeeled zucchini + chard + green beans)
Grilled chicken breast
4 tablespoons brown rice
2 cups spring salad (red cabbage , almonds, apple with skin, corn)
Aromatic water: put some mint leaves in a jar with a handful of strawberries, press them with a pestle and add some cold water
(leave in the fridge for 10 min to flavour)
1 slice whole wheat bread with
cottage cheese + lettuce + sliced tomato + oregano
1 cup of tea
Tuna fish salad with six tablespoons beans + tomato + onion + parsley
1 glass of sugar free lemonade
1/2 cup raspberries
1 tablespoon milled flaxseeds
1 cup of tea
By Marina Augusto
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Marina Augusto Estevão is a dietician at the Hospital Particular do Algarve Group