I'm often asked what my opinion about a diet or diseases. Who cares, what my or anyone else's opinion
is, always you care about
is what the science says. What does the best available balance of evidence
published? In the peer-reviewed medical literature have to say right now, welcome to the nutrition facts podcast. I'm your
host dr. Michael Greger. Today, we examine the best
Way to have the most regular and otherwise agreeable bowel movements and we're going to start with the best pooping position while squatting continues to be the traditional position and populations of Asia and Africa westerners have become accustomed to sitting on toilet seats. And when we do that, when we sit upright or poop is forced to make nearly 90 degree turn the so-called wreck do anal angle and now that's a good thing in terms of keeping us from pooping my pants, every time we sit down,
When it comes to doing our business to sitting toilet posture, defeats the purpose of our bodies. Brilliant design. Like trying to drive a car without releasing the parking brake yet, many Physicians are hesitant to discuss, such an unmentionable bodily function, or may just be ignorant, doctors, don't know. Squat, of course, this is coming from someone who owns a company selling people squatting platforms for their toilets and a previous video, I talked about the littlefoot's tools. You can use to raise your knees when you assume that.
The pooping position but they were not found to make a difference in terms of self-described difficulty and defecating or the average time spent emptying one's bowels, but those stools give just a measly four inch boost. The so-called Squatty Potty is twice that height and while you have to admire their Graphics from booty blockage to fecal, Fiesta complete with little Rainbow poops, it had never been put to the test on till now.
The implementation of a defecation posture modification device, IE squatty body and it worked increased feelings of bowel emptiness, reduce stranding in about a minute off of there on the pot reading time. The only downside is that discomfort even just a 6 inch Riser was found to cause such extreme discomfort in research subjects and previous trial, they'd abandoned even trying to study.
How else could we get that? Same change in angle, you get from raising your feet? How about just tipping forward? It's like that famous sculpture by Rodin The Thinker and indeed Cleveland Clinic researchers. Set out to study the Thinker position for defecation, and was able to show an opening of the anal rectal angle as measured using Synod ethic ography your sat word for the day. Meaning, basically, x-ray. Boot movie opening to more than 130 degrees better than
You get just raising your feet which is only around 90 degrees. So the Thinker position may be a more efficient method for defecation and may help with constipation, but it has not yet been formally put to the test as an aside. You can imagine how the worst position might be flat on your back using a bedpan because of the spike in blood pressure in your heart and brain. When you Bear Down straining, it's tool associated with sudden death from heart attack and stroke. In fact, has been found to be the most common activity of daily living.
Living being performed at the time of death in Japan, and those who can't get out of bed would seem to be, especially at risk. That's why? If at all possible, it can help to sit people up in bed because the less strain on the system. It's important to take a step back though, in this sitting versus squatting debate, as this commentary did nearly 50 years ago. Yes, the squatting position is said to be natural. Since it's used by so-called primitive peoples, who passed large stools easily such as squatting Advocates blame, the poor.
Whistlin throne and all manner of Western maladies, but does the position really make a difference? If you're eating the right Foods, the man who squats because he has no modern plumbing also tends to eat more natural foods. That haven't had the fiber. Processed out, adding fiber to the dye can enable constipated patients to poop effortlessly without having to squat over some hole in the ground. So maybe if we just change the design of our diets, we don't have to change the design of our plumbing, in our next story. We looking out,
Most people have between three bowel movements a day and three all week,
but normal doesn't necessarily
mean optimal ancient Egypt
was one of the great civilizations lasting for 3,000 years. It's knowledge of medicine, vastly underestimated, they had medical subspecialties the Pharaohs, for example. How to access to Dedicated Physicians to be Guardians of the royal bowel movement.
A title alternately translated from the hieroglyphics to mean, Shepherd of the anus? How's that for a Resume Builder today, the Primacy of its importance continues with some calling for bowel habits to be considered a Vital sign on how the body is functioning along with blood pressure heart breathing rate although we may not particularly like hearing the details of someone else's bowel movement is a function that nurses and doctors need to
assess
surprisingly the
And remained relatively unexplored, territory, one of the body's final. Frontiers, for example, current concepts of what normal stools are like, primarily emanates from the detailed records of 12 consecutive bowel movements in 27. Healthy. Subjects from the United Kingdom, who boldly went where? No one had gone before. Those must have been really detailed records.
The reason we need to Define normal when it comes to bowel movement frequency, for example is, how else can you define Concepts like constipation or diarrhea?
If you don't know what
normal is standard? Physiology textbooks may not be helpful in this regard, implying that anything from one bowel movement every few weeks or months to 24 a day can be regarded as normal.
Once every few
months
of all human bodily functions defecation is perhaps the least understood and least studied,
can't you just ask people
turns out people tend to exaggerate there's a discrepancy between what people report and what researchers find when they actually have them recorded. It wasn't until 2010. When we got the first serious, look defining normal stool free.
C is between three per week and three per day. Based on the fact that that's where 98% of people tend to fall, but normal doesn't necessarily mean optimal, right? Having a normal salt intake can lead to a normal blood pressure, which can help us die from all the normal causes like heart attacks and strokes. Having a normal cholesterol level in a society where it's normal to drop dead of heart disease. Or number one, killer not necessarily a good thing. And indeed significant proportions of
people with quote-unquote normal bowel function, reported urgency straining, incomplete defecation leaving the researchers to conclude that, that kind of thing. Must just be normal normal, maybe if you're eating a fiber deficient diet, but not normal for our species defecation should not be a painful exercise. This is readily demonstrable. For example, the majority of rural Africans eating their traditional fiber-rich plant-based diets and usually pass without straining a stool.
Men on demand as either, the rectum may need to accumulate for five ounces of fecal matter before the defecation, reflex is fully initiated. So if you don't even build up that much over the day, you'd have to strain to Prime the rectal
pump, Hippocrates
thought, bowel movements should, ideally be two or three times a day. Which is what you see in populations on traditional plant-based diets and the kind of fiber intakes. You see in our fellow, great apes and
In what may be more representative of the type of diets we evolved eating for millions of years. It seems somewhat optimistic though to expect the average American to adopt a rural African diet. We can however, eat more plant-based and bulk up enough to take the Hippocratic oath, to go two to three times a day. No need to obsess about. In fact, there's actually a bowel Obsession syndrome characterized in part by ideation.
Rambling over bowel habits, but three times a day makes sense. We have, what's called a gastrocolic reflex, which consists of a prompt activation of muscular waves in our colon, within one to three minutes of the ingestion of the first mouthfuls of food, even just talking about food can cause your brain to increase: activity. This suggests the body figure that one meal should be just enough to fill you up down there. So
Maybe we should eat enough, unprocessed plant foods to get up to three a day, a movement for every meal.
In our final story today, prunes figs and exercise are put to the test as natural home
remedies for constipation
the act of defecation involves a very private sphere and is the object of cultural taboo so much so that it's really thought of even by physicians. But it should be a constipation accounts for 3 million annual, visits to doctors the United States and 800,000 emergency room, visit depending on how you define it up.
To 80% of the population may be suffering, even people who don't think they're constipated may very well be clinically constipated a quarter of their so-called healthy subjects. Reported experiencing incomplete emptying and approximately half indicated increased straining. In fact, more than half had found Blood on the toilet paper within the past year. In severe cases, the blood pressure spiked associated with straining. Its tool can even trigger a heart attack or stroke. There are drugs for their old
Is drugs, resulting in side effects? Like Headache, nausea, diarrhea, and abdominal pain, leaving most patients unsatisfied. So what? Instead, just try to treat the cause
Common causes of chronic, constipation include lack of adequate whole plant Foods or insufficient water intake. So making changes in the patient's diet and lifestyle is the preferred method for relieving constipation such non-pharmacological clinical effective, interventions include engaging in physical activity, for about 30 minutes a day, a systematic review and meta-analysis found aerobic exercise interventions. Help the starting at about 140 minutes a week and then, of course, a diet centered around whole plant foods, which
The only naturally concentrated sources of fiber, any plants in particular, if you give elderly women with severe constipation about a dozen, prunes a day, the experience significant Improvement within the first week, the control group in. The study wasn't told to do anything, though. And anytime you have one group doing something and the other doing nothing, you can't discount the placebo effect and the placebo response for constipation. Trials, Come range up to 44 percent. Meaning up to nearly half of the people given a
were people claim to experience an improvement. So that's why we need studies like this subject were randomized about eight prunes a day. Plus a large glass of water, 12 prunes in water or just the water alone. So even the control group got an intervention. There were told might help with constipation, previous studies, mostly signed 10 prunes or so a day. So, the researchers wanted to see if more was better or less with sufficient and they found a significant Improvement in stool bulk on
Prunes and a significant increase in bowel movement frequency though. No, real difference between 8 and 12. So a today, seems sufficient prunes, even a superior to psyllium sold as Metamucil beating it out. In terms of improved stool frequency and consistency. We used to think was just all the fiber in prunes. I was helping, but prune, juice evidently Works to, which like most juices says, had the fiber removed other potential, Active Components, include a natural sugar, alcohol known as
s orbital that's used in some sugar-free gum. Once you eat more than a dozen or so, large prunes a day. However, the dose of sorbitol could start reaching laxative levels in susceptible individuals. So be careful. If you don't have constipation, should you avoid prunes? That's been put to the test, and most people should be able to eat a dozen or so a day without any issues. In fact is interesting to note, that prunes have been traditionally used as both a laxative and an anti-diarrheal remedy.
What about dried? Figs one of the few medicinal plants mentioned. Explicitly in the Bible, researchers took patients with the type of irritable bowel syndrome characterized by constipation and randomize them to one filled with breakfast and one fig with lunch each with a glass of water and there are significant Improvement in frequency of defecation and a significant drop in the frequency of hard stools compared to control. But what was the control? The control group was just asked to continue their normal diet. In other words, to
Nothing special the placebo response for irritable bowel is Infamous give people with IBS on fake sugar pills sometimes 72 percent say they magically feel better. That's why we need this. Kind of study a randomized. Double-blind placebo-controlled, trial researchers made a gross, sounding fig paste Placebo. That supposedly had the same taste smell and appearances. The real deal. Those who got the real figs about six a day seemed to improve: Transit time stool consistency.
And abdominal discomfort compared to the placebo researchers. Measured Transit Time by having people swallow. Little beads that would show up on x-rays. So they could track the progress through the digestive system. They found that those things are real. Figs sped up their gut Movement by a full 24 hours defecation frequency per week. Didn't beat out Placebo, though. In fact, they tested so many different outcomes. Even the stool consistency and tummy discomfort results may have been statistical flukes. So it looks like prunes
Would be the better treatment choice. We would love it if you could
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