Nutritional Management

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NUTRITIONAL MANAGEMENT

High fiber diet and plenty of fluid are recommended both for treatment and prevention of constipation :

  • Fruits (both fresh and dry), vegetables, beans and whole grains are rich in fibers.
  • Fiber is any edible food material that passes through the intestinal tract undigested. It is indigestible carbohydrate found in plant cell walls and can be soluble or insoluble. While soluble fiber acts as gel and increases the water content of the stool, the insoluble fiber adds bulk to the stool and softens it.
  • Insoluble fiber are present in wheat bran, whole cereal grains and raw vegetables are additionally known to reduce colon cancer and Diverticulosis (disease condition of the colon). Soluble fibers are found in citrus fruits, legumes (dried beans and peas), oats and barley. Soluble fiber also lowers blood cholesterol and blood sugar (in diabetics).
  • The recommended intake of fiber is 1 gm per 100 calories. This averages to a daily need of 15 – 20g of fibers (for people with sedentary to moderate activity).
  • Besides, it is of foremost importance to include plenty of liquids in diet as high fiber content in intestine absorbs water and adds bulk to the stools. The recommended fluid intake for an adult is at least 1 – 2 liters per day.

CAUTION:

Tea, coffee, soft drinks (due to their caffeine content) and hard drinks (due to their alcohol content) have dehydrating effect and their excess use can lead to constipation.


If one has tendency to constipate, the food items advised are :

  • Fresh fruits including those with edible peeling.
  • (Exception is banana that is known to cause constipation and should be avoided).
  • Raw and cooked vegetables
  • Whole cereal grains
  • Legumes (peanuts and ground nuts)
  • Dried beans
  • Dried peas
  • Dry fruits (dry prunes, figs, etc)

The food items to be avoided are :

  • Meat and non vegetarian food.
  • Finely processed flour and its products.
  • Refined sugars and their products.
  • Tea and coffee (dehydrating effect of caffeine).
  • Whisky with high alcohol content (dehydrating effect of alcohol).
  • Dairy products.

Diet for children

The dietary advice is even more important for children. In most instances, children are found to suffer from preventable type of constipation, that develops due to their faulty dietary habits.

The dietary faults commonly noticed in children are :

  • A low intake of fluids: A child may not respond to his fluid needs either because of engrossment in his activities or games or because it has been a routine for him to decrease his fluid intake in the evenings so as to avoid bedwetting.
  • Late weaning : This problem is rampant among illiterate mothers of backward societies of rural India. The weaning from breast milk is delayed enormously even till the age of 1 to 11/2 years. This leads to growth retardation as well as constipation.
  • Preference for fast food, sweet and commercial foods with low fiber content The children globally, are known to prefer fast food (hamburger, noodles), sweets (chocolates, candies, sweetened aerated drinks) and other packed low fiber food (snacks made of processed gram flour). This food is used as a replacement to a nutritional high fiber diet. This is an important cause of preventable constipation not only in growing children but also in young adolescents as well.
  • Faulty food preparation : The fault on the part of either of parents can make even the fiber present in the diet unavailable to the child. This occurs when the flour used for preparation of chapattis is passed through a fine sieve (that almost removes the entire bran from the flour). Similarly, mothers offer the fruits with edible peeling to a child after peeling it off. Some mothers prefer to give fruit juice that is thoroughly sieved to remove the fibers, based on their ill based concept that giving fruit juice is better than giving whole fruit. So, the useful fiber is removed from the diet of a child.

Obviously, the solution to the problem is to educate the parents and stress on the child for a need for a wholesome diet rich in fiber. Educative Programmes and advertisements on TV can go a long way in promoting the concept of a high fiber diet among public.