title: Fiber supplements and clinically proven health benefits: How to recognize and recommend an effective fiber therapy.
abstract: BACKGROUND
  Only 5% of adults consume the recommended level of dietary fiber. Fiber supplements appear to be a convenient and concentrated source of fiber, but most do not provide the health benefits associated with dietary fiber.
  
  
  OBJECTIVE
  This review will summarize the physical effects of isolated fibers in small and large intestines, which drive clinically meaningful health benefits.
  
  
  METHODS
  A comprehensive literature review was conducted (Scopus and PubMed) without limits to year of publication (latest date included: October 31, 2016).
  
  
  CONCLUSIONS
  The physical effects of fiber in the small intestine drive metabolic health effects (e.g., cholesterol lowering, improved glycemic control), and efficacy is a function of the viscosity of gel-forming fibers (e.g., psyllium, β-glucan). In the large intestine, fiber can provide a laxative effect if (a) it resists fermentation to remain intact throughout the large intestine, and (b) it increases percentage of water content to soften/bulk stool (e.g., wheat bran and psyllium).
  
  
  CONCLUSIONS
  It is important for nurse practitioners to understand the underlying mechanisms that drive specific fiber-related health benefits, and which fiber supplements have rigorous clinical data to support a recommendation.
  For most fiber-related beneficial effects, "Fiber needs to gel to keep your patients well."
authors.affiliation: Employee and Community Health, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kellen V
authors.initials: KV
authors.lastname: Lambeau
authors.affiliation: Global Clinical Sciences, Procter & Gamble, Mason, Ohio.
authors.forename: Johnson W
authors.initials: JW
authors.lastname: McRorie
mesh_terms: D004043:Dietary Fiber / Q000494:pharmacology / Q000627:therapeutic use*; D019587:Dietary Supplements / Q000592:standards*; D005936:Glucans / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007421:Intestine, Small / Q000502:physiology; D007444:Inulin / Q000494:pharmacology / Q000627:therapeutic use; D008660:Metabolism / Q000187:drug effects* / Q000502:physiology*; D011620:Psyllium / Q000494:pharmacology / Q000627:therapeutic use; D047071:beta-Glucans / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D004043:Dietary Fiber; D005936:Glucans; D047071:beta-Glucans; D011620:Psyllium; D007444:Inulin; C033375:polydextrose
keywords: Dietary fiber; advanced practice nurse; large intestine; nurse practitioner; small intestine; therapeutics; viscosity