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Chronic Constipation

Sometime we forget the basics. I read a 2011 study that was a questionnaire of over 14,000 Taiwanese teens. It measured lifestyle behaviors that were most associated with chronic constipation ( defined by less than 3 defecations per week).


Not surprisingly; the most convincing risk factors for constipation with a 95% confidence interval were:


  1. Being female had an odds ratio of 2.24 (Note: Odd ratio is abbreviated as OR and means . An Odds Ratio of 2.24 suggests that the odds of the outcome occurring in the females are 2.3 times higher than the odds of the outcome occurring in non females.

  2. Increased Sedentary awake time . OR :1.00

  3. Fluid consumption <1800 mL/day. OR: 1.23

  4. Vegetable consumption <1 portion/day. OR :1.44

  5. Fruit consumption <1 portion/day. OR: 1.62

  6. Whole-grain products <50% of staple food consumption. OR 1.22


Sedentary behaviors were measured by assessing the time spent watching television, using computers or playing video games, reading , riding in a vehicle, and studying and doing homework.


There is much more I covered on this topic here. Especially the link between hormones and constipation , medications, as well as stooling positioning.


If you are constipated and fall in some of those risk categories keep reading.


For the sake of a blog post I am going to highlight some foods that you can incorporate and some lifestyle changes that you can make that are relatively easy.


Now is a good time to mention some gut foods that can help with constipation.:


  1. Unpeeled carrots is #1 on my list. The cellulose and resistant fibers helps quite bit with the bulk of your stool. I find that 2 large unpeeled carrots per day does the trick. (Of course wash the carrots, but don’t peel them)

  2. Almonds. Both almonds and almond skins. About 23 almonds twice per day seems to be the right dose. Almonds skin polyphenol seem to be the active component. Almonds increase fecal Lactobacillus spp and Bifidobacterium spp and decreased b-glucuronidases. If you are scared to eat this much because you are worried about weight gain; then maybe just try 23 almonds per day with some of the other suggestions.

  3. Figs. They have been used in studies to increase fecal weight and moisture. The dosing was about 6 figs per day.

  4. Raisins 120 grams per day have been shown to increase fecal weight, decreased intestinal transit time, and increase Short Chain Fatty Acid production.


Of course there are others; but these can be started tomorrow with little effort or expense.


Now, onto the discussion of sedentary lifestyle… with an emphasis on NEAT .


Driving , desk work, ordering in, shopping, delivery, hiring out for yard work, web meetings are mainstays in today's society.


In fact, in industrialized countries were are sitting on average of 6-7 hours per day . When combined with sleep ; the majority of our life is being spent inactive. In an effort to get more done, make more of our time, and be more efficient; we are using our physical bodies less and less. It may seem like this is ok as long as we are making up for the less activity by continuing to work out for an hour; but actually the deficit of these activities may be having a profound effect on our metabolism.


Non-exercise activity thermogenesis (NEAT) is the energy expended for everything we do that is not sleeping, eating or sports-like exercise. It ranges from the energy expended walking to work, typing, singing, handwriting, performing yard work, undertaking agricultural tasks and fidgeting. NEAT is a critical component of how much Total Energy Expenditure (TEE) we output ; being responsible for up to 20% of our caloric burn . NEAT activities can make up 60% of the day's time compared to exercise which on average is only 4% of the day. By skimming off NEAT activities from our lives we are significantly disrupting metabolic balance.





NEAT is regulated by the activity of the central nervous system and peripheral nervous system. It appears to be a factor of wakefulness behavior and sympathetic nervous system-driven musculoskelatal activity.

It appears to be one of the many factors in adaptive thermogenesis ; which can be explained as things other then exercise or resting metabolism that may contribute to metabolic burn rate.


NEAT is influenced by many factors including the environment one lives in. Communities, regions, workplaces, and cultures are built for NEAT and some are not.


For example if living in a bike commuter friendly town then NEAT would likely be more accessible.

In addition there are many physiologic impacts that may influence our ability to engage in NEAT . These includes levels of dopamine and testosterone, and thyroid hormone .


The solutions to getting more NEAT include conscious effort to move and behaviors that lead less of a sedentary lifestyle.


Some examples of NEAT .

1. Cold Hydrotherapy

2. Walking the dog

3. Commuting to work by bike

4. Parking your car far from the entrance.

5. Taking the stairs instead of elevators

6. Using a standing desk

7. Daily yard work, garage work, and household chores

8. Shopping in person instead of on-line

9. Fidgeting/pacing

10. Handwriting/Journaling


Incorporating more movement overall through N.E.A.T. is nonetheless a great addition to prevent and treat constipation.


There are countless more complex reasons for chronic constipation, but we must not overlook the basics. My future posts will cover aspects of pelvic outlet issues .



references:

Chien, L. Y., Liou, Y. M., & Chang, P. (2011). Low defaecation frequency in taiwanese adolescents: association with dietary intake, physical activity and sedentary behaviour. Journal of Paediatrics and Child Health, 47(6), 381-386. https://doi.org/10.1111/j.1440-1754.2010.01990.x


(2022). Progress of research on the effect of fruits on intestinal motility and constipation treatment. Journal of Contemporary Medical Practice, 4(7). https://doi.org/10.53469/jcmp.2022.04(07).2

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