Patrick Burrows

Prof. Matuszak
KNH 413
4/28/16
High Fiber Diet Instruction
Description of the patient and diagnosis
Beth Carter is a 43-year-old white female who was referred to a
dietitian by her physician when she expressed a concern for her own
low fiber intake. Mrs. Carter is interested in learning how to increase
her fiber intake and eat an overall healthier diet. She complains of
intermittent constipation as well. Mrs. Carter admits to eating poorly
and complains that in the past she has increased her fiber intake but
the increase gave her gastrointestinal discomfort. She admits to
consuming a poor diet and only cooking a few meals a week for herself.
Weight: 150 lbs
Height: 5 6
EER= 1600-1700 calories/day
Etiology
The Nation Fiber Council recommends on average that adults
consume 32g of fiber daily. Most Americans intake less than this
recommended amount on average (General Information About Fiber).
The U.S. Dietary guidelines recommend a total fiber consumption of
25g per day for women and 38g per day for men (319). It has been
shown that intake of fiber below the minimum recommendation is a
risk factor for chronic constipation (Morais, Vitolo, Aguirre, & FagundesNeto). High fiber diets normalize bowel movements, help maintain
bowel health, lower cholesterol levels, help control blood sugar levels,
and aid in achieving healthy weight (Nutrition and healthy eating).
General Information About Fiber [Pamphlet]. (n.d.). National Fiber
Council.
Morais, M. B., Vtolo, M. R., Aguirre, A. N., & Fagundes-Neto, U. (1999).
Measurement of Low Dietary Fiber Intake As a Risk Factor for
Chronic Constipation in Children. Journal of Pediatric
Gastroenterology and Nutrition, 29(2), 132-135.
doi:10.1097/00005176-199908000-00007
Nelms, M. (2011). Nutrition therapy and pathophysiology. Belmont, CA:
Wadsworth, Cengage Learning.

Nutrition and healthy eating. (n.d.). Retrieved April 20, 2016, from
http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthyeating/in-depth/fiber/art-20043983
Diagnostic Measures
Other than a 24-hour recall or a food log there are not really any
direct ways to measure fiber intake. However fiber has been shown to
reduce LDL and total serum cholesterol (319). Based on this
information fiber intake can be indirectly measured by checking LDL
and total serum cholesterol levels. Obviously there are other factors
that attribute to those levels but if those levels are high and the person
does not have very much fiber present in their 24-hour recall then it
shows that they have an inadequate intake of fiber. Fiber intake could
also be measured by how often a person has a bowel movement. If
they have very irregular or extremely soft bowel movements then they
may also have inadequate intake of fiber.
Nelms, M. (2011). Nutrition therapy and pathophysiology. Belmont, CA:
Wadsworth, Cengage Learning.
Medical, Surgical, and/or Psychological Treatment
From a medical standpoint someone may be prescribed a fiber
supplement, such as Miralax, to help with chronic constipation. There
are not surgical methods to help someone increase a fiber in their diet.
If someone has some type of fear or aversion to fiber then they may
need to seek some type of psychological treatment.
Medical Nutrition Therapy
Treatment for low fiber intake is easily treatable provided that
there are no underlying medical or psychological issues related to the
intake of fiber. The patient should be placed on a diet that gradually
increases her intake of fiber up to the daily recommendation of 25g per
day. It is also very important to be sure she understands that she must
consume and adequate amount of water daily to avoid gastrointestinal
discomfort. The patient should be at least consuming 1ml of water per
calorie taken in. In order to reach the recommended intake of fiber the
patient should focus on consuming more whole grains, fruits,
vegetables, nuts, and beans (Nutrition and healthy eating). The patient
states that she does not cook for herself very often so she should be
instructed to gradually begin cooking for herself. If the patient needs
culinary skill lessons she will be provided with those resources. The
patient should also keep a food log so that they can be evaluated for

adequate intake of macro and micronutrients as well as to track fiber

intake.
Nutrition and healthy eating. (n.d.). Retrieved April 20, 2016, from
http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthyeating/in-depth/fiber/art-20043983
Prognosis
Low fiber intake is relatively easy to treat and can be achieved
by encouraging a whole food diet with minimal amounts of processed
foods. There are a multitude of ways to increase the amount of fiber in
your diets, which limits the ways in which a patient may fail.
Fiber: How to Increase the Amount in Your Diet. (n.d.). Retrieved April
21, 2016, from http://familydoctor.org/familydoctor/en/preventionwellness/food-nutrition/nutrients/fiber-how-to-increase-theamount-in-your-diet.html