Fiber is what gives strength and structure to plants. Most grains, beans, vegetables, and fruits contain fiber. Foods rich in fiber are often low in calories and fat, and they fill you up more. They may also reduce your risks for certain health problems. To find out the amount of fiber in canned, packaged, or frozen foods, read the “Nutrition Facts” label. It tells you how much fiber is in a serving.

Types of Fiber and Their Benefits

There are two types of fiber: insoluble and soluble. They both aid digestion and help you maintain a healthy weight.

Insoluble fiber. This is found in whole grains, cereals, certain fruits and vegetables (such as apple skin, corn, and carrots). Insoluble fiber may prevent constipation and reduce the risk of certain types of cancer.

Soluble fiber. This type of fiber is in oats, beans, and certain fruits and vegetables (such as strawberries and peas). Soluble fiber can reduce cholesterol (which may help lower the risk of heart disease), and helps control blood sugar levels.

Look for High-Fiber Foods

Whole-grain breads and cereals. Try to eat 6-8 ounces a day. Include wheat and oat bran cereals, whole-wheat muffins or toast, and corn tortillas in your meals.

Fruits. Try to eat 2 cups a day. Apples, oranges, strawberries, pears, and bananas are good sources. (Note: Fruit juice is low in fiber.)

Vegetables. Try to eat 3 cups a day. Add asparagus, carrots, broccoli, peas, and corn to your meals.

Legumes (beans). One cup of cooked lentils gives you over 15 grams of fiber. Try navy beans, lentils, and chickpeas.

Seeds. A small handful of seeds gives you about 3 grams of fiber. Try sunflower seeds.

Keep Track of Your Fiber

A healthy diet includes 31 grams of fiber a day if you have a 2,000-calorie diet. Keep track of how much fiber you eat. Start by reading food labels. Then eat a variety of foods high in fiber. Ask your doctor about supplemental fiber products.

If you are lactose intolerant, you can’t digest lactose, a sugar found in milk and other dairy products. Many people are lactose intolerant. Undigested lactose won’t hurt you, but it can cause unpleasant symptoms. The good news is that you can get relief. To help reduce symptoms, look for ways to limit the amount of lactose you eat.

Nondairy substitutes are available for many dairy foods.

Finding Your Limit

People with lactose intolerance may think they can’t eat or drink any dairy products. This is often not true. Many people with lactose intolerance can eat or drink small amounts of dairy products without symptoms. To find your own limit, keep track of what you eat and drink. Write down when you have symptoms. Learn how much and what kinds of dairy products you can handle.

Tips to Reduce Symptoms

• Choose low-lactose dairy products. These include buttermilk and aged cheeses (such as cheddar).
• Eat foods with active cultures, such as yogurt. Active cultures make lactose easier to digest.
• Eat or drink dairy products with other foods to lessen symptoms.
• Substitute fruit juice for some or all of the milk in recipes.
• Take lactase enzyme tablets with dairy products to help reduce symptoms.
• Avoid eating many high-lactose foods (such as milk, butter, and ice cream) at one time.

Eat Other Calcium-rich Foods

If you eat less dairy, you may be getting less calcium. Ask your doctor about calcium supplements. Also, eat more dairy-free, calcium-rich foods such as:

• Broccoli, kale, bok choy (Chinese cabbage), turnip greens
• Fish with edible bones (canned salmon)
• Alfalfa sprouts, soy sprouts
• Tofu, soybeans, pinto beans, navy beans
• Almonds, sesame seeds
• Calcium-fortified orange juice, soy drink, and rice drink
• Molasses

Celiac disease is caused by a sensitivity to gluten. This is a protein found in many grains such as wheat, barley, and rye. Celiac disease affects villi (tiny, fingerlike stalks) in the small bowel (intestine). Normally, the villi make it possible for the small bowel to absorb nutrients from the food you eat. But celiac disease damages the villi. As a result, you can’t get the nutrients you need, even if you eat plenty of food. Celiac disease can’t be cured. However, you can manage the disease by removing gluten from your diet. This relieves your symptoms. It also reverses the damage to your small bowel.

Causes of Celiac Disease

With celiac disease, villi that line the small bowel become damaged and cannot absorb nutrients properly.

Celiac disease is likely genetic. This means it can be passed down in families. If your doctor thinks that you have celiac disease, he or she may advise that other members of your family be checked for it as well.

Signs and Symptoms of Celiac Disease

The symptoms of celiac disease can vary for each person. Some people have no symptoms at all. If symptoms do occur, they can include:

• Diarrhea, constipation, or both
• Abdominal pain and cramping
• Abdominal swelling or bloating
• Weight loss
• Bone or joint pain
• Tiredness and loss of energy
• Mood changes, irritability, and depression
• Canker sores
• Skin rash
• Tooth enamel problems

Diagnosing Celiac Disease

Your doctor will ask about your symptoms and health history. You’ll also have a physical exam. Tests are then done to confirm the problem. These can include:

• Blood tests. These help check for specific proteins in the blood that are present with celiac disease. They also check for anemia and help rule out other problems. The tests are done by taking a blood sample.
• Upper endoscopy with biopsy. This is done to see inside the stomach and duodenum (first part of the small bowel). For the test, an endoscope is used. This is a thin, flexible tube with a tiny camera on the end. It’s inserted through the mouth and down into the stomach and duodenum. Tools are passed through the endoscope to remove tiny tissue samples (biopsy). The tissue samples are taken to a lab and looked at under a microscope. This is to check the tiny villi for damage. This test must be done while you are still eating food with gluten. This is the only way to see if the presence of gluten is damaging the villi.
• Genetic tests. These check for problems with specific genes linked to celiac disease. They are done by taking a blood or saliva samples.

Treating Celiac Disease

To treat celiac disease, you must remove all sources of gluten from your diet. This will allow the villi to heal, so that nutrients can be absorbed normally. It’s important to follow a strict, gluten-free diet daily, even if you don’t have symptoms. If you don’t do this, the small bowel can become permanently damaged, which can lead to serious health problems. These include bone disease, cancer of the small bowel, and various nervous system disorders.

Sources of Gluten

Gluten is found in wheat, barley, and rye. The most common foods with gluten are those made with wheat flour. These include bread, pasta, cake, and cereal. Gluten is also often found in beer, gravies, salad dressings, and most packaged foods. It is even found in some non-food products such as certain medications and cosmetics. Your doctor can refer you to a dietitian to counsel you about what you should avoid. The resources below will also give you lists of food and products that contain gluten.

Follow-Up

You’ll meet with your doctor at least once a year to check your health. During these visits, routine blood tests are often done to make sure your condition is under control. If needed, your doctor can refer you to other healthcare providers or support and advocacy groups to help you cope with your condition.