Both fresh fruits and vegetables are high in insoluble fiber (roughage). While fiber is usually a means to help regulate bowel movements, some patients have extreme sensitivity to roughage and cannot tolerate it. Reasons for fiber intolerance include nonulcer dyspepsia; some forms of irritable bowel syndrome, in which high fiber can increase gas production and a feeling of bloating; and a gastric-emptying disorder that prevents the stomach from processing food properly and can lead to feelings of fullness, indigestion, pain, and occasionally, reflux. I recommend that you see a gastroenterologist to determine whether you have a gastric-emptying disorder that may be treatable with medication or other approaches. If not, cooked fruits and vegetables are easier to digest for most individuals. Further, some fruits and vegetables, such as bananas and tomatoes, are lower in roughage and may be easier for you to digest. Finally, I recommend eating fruits and vegetables in small amounts to see whether this improves tolerance. Q2. Will freshly ground flaxseed, taken on a daily basis, make your bowels lazy or give you soft, diarrhea-type stools? — Nancy, California Ground flaxseed is a rich source of alpha-linolenic acid, a precursor of the omega-3 fatty acids that are known to help address hyperlipidemia (high levels of fat in the blood) by improving the balance of good to bad cholesterol. Omega-3 fatty acids help reduce atherosclerosis and coronary artery disease through this mechanism, although there is no clear evidence yet that ingesting flaxseed products improves cardiovascular outcomes. Flaxseed also demonstrates antioxidant properties and may affect the estrogen receptor, so some have advocated its use for preventing breast cancer. The clearest evidence for usefulness of ground flaxseed has been as a laxative, so looser stools are common, although frank diarrhea is much less common. As the loose stools appear to be dose-related, lowering the dose of ground flaxseed may firm up the stools somewhat. Q3. I am lactose-intolerant and enjoy soy milk, but I have read that it increases your estrogen hormone levels and this can be bad for you. I take a supplement for calcium and I don’t want to take any chemically enhanced products, such as Lactaid. I have tried rice milk and some of the nut milks, but I just don’t like anything as well as soy milk. Is soy milk really that bad for me to drink? What about my children? Soy contains natural plant estrogens — that is correct. However, it is not bad for you to drink soy milk, since you would need to drink a lot of it before you took in a concerning amount of estrogen. Plant estrogens are much weaker than human estrogens as far as their effects in the body. In fact, many of the studies of menopausal women who try to boost the amount of soy in their diets to relieve menopausal symptoms cannot show that this dietary therapy has any effect whatsoever. If you (or your children) are just drinking normal amounts of milk (several cups daily), then you really do not need to worry. Soy is not the only food that contains plant estrogens — lentils, chickpeas, various grains, flaxseeds, and other fruits and vegetables do, too. These foods are part of a healthy diet. Finally, you can be reassured by the fact that in parts of the world where soy makes up a major part of the diet, such as Asian countries, there are no higher rates of breast cancer. I hope that puts your mind at ease. Learn more in the Everyday Health Digestive Health Center.
