Why Dietary Fiber Is a Menace with Konstantin Monastyrsky

Dietary fiber has a long stereotype of being healthy, but if you have been following our work, you have likely heard a few things that challenge this concept. Today we speak with Konstantin Monastyrsky, author of Fiber Menace, to dig into some of these details.

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Konstantin Monastyrsky Bio….. 1:16
Types of Fiber….. 4:12
The Role of Fiber in the Small and Large Intestine….. 12:04
Fiber and Microbiotal Diversity….. 15:07
Fiber and Colon Health….. 21:24
Dietary Recommendations….. 28:07
Vegetables, Grains, and Starches….. 32:22
Episode Wrap Up….. 37:52


  1. GutSense.org
  2. Lundberg Family Farms Rice
  3. Fiber Menace

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Why Dietary Fiber Is a Menace with Konstantin Monastyrsky

Dr. Michael Ruscio: Hey, everyone! Welcome to Dr. Ruscio Radio. I am really excited about the guest. And the topic that we will be diving into today is “Why Is Dietary Fiber a Menace with Konstantin.” And I wanted to thank you, my friend, for taking a moment to be here and welcome you to the show!

Konstantin Monastyrsky: Oh, thank you so much, Michael, for welcoming me to your show and for giving me this opportunity. And I hope this message will do a lot of good for your audience and your patients.

DrMR: Absolutely. Same here.

Konstantin Monastyrsky Bio

Can you tell people a little bit about your background and how you fell into or discovered some of the negative attributes of fiber? And we’ll definitely go into more detail, but your background, your training, and how you got to where you are.

KM: I graduated from medical school, medical university back in 1977. So I’ll be 62 this year. I sound much younger. [Both laugh]. And it was in Russia in Ukraine, actually, Soviet Union, Ukraine. And so my major was pharmacy. And my family immigrated here in 1978. And I didn’t like the pharmaceutical tract, so I just went into business and did a variety of things quite successfully to my amazement.

And by 1996, I got hit by late-stage type 2 diabetes. I almost passed away. I was very obese and very sick. I had a lot of money, great doctors, but unfortunately no help. And at that point, I recalled that I had a medical education, so I decided to get myself out of that mess. I spent about two years recovering [was 2:22] my IT business and started writing on all medical subjects and wrote a bunch of books. My original effort was primarily in Russian language.

And in 2005, actually in 2003, I stumbled on the subject of chronic constipation, and started to do a lot of research and came to a conclusion that fiber, dietary fiber is a primary cause of chronic constipation. And out of this effort came out with a book called Fiber Menace in 2005. And I’ve been working on this ever since.

DrMR: Got you. Got you. And I came across your work, I think just randomly actually on the internet or it may have been one of our listeners who forwarded me your information and thought it might be interesting. But certainly, we’ve bridged on this topic of dietary fiber maybe not being this super healthy compound as we’re steered typically led to believe. Definitely for some digestive conditions—SIBO, small intestinal bacteria overgrowth—if people eat too much fiber, especially too many fermentable fibers, that can be a problem.

This is why, I’m sure many people listening have heard us cover the low-FODMAP type diets or low-fermentability type diets, as we discussed with Dr. Robillard recently, can be very helpful for SIBO and for IBS. And then there’s also subsets of, or all of really, inflammatory bowel disease that may do better with a lower, especially insoluble, fiber diet. So a lot of what you’re saying, at least superficially, I want to dig into the details, but are things that we’ve bridged on in the show.

Types of Fiber

So to take us a level deeper, what are some of the specifics with fiber? For example, I just went through a couple where there are certain conditions like IBS and SIBO that may be fed by fermentable fibers. Can you provide people with a little more details? Because I’m sure people listening to this are saying, “Well, what kind of fiber? How much? You know, are there better fibers than others?” So can you help people get a little better of an understanding of what your more specific recommendations regarding fiber are?

KM: Sure. Absolutely. Well, we know there are two types of fiber: fermentable and unfermentable or insoluble and soluble. And today, a lot of physicians are now focused on soluble fiber and its harms. And as you pointed out SIBO and IBS obviously.

And it’s quite insidious. It’s hidden in most foods. People don’t even realize that they’re consuming foods with soluble fiber because it’s routinely added as food ingredients to a lot of dairy products, such as ice creams. And it’s used in industrial cooking. Any time you buy processed foods, most likely will have some kind of a soluble fiber. And it is an agent for whatever kind of, for giving it more taste or for giving it—

DrMR: Texture.

KM: Texture. Exactly. And but then you have this huge problem with insoluble fiber or indigestible fiber. And it is primarily present as bran in cereals, added as for fortification reasons. And a lot of people take fiber-based laxatives, such as Metamucil. And they don’t realize is that they eventually may run into problems. And fiber of both kinds, especially insoluble, my book was primarily on insoluble because I started this research very early in 2003.

And at that time, it was still very popular and still quite heavily promoted.

And I actually came into this concept on working with patients on the Atkins Diet. And a lot of people were coming to me was having chronic constipation right after assuming the Atkins lifestyle, and the same thing with Paleo. Essentially, it’s a low-density diet. And once you go to this kind of diet and you cut out all your foods which were laden with fiber, you suddenly run into constipation and some kind of digestive disorders.

So it was a very interesting journey. Like you can imagine, very…in the book. And in 2005, it was laughed off. But now, people are coming around. Even the Merck Manual of Diagnosis and Therapy is on the record saying fiber may not be as good. And my very simple argument to people, especially to physicians, when I’m talking to doctors and they say, “Konstantin, it’s very strange, your point. If you give me a reason why I should trust you or believe your opinion.”

I say, “Well, doctor, it’s very easy. I mean, if you have a patient admitted with the diverticular disease, acute hemorrhoids or acute IBS or acute something or colon cancer, the first thing you say, “Hey, go on the low-density diet.” And low density, it’s a term for the low-fiber diet, the zero-fiber diet because it helps. “So please tell me, how come when you admit a patient into hospital, and you put them on a low-density diet, once they’re out of the hospital, you put them back on a high-fiber diet?”

And that’s when it clicks for a lot of people because obviously when you start to go on in-depth and saying, “Well, fiber bulks up stools.” And bulking up stools initially in healthy people may provide laxative effect. And yes, it does work. But as years goes by and you bulk up stools, anus is a very narrow passage for stools out of the body.

And so if your stools are very large and you’re dealing with a very small anus to get them out, some people start to strain. And the more they strain, the more problems they develop, starting with enlarged hemorrhoids and then sometimes anal fissures and sometimes colorectal or anal damage where they no longer perceive the urge to move bowels. And that’s how they run into all kinds of problems. And then they run into delayed stomach and delayed colon emptying, delayed bowel emptying, rectal seal, and so many other problems that come up in men and women, alike.

DrMR: And certainly, I think there is some evidence that supports this with using a very low-fiber intervention like an elemental or a semi-elemental liquid diet that is going to be about as low in fiber as you can get. And that’s been shown to be very helpful, both for SIBO and for the symptoms of IBS. And also, there’s been quite a bit of good research looking at that in different types of inflammatory bowel disease.

And it seems to be especially helpful, the elemental or the semi-elemental diets that is for Crohn’s disease. And it’s important to remember that 80% of Crohn’s disease will affect the small intestine. And I can’t help but wonder if there’s a lot of impact in the small intestine that were not very well in tune to because so much of the focus on digestive health is on the colon because it’s easier to assess.

But I can’t help but wonder if fiber is very or can be deleterious to the small intestine. This is where, of course, SIBO will occur. This is where Crohn’s will occur. It’s got a thinner mucous membrane. It’s more prone to leaky guts. It’s essentially more sensitive. So I certainly think there’s some evidence points to reinforce a lower fiber-type diet.

And I wanted to have you clarify something you said just a moment ago. You were seeing that when people went on a low-fiber diet for… Let me make sure I heard this correctly first. Were you seeing people go on a lower-fiber diet when they were going on Atkins and Paleo?

KM: Mmm hmm. Well, by definition, it’s a low-fiber diet if you switch over from a high-carbohydrates diet, carbohydrates in general. If people are on a plant-based diet, fruits and vegetables, they will have 5 to 7% of the diet with fiber and includes the targeting 500 grams of carbohydrates a day. If they’re getting 5% to 10%, we’re talking about anywhere from 25 to 50 grams of fiber a day. That’s a lot.

DrMR: Sure. Okay. So I just wanted to clarify that for people because… And I would agree with you. I think there could be a relative shift going to a low-carb or a Paleo diet being lower fiber. Even though there’s probably going to be a little bit more insoluble fiber consumed because people will be eating more vegetables, their overall fiber content may go down. And I think that may be one of the reasons why people on lower-carb diets do well.

But also something interesting that I’ve seen is if people are going to low carb, sometimes they may be ingesting too much insoluble fiber. And when they take out some of the insoluble fibers and up their soluble fiber, that tends to help with some of their digestion. Have you seen anything similar in that regard?

KM: Ah, yes, it depends on the person. But in general, if people already have a predisposition to constipation, they usually have a very hard time with going on into low-density elementary diet. And the reason being is that their colon is already enlarged and the anus is primarily narrow. And so when you have a sudden reduction of stools, they no longer perceive an urge to move bowels. Meaning the reflex to move bowel is no longer registered into their brain. And so they miss stools and stools harden up. And it causes even more difficulties.

The Role of Fiber in the Small and Large Intestine

Michael, if you allow me, I stop on you made a very, very distinct connection between the small intestine and the large intestine and their role in fiber, soluble and insoluble and SIBO and all other conditions. And here’s where the association comes from. When people actually consume a lot of fiber, and especially when they start to experience latent constipation, meaning they are moving bowels, but it’s a laborious effort. They have to strain. And it’s usually perceived as incomplete emptying.

So what happens is the colon can relay so much stools that they start to reflux back into the small intestines. And so you run into conditions when stools end up in the small intestines. You end up with a lot of bacteria there. It’s supposed to be sterile. And so when you have bacteria and you add more fiber on top of it, especially insoluble fiber, you essentially create a proverbial compost pile right inside your body.

And so all the byproducts of fermentation—gases, and acids, and alcohols—they’re the ones who cause so much harm. And it’s very easy to actually diagnose for SIBO. If people have on their breath a smell of stools, that’s where true SIBO is because gases from fermentation and the smell of stools being absorbed into the blood and expunged through the lungs.

DrMR: Yeah, it’s definitely a very interesting point that you make. And it reminds me of gastroparesis, which is a condition where there’s altered motility and emptying of the stomach contents into the small intestine. And one of the things that could be very helpful for gastroparesis is a lower fiber diet.

And I think it speaks to the same thing where if someone has challenges with motility, fiber may provoke that or may irritate those challenges. I’m speculating. But certainly, reasons suggest that too much fiber may be problematic for those with motility impairment.

KM: You’re absolutely correct because essentially also the small intestine is a fairly tiny organ. It’s a very narrow tube. So if you do have a lot of bulk, it did peristalsis in the cells sometimes. And it’s not that efficient to move it out. And in terms of gastroparesis, the connection’s fairly obvious.

If you have a large volume of foods, especially indigestive food in the stomach, it will not release it until it perceives them being completely digested. And obviously, fiber tends to bulk up. And it’s not easy to get out. So that’s when … there’s other complications in the stomach.

And so my advice to everyone with gastroparesis is reduce fluid consumption because every time you drink water on top of your meal, you dilute gastric juices, gastric acids, and enzymes. And if you had a lot of fiber, it also sucks them in. And you just delayed the digestion. And the more you delay the digestion, the more difficult it is for the stomach to clear itself out.

DrMR: Sure. Sure. Yeah, that makes complete sense. And as you’re saying that I’m reminded of and I’m anticipating what people, either listening or reading this are thinking, which is “Doesn’t dietary fiber feed microbial diversity, feed bacteria? And isn’t that important for our health?”

And we’ve talked about this on the podcast and other posts in different context. But I think that it’s not quite that simple. And I think we have some very interesting preliminary data in this new realm of the microbiota that we’re learning. But we’re very, very early in our understanding.

And if you read the literature with a critical eye, you see that we really haven’t teased out whether or not the microbial diversity is a cause or an association. And I think, as we’re learning more, we’re starting to see that microbial diversity may be as much a reaction to the environment or may be more so a reaction to the environment, than it is a cause of an unhealthy environment.

And what I mean by that is it’s been shown, for example, that inflammation will allow certain types of bacteria to thrive and other healthier types of bacteria will dwindle. And my posit is if we can improve the environment of the intestinal tract, we will create an environment that’s more hospitable to healthy and diverse bacteria.

And this has been reinforced by the most notable study I can remember in this regard is one using an elemental diet in Crohn’s disease. And they actually showed microbial diversity increased while patients were on an elemental diet. Even though an elemental diet is going to starve the microbiota, it’s probably because the inflammatory milieu, the inflammatory environment of the intestines was improved by the elemental diet. And when the inflammation dissipated, it allowed the environment to become more hospitable to healthy bacteria. And then you saw those bacteria counts flourish, rather than dwindle. And that manifests itself as improved microbial diversity.

So certainly, I think it’s important to keep in mind that this whole microbiota and how it interfaces to health may not be as simple as, feed bacteria and then bacteria make you healthy.

KM: You are correct. And I will explain the reasons behind this paradox. There are two types of essentially flora, intestinal flora. Innate flora is the ones that we have from birth. And then exogenous flora coming from probiotics. Now, probiotics, we do need some feed, either in a soluble fiber format or an insoluble fiber format.

However, innate flora resides fully inside of the mucosal membrane. And it takes all its nutrients from mucous. And exogenous flora, primarily from probiotics or pathogenic, it takes feed from undigested carbohydrates inside the colon, inside the lumen. And it resides in the lumen. And so what happens is the process of—again, when the compost pile is in its effect, we have a lot of acidity.

And we have a lot of alcohols. And also, we have a lot of bulk. And all those three factors, bulk meaning this very harsh mechanical contact of enlarged stools with the intestinal wall with bacteria and mucosal membrane, and then high acidity. And also, a high level of alcohols formed in the process of fermentation. They are the primary factors behind inflammation.

And so when we have an inflammatory condition inside the colon or even inside the small intestine, the mucosal membrane thins out. And it actually affects and kills off all the endogenous bacteria that are not really that resistant to a high level of acidity and a high level of variety of stuff formed during the fermentation.

And so you’re absolutely correct. When you reduce the fiber, when you reduce exogenous flora from probiotics, that’s where you allow innate flora to flourish inside the mucosal membrane. It doesn’t live in the lumen.

DrMR: Yeah. And as you’re saying that, it reminds me of another study that I read that showed that fasting helped to increase fecal bacteria in prausnitzii. But I should also mention that if you really look at this literature carefully, half the studies show that low carb or fasting increases fecal bacteria in prausnitzii.

Another half of this study show that high carb and high fermentability increases fecal bacteria in prausnitzii. So there’s so much inconsistency in the findings there. And even more importantly, there have been studies that have given probiotics that have helped to increase fecal bacteria in prausnitzii. And that has not correlated with health. It’s actually correlated with detriment in some cases.

So, again, it’s interesting for me to footnote something interesting there. But I want to anchor people back to, it’s not quite as simple as, “Hey, this bacteria seems to be good. Let’s feed that bacteria.” I think it’s important that we think about these things more globally. Exactly like you’re saying, to modulate the health of the intestinal environment to be as healthy as we can. And you make an excellent, excellent point about the luminal versus mucosal microbiota.

And that’s definitely, in my opinion, a gaping hole in the research right now, is most of the research, the vast majority of the research is looking at the colonic lumen. And we’re missing the colonic mucosa. We’re missing the small intestinal lumen and the small intestinal mucosa. So we’re missing the majority of the digestive tract in the current microbiota sampling literature.

So it’s definitely something that we have to take into account and probably why we see some discordance in what we think is healthy, but then what the clinical science shows people actually respond well to.

KM: Exactly. And I’m fully in agreement with you on that. And obviously, you provide a very clinically perspective. And I’m trained to, not being a medical doctor, I’m trained to explain it in very simple terms. And so if you overlook the colon, you run into problems with innate flora and exogenous flora just, as well.

Fiber and Colon Health

DrMR: Absolutely. So here’s something I’d like to get your perspective on if you have done research in this area. This is something that Norm Robillard and I have been talking about doing another podcast on. And at some point, I plan on doing a pretty comprehensive literature review on this topic, and then reporting back on what we find.

But I’ve heard that the thinking that dietary fiber helps us prevent colon cancer is a bit erroneous. And it may be one of those things where the fiber is just associated, but it’s not really causal to improve colon health because maybe a lower fiber diet is associated with more processed food consumption, more trans fat. And it’s not really the fiber. It’s just the fact that a lower fiber diet is usually accompanied by pretty unhealthy foods. So do you have any thoughts with fiber and colon cancer?

KM: Yes, I do. We know there are two types of colon cancer. Genetics. Genetic. And they affect a very small minority of people, only about one percent. And most of them are dead by age 45. And then we have age-onset colon cancers. And we know that colon cancers are preceded by inflammatory conditions. For example, it’s a well-established fact that having Crohn’s disease or ulcerative colitis increases your chance of colon cancer by 3,000%. Incredible number!

And the death rate is not as high because 300,000 people a year go through colectomy. So those people, most likely, they wouldn’t have a colectomy, meaning the removal of their colon, surgical removal, they would die from a colon cancer.

So there is a clear cut connection between inflammation or inflammatory conditions inside the colon and the colon cancer. Odds are that we can surmise that if we will reduce the inflammation, we can then reduce the rate of colon cancers.

And what’s the simplest way to reduce the connection, to reduce inflammation is to remove all the chemical irritants from the colon. And the primary chemical irritants for the colon is high acidity and the alcohols and as a toxin, so fermentation. And fiber is a primary cause of fermentation because, if you do consume a low-fiber diet, then the remnants of food in stools are no more than 3% to 4%.

And only by adding a lot of fiber, soluble and insoluble, as well as a probiotic, that’s where you, again turn the colon into compost pile. And that’s where you get into high acidic situations and high inflammation. And that’s when earlier you mentioned the fact that people go on an elementary diet, the symptoms of IBS and Crohn’s disease improve, it’s the same connection.

So a message to everybody. Guys, girls, doctors, if you want to reduce your chance of getting non-genetic colon cancer, particularly past 50, the best way to do it is to eliminate inflammatory conditions inside your colon.

DrMR: Yeah, I would totally agree. And I think there is definitely a subset of people that a lower fiber diet will help to that end point. I don’t think everyone needs to be on a lower fiber diet. And we can come back to more specifics than this in a second. I think there are some that do just fine on a higher fiber diet. But there are definitely some that really don’t seem to do well. And I think inflammatory bowel disease is such a shining example of that.

And I’m reminded of a number of studies that have used what’s known as a hybrid approach of semi-elemental diet. So semi-elemental diets don’t taste quite as bad as regular elemental diets. They’re much more palatable. They’re much more filling. They’re much more nourishing. And they’ve done studies using a hybrid approach, meaning people will get anywhere from 30 to maybe even a little over 50% of their daily calories from a liquid semi-elemental diet solution.

And then the other 50% to 70% of their calories, they will get from whole foods. And they’ve done this hybrid semi-elemental diet, whole foods diet for up to four years with patients with Crohn’s. And they’ve consistently shown that the levels of inflammation and the incidence of relapse are much lower in the groups that are using the semi-elemental diet hybrid approach, compared to those that are just eating regular.

And there’s more than one thing that the semi-elemental diet is doing. But one thing it definitely is, is very low fiber and very low residue. So again, I think this perfectly reinforces your point, which is this type of hybrid semi-elemental diet is very powerful at lowering inflammation. And that correlates with less disease activity in Crohn’s, which as you pointed out, has a monstrous impact on your risk for colorectal cancer. So definitely [crosstalk 26:15].

KM: And you are correct. And I’m basically a proponent of a moderate balanced diet. And one of the core food for people that come to me with severe colorectal disorders, primarily inflammatory bowel disease, is rice—white rice.

And the reason why, white rice is 96% starch. And the other 2% are fiber residue and very little fats and some very tiny amount of proteins. And so rice, essentially, they just provide you with a fairly fulfilling amount of energy. And it kind of leads to satiety. It gives people choice.

And so it’s very important, the psychosomatic effect of diet on people. Depravation is always very negative. People lapse into bad habits often for psychological reasons. So if you try to keep them on a narrow-focused diet and say, “All liquids,” it’s very hard because people need to chew.

If we don’t chew, we damage our teeth. We damage our stomach. We don’t produce enough of saliva. We don’t produce enough enzymes. We don’t produce enough of acids. So chewing aspect is very important. So a high-quality diet is always a balanced diet in a similar proportion of fats, natural fats preferably, animal fats in my book, carbohydrates in moderation, and proteins in moderation.

And the trick to this—people ask me, “How do you stay on a diet that is balanced and not excessive?” I said, “Well, you know, you eat in moderation. And I recommend eating only once or twice a day. And that’s what keep me going very well.” [Both laugh]

Dietary Recommendations

DrMR: Well, I’m glad you gave some specifics because that was the next question I wanted to ask you, because I’m sure people are asking themselves, “What types of foods should I focus on to get the right types of fiber or the right ratios?” So can you elaborate a little bit more on maybe some foods people should avoid and others that people should try to emphasize?

KM: Well, besides fiber, there are other reasons to avoid certain foods. And there are food allergies. So if you allergic to certain foods, let’s say you are allergic or you are allergic to grapefruits or oranges—citrus fruits—then you should stay away from them, regardless of their fiber content or even if there is no fiber content.

And, in general, if you consume a moderate diet, if you don’t focus specifically on increasing your fiber intake, you’re fine. Natural vegetables are very low in fiber. It is a misconception that vegetables contain a lot of fibers, except for vegetables with skins. So I wouldn’t recommend eating potatoes with skin, so eating apples with skin. So if you cut the skin, most of it is water. So if you eat moderately, you simply would not be able to over-consume fiber.

Same applies to fruits. Fruits are primarily water. So if you’re not allergenic to any particular fruits, have them, just take the skins off. Like you’re taking a skin from orange, take a skin from apple. And if you eat grapes, don’t swallow the skins. I wouldn’t eat grapes because of their sweetness, but some people do.

It also, a lot of it depends on your age. If you’re young and everything works well like a clockwork, you’re okay. But when you reach your 40s and 50s and beyond, that’s where you usually run into problems because obviously your organs are no longer as elastic, no longer as resilient, no longer as fluid as they were when you were young. And obviously, there’s lots of other factors that run into problems.

By the way, Michael, I want to make a point. What we discussed, at least my perspective, for some people, it is scandalous and it may sound superficial. And it’s obviously we can only squeeze so much information. And I try to not to talk too much because it just overwhelms people. I have a very large site on a subject that’s called GutSense.org. And GutSense.org was a follow-up on the Fiber Menace because I first created the scare, but didn’t really provide the recipe.

So what do you do? What do you do with diverticular disease? What do you do with IBS? What do you do with hemorrhoids? What do you do with anal fissures? What do you do with chronic constipation? And so the site now contains almost 1,200 pages worth of information, books as pages and full text of Fiber Menace, as well.

And so for people who are healthy, for people who are at their prime, it’s a mute subject. It doesn’t really matter, for as long as you don’t take fiber laxatives and you don’t suffer from any of the conditions were mentioned. But if you are older, if you do have problems, if you do have to take laxatives, or if you do have to take supplemental fiber to just move bowels, that’s where you will derive inflammation. And you really have to—and again, it’s to our listeners. You understand the sugar well. I understand the sugar well. But a lot of people don’t.

And so the only way to understand, the only way to be able to notice or come to group things and not to be being bullied by nutritionist or dieticians or even medical doctors because especially when they’re young, and for fiber for them is okay, is to understand.

Once you understand the physiology behind this concept, once you understand the chemistry result behind this concept, it becomes a common sense thing. And then it’s very, very easy to abide. So I recommend for everyone who wants to really understand this in-depth go to that site, GutSense.org. It’s all free. There is no fee for anything. And you don’t have to buy anything. And so you understand how it works.

DrMR: Great. Great. I’m happy that you have that resource there because I know that people need more help and more specifics a lot of times. And it’s nice to have the resources to provide that. And I also agree with your point of, maybe to restate it generally, the healthier someone is, the more fiber they can tolerate. And the less healthy they are, the more they have to be careful of the fiber, to put it very broadly.

Vegetables, Grains, and Starches

And you mentioned that vegetables tend to be okay. And by the way, I love your general perspective of this doesn’t have to be overly complicated. If people just eat a somewhat normal diet and don’t try to ingest copious amounts of fiber, they’ll probably land at a pretty good spot. I like that simplicity. It sounds like you think vegetables are maybe one of the safer forms of fiber.

But I’m wondering, vegetables over grains, like certain grains or starches. Are there some broad strokes that you can provide people with fiber from vegetables, fiber from grains, fiber from starches that may help them with this?

KM: Well, we have a national psychosis with wheat over gluten. And I think it’s an overblown epidemic. Celiac disease is there. It’s a well-known fact. And the real numbers behind celiacs is very small. It’s under 1%. And my theory is that people are not sensitive to gluten so much as they are sensitive to, A, overeating and, B, the fortification of wheat with iron primarily, and some other supplements. But iron is a primary.

You see, what iron does, especially if you have an abundance of probiotics, iron stimulates proliferation of flora. And any time we have a proliferation of flora, we have fermentation. It kicks fermentation really very hard in combination with fiber.

And so when people start to suffer from bloating and from irritation and from copious gases and from constipation, they blame it on gluten. And I came to this observation by—I talk to a lot of people every day. And this question comes over and over and over again. “Konstantin, why is when I go to Europe and I eat there like in France or Italy abundant amount of pasta and abundant of bread, I’m okay? The moment I come back home, I start eating the same bread and pasta, I run into problems.”

Well, the explanation is fairly simple. I came to this explanation by accident. I used to eat pasta from Italy. And also, it was fortified. I really didn’t run into a lot of problems. And at one point, my wife went for vacation and I run out of pasta. I went to the store and I bought like a Manischewitz American pasta.

And it’s like I ate it. And I ate the normal serving. And suddenly, like my abdomen exploded. It was bloating. And I started to think about it. And I came to the conclusion that iron—and a lot of people are very sensitive to iron, myself including, because I guess they have a makeup of flora.

And so when people eliminate wheat products, but just go on to presumably gluten-free diet and they no longer display those symptoms, it may be as a result of not eliminating gluten, but eliminating fiber from petrification, by eliminating iron from fortification, and by simply eating less. You have a low-density diet. So I’m all okay for it.

But back to your question. So I’m okay with all grains for as long as you are not overly sensitive. A lot of grains, like let’s say buckwheat, are very high in proteins. And plant proteins are difficult to digest. And one of the reason buckwheat is recommended to diabetics is because it creates a gastroparesis. And so it doesn’t digest very fast. And so sugar release, in effect, is very slow.

So it’s a low GI, low glycemic index food. So you consume moderate amount of grains and you have no issues with them, you’ll be okay. Again rice, not fortified rice, very difficult to get one. But it’s available. And it’s available from like Korean stores, Chinese stores. And there’s also one national brand you can buy on Amazon or in Whole Foods. It’s called Lundberg long grain white rice. They’re not fortified. So I, for example, cannot eat American rice.

Now, if you still cannot get it, fortification, there are two ways the fortification of rice is done. One is by soaking it into this fortifiable components. And so that kind of covered with them. And so you can soak a rice for couple of hours in cold water. And it will just float away.

And another one is adding grains of imitation rice, which contains the supplements. And then also soaking, they will actually flow to the surface. And you just take them out. And so you can cook them with Western pot. But best is buy high quality organic rice without petrification. You look on the label. If it says 2% iron, it’s not fortified. It’s a native iron. If it says 4% to 6%, that’s fortification.

Lundberg is one of the best. And you can get it in Whole Foods. So that’s what I use. And I eat a day about 200 grams of rice, not a problem. And I’m incredibly sensitive. I came to a lot of these observations from my own suffering, so from my own misery.

DrMR: Interesting. That’s very interesting. And I know that there’s been a couple different additives blamed for the rise in gluten sensitivity. Glycol phosphate being one that comes to mind. And the iron one is also really interesting. I hadn’t heard that before. But it certainly makes sense.

KM: If you have privilege of working with patients, if patients present themselves, just try to change them over to the organic rice without, and you will notice a difference right away, especially for people with SIBO.

DrMR: That’s a great point. And something for people to experiment with and see if they can dial in some tweaks that will allow them less sensitivities. Definitely.

Episode Wrap Up

This has been great. Is there anything that you’d like to say in closing. And would you please remind people of your website in case they wanted to visit there and get some more information?

KM: Well, again, website is GutSense.org. Or you can just try FiberMenace.com. Or you can simply just type my name in English, Konstantin Monastyrsky. And it will bring you to a site. And there’s a great deal of information there. And Fiber Menace, there’s a whole text of the book is also free or you can obtain it on Amazon.

And this is a mental issue. I know when it’s a group thing, a pervasive policy in nutrition and in doctoring is to actually go after fiber. It’s given a lot of pro-health features. But if you start to read and understand how does the body works, you go into the basics, and you start to realize where the problem is.

And again, this whole dilemma, whole problem is insidious because a lot of people, young people don’t see it as a problem. It really works for them. So if people around enter this fairly late in life, some unlikely souls enter early, and that’s why it’s so difficult to catch and that’s why it’s so difficult to comprehend and to observe. But I see a lot of changes are going on now.

And it’s so nice talking with you, Michael. You’re already on the cutting-edge of this. And you understand the concept right away. And so thank you so much for the privilege of being on your podcast and providing this take on this unusual situation.

DrMR: Absolutely. And thank you again for being here. And I’m sure people will get a lot out of this and keep doing the good work over there at Gut Sense. And we’ll hopefully talk to you soon.

KM: My pleasure. I look forward to speaking with you again. And I would like to wish all of your listeners a very good health and good appetite. Goodbye, everybody!

DrMR: Thanks. Bye-Bye.

KM: Bye-Bye.

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