Dr Dray Links Fiber to Clearer Skin, Warns Diet Cannot Replace Medicine

Dr Dray

While gut fermentation of whole-food fiber curbs systemic inflammation and stabilizes acne-triggering insulin spikes, it cannot reliably clear chronic inflammatory disorders like eczema or psoriasis without prescription therapy.

AI-assisted summary of Can Eating More Fiber Improve Your Skin? | Dermatologist Explains — original source. Check the original for full context.

Source published: 2026-08-27

Key ideas

Dietary fiber is fermented by colon bacteria into short-chain fatty acids—acetate, propionate, and butyrate—which enter systemic circulation to suppress pro-inflammatory cytokines (IL-6 and TNF-alpha) and directly interact with epidermal keratinocytes to support skin barrier repair. (1:41)
In acne management, dietary fiber acts primarily by lowering dietary glycemic load, blunting postprandial blood sugar spikes to prevent surges of insulin and IGF-1 that stimulate sebaceous oil production and follicular hyperkeratinization. (6:45)
While preclinical models demonstrate that fiber-derived metabolites reduce cutaneous inflammation in eczema and psoriasis, clinical evidence in humans remains insufficient to treat dietary fiber as a cure or a replacement for prescription medications. (0:00)
Consuming concentrated insoluble fiber additives found in commercial keto and low-carb breads (such as modified wheat starch and cellulose) without adequate hydration can pull moisture from the colon wall, risking severe constipation and fecal impaction. (14:36)

Detailed notes

## Background Published on YouTube by board-certified dermatologist Dr Dray on August 27, 2026, this video examines the emerging science behind dietary fiber and the gut-skin axis. According to the page description, Dr Dray breaks down how microbial fermentation produces short-chain fatty acids that influence inflammation, evaluates the research linking fiber to conditions like eczema, psoriasis, and acne, and shares practical guidance for increasing fiber intake without gastrointestinal distress.

## TL;DR Dr Dray explores how gut bacteria ferment dietary fiber into short-chain fatty acids like butyrate, dampening systemic inflammatory cytokines and reinforcing epidermal barrier function via the gut-skin axis. Although high-fiber diets provide clear metabolic and anti-inflammatory advantages—such as stabilizing blood sugar to reduce acne triggers and protecting cardiovascular health in psoriasis—fiber is an adjunct lifestyle measure rather than a standalone medical cure. She cautions against misleading commercial 'high-fiber' processed foods and vague Mediterranean diet prescriptions, highlighting the importance of whole plant foods and sufficient hydration. To prevent severe gastrointestinal side effects, she advises gradually building up legume, nut, seed, and vegetable portions across meals over time.

## Atmosphere & style The presentation is candid, educational, and refreshingly no-nonsense, delivered in Dr Dray's characteristically dry, methodical style. Her tone balances rigorous scientific breakdowns of immunological and metabolic pathways with sharp, humorous critiques of food-industry marketing gimmicks and lazy dietary advice. Watching feels like having an honest, grounding consultation with an experienced clinician who demystifies wellness trends while firmly emphasizing patient safety and realistic lifestyle habits.

## Bulletin - [01:41](https://www.youtube.com/watch?v=FzrowYqQnnE&t=101s) Dietary fiber is fermented by colon bacteria into short-chain fatty acids—acetate, propionate, and butyrate—which enter systemic circulation to suppress pro-inflammatory cytokines (IL-6 and TNF-alpha) and directly interact with epidermal keratinocytes to support skin barrier repair. - [06:45](https://www.youtube.com/watch?v=FzrowYqQnnE&t=405s) In acne management, dietary fiber acts primarily by lowering dietary glycemic load, blunting postprandial blood sugar spikes to prevent surges of insulin and IGF-1 that stimulate sebaceous oil production and follicular hyperkeratinization. - [00:00](https://www.youtube.com/watch?v=FzrowYqQnnE&t=0s) While preclinical models demonstrate that fiber-derived metabolites reduce cutaneous inflammation in eczema and psoriasis, clinical evidence in humans remains insufficient to treat dietary fiber as a cure or a replacement for prescription medications. - [14:36](https://www.youtube.com/watch?v=FzrowYqQnnE&t=876s) Consuming concentrated insoluble fiber additives found in commercial keto and low-carb breads (such as modified wheat starch and cellulose) without adequate hydration can pull moisture from the colon wall, risking severe constipation and fecal impaction.

## Key takeaways - [00:00](https://www.youtube.com/watch?v=FzrowYqQnnE&t=0s) Increasing dietary fiber is an excellent nutritional habit, but it is not a standalone cure for chronic inflammatory skin diseases like eczema, psoriasis, or hidradenitis suppurativa, and should never replace prescribed medical treatments. - [01:41](https://www.youtube.com/watch?v=FzrowYqQnnE&t=101s) Indigestible fiber reaches the colon intact, where microbial fermentation generates short-chain fatty acids (SCFAs)—particularly butyrate, which fuels colonocytes and maintains local gut lining integrity. - [02:38](https://www.youtube.com/watch?v=FzrowYqQnnE&t=158s) The gut-skin axis connects the body's internal and external barriers; higher gut microbial diversity drives SCFA production that dampens systemic IL-6 and TNF-alpha while reinforcing epidermal barrier function. - [04:06](https://www.youtube.com/watch?v=FzrowYqQnnE&t=246s) Although preclinical animal models indicate that dietary fiber and microbial metabolites diminish atopic dermatitis inflammation, human trials have not yet validated specific clinical dosages or outcomes. - [05:36](https://www.youtube.com/watch?v=FzrowYqQnnE&t=336s) While eating 30 grams of daily fiber will not reliably resolve psoriasis plaques, it provides crucial cardiometabolic and lipid protection against the systemic inflammatory risks tied to psoriasis. - [06:45](https://www.youtube.com/watch?v=FzrowYqQnnE&t=405s) Fiber improves acne primarily through metabolic pathways rather than direct microbiome shifts, slowing glucose absorption and curbing insulin and IGF-1 spikes that trigger excess sebum production. - [07:57](https://www.youtube.com/watch?v=FzrowYqQnnE&t=477s) Blanket clinical recommendations to follow a 'Mediterranean diet' are often overly vague; the real dermatological benefit comes from adopting a low-processed dietary pattern rich in whole plant fibers, polyphenols, and omega-3s. - [08:44](https://www.youtube.com/watch?v=FzrowYqQnnE&t=524s) The food processing industry frequently co-opts nutritional health advice—similar to past low-fat and high-protein trends—by marketing packaged 'Mediterranean' items laden with excess sodium, refined sugars, and cheap oils. - [11:19](https://www.youtube.com/watch?v=FzrowYqQnnE&t=679s) Adult fiber guidelines recommend 25 to 38 grams daily, but whole foods provide a synergistic package of intrinsic moisture, micronutrients, and polyphenols that isolated fiber supplements and fortified snacks lack. - [11:19](https://www.youtube.com/watch?v=FzrowYqQnnE&t=679s) Concerns that high-fiber diets inhibit the bioavailability of essential minerals like iron, zinc, and calcium are largely disproven when fiber originates from intact whole foods rather than isolated extracts. - [14:36](https://www.youtube.com/watch?v=FzrowYqQnnE&t=876s) Insoluble fiber additives like modified wheat starch and cellulose in packaged keto products lack natural moisture and can pull fluid directly from the intestinal wall if consumed without adequate water. - [16:14](https://www.youtube.com/watch?v=FzrowYqQnnE&t=974s) Digestive distress from dietary transitions can be prevented by scaling up fiber gradually, beginning with easily digestible legumes like lentils in single-tablespoon increments. - [17:48](https://www.youtube.com/watch?v=FzrowYqQnnE&t=1068s) Replacing pure cooking oils and dressings with whole nuts and seeds like pumpkin seeds or almonds adds intact plant fiber and micronutrients while preserving healthy fats and natural satiety. - [18:48](https://www.youtube.com/watch?v=FzrowYqQnnE&t=1128s) Long-term dietary sustainability matters more than perfection; fortified fiber products are acceptable in moderation, but the core foundation should consist of diverse, hydrating whole plant foods.

## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=FzrowYqQnnE&t=0s) Dietary Fiber, Chronic Skin Conditions, and a Crucial Medical Warning

Board-certified dermatologist Dr. Dray opens by addressing a ubiquitous health conversation: the widespread lament that most people fail to consume enough dietary fiber despite its well-documented whole-body benefits. While fiber is universally celebrated for supporting general well-being, Dr. Dray highlights emerging science showing that increasing fiber intake can have direct, tangible impacts on the skin. As researchers uncover the complexities of the gut-skin axis, it has become evident that inflammation rooted in digestion exerts downstream effects on how skin looks, behaves, and manages disease. This relationship is particularly compelling for chronic inflammatory dermatological conditions, including atopic dermatitis, hidradenitis suppurativa, and psoriasis.

Before diving into the nutritional mechanisms, Dr. Dray issues an emphatic caveat: eating more fiber is a wonderful nutritional upgrade, but it is not a standalone cure for inflammatory skin disease. It should never serve as the primary pursuit in treating chronic conditions or replace evidence-based medical therapies. While rare individuals manage to control or clear skin disease through dietary modifications alone, Dr. Dray stresses that this is decidedly "not the norm." Most patients who experience improvement still require prescription medications. She issues a strong warning against abruptly discontinuing prescribed treatments without physician supervision, cautioning that attempting to "DIY your own medical therapy" can severely backfire.

[01:41](https://www.youtube.com/watch?v=FzrowYqQnnE&t=101s) What Actually Happens to Fiber in the Colon: The Role of Short-Chain Fatty Acids

The biological magic of fiber begins with an apparent paradox: fiber is a carbohydrate that the human body cannot fully digest. Rather than being broken down and absorbed in the small intestine alongside simple carbohydrates, fiber travels intact into the colon. In the large intestine, gut bacteria step in to ferment this indigestible plant matter, creating potent metabolic byproducts.

The primary outputs of this microbial fermentation are short-chain fatty acids (SCFAs), most notably acetate, propionate, and butyrate. Butyrate is especially crucial because colonocytes (the cells lining the colon) rely on it as their primary energy fuel. Beyond nourishing the local gut epithelium, these SCFAs enter the circulation, where they modulate immune signaling and regulate inflammatory cascades throughout the entire body, setting the stage for systemic crosstalk between the digestive tract and the skin.

[02:38](https://www.youtube.com/watch?v=FzrowYqQnnE&t=158s) The Gut-Skin Axis: Microbial Diversity and Epidermal Barrier Crosstalk

The gut and the skin share an identical evolutionary purpose: both are primary barrier interfaces separating the body from the external environment. The intestinal tract must continuously filter nutrients while barring pathogens, just as the cutaneous barrier shields internal tissues from environmental insults. Because both organs constantly interact with dense microbial communities, external exposures, and immune cells, changes in intestinal immune tone reverberate outward to the skin. This reciprocal communication network is precisely what scientists define as the gut-skin axis.

A fiber-dense diet fosters a richer, more diverse gut microbiome. In turn, diverse bacteria churn out higher levels of SCFAs that suppress systemic inflammatory mediators, specifically interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). Fascinatingly, these metabolites appear to act directly on cutaneous tissue: research indicates SCFAs can interact with epidermal keratinocytes, reinforcing biological processes that preserve and repair the skin barrier.

```mermaid flowchart TD accTitle: The Gut-Skin Axis Mechanism accDescr: Flowchart illustrating how dietary fiber is fermented into short-chain fatty acids to influence systemic inflammation and the epidermal barrier.

subgraph Colon ["Large Intestine"] A["Dietary Fiber Intake"] --> B["Bacterial Fermentation"] B --> C["Short-Chain Fatty Acids (SCFAs) • Acetate • Propionate • Butyrate"] C --> D["Colonocyte Fuel & Local Integrity"] end

subgraph Systemic ["Systemic Circulation & Immunity"] C --> E["Modulation of Immune Cells"] E --> F["Suppression of Pro-Inflammatory Cytokines (IL-6 & TNF-alpha)"] end

subgraph Skin ["Cutaneous Interface"] F --> G["Lower Systemic Inflammatory Burden"] C --> H["Direct Interaction with Keratinocytes"] G --> I["Support for Epidermal Barrier Function"] H --> I end ```

[04:06](https://www.youtube.com/watch?v=FzrowYqQnnE&t=246s) Atopic Dermatitis: Between Promising Animal Data and Human Clinical Realities

When evaluating barrier dysfunction, atopic dermatitis (eczema) represents the textbook example, marked by an impaired epidermal stratum corneum coupled with an overactive immune response. Scientists frequently detect distinct gut microbiome variations in patients with eczema compared to healthy controls. Dr. Dray clarifies that a disrupted gut microbiome is not necessarily the sole direct cause of eczema, as genetics and environmental triggers remain paramount, but observational research shows that populations with higher dietary fiber intake exhibit a lower risk of allergic and atopic disorders.

In preclinical animal studies, supplementing feed with dietary fiber or administering specific microbial metabolites significantly diminishes cutaneous inflammation. Nevertheless, Dr. Dray emphasizes her recurring rule of evidence: animal models spark exciting hypotheses, but they do not prove what happens in human biology. Until robust human clinical trials confirm exact dosages and effects, dietary fiber should be viewed as a supportive lifestyle adjunct rather than a primary treatment. As Dr. Dray dryly warns, "don't just abandon your eczema treatments and start eating a bunch of beans and thinking that's going to solve everything."

[05:36](https://www.youtube.com/watch?v=FzrowYqQnnE&t=336s) Psoriasis: Beyond Skin Plaques to Systemic Cardiometabolic Health

Psoriasis represents another classic chronic inflammatory disorder where gut dysbiosis has been thoroughly documented. While animal models demonstrate that fiber-derived metabolites can dampen the specific inflammatory profiles seen in psoriasis, human clinical data remains insufficient to prescribe dietary changes as a targeted cure. Dr. Dray states bluntly that "simply eating 30 g of fiber every day is not going to clear your psoriasis predictably."

However, fiber is uniquely valuable for psoriasis patients because psoriasis is not merely an isolated skin condition; it is a systemic inflammatory disease carrying heightened risks of cardiovascular disease and metabolic dysfunction. A fiber-rich dietary pattern reliably improves cardiometabolic markers, regulates lipids, and reduces overall systemic inflammatory burden. Consequently, prioritizing fiber delivers critical systemic protection even if it does not single-handedly clear cutaneous plaques.

[06:45](https://www.youtube.com/watch?v=FzrowYqQnnE&t=405s) Fiber and Acne: The Crucial Link to Glycemic Load, Insulin, and IGF-1

The rationale linking fiber to acne differs fundamentally from the microbiome-centric pathways of eczema and psoriasis. While gut flora may play a secondary role, the primary driver connecting fiber to clearer skin is dietary glycemic load. Clinical dermatology recognizes that low glycemic load diets correlate with demonstrable reductions in acne severity, and dietary fiber serves as the central lever for lowering glycemic impact.

Replacing refined, ultra-processed carbohydrates with fiber-rich whole plant foods slows the absorption of glucose into the bloodstream, blunting sharp postprandial blood sugar spikes. This steady release prevents surges in circulating insulin and insulin-like growth factor 1 (IGF-1), endocrine triggers known to drive sebaceous oil production and follicular hyperkeratinization in acne-prone skin. Over time, high-fiber eating protects against insulin resistance. Dr. Dray notes that simply "kicking back a couple of fiber supplements" will not cure acne, but swapping refined grains for whole foods provides real, sustained therapeutic momentum.

[07:57](https://www.youtube.com/watch?v=FzrowYqQnnE&t=477s) Why the Blanket "Mediterranean Diet" Recommendation Drives Dr. Dray Berserk

Dr. Dray vents her frustration with how frequently physicians tell patients to "eat a Mediterranean diet" without offering meaningful guidance. She finds the blanket recommendation deeply flawed and unhelpful because the Mediterranean encompasses diverse nations with wildly distinct culinary traditions; someone living in Greece does not eat the same foods as someone in Spain, Italy, or Morocco. She humorously asks viewers from Mediterranean regions to drop their home countries in the comments, confessing that vague medical hand-waving around the diet "drives me berserk."

Stripped of romanticized branding, what the Mediterranean diet truly represents is an overarching dietary pattern defined by high fiber and minimal industrial processing. Rather than a magical geographical formula, its clinical utility rests on replacing ultra-processed convenience foods with abundant fruits, vegetables, legumes, whole grains, nuts, and seeds.

[08:44](https://www.youtube.com/watch?v=FzrowYqQnnE&t=524s) The Reality of the Mediterranean Diet and Food Industry Marketing

The Mediterranean diet is fundamentally structured around plants, legumes, and whole grains while strictly moderating meat consumption, emphasizing seafood, fish, and olive oil, with optional red wine in moderation. The mechanistic benefit of this pattern comes from combining plant fibers, anti-inflammatory omega-3 fatty acids from fish, and a diverse profile of polyphenols from olive oil. At the same time, it sharply curbs dietary sodium and limits exposure to harmful pro-inflammatory and carcinogenic compounds formed during high-heat red meat cooking—such as polycyclic aromatic hydrocarbons (PAHs) and advanced glycation end products (AGEs) common in smoked meats. However, this dietary pattern represents an overall nutritional archetype rather than an exact adherence to specific regional cuisines. Because broad health recommendations often lack actionable specifics, consumers easily "fall prey to... the food industry."

Dr. Dray cautions viewers bluntly: "I highly caution against letting the food industry tell you that their food is healthy because they're lying through their teeth." She draws a parallel to the low-fat and fat-free craze of decades past. While recommending lower saturated fat intake had sound clinical reasoning, food manufacturers co-opted the message by stripping out fats and replacing them with refined sugar. The resulting snacks were just as caloric, but consumers ate multiple servings under the halo of health, fueling weight gain and increased body fat. The exact same trajectory is unfolding with protein-obsession—spawning high-protein toaster pastries and chips—and will soon produce deceptive "Mediterranean diet-approved" frozen TV dinners laden with sodium, sugar-sweetened sauces, and cheap industrial oils cut with only a token drop of actual olive oil.

```mermaid flowchart TD accTitle: Dietary Guidance vs Commercial Distortion accDescr: Flowchart illustrating how legitimate nutritional advice gets distorted by the ultra-processed food industry.

subgraph ScientificGuidance ["Evidence-Based Nutritional Advice"] A["Focus on Whole Plant Foods & Fiber"] B["Reduce Saturated Fats & Red Meat"] C["Incorporate Omega-3s & Polyphenols"] end

subgraph IndustryDistortion ["Food Industry Manipulation"] D["Ultra-Processed Low-Fat Items (Fat replaced with refined sugar)"] E["'High-Protein' Junk Food (Snacks with protein isolate added)"] F["'Mediterranean' Packaged Foods (High salt, sugar sauces, cheap seed oils)"] end

subgraph ConsumerOutcome ["Patient Health Consequences"] G["Low Satiety & Overeating"] H["Excess Calorie Intake & Weight Gain"] I["Persistent Systemic Inflammation"] end

ScientificGuidance -->|"Co-opted for profit"| IndustryDistortion IndustryDistortion -->|"Marketed with health claims"| ConsumerOutcome ```

[11:19](https://www.youtube.com/watch?v=FzrowYqQnnE&t=679s) Fiber Targets, Whole Foods, and Micronutrient Absorption

For average adults, general dietary guidelines recommend consuming roughly 25 to 38 grams of fiber daily based on age and sex. For an individual accustomed to the standard American diet, reaching this target is an enormous leap, whereas for those already consuming plant-forward diets, it might look like an ordinary or even light intake. Dr. Dray advises against obsessively counting every gram. The critical question is the dietary matrix delivering that fiber:

- **Isolated & Fortified Fiber:** Ultra-processed goods—like fiber-enriched cookies or breakfast cereals—often carry high concentrations of added fats and sugars while offering minimal volume. Although supplemental fiber can offer marginal satiety, these packaged items encourage overconsumption without providing a complete nutrient profile. - **The Whole Food Package:** Intrinsic fiber from legumes, vegetables, fruits, and whole grains comes naturally packaged with water, essential micronutrients, and bioactive polyphenols that nourish the gut microbiome.

When addressing whether one can consume "too much fiber," there is technically no established upper limit. However, a rapid surge in intake causes significant gastrointestinal distress, throwing patients into what Dr. Dray calls the "house of pain"—characterized by acute bloating, cramping, gas, and bowel distress. Furthermore, patients frequently worry that excess dietary fiber will bind to essential minerals and prevent their uptake. Clinical evaluations of rural, non-Westernized populations consuming high-fiber diets of whole beans, greens, and produce show no deficiencies in serum zinc, iron, or calcium. The intestinal tract increases its absorption efficiency and adapts over time, provided the fiber originates from natural whole foods rather than concentrated supplements or processed isolates.

[14:36](https://www.youtube.com/watch?v=FzrowYqQnnE&t=876s) The Critical Need for Hydration and Insoluble Fiber Pitfalls

Fiber supports regularity by adding bulk to the stool, but bulking alone is insufficient for healthy transit: it requires water to lubricate and pass waste through the gastrointestinal tract. Whole plant sources, including properly cooked beans, vegetables, and fresh fruits, naturally bring significant moisture along with their fibrous structure.

In contrast, modern commercial items like keto or low-carbohydrate breads and tortillas rely heavily on extracted, concentrated insoluble fibers—primarily modified wheat starch and purified cellulose—to drive down net carbohydrates on the nutrition label. When individuals consume these dense, dry, fiber-fortified products without substantial water intake, the insoluble fibers draw existing moisture directly out of the intestinal wall. This sharp drop in hydration can trigger severe constipation, ileus, or painful fecal impaction—the clinical reality behind consumer ads warning about "stuck poop."

[16:14](https://www.youtube.com/watch?v=FzrowYqQnnE&t=974s) Strategic, Pain-Free Steps to Increase Daily Fiber

To successfully elevate fiber intake without triggering severe digestive side effects, transitions must be gradual and deliberate:

- **Begin with Lentils:** Among legumes, lentils are considerably easier to break down than dense beans or chickpeas. - **Micro-Dosing Legumes:** Start with just a single tablespoon of cooked beans or lentils added to an existing meal for several weeks before slowly expanding the portion size. - **Smart Substitutions:** Use the gradual introduction of legumes to displace inflammatory ingredients, such as swapping processed deli meats in a salad for a serving of seasoned beans. - **Incremental Scaling:** Incorporating modest vegetable portions across every meal allows the gut microbiome and intestinal transit to adjust over time. Shifting slowly from 5 grams to 7 grams daily over several weeks—and gradually building across an entire year—prevents patients from suffering gastrointestinal distress and abandoning a beneficial dietary pattern altogether.

[17:48](https://www.youtube.com/watch?v=FzrowYqQnnE&t=1068s) Simple Swaps: Nuts, Seeds, and Gut Adaptation

Dr. Dray acknowledges that some viewers might not need to start with tiny single-tablespoon increments of beans if they already have a cultural background rooted in fiber-rich cooking. For many people, it is simply a matter of returning to the home-cooked meals they grew up on—like a daily staple of beans and rice—and cutting back on convenience junk food. Over time, the gut microbiome adapts to handling complex plant carbohydrates: beneficial bacterial populations expand, and digestion becomes significantly more efficient.

```mermaid flowchart LR accTitle: Dietary Fat Swap Mechanism accDescr: Replacing extracted cooking oils with whole nuts and seeds adds dietary fiber and micronutrient diversity while maintaining healthy fats. subgraph Swap["Dietary Adjustment"] A["Extracted Cooking Oils"] -->|"Swap for"| B["Whole Nuts & Seeds (Almonds, Pumpkin Seeds)"] end subgraph Benefits["Nutritional Payoff"] B --> C["Retains Healthy Fats"] B --> D["Adds Dietary Fiber"] B --> E["Boosts Micronutrients & Satiety"] end ```

To easily sneak more fiber into everyday meals without feeling like you are overhauling your entire lifestyle, Dr. Dray recommends swapping out some servings of cooking or dressing oils for whole nuts and seeds: - **Pumpkin seeds and almonds**: Replacing pure liquid fats with whole seeds or nuts preserves healthy dietary fats while introducing intact plant fiber. - **Micronutrient density**: Whole nuts and seeds "bring something else along for the ride," expanding the spectrum of micronutrients and polyphenols without dramatically slashing calories. - **Effortless satiety**: Elevating fiber intake naturally regulates appetite, making healthy body weight maintenance considerably easier without conscious deprivation.

---

[18:48](https://www.youtube.com/watch?v=FzrowYqQnnE&t=1128s) Whole Foods vs. Processed "High Fiber" Products

When building a fiber-rich dietary pattern, Dr. Dray urges viewers to focus on intact whole plant foods rather than relying on ultra-processed products marketed as "high fiber." Whole plants naturally contain high water volume, which helps the fiber swell and navigate the gastrointestinal tract smoothly. In contrast, many packaged foods—such as low-carbohydrate, keto-friendly breads and wraps—rely on isolated, low-moisture fiber additives like cellulose or modified wheat starch. While these fortified products are far from harmful and provide significantly more satiety than refined white bread, relying on them as your sole fiber source can lead to sluggish digestion and discomfort if not accompanied by adequate fluid intake.

Dietary changes should remain practical and sustainable rather than punitive: "It's not about making your diet insufferable. It has to be something that you can maintain." If you love having a sandwich every day and find that modified low-carb breads help you feel satisfied, there is no need to eliminate them entirely. The goal is simply to avoid leaning on them exclusively to hit daily nutritional targets, ensuring the foundation of your diet consists of diverse whole foods.

---

[20:12](https://www.youtube.com/watch?v=FzrowYqQnnE&t=1212s) Final Takeaway and Sign-off

Dr. Dray closes by reminding viewers that nutrition should work for your lifestyle, supporting your gut microbiome and overall systemic wellness through consistent, realistic whole-food choices. She encourages viewers to give the video a thumbs up if they found the breakdown helpful, share it with friends, and leaves everyone with her signature sign-off: remember to wear your sunscreen, subscribe to the channel, and tune in for the next video.

## Notable quotes > [00:00](https://www.youtube.com/watch?v=FzrowYqQnnE&t=0s) not the norm — Dr. Dray

> [00:00](https://www.youtube.com/watch?v=FzrowYqQnnE&t=0s) DIY your own medical therapy — Dr. Dray

> [04:06](https://www.youtube.com/watch?v=FzrowYqQnnE&t=246s) don't just abandon your eczema treatments and start eating a bunch of beans and thinking that's going to solve everything. — Dr. Dray

> [05:36](https://www.youtube.com/watch?v=FzrowYqQnnE&t=336s) simply eating 30 g of fiber every day is not going to clear your psoriasis predictably. — Dr. Dray

> [06:45](https://www.youtube.com/watch?v=FzrowYqQnnE&t=405s) kicking back a couple of fiber supplements — Dr. Dray

> [07:57](https://www.youtube.com/watch?v=FzrowYqQnnE&t=477s) drives me berserk — Dr. Dray

> [08:44](https://www.youtube.com/watch?v=FzrowYqQnnE&t=524s) fall prey to... the food industry. — Dr. Dray

> [08:44](https://www.youtube.com/watch?v=FzrowYqQnnE&t=524s) I highly caution against letting the food industry tell you that their food is healthy because they're lying through their teeth. — Dr. Dray

> [11:19](https://www.youtube.com/watch?v=FzrowYqQnnE&t=679s) house of pain — Dr. Dray

> [14:36](https://www.youtube.com/watch?v=FzrowYqQnnE&t=876s) stuck poop — Dr. Dray

> [17:48](https://www.youtube.com/watch?v=FzrowYqQnnE&t=1068s) bring something else along for the ride — Dr. Dray

> [18:48](https://www.youtube.com/watch?v=FzrowYqQnnE&t=1128s) It's not about making your diet insufferable. It has to be something that you can maintain. — Dr. Dray

## Mentioned Dr. Dray, Short-chain fatty acids (SCFAs), Acetate, Propionate, Butyrate, Interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-alpha), Insulin-like growth factor 1 (IGF-1), Polycyclic aromatic hydrocarbons (PAHs), Advanced glycation end products (AGEs), Cellulose, Modified wheat starch

## Video description Fiber may be doing much more than supporting digestion. In this video, dermatologist Dr. Dray explains the emerging science behind the gut-skin axis and how dietary fiber may influence the gut microbiome, inflammation, immune function, metabolic health, and potentially skin health.

When gut bacteria ferment fiber, they produce short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate. These compounds can influence immune signaling and may play a role in maintaining the skin barrier and regulating inflammation.

Dr. Dray discusses what the research currently shows about fiber and eczema, psoriasis, acne, and other inflammatory skin conditions, while separating promising mechanisms from what has actually been demonstrated in human clinical studies.

The video also explains why fiber may be relevant to acne through its relationship with blood sugar, insulin, IGF-1, and dietary glycemic load, and why a Mediterranean-style dietary pattern keeps appearing in discussions about gut and skin health.

Dr. Dray also shares practical advice for increasing fiber intake without triggering excessive bloating, gas, or abdominal discomfort, including how to gradually introduce foods such as beans, vegetables, fruits, whole grains, nuts, and seeds.

In this video:

00:00 Introduction 01:41 What Happens to Fiber in Your Gut? 02:38 The Gut-Skin Axis 04:06 Fiber and Eczema 05:36 What About Psoriasis? 06:45 Fiber and Acne: The Connection May Be More Indirect 07:57 Why the Mediterranean Diet Keeps Coming Up 11:19 How Much Fiber Should You Eat? 12:45 How to Increase Fiber Without Feeling Awful 13:45 What About Inflammatory Skin Disease? 20:12 Final Takeaway

Key topics covered:

• Dietary fiber and skin health • The gut-skin axis • Gut microbiome and skin • Short-chain fatty acids and butyrate • Fiber and inflammation • Fiber and eczema • Fiber and psoriasis • Fiber and acne • Insulin, IGF-1 and acne • Mediterranean diet and skin health • How much fiber to eat • Whole food sources of fiber • How to increase fiber gradually • Fiber supplements and highly processed high-fiber foods

Dr. Dray emphasizes that fiber is not a treatment or cure for inflammatory skin diseases. While laboratory, animal, and observational research provides interesting evidence connecting fiber, the microbiome, immune regulation, and skin inflammation, more high-quality human clinical trials are needed to determine how much increasing fiber intake can actually influence conditions such as eczema or psoriasis.

The goal is not to find a highly processed food simply because it is labeled "high fiber." Instead, Dr. Dray discusses the benefits of getting fiber from a variety of whole plant foods, which also provide vitamins, minerals, polyphenols, and other compounds that interact with the gut microbiome.

If you're interested in gut health, skin health, eczema, psoriasis, acne, nutrition, the microbiome, or the connection between diet and skin, this video provides an evidence-based look at what researchers currently know about fiber and the skin.

#Fiber #GutSkinAxis #GutHealth #SkinHealth #Dermatologist #Eczema #Psoriasis #Acne #GutMicrobiome #Nutrition #DietAndSkin #ShortChainFattyAcids #HealthySkin #skincare

FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links.

💜Shop my Amazon store https://o.bttn.io/0BwiPWFIZLG 💜Follow me on liketoknowit https://www.liketoknow.it/drdrayzday 💜Social media Instagram @drdrayzday Pinterest https://www.pinterest.com/drdrayzday/ Facebook @DrDrayzDay Twitter: @drdrayzday Tiktok: @drdrayzday

Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Content provided on this Youtube channel is for informational purposes only. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. Information on this Youtube channel should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose, treat, cure or prevent disease.

[Source](https://www.youtube.com/watch?v=FzrowYqQnnE)

中文简报

Dr Dray 指出膳食纤维有助改善皮肤，但警告饮食不能替代药物尽管天然全谷物食物中的纤维经肠道发酵可抑制全身性炎症并稳定诱发痤疮的胰岛素激增，但若无处方药物治疗，它无法可靠地治愈湿疹或银屑病等慢性炎症性疾病。 Dr Dray 探讨了肠道细菌如何将膳食纤维发酵为丁酸等短链脂肪酸，进而抑制全身促炎细胞因子，并通过肠-皮轴增强表皮屏障功能。尽管高纤维饮食具有明显的代谢和抗炎优势——例如稳定血糖以减少痤疮诱因，以及在银屑病患者中保护心血管健康——但膳食纤维只是一种辅助性的生活方式措施，而非独立的医疗手段。她提醒公众警惕具有误导性的商业化“高纤维”加工食品和模糊的地中海饮食建议，强调了天然全植物食物和充足水分摄入的重要性。为防止严重的胃肠道副作用，她建议随着时间的推移，在每餐中逐步增加豆类、坚果、种子和蔬菜的份量。膳食纤维被结肠细菌发酵为乙酸、丙酸和丁酸等短链脂肪酸，这些成分进入全身循环以抑制促炎细胞因子（IL-6 和 TNF-alpha），并直接与表皮角质形成细胞相互作用以支持皮肤屏障修复。 (1:41) 在痤疮管理中，膳食纤维主要通过降低饮食升糖负荷发挥作用，平缓餐后血糖峰值，以防止胰岛素和 IGF-1 激增刺激皮脂分泌及毛囊过度角化。 (6:45) 虽然临床前模型表明纤维衍生代谢物可减轻湿疹和银屑病的皮肤炎症，但人体临床证据仍不足以将膳食纤维视为疗法或处方药的替代品。 (0:00) 在缺乏充足水分的情况下摄入商业生酮及低碳面包中添加的浓缩非水溶性纤维（如变性小麦淀粉和纤维素），会从结肠壁抽取水分，带来严重便秘和粪便嵌顿的风险。 (14:36)

Reading summary

Board-certified dermatologist Dr. Dray explains that increasing dietary fiber supports skin health by modulating systemic inflammation, microbial diversity, and glycemic response, but emphasizes that nutritional changes cannot replace medical therapies for chronic inflammatory skin conditions. Biological Pathways of the Gut-Skin Axis (1:41) Dietary fiber consists of plant carbohydrates that bypass digestion in the small intestine to reach the colon intact. There, resident gut bacteria ferment this material into short-chain fatty acids (SCFAs), primarily acetate, propionate, and butyrate. While colonocytes utilize butyrate as their main cellular energy substrate, these metabolites also enter the bloodstream to regulate immune signaling and downregulate pro-inflammatory cytokines, specifically interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). Dr. Dray notes that the gut and skin share evolutionary roles as primary barrier interfaces between the internal body and external environment. In circulation, SCFAs directly interact with epidermal keratinocytes, reinforcing the cellular processes required to maintain and repair the cutaneous barrier while reducing systemic inflammatory burden. Clinical Impact on Eczema, Psoriasis, and Acne (4:06) The dermatological benefits of fiber vary significantly across disorders. In atopic dermatitis and psoriasis, altered gut microbial profiles are common, and preclinical animal models demonstrate that fiber-derived metabolites suppress disease-specific inflammation. However, Dr. Dray emphasizes that animal data do not constitute human clinical proof; consuming high-fiber foods will not predictably clear psoriasis plaques or eczema, and patients must not abandon prescribed medications. Instead, fiber aids psoriasis patients primarily by improving cardiometabolic markers and dampening systemic inflammation linked to elevated cardiovascular risks. For acne, fiber operates primarily through metabolic rather than microbial pathways. Diets with a high glycemic load provoke postprandial glucose spikes, triggering surges in insulin and insulin-like growth factor 1 (IGF-1) that stimulate sebaceous oil production and follicular hyperkeratinization. Swapping refined carbohydrates for fiber-dense whole foods blunts glucose absorption, reducing these endocrine drivers of acne. Whole Plant Foods Versus Industrial Fortification (8:44) Dr. Dray criticizes generic clinical recommendations to follow a "Mediterranean diet," arguing that the phrase obscures the core active mechanism: consuming high-fiber, minimally processed whole plants while reducing red meats and ultra-processed foods. This archetype provides protective polyphenols and omega-3 fatty acids while limiting exposure to pro-inflammatory compounds like advanced glycation end products (AGEs) and polycyclic aromatic hydrocarbons (PAHs) produced by high-heat meat cooking. She cautions that commercial food marketing routinely co-opts health guidance, comparing modern "high-fiber" products to previous low-fat trends that substituted fat with refined sugars. Packaged low-carbohydrate breads and tortillas often rely on dry, isolated insoluble fibers like purified cellulose and modified wheat starch. Unlike whole fruits, vegetables, and cooked legumes that carry intrinsic water, these concentrated dry fibers pull hydration from the intestinal wall, creating risks of severe constipation or fecal impaction if consumed without adequate fluids. Strategies for Increasing Fiber Without Digestive Distress (16:14) While daily dietary guidelines recommend roughly 25 to 38 grams of fiber depending on age and sex, rapid increases frequently cause acute cramping, gas, and abdominal bloating. Addressing common concerns regarding nutrient absorption, Dr. Dray notes that clinical evaluations of populations consuming traditional, high-fiber whole foods show normal serum levels of zinc, iron, and calcium, as the digestive tract adapts naturally over time. To prevent gastrointestinal complications, Dr. Dray advises a gradual approach. Individuals can start by adding single-tablespoon portions of easily digestible legumes, such as lentils, to existing meals before scaling up over months. Simple substitutions—such as replacing pure culinary oils or dressings with whole pumpkin seeds or almonds—preserve dietary fats while providing intact fiber, micronutrients, and enhanced satiety without requiring disruptive lifestyle overhauls. Dr. Dray highlights that while dietary fiber offers robust systemic and dermatological support, it functions strictly as an adjunctive lifestyle intervention rather than a standalone cure. Because definitive human trials establishing therapeutic dosing for specific skin conditions are still lacking, patients must maintain evidence-based medical regimens alongside sustainable whole-food dietary adjustments.

Source quotes

[0:00] Dr. Dray: not the norm [0:00] Dr. Dray: DIY your own medical therapy [4:06] Dr. Dray: don't just abandon your eczema treatments and start eating a bunch of beans and thinking that's going to solve everything. [5:36] Dr. Dray: simply eating 30 g of fiber every day is not going to clear your psoriasis predictably. [6:45] Dr. Dray: kicking back a couple of fiber supplements [7:57] Dr. Dray: drives me berserk [8:44] Dr. Dray: fall prey to... the food industry. [8:44] Dr. Dray: I highly caution against letting the food industry tell you that their food is healthy because they're lying through their teeth. [11:19] Dr. Dray: house of pain [14:36] Dr. Dray: stuck poop [17:48] Dr. Dray: bring something else along for the ride [18:48] Dr. Dray: It's not about making your diet insufferable. It has to be something that you can maintain.

Original transcript

[0:00] Well, hey guys. Welcome back. If you're [0:01] new here, I'm Dr. Dray. I'm a [0:03] board-certified dermatologist. There's a [0:05] good chance you have heard someone [0:06] lament the fact that most people do not [0:09] get enough dietary fiber, and that [0:11] dietary fiber has all of these health [0:13] benefits, and we should all be trying to [0:15] get more dietary fiber. Today, I want to [0:17] talk about how increasing dietary fiber [0:20] can not only, of course, have these [0:22] benefits for your overall health, but it [0:24] can directly impact the health of your [0:26] skin. As we learn more about the [0:28] gut-skin axis, the role of inflammation [0:31] starting with digestion and how that has [0:33] a downstream effect on skin diseases and [0:36] the way your skin looks and behaves, [0:37] we're learning a lot more about how [0:39] vital it is to get a good amount of [0:42] fiber in the diet. And this is a [0:43] particularly interesting area of [0:46] interest for specific skin conditions [0:48] known to have chronic inflammation, such [0:50] as atopic dermatitis, hidradenitis [0:52] suppurativa, and psoriasis. But, it's [0:54] very important to be clear from the [0:56] beginning. Adding more fiber can be a [0:58] good move in your diet. However, it [1:00] doesn't mean that it's going to [1:01] completely cure a skin problem, nor [1:04] should it be your main pursuit when it [1:06] comes to improving your skin. And it [1:08] should never replace standard medical [1:11] therapies for skin diseases. In some [1:13] cases, people are able to get their [1:15] disease in remission, to control it, to [1:17] clear it, just by making some better [1:19] diet choices. That definitely can and [1:21] does happen, but it's not the norm. And [1:23] in many cases, people get improvement [1:25] from certain dietary modifications, but [1:27] they still need to stay on medication. I [1:29] also want to draw your attention to the [1:31] fact that suddenly stopping medications [1:33] without doctor supervision can have some [1:35] serious negative consequences, so never [1:38] just DIY your own medical therapy. It [1:40] can backfire. One of the things that [1:42] makes fiber so interesting in this [1:43] conversation is what exactly is going on [1:46] in the gut. Fiber is a type of [1:47] carbohydrate that your body doesn't [1:49] completely digest. And it's kind of odd, [1:51] like, why are you telling us to eat more [1:53] of this thing that we don't really [1:54] digest? But, that's actually a good [1:55] thing, because instead of being broken [1:57] down and absorbed in your small [1:59] intestine like many other carbohydrates, [2:01] much of the fiber that you eat actually [2:03] is able to make its way from the small [2:05] intestine to the colon. And that's where [2:07] your gut bacteria come in, because [2:08] certain bacteria in your colon can [2:10] ferment that dietary fiber. One of the [2:12] major products of this fermentation is a [2:14] group of compounds known as short-chain [2:16] fatty acids. These include acetate, [2:18] propionate, and butyrate. Butyrate is [2:20] particularly interesting, because your [2:22] colon cells actually use butyrate as an [2:24] energy source. But its effects might [2:26] actually extend beyond the gut, because [2:27] these short-chain fatty acids can [2:29] influence immune signaling and [2:31] inflammatory pathways throughout the [2:32] body. So, this is where there is [2:34] significant potential for crosstalk with [2:36] the gut and the skin. If you think about [2:38] it, your gut and your skin, they're both [2:41] major interfaces between your body and [2:43] the outside world. Your intestinal [2:44] tract's got to decide what to allow in [2:47] from the foods that you take in and what [2:49] to keep out. Your skin does the same [2:51] thing. Both are constantly interacting [2:52] with microorganisms, environmental [2:54] exposures, and your immune system. So, [2:56] it's not at all surprising that changes [2:58] in your gut can influence immune [3:00] activity in your skin. And this is [3:01] basically what researchers are referring [3:03] to when you hear gut-skin axis. When [3:05] your diet is rich in fiber, it can [3:07] actually support a more diverse gut [3:09] microbiome. In other words, a greater [3:11] number of different bacteria. These [3:13] microorganisms can ferment the fiber and [3:15] produce short-chain fatty acids. Those [3:17] metabolites can influence immune [3:18] function and inflammatory cells. [3:20] Specifically, these compounds can reduce [3:23] the formation of different inflammatory [3:25] mediators, namely interleukin-6 and [3:27] TNF-alpha. There's also evidence that [3:29] the short-chain fatty acids themselves [3:32] can directly influence your skin. Some [3:34] studies suggest that short-chain fatty [3:35] acids can interact directly with [3:37] keratinocytes, which are the cells that [3:39] make up your epidermis. This interaction [3:41] is thought to support processes that [3:43] maintain your skin barrier. Think about [3:44] it as this chain of events. Fiber feeds [3:47] the good gut bacteria. Those bacteria [3:49] produce different metabolites. And it's [3:51] those metabolites that directly [3:53] influence immune function, inflammatory [3:55] cells, and skin cells, potentially the [3:57] skin barrier. So, this is one of the [3:59] major reasons why scientists, [4:01] researchers are specifically interested [4:03] in the role of dietary fiber and [4:04] inflammatory skin conditions. Speaking [4:06] of skin barrier, let's talk about atopic [4:08] dermatitis, a type of eczema [4:09] characterized by, well, an impaired skin [4:12] barrier, as well as an overactive immune [4:13] response. Researchers have taken note of [4:16] differences in the gut microbiome of [4:17] patients with atopic dermatitis. Now, [4:19] that's not to say that a screwed-up gut [4:21] microbiome is what causes the eczema. [4:23] It's definitely a more complicated [4:25] relationship, with of course environment [4:27] and genetics playing a role. But [4:28] observational research has found that [4:31] many people who have a higher dietary [4:33] fiber intake might actually have a lower [4:35] risk of allergic conditions, which [4:36] include atopic dermatitis. And in animal [4:39] models, either increasing the dietary [4:41] fiber or giving the animals some of [4:43] these metabolites that the bacteria [4:45] produce when they break down the fiber, [4:47] has actually been shown to reduce the [4:49] inflammation of inflammatory skin [4:51] conditions. That's really cool and very [4:53] interesting, but what I always harp on [4:55] is that animal studies, they provide [4:56] interesting, cool, exciting questions [4:59] for further testing, but they don't [5:01] necessarily establish that this is a [5:03] reality for human disease. You need [5:05] larger human clinical trials to do that. [5:07] In other words, we still need much [5:08] better human research to really get at [5:10] the nitty-gritty with regards to the [5:11] role of dietary fiber, the gut [5:13] microbiome, and atopic dermatitis. If [5:15] you have atopic dermatitis, don't just [5:17] abandon your eczema treatments and start [5:19] eating a bunch of beans and thinking [5:21] that's going to solve everything. But [5:22] what I would say is that attempting to [5:24] improve the fiber content in your diet [5:26] is a step in the right direction and a [5:28] reasonable lifestyle modification to [5:30] support healthier skin and perhaps [5:33] improvement in the overall severity of [5:35] your inflammatory skin disease. The same [5:37] concept applies to psoriasis, a chronic [5:40] inflammatory disease with skin findings. [5:43] The gut microbiome has actually been [5:44] extensively examined in patients who [5:46] have psoriasis. And again, researchers [5:48] are observing differences in the gut [5:50] microbiome of patients with versus [5:52] without psoriasis. These individual [5:54] changes are sometimes referred to as gut [5:55] dysbiosis. Animal studies suggest that [5:58] dietary fiber and its metabolites might [6:00] actually help with the inflammatory [6:02] profiles of psoriasis. Again, we need [6:04] more high-quality human studies to [6:06] really get at the nitty-gritty of this. [6:08] The animal-based and laboratory studies [6:10] really just provide us some windows into [6:12] looking at the possible mechanisms. We [6:14] need that human data to really guide [6:16] decision-making moving forward. In other [6:18] words, simply eating 30 g of fiber every [6:20] day is not going to clear your psoriasis [6:22] predictably. But what we can say is that [6:24] a fiber-rich dietary pattern of eating [6:26] is associated with a variety of [6:28] beneficial cardiometabolic outcomes and [6:31] a potentially lower inflammatory burden [6:33] overall. All of these things bode well [6:34] for psoriasis, which is a chronic [6:36] inflammatory disease that has skin [6:39] findings, but also is associated with a [6:41] variety of health problems like [6:43] cardiovascular disease. So, that's [6:44] particularly relevant. It's interesting, [6:46] though, when we talk about the role for [6:48] dietary fiber in acne because the [6:50] conversation's a little bit different [6:52] here. Instead of focusing so much on the [6:53] gut microbiome, that probably does play [6:56] a role, we also need to think about [6:57] something else that is known to be a [6:59] problem for patients with acne. And that [7:02] is the role of the glycemic load of your [7:05] diet. So, we know that low glycemic load [7:07] diets can actually be associated with [7:09] improvements in acne. Fiber can be a key [7:12] part of that. When you replace highly [7:14] refined carbohydrates with whole foods [7:16] rich in fiber, not only are you getting [7:18] more micronutrients, but you're also [7:20] getting a slower release of that [7:22] glucose. And overall, it's going to be [7:24] much better for the insulin levels and [7:27] bode well long-term as far as keeping [7:30] your insulin at a healthy level and not [7:31] resulting in, well, insulin resistance. [7:34] Because insulin and insulin-like growth [7:36] factor, when they're high, it actually [7:37] triggers more acne in skin. This doesn't [7:40] mean that kicking back a couple of fiber [7:42] supplements is going to clear your skin [7:43] by any means, but again, a lifestyle [7:46] where you are replacing refined [7:48] ultra-processed carbohydrates with whole [7:51] food fiber-rich carbohydrates, it is a [7:54] step in the right direction and [7:56] something that I definitely recommend. [7:58] Why is it then that doctors keep harping [8:00] on this Mediterranean diet? Is it [8:02] something magical about the food that [8:05] they're eating in the Mediterranean [8:07] countries, which [8:09] they don't all eat the same thing. So, [8:11] what exactly are we talking about here? [8:13] I admit it is a terminology and a [8:15] blanket recommendation that I personally [8:17] am not a fan of telling people eat a [8:19] Mediterranean diet. What does that mean? [8:21] People need more specific guidelines [8:23] than eat a Mediterranean diet. If you [8:24] live in a Mediterranean country, comment [8:26] which one. I'm sure you don't eat the [8:28] same things as somebody in another [8:30] Mediterranean country. That's why it [8:32] drives me berserk. Generally, it tends [8:34] to emphasize this overall pattern of [8:36] eating. The pattern includes relatively [8:39] little um ultra-processed foods. It [8:41] includes plenty of fruits, vegetables, [8:44] legumes, whole grains. [snorts] It [8:45] limits meats, but includes the [8:47] consumption of seafood, fish, and olive [8:50] oil, um as well as some red wine in [8:53] moderation. The idea here is that you're [8:55] getting fiber from the plants. You're [8:58] getting anti-inflammatory omega-3 fatty [9:01] acids when the fish is included, and [9:03] you're getting a variety of polyphenols [9:05] from the olive oil. You're limiting [9:07] intake of salt first of all, and you're [9:10] also limiting intake of uh many of the [9:13] harmful compounds produced from red meat [9:16] that are cancer-causing and inflammatory [9:18] like the polycyclic aromatic [9:20] hydrocarbons, the advanced glycation end [9:22] products that come from eating like [9:23] smoked meats, for example. In other [9:25] words, it's not even necessarily about [9:28] the countries of inspiration, but rather [9:31] just this kind of overall pattern. And [9:33] that's kind of why I'm not a fan of it [9:34] because it's vague advice, and I think [9:37] unless patients have very, very [9:39] specific, detailed guidelines, they're [9:41] going to fall prey to well, the food [9:43] industry. I highly caution against [9:45] letting the food industry tell you that [9:47] their food is healthy because they're [9:49] lying through their teeth, okay? A lot [9:51] of times there'll be some dietary advice [9:54] that a nutrition expert body, a medical [9:57] expert body, if you will, comes out [9:59] with. The food industry takes that and [10:01] runs with it. Did we learn nothing from [10:02] the fat-free, the low-fat era? There was [10:04] some good reason to recommend people to [10:06] reduce their dietary fat, but uh it all [10:09] backfired when the food industry took [10:11] advantage of it and made all this [10:12] fat-free, low-fat junk food that instead [10:14] of having fat, now they replaced the fat [10:17] with the sugar. The food was just as [10:19] high calorie, and people were like, oh, [10:21] it's fat-free, it's low-fat. So, they [10:22] ate multiple servings of it and [10:24] increased their calorie content and [10:26] increased their weight as a result. The [10:27] increase in body fat is I mean, it [10:29] backfired. It backfired for sure. The [10:31] same thing I predict will happen with [10:33] the Mediterranean diet as well as with [10:35] this recommendation to prioritize [10:38] protein. That's going to backfire [10:39] because you can see it in the grocery [10:41] store now with the high-protein [10:42] Pop-Tarts, the high-protein Doritos. [10:44] Pretty soon you're going to have a [10:45] Mediterranean diet-approved TV dinner, [10:48] all right? That's loaded with salt. It's [10:50] got a sugar-sweetened sauce in it, like [10:53] eight servings of olive oil in there. [10:55] That is olive oil, but if you actually [10:57] look at it, it's like one part olive [10:59] oil, and the rest is just some other [11:00] oil, okay? So, in other words, not at [11:03] all like the Mediterranean diet, but [11:05] just the same pretty much the same junk [11:07] that people have been eating to get away [11:09] from, just a different a different [11:11] tagline on the front, okay? Be really [11:13] careful with the food. They're there to [11:15] get you hooked on their product. They're [11:16] there to sell. They're there to make [11:17] money. They're not there to promote your [11:19] health. As we're highlighting here the [11:21] benefits of including fiber in your [11:22] diet, this question always comes up. How [11:24] much fiber should we be eating? You [11:26] know, it's a really good question. For [11:28] many adults, the recommended intake is [11:30] somewhere between 25 to 38 g a day, [11:33] which is a ton for most people who are [11:36] used to eating the standard American [11:38] diet. That's actually a ton. For other [11:40] people, that is a low fiber day of [11:43] eating, frankly. But for most people, [11:45] that's going to be a lot. A lot of [11:47] that's going to depend on your age, your [11:49] gender. But I'm less interested in [11:51] having everyone obsessively track their [11:52] fiber intake. Instead, I'd rather you [11:54] guys look at where your fiber is coming [11:57] from. Because again, this is where the [11:58] food industry is going to get you, and [12:00] it's not going to go as well for you as [12:03] as it should. And that is you can walk [12:04] in the grocery store and you can find [12:06] fiber-packed cookies, fiber-packed [12:09] breakfast cereals, all of which still [12:12] have the same host of garbage in them. [12:14] Ton of sugar, ton of fat, very low [12:17] volume, aka low satiety, encourages [12:20] overeating, excess calorie consumption, [12:22] excess body weight, okay? Yeah, the [12:24] fiber added to those foods, it can help [12:27] with satiety. So, maybe it's there doing [12:30] something. If you're going to insist on [12:31] eating ultra-processed foods, I'm not [12:33] saying it's necessarily bad. I just [12:35] would not turn to those foods. While the [12:37] added fiber in these foods may help with [12:39] satiety and bowel regularity, it doesn't [12:41] automatically make the product healthy. [12:43] You don't get the same nutritional [12:44] package that you get from the fiber from [12:47] like beans or greens or fruits or whole [12:51] grains. Because whole plant food, along [12:54] with the fiber, has some other stuff. [12:56] It's got micronutrients. It's got [12:58] anti-inflammatory compounds, [12:59] polyphenols. And it has usually its own [13:04] water accompanying it, which brings me [13:06] to my next point and why this will make [13:08] sense in a moment. Can you eat too much [13:10] fiber? Well, there's not an upper limit [13:12] of fiber recommendation, but eating too [13:14] much fiber when you're not used to it [13:16] can cause a variety of gastrointestinal [13:19] discomfort. So, I don't suggest going [13:21] from zero to 100 overnight. You will be [13:23] in the house of pain if you're not used [13:25] to eating a lot of fiber, okay? You're [13:26] going to have bloating, digestive [13:28] problems, gas, upset stomach. It It's [13:31] not going to be pleasant for you. You'll [13:33] often hear um people say, "Well, I'm a [13:35] little concerned that eating too much [13:37] fiber might actually interfere with the [13:38] absorption of certain micronutrients." [13:41] That's a valid concern. Here's what I [13:43] can tell you clinically. Clinical [13:45] studies have looked at um communities, [13:48] um certain rural communities where [13:49] they're eating a high-fiber diet. [13:51] Populations where they're not eating the [13:53] junk. They haven't been introduced to [13:54] the Western diet, in other words. [13:56] They're eating beans, legumes, fruits, [13:59] vegetables. They're eating a lot You [14:01] know, a substantial daily fiber intake, [14:03] in other words, and they're not finding [14:05] reduced blood levels of zinc or iron in [14:07] these populations, or problems with [14:10] calcium, either, okay? Really what it [14:12] seems is that over time your body will [14:14] adapt, and you're you're pretty good at [14:16] increasing your absorption efficiency [14:18] over time. Yet another reason not to go [14:20] from zero to 100 overnight. You're much [14:22] more at likely at risk to have problems [14:25] with the excess fiber compromising [14:27] nutrient uptake if most of the fiber is [14:29] coming from like dietary supplements or [14:32] these fiber-fortified ultra-processed [14:34] foods. And here's where it all matters, [14:36] okay? Because fiber is great for your [14:38] digestive health, it's great for bowel [14:40] movement regularity. But the way it [14:42] works to help you have a bowel movement [14:44] is it adds bulk to the stool. But in [14:47] order for it to really help you have a [14:48] bowel movement, it's not enough to just [14:50] bulk up your stool. It's got to flow [14:52] through and get out, right? [14:54] I know it's TMI, but we got to talk [14:56] about it. It needs water to do that. [14:58] Hence why whole food sources of fiber, [15:00] they bring that along in most cases. [15:02] Vegetables, fruits, provided you're not [15:04] eating dried beans, which I don't [15:06] recommend you do. You're cooking them. [15:08] They They bring a a good amount of water [15:09] in. So, you're getting that water along [15:12] for the ride. And that's really [15:13] important, because what you'll find is [15:14] that One example I'll show you share [15:16] with you guys is Nowadays, it's really [15:18] popular to have these low-carb breads [15:20] and low-carb carb tortillas. I'm not [15:22] saying those are bad or anything, but [15:24] one thing I want to point out about [15:25] those is they add fiber, which sounds [15:28] great. They market it as high fiber, and [15:30] that sounds great, and that's how [15:31] they're able to reduce the net [15:33] carbohydrate. But, here is where you can [15:35] run into some digestive problems with [15:37] those in that they're not bringing that [15:39] water along. The fiber in that is going [15:41] to be like modified wheat starch and [15:43] cellulose. These are just pure insoluble [15:45] fibers. They add bulk, but they don't [15:48] add that hydration piece of things. What [15:50] happens is that insoluble fiber, a lot [15:52] of water gets sucked into the colon in [15:54] order to move things along, and [15:56] therefore, you can become dehydrated [15:58] first of all. So, you need to be [15:59] drinking a lot of water. You need to be [16:01] drinking a lot of water. But, uh you can [16:03] get stuck there, and you can have a [16:05] fecal impaction in the ileus. Not good. [16:08] In other words, you've heard those [16:09] commercials, stuck poop? Yeah, that's [16:10] what you can have. It's painful, it's [16:12] uncomfortable. Um so, be really careful. [16:14] How do you go about increasing the fiber [16:16] in your diet safely? Well, I suggest, [16:18] again, slowly. Slowly. One of the tips I [16:21] like to give is when it comes to [16:23] legumes, beans, lentils, chickpeas, [16:26] start with lentils. They're a lot easier [16:28] to digest first of all. So, start with [16:30] lentils, but a good tip is, in order to [16:33] introduce these, start slowly. Just [16:35] start by adding a tablespoon of beans to [16:37] a meal. Do that for, you know, a couple [16:40] of weeks, then add a little bit more [16:41] beans. Every time you add beans, take [16:43] out something else that wasn't [16:45] necessarily the most healthy thing in [16:47] there, okay? Until before you know it, [16:48] you have replaced like maybe the deli [16:51] meat in your salad with a full serving [16:54] of beans. Try and make that swap. That's [16:56] a really good swap right there is to [16:58] slowly introduce the beans to replace [17:00] that ultra-processed deli meat. I also [17:02] recommend adding vegetables to every [17:05] meal. Start small and slowly over time. [17:08] I would much rather somebody go from [17:10] eating 5 g of fiber a day to 7 g of [17:14] fiber over a couple of weeks and [17:16] tolerating it well and just slowly over [17:18] a year sneaking up and sneaking up to [17:20] higher and higher amount, than to suffer [17:22] and get completely turned off and say [17:24] this way of eating doesn't work for me. [17:26] I see a lot of people try this diet this [17:28] way of eating out and end up bailing on [17:30] it because digestively speaking it can [17:33] be a lot if you are not if you're not [17:36] strategic about how you transition and [17:38] you can be uncomfortable. It's really [17:40] going to vary depending on where you're [17:41] starting from. Some people are already [17:43] used to eating beans and they're not [17:44] going to need to do this. Depending on [17:46] your ethnic background, too. You may be [17:48] like, "Yeah, we eat beans and rice every [17:50] day in my house. Like, I don't need to [17:51] do this tablespoon thing. I'm already [17:53] I'm already there. I just need to get [17:54] back to eating the food that my mom [17:56] prepared for me growing up and stop [17:57] eating this junk." Over time your gut [17:59] will adapt to it. The bacteria there [18:01] will take off and you'll be a lot more [18:04] efficient. And another great way to get [18:05] in some fiber is if you replace some [18:08] servings of oil in your diet with some [18:10] nuts and seeds. Then you get that fiber [18:12] in there as well. Plus, you get a [18:14] variety of other health benefits from [18:16] like pumpkin seeds is great, for [18:17] example, or almonds. Just, you know, [18:20] that simple swap alone is another way to [18:23] not sacrifice the fat the healthy fats [18:25] in your diet, but instead you're [18:27] bringing something else along for the [18:28] ride and you're really maximizing the [18:30] micronutrient diversity in the meal [18:33] without necessarily like slashing [18:35] calories dramatically or anything of [18:37] that sort. So, I think that's another [18:39] great way. When you add more fiber into [18:41] your diet, you'll find it makes it a lot [18:43] easier to maintain your body weight as [18:46] well because it helps you stay full [18:48] naturally. Regardless of how you want to [18:50] tweak it and begin to make some changes, [18:52] my main take home point is focus on [18:54] whole foods. Focus on on introducing the [18:57] whole foods. Try not get it from [18:59] exclusively processed stuff where it's [19:02] marketed as high fiber because that's [19:04] not to say that that's bad and you [19:06] should never eat those things, but you [19:07] should be limiting consumption of those [19:09] and prioritizing these whole food [19:11] sources to really derive maximum [19:13] benefits and honestly for your overall [19:15] digestive health, I think it'll go a lot [19:17] easier for you given what I said about [19:19] how a lot of these foods just naturally [19:21] are accompanied by water and move [19:23] through the digestive tract more [19:24] efficiently than like the fiber [19:26] supplements or the [19:28] cellulose and modified wheat starch that [19:31] is added to low water content processed [19:34] foods. You know, the low carbohydrate [19:36] breads and things like that. I mean, [19:37] they're they're fine. I'm not saying [19:39] they're bad do help you stay a lot [19:41] fuller than just eating regular white [19:43] bread. I think there's reason to eat [19:44] those over just regular white bread from [19:46] a satiety standpoint. If you really like [19:49] to have your sandwich every day and [19:50] you're like, I don't really want to eat [19:51] these different types of breads with all [19:53] the whole grains in them. I just want to [19:54] have white bread and I'll figure out a [19:56] way to add some add some whole food [19:58] thing in there. By all means, it's not [19:59] about making your diet insufferable. It [20:01] has to be something that you can [20:02] maintain. So, if you have been eating [20:04] those and you like them and you find [20:06] that they satisfy that need, I think [20:09] they're a good ultimately, but I would [20:10] not rely solely on those to get all of [20:13] your fiber in. All right, y'all. I hope [20:15] today's video was informative. If you [20:17] enjoyed it, give it a thumbs up. Share [20:18] it with your friends and as always, [20:19] don't forget sunscreen and subscribe. [20:21] I'll talk to you guys tomorrow. Bye. [20:28] >> [music]