If you’re an avid follower of social media, you’d have surely come across a viral trend called ‘fibermaxxing’. The latest health craze has people piling up on dietary fibre — encouraging them to eat a range of fibre-rich foods and meeting or even exceeding the recommended daily intake. The idea is to optimise gut health, digestion, and overall well-being, often by prioritising whole foods like fruits, vegetables, legumes, whole grains, nuts, and seeds.
While fibermaxxing, like most other social media trends, could be seasonal, it highlights a growing health crisis that is definitely not.
Often misunderstood for mere indigestion, declining “gut health is a becoming real issue”, says Dr Vikas Singla, senior director and head, gastroenterology, hepatology and endoscopy, Max Super Speciality Hospital, New Delhi. “Of late, we are seeing more patients with cases of gas, bloating, barrier, and constipation. It’s monsoon season and the number of cases with gut infection or gastrointestinal (GI) tract infection is only going up. We are seeing many patients with pain in the abdomen, loose stool or blood in the stool,” he adds.
A 2023 survey by the Indian Dietetic Association, Mumbai, and Country Delight, an online milk and grocery delivery service, revealed that seven out of 10 Indians residing in urban India were experiencing digestive or gut health issues. The study also found that 59% complained about it every week and 12% suffered daily. Around 63% of respondents said that they consumed processed or packaged food every week with gastric issues recorded among 68% of the respondents. Doctors estimate that these health trends have only exacerbated since then.
Healthy co-existence
Research on gut microbiota is advancing in the gut health field, says Dr Arun Prasad, senior consultant, gastrointestinal, bariatric and robotic surgery, Indraprastha Apollo Hospitals. “One of the key areas of innovation is microbiome-based therapy, particularly the use of targeted probiotics, prebiotics, and synbiotics designed to restore microbial balance and improve digestion, immunity, and even mood disorders,” he adds. The microbial balance refers to the healthy coexistence of the diverse community of microorganisms (bacteria, fungi, etc) in the digestive system.
Both Dr Prasad and Dr Singla point to ‘fecal microbiota therapy’ or FMT, which is another “promising development” to treat gut health. Dr Singla explains, “In this method, healthy gut bacteria from a donor are transferred to the patient. But this is only used in a few conditions like ulcerative colitis that doesn’t improve with normal treatment (where there is blood in the stool and ulcers in the intestine), clostridium difficile infection in elderly or hospitalised patients when other treatments fail, and diarrhoea-predominant irritable bowel syndrome (IBS-D), where the patient has long-term stomach pain and loose motions.
Another pertinent development was the research into akkermansia, which is a bacteria occurring in the gut microbiome, is also one that plays an important role in maintaining the lining of the gut, as it thrives on the mucus and not the food in the stomach. Probiotics to manage akkermansia are also available and often advised by doctors. The probiotic can improve gut health and digestion by strengthening the gut lining, and reduce cravings, among other gut functions.
Pendulum, a US-based organisation of doctors, scientists and innovators who launched their own akkermansia pill in 2021, did a survey for three months of 172 people who took the probiotic. According to the findings, 77% reported improved gut health, 82% saw more regular bowel movements, and 67% had reduced diarrhoea. Another survey sampling 80 people over three months found that 91% had reduced food cravings.
Gut-brain axis
Doctors also stress on the importance of maintaining the gut-brain axis, which “is a bidirectional communication pathway between the gastrointestinal system and the central nervous system”. “It involves neural, hormonal, and immune signaling and the gut plays a central role in this interaction,” explains Dr Prasad. Experts say that maintaining gut health is essential not only for digestion, but also for overall psychological balance. “A healthy gut can positively influence mood, cognitive function, and stress resilience, whereas dysregulation may contribute to anxiety, depression, and neuroinflammatory disorders.” Research is evolving on the gut-brain axis as well with clinical studies examining how gut bacteria influence mental health conditions like anxiety and depression.
Dr Singla further expounds that if there is excessive stress, anxiety, or depression, it will lead to release of bad chemicals, and they can lead to effects on the intestine. This in turn can lead to “pain in the abdomen, there can be loose stool, or constipation,” he says, adding, “If anyone is having psychological issues, they are more prone to suffer from gut problems. So, treating psychological disorders can help in maintaining good gut health.”
In the same report by the Indian Dietetics Association, it was also stated that 59% of people who suffer from gut health issues every week also experienced certain mental health challenges such as anxiety, poor memory, mood swings, and lack of energy significantly more than the ones who report less frequent bouts of digestive issues.
Beyond metabolism
Dr Singla brings back the emerging studies in the gut microbiome, warning that it is not a ‘one solution fits all’ case for gut health. “A lot of patients come to us with gut microbiome testing and they tell us to treat their microbiome,” he says, however, “In the given clinical settings, gut microbiome testing is not recommended as of now. Things may change in the future where we check the gut microbiome of an individual, then correlate it with various clinical issues, and then we can change the gut microbiome.”
Adding to the common myths about gut health, Dr Prasad says, “A major misconception is that gut health is only related to digestion or bowel regularity. In reality, gut health is intricately linked to multiple functions including immunity, mental well-being, nutrient absorption, and inflammation regulation.” Many people also believe that over-the-counter probiotics or random dietary supplements can fix all gut-related issues – this is false, and gut issues should not be medicated without understanding the underlying causes, he adds.
Referring to the new dietary trend on social media called ‘fibermaxxing’, he says, “Social media is full of such trends many of which oversimplify complex gut mechanisms.” He goes on to explain that while increasing fibre intake is beneficial, excessive and sudden fibre loading without medical advice can lead to bloating, gas, and even intestinal discomfort, especially in patients with motility disorders. “It is essential that individuals consult healthcare professionals before adopting such trends,” he adds.
In Dr Prasad’s experience, with seasonal transitions, particularly from summer to monsoon, “we observe a significant uptick in gastrointestinal issues.” He shares that the commonly occurring ones include acute gastroenteritis, food poisoning, IBS flare-ups, and functional dyspepsia. “The shift in weather, combined with increased humidity, often facilitates the growth of bacteria and viruses in food and water sources, leading to infections. There’s also a noticeable rise in patients complaining of bloating, abdominal discomfort, irregular bowel movements, and acid reflux during this time,” he adds.