Dietary Fiber and Wheat Bran in Childhood Constipation and Health
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Chronic childhood functional constipation is highly prevalent and a public health problem. Prevention should begin early, since its onset after weaning is frequent. This chapter discusses breastfeeding, other preventive measures, and dietary fiber (DF) recommendations. Population surveys show that DF intake is mostly below what is recommended. An adequate DF intake from weaning onwards seems fundamental, but recommendations concerning complementary foods/DF for premature weaning, and DF for 6- to 12-month-olds, are lacking.The relationship between DF intake and constipation is presented, along with a detailed account of the factors possibly involved in the conflicting data. A vicious circle maintains and aggravates constipation; thus, treatment should not be postponed. A DF-dense diet is recommended, but little emphasis is placed on this in the guidelines. The chapter provides a dietary treatment schedule, proposals to implement its acceptance, and a summary of studies in adults and children evaluating dietary treatment of constipation with emphasis on supplements with DF/wheat bran. More studies are necessary to recommend DF supplements. Nevertheless, DF treatment of constipation should not be neglected, since, in general, studies show its beneficial effects. © 2014 Elsevier Inc. All rights reserved.