Constipation improves with a surprising starch

Starch for constipation?  Sounds strange I’m sure, but let’s uncover this viable option for all constipation sufferers.

First off, constipation after gastric sleeve or gastric bypass surgery is common.  Many will begin this battle only after bariatric surgery.

Unfortunately, constipation is complex.  Requiring multiple approaches to correct.  In fact, this surprising starch may be a viable option to consider!

Hmm…starch after bariatric surgery?

Just hear me out…

I’m sure you’re questioning the use of “starch” after gastric sleeve & bypass.  As a high protein low “starch” diet is likely what you follow.

To some degree, I’m on board with this.  However, including certain types of starch have health benefits.

Yes, you read that correctly.   Certain types of starch have health benefits!

In actuality, not all starch are the same.  Refined carbohydrates found in ultra-processed foods rarely contain beneficial starch.

The most common starchy foods in a standard American diet consist of white bread, cakes and noodles.  These starch are rapidly digested. Increasing your blood sugar.

So choosing the right type of starch is key.

To elaborate further, why the “type” of starch matters.  Certain starch produce  short-chain fatty acids(SCFA).  To explain, SCFA are potent signaling molecules that change the biochemistry of your cells & tissue.

For most, this means your health will improve when more short-chain fatty acids are produced.  This includes bariatric surgery!

Importance of short-chain fatty acids(SCFA)

SCFA are produced by bacterial fermentation of non-digestible carbohydrates and fiber.

In reality, think of it as food for your gut bacteria.  AKA prebiotics. 

Not consuming enough will prevent you from having adequate good bacteria.

To further explain, acetate, propionate and butyrate are the major products of this fermentation.

Each SCFA benefit your health differently.

• Acetate has been associated with improved insulin sensitivity.
• Propionate is thought to lower serum cholesterol levels, fat stores & tissue carcinogenesis.
• Butyrate influences metabolism, lowers gut inflammation, improves intestinal permeability. as well as impacts gene expression and intestinal motility.

What do we know about SCFA and bariatric surgery?

A study published in 2020 in the Journal of Nutrients found…

“Six months post roux-en-y gastric bypass and gastric sleeve surgery the total amount of SCFA was reduced.”

They associate this result with a lower carbohydrate/starch intake.  In fact, this study stated, “Dietary interventions could counteract the unfavorable effects.”

I think something to acknowledge is the timing.  The results were documented after six months.  The good news is, no matter how far out from surgery.  You can change your food choices.  You can be intentional.

Whew!  Drum roll please!

We’re finally able to discuss the starch that produces SCFA.

SCFA producers

As we’ve discussed, non-digestible carbohydrate and fiber manufacture SCFA.  These include:

• Resistant starch
• Oligosaccharides
• Disaccharides
• Sugar alcohols

Although the production of all SCFA are beneficial, we’ll focus on the starch that produces butyrate.

So the star of the show for this discussion is resistant starch.  

Resistant starch is the major producer of butyrate.  Many call it butyrogenic!

What is resistant starch?

Resistant starch just means its digestion resistant.  It’s a portion of starch that cannot be digested by amylases(digestive enzyme) in the small intestines.  It passes to the colon fermented by gut bacteria.  As a result, your blood sugar is not impacted.

The estimated daily intake of resistant starch by Americans is ∼5 g per day.  The minimum recommended for health benefits is 6 g of resistant starch per meal.

Technically, there are five different types of resistant starch.  For example, resistant starch 3 is produced in the cooking and cooling process.

Think of starches like potato and rice.  When you heat them the starch molecule unravels.  Once the potato or rice is chilled.  The starch molecule balls back up making it resistant to digestion.  Unfortunately, if reheated the starch molecule unravels again.  In short, the chilling is key!

So the next time you have a choice between fries, baked potato, chips or potato salad, choose potato salad!!

For a more complete list, let’s discuss all the foods rich in resistant starch.

Foods rich in resistant starch

Additional foods rich in resistant starch are:

• Partially milled grains and seeds
• Uncooked potatoes
• Cooked and chilled potatoes and rice
• Green bananas & plantains
• Beans & lentils

This is one reason your health benefits by choosing 100% whole-grain.  If you’re eating bread, choose one that doesn’t use enriched wheat flour.  Instead look for whole grain wheat flour.  Another alternative is grinding uncooked rolled oats into a flour.  Once cup of uncooked rolled oats contains 4.4 grams of resistant starch.

When using flax seed, choose ground.  This allows better utilization and maximum butyrate production.

When choosing bananas, choose green.  One medium banana contains 4.7 grams of resistant starch. If it taste to starchy, add to a smoothie instead.   You can also purchase green banana flour.   This can be made into muffins or a spoonful added to a smoothie.

Furthermore, beans and lentils can be added to most meals. One cup of white beans contain 7.4 grams of resistant starch.  And only a half cup of lentils have 3.4 grams.

Although bariatric surgery limits the amount of food you consume at a meal.  It doesn’t have to limit your resistant starch.

This is where being intentional about your choices help!

You don’t have belly space to waste on ultra-processed foods.  Try breaking a cup of white beans into two meals.  Add ground flax seed to your smoothie.  Experiment with making rolled oats into flour.  Try pasta made from lentils.

To conclude, if you struggle with constipation after gastric sleeve and bypass surgery.  You may want to work on increasing SCFA.  Specifically butyrate.   Butyrate has the ability to influence intestinal motility lessening constipation.  In short, increasing resistant starch foods is one way to increase butyrate.