updates in evaluation and management. Korean J Fam Med. 2020;41(3):139–45. https://pubmed.ncbi.nlm.nih.gov/32062960/

3389

Pont LG, Fisher M, Williams K. Appropriate use of laxatives in the older person. Drugs Aging. 2019;36(11):999–1005. https://pubmed.ncbi.nlm.nih.gov/31478168/

3390

Burkitt DP. A deficiency of dietary fiber may be one cause of certain colonic and venous disorders. Am J Dig Dis. 1976;21(2):104–8. https://pubmed.ncbi.nlm.nih.gov/1274909/

3391

Clemens R, Kranz S, Mobley AR, et al. Filling America’s fiber intake gap: summary of a roundtable to probe realistic solutions with a focus on grain-based foods. J Nutr. 2012;142(7):1390S-401S. https://pubmed.ncbi.nlm.nih.gov/22649260/

3392

Sanjoaquin MA, Appleby PN, Spencer EA, Key TJ. Nutrition and lifestyle in relation to bowel movement frequency: a cross-sectional study of 20630 men and women in EPIC-Oxford. Public Health Nutr. 2004 Feb;7(1):77–83. https://pubmed.ncbi.nlm.nih.gov/14972075/

3393

Schmier JK, Miller PE, Levine JA, et al. Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model. BMC Public Health. 2014;14:374. https://pubmed.ncbi.nlm.nih.gov/24739472/

3394

Oh SJ, Fuller G, Patel D, et al. Chronic constipation in the United States: results from a population-based survey assessing healthcare seeking and use of pharmacotherapy. Am J Gastroenterol. 2020;115(6):895–905. https://pubmed.ncbi.nlm.nih.gov/32324606/

3395

Christodoulides S, Dimidi E, Fragkos KC, Farmer AD, Whelan K, Scott SM. Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults. Aliment Pharmacol Ther. 2016;44(2):103–16. https://pubmed.ncbi.nlm.nih.gov/27170558/

3396

Staller K, Cash BD. Myths and misconceptions about constipation: a new view for the 2020s. Am J Gastroenterol. 2020;115(11):1741–5. https://pubmed.ncbi.nlm.nih.gov/33156087/

3397

Jalanka J, Major G, Murray K, et al. The effect of psyllium husk on intestinal microbiota in constipated patients and healthy controls. Int J Mol Sci. 2019;20(2):E433. https://pubmed.ncbi.nlm.nih.gov/30669509/

3398

Hefny AF, Ayad AZ, Matev N, Bashir MO. Intestinal obstruction caused by a laxative drug (Psyllium): a case report and review of the literature. Int J Surg Case Rep. 2018;52:59–62. https://pubmed.ncbi.nlm.nih.gov/30321826/

3399

Gill SK, Rossi M, Bajka B, Whelan K. Dietary fibre in gastrointestinal health and disease. Nat Rev Gastroenterol Hepatol. 2021;18(2):101–16. https://pubmed.ncbi.nlm.nih.gov/33208922/

3400

Threapleton DE, Greenwood DC, Evans CE, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013;347:f6879. https://pubmed.ncbi.nlm.nih.gov/24355537/

3401

Gill SK, Rossi M, Bajka B, Whelan K. Dietary fibre in gastrointestinal health and disease. Nat Rev Gastroenterol Hepatol. 2021;18(2):101–16. https://pubmed.ncbi.nlm.nih.gov/33208922/

3402

Maskarinec G, Takata Y, Pagano I, et al. Trends and dietary determinants of overweight and obesity in a multiethnic population. Obesity (Silver Spring). 2006;14(4):717–26. https://pubmed.ncbi.nlm.nih.gov/16741275/

3403

Yao B, Fang H, Xu W, et al. Dietary fiber intake and risk of type 2 diabetes: a dose-response analysis of prospective studies. Eur J Epidemiol. 2014;29(2):79–88. https://pubmed.ncbi.nlm.nih.gov/24389767/

3404

Fatahi S, Matin SS, Sohouli MH, et al. Association of dietary fiber and depression symptom: a systematic review and meta-analysis of observational studies. Complement Ther Med. 2021;56:102621. https://pubmed.ncbi.nlm.nih.gov/33220451/

3405

Kim Y, Je Y. Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies. Am J Epidemiol. 2014;180(6):565–73. https://pubmed.ncbi.nlm.nih.gov/25143474/

3406

Threapleton DE, Greenwood DC, Evans CEL, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013;347:f6879. https://pubmed.ncbi.nlm.nih.gov/24355537/

3407

Wolever TM, Jenkins DJ. What is a high fiber diet? Adv Exp Med Biol. 1997;427:35–42. https://pubmed.ncbi.nlm.nih.gov/9361828/

3408

Shaper AG, Jones KW. Serum-cholesterol, diet, and coronary heart-disease in Africans and Asians in Uganda: 1959. Int J Epidemiol. 2012;41(5):1221–5. https://pubmed.ncbi.nlm.nih.gov/23045195/

3409

Singh SA, Trowell HC. A case of coronary heart disease in an African. East Afr Med J. 1956;33(10):391–4. https://pubmed.ncbi.nlm.nih.gov/13375489/

3410

Ikem I, Sumpio BE. Cardiovascular disease: the new epidemic in sub-Saharan Africa. Vascular. 2011;19(6):301–7. https://pubmed.ncbi.nlm.nih.gov/21940758/

3411

Burkitt DP, Walker AR, Painter NS. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet. 1972;2(7792):1408–12. https://pubmed.ncbi.nlm.nih.gov/4118696/

3412

Dietary fiber market to reach $3.25 billion by 2017. Neutraceuticals World. https://nutraceuticalsworld.com/contents/view_breaking-news/2012–10–29/dietary-fiber-market-to-reach-325-billion-by-2017. Published October 29, 2012. Accessed March 29, 2022.; https://nutraceuticalsworld.com/contents/view_breaking-news/2012-10-29/dietary-fiber-market-to-reach-325-billion-by-2017

3413

Eastwood M, Kritchevsky D. Dietary fiber: how did we get where we are? Annu Rev Nutr. 2005;25:1–8. https://pubmed.ncbi.nlm.nih.gov/16011456/

3414

Threapleton DE, Greenwood DC, Evans CE, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013;347:f6879. https://pubmed.ncbi.nlm.nih.gov/24355537/

3415

Eastwood M, Kritchevsky D. Dietary fiber: how did we get where we are? Annu Rev Nutr. 2005;25:1–8. https://pubmed.ncbi.nlm.nih.gov/16011456/

3416

McRorie JW. Evidence-based approach to fiber supplements and clinically meaningful health benefits, part 2: what to look for and how to recommend an effective fiber therapy. Nutr Today. 2015;50(2):90–7. https://pubmed.ncbi.nlm.nih.gov/25972618/

3417

Agricultural Research Service, United States Department of Agriculture. Seeds, flaxseeds. FoodData Central. https://fdc.nal.usda.gov/fdc-app.html#/food-details/169414/nutrients. Published April 1, 2019. Accessed February 22, 2023.; https://fdc.nal.usda.gov/fdc-app.html#/food-details/169414/nutrients

3418

Soltanian N, Janghorbani M. A randomized trial of the effects of flaxseed to manage constipation, weight, glycemia, and lipids in constipated patients with type 2 diabetes. Nutr Metab (Lond). 2018;15:36. https://pubmed.ncbi.nlm.nih.gov/29760761/

3419

Soltanian N, Janghorbani M. Effect of flaxseed or psyllium vs. placebo on management of constipation, weight, glycemia, and lipids: a randomized trial in constipated patients with type 2 diabetes. Clin Nutr ESPEN. 2019;29:41–8. https://pubmed.ncbi.nlm.nih.gov/30661699/

3420

Sun J, Bai H, Ma J, et al. Effects of flaxseed supplementation on functional constipation