Sturtzel, B., & Elmadfa, I. (2008). Intervention with dietary fiber to treat constipation and reduce laxative use in residents of nursing homes. Annals of Nutrition and Metabolism, 52(Suppl. 1), 54–56.

To determine whether the addition of oat bran to the diets of older adult residents of a long-term care facility would lead to a reduction in laxative use.

The control group (15 patients assigned) received usual diet.

The intervention group had oat fiber containing 8.3 g of nondigestible fermentable fiber and 9.7 g of nondigestible nonfermentable fiber per 100 g incorporated into their diet for 12 weeks.

• The study reported on a sample of 30 older adult patients.
• Patient age ranged from 57 to 98 years. Mean age was 86 years (SD = 9) in the intervention group and 84.6 years (SD = 11.4) in the control group.
• Gender information was not provided.
• Patients were excluded if they were receiving parenteral or enteral nutrition or any medication that would alter transit time through the gut.

Single ward of a long-term care facility in Vienna, Austria

The study has clinical applicability to older adult care.

This was a controlled, parallel, blind intervention trial.

• Nursing staff began recording laxative use after 10 days.
• Body weight was recorded on days 1, 42, and 84.
• Kilojoule (calorie) and fluid intake were recorded daily.
• Observations concerning patients' eating habits were used to adapt recipes to ensure compliance.

• The intervention group increased fiber intake by 5.1 g over the 12-week study period.
• The intervention group had a 59% reduction in laxative use (p < 0.001), with a constant body weight (p = 0.455). 
• The control group had a decrease in fiber intake by 1.8 g. Mean energy intake was 5,203 kilojoules (SD = 1,285) per day, and mean fluid intake was 1.794 ml (SD = 276 ml) per day.
• The control group increased laxative use by 8% (p = 0.218), and their body weight decreased significantly (p < 0.005).

Fiber supplementation with oat bran may be an alternative to laxatives for treating constipation in an older adult population.

• The study used a small convenience sample that did not include patients with cancer.
• Whether simple or double blinding was used is unclear.
• Exercise may have decreased constipation, but patients' activity level was not noted.

Increasing fiber supplementation with oat bran may be an alternative to laxative use for treating constipation in older adults. Additional study is warranted in a larger population that includes patients with cancer.