Constipation is defined as a difficulty emptying the bowel and is most often defined as having a bowel movement less than 3 times per week and is usually associated with hard stools.

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Constipation is very common, especially in populations that eat very little fiber in their diets on average (high processed foods and high animal product intake). It is estimated that in North America, approximately 63 million people have constipation.1 Constipation is most often caused by the following:

  • Delay in going to the bathroom when you have the urge
  • Low intake of water
  • Limited or lack of physical activity
  • Low-fiber diet

Having a bowel movement 1-3 times per day is considered in the normal range. Remember that frequency isn’t the only factor to measure. In a healthy normal individual, bowel movements shouldn’t be uncomfortable, there should not be blood in the stool, and the stools should not be black or tarry in appearance. A Nutritarian diet is high in fiber and water, making it favorable for healthy bowel movements!

  1. Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol 2004, 99:750-759.

Action Plan


A Nutritarian diet is a very effective way to achieve regularity and ease of bowel movements, as it is high in all types of fiber and water and has favorable effects on fueling the growth of healthy gut bacteria.

Other Considerations

If after following a Nutritarian eating style for a few weeks, you still are constipated or uncomfortable:

  • Chew thoroughly. For best results, fiber from vegetables, fruits, and legumes needs to be broken down by thorough chewing (or blending) before it reaches the stomach and intestines. One way to think of it is to remember to chew each bite of food until it is liquid in your mouth.
  • Consider using a probiotic daily, which may help break down the fiber in the food better as you transition to a Nutritarian eating style.
  • If your constipation has not subsided after trying the ideas above, or you have not had a bowel movement in a few days, it is important to see a physician.

Stay active. Physically moving helps move your stool through your intestines better. The more regular your physical movements are, the better it works.

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Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


Is there anything than can be done for chronic constipation? I eat greens, drink water, etc. and for as long as I can remember, I have had to take something in order to have a bowel movement. That is not working anymore. Is there any way to re-train your body to achieve normal elimination?


The long-term use of laxatives and stool softeners can lead to dependency and chronic constipation. A complete overhaul of your diet is needed, not just the addition of greens. The first step is to eat a diet that is mostly raw and that uses shredded cabbage, collards or kale, shredded carrots, beets, jicama, onions, and apples. Exercise, that includes jogging and bouncing, is also important. Then, over time, you should be able to very slowly reduce the amount of laxative you are taking. Switching to stool softeners and gradually reducing the laxatives is the first step. An occasional warm water enema can be used if you're having problems reducing your dependency on laxatives. It is wise to do this under the care of your local physician.


I am wondering if there are any solutions for constipation. Should I be drinking a certain amount of water? Is there a certain recipe that will help?


A Nutritarian diet style is rich in fiber and other nutrients that optimize digestion and bowel function. Itis likely all that is necessary to resolve any difficulty you have had with your bowels in the past. Many find it helpful to add one tablespoon of ground flax seeds or chia seeds to your daily menu. Prunes and shredded raw vegetables and fruits, such as raw apples, cabbage, beets, and carrots, are particularly helpful.