Fibre! Fibre! Fibre!

I’ve written lots about fibre and its central importance for our health 1 2 3 , so it’s refreshing to see articles such as one that’s just appeared on the BBC News channel entitled “The lifesaving food 90% aren’t eating enough of” 4 . And what’s that lifesaving food? Of course, it’s fibre. Ignore its importance at your peril…

The study

The BBC article comments on a recent systematic review/meta-analysis published in The Lancet 5 and undertaken, in part, on behalf of the WHO (World Health Organisation). The WHO recognises the vital role played by dietary fibre and it wants to reevaluate its recommendations for daily fibre consumption. The WHO’s current recommended minimum dietary fibre intake per day is 30g (1 oz).

Study background

There’s growing concern about the lamentably low amount of fibre consumed around the world, with most people eating less than 20 grams of fibre a day. Less than 10% of UK adults eat 30 grams or more of fibre daily, with women consuming an average of 17 grams, and men 21 grams, a day. Things are even worse in the USA, where less than 3 percent of Americans meet the minimum daily recommendation for fibre 6 .

25-30 grams of fibre looks like this (according to Elaine Rush, a professor of nutrition at Auckland University of Technology):

  • half a cup of rolled oats – 9g fibre
  • two Weetabix – 3g fibre
  • a thick slice of brown bread – 2g fibre
  • a cup of cooked lentils – 4g fibre
  • a potato cooked with the skin on – 2g fibre
  • half a cup of chard (or silverbeet in New Zealand) – 1g fibre
  • a carrot – 3g fibre
  • an apple with the skin on – 4g fibre

Of course, most people get nowhere near this in countries like the UK and USA, and only a negligible number of people, with most people’s diets consisting of processed foods and animal products.

  • processed foods – almost all the fibre (soluble and insoluble) is removed
  • animal products – there is zero fibre in meat, fish, dairy and eggs

Study conclusion

Findings from prospective studies and clinical trials associated with relatively high intakes of dietary fibre and whole grains were complementary, and striking dose-response evidence indicates that the relationships to several non-communicable diseases could be causal. Implementation of recommendations to increase dietary fibre intake and to replace refined grains with whole grains is expected to benefit human health.

Chronic disease & fibre

I could go into the details of the BBC article and the Lancet study, as well as other studies on fibre – about how many diseases appear to be preventable by consuming larger quantities of fibre and considerably less quantities of processed and animal foods, including…

  • hiatal hernias, varicose veins, haemorrhoids 7
  • anal fissures 8
  • heavy metal toxicity 9
  • cholesterolemia 10
  • hyperglycaemia 11
  • hypertension 12 13
  • hypertriglyceridaemia 14
  • atherosclerosis 15 16
  • Alzheimer’s disease17
  • colon cancer 18 19
  • breast cancer 20
  • ovarian cancer 21 22
  • laryngeal cancer 23 22
  • diabetes 24 25
  • heart disease 26 27 28
  • obesity 29
  • stroke 30 31
  • premature death in general 13 32 33

…so it’s not just that it ‘keeps you regular’ by avoiding constipation. But what I want to point out is the following:

Eat a WFPB diet and you will ALWAYS get more than enough fibre in your diet. It’s as simple as that!

And not only that, as Dr Michael Greger points out in his excellent book How Not To Die 34 : “…whole-food, plant-based diets used therapeutically to reverse chronic disease contain upward of sixty grams of fibre.” That’s right, whole food therapy that’s been shown 35 36 to reverse and not just prevent chronic diseases.

Fiddling while Rome burns

Talking about ways of introducing more fibre into diets is all well and good for those people who are more interested in reciting the mantra “Moderation in all things“, but that’s not what I believe is the best advice that the medical/nutrition professions, media or government should be saying.

For me, tinkering with diets so that they have enough fibre intake (while still piling in the processed junk and animal foods) is no different from the myriad of ‘experts’ trying to tinker with the amount of calories or saturated fat we should eat: it’s like telling someone who keeps banging their head against the wall that there are a number of new medications available to deal with infections and pain resulting from the head-banging; or that the new government guidelines are that you should introduce a pillow between the head and the wall for at least an hour a day; or that you could try not banging your head during January Non-Head-Banging Month.

Of course, the manufacturers and sellers of medications, head-banging guides and accessories would not want everyone to stop head-banging since they would then be out of a job. No profits in healthy people.

This is why the true facts are hardly ever found in the public arena (although they’re plentiful in medical literature and research documents going back many decades): a diet consisting of whole plant foods (fruits, vegetables, legumes, grains, mushrooms, nuts and seeds), with no animal foods and no added salt, sugar or oil is the optimal diet for human health and longevity.

It’s estimated 37 that humans evolved eating huge amounts of fibre – as much as 100 grams a day!

As a previous blog suggested 38 , this is because we humans are essentially frugivores (fruit-eaters). Thus, our bodies are designed to process huge quantities of fibre and to depend on that fibre for long and healthy lives.

Final thoughts

By all means have a read of the BBC News article 4 , it makes some nice points and I applaud James Gallagher (the author) for contributing it for those readers who might make a few tentative steps towards improving their diets.

But don’t be deceived – you will not achieve optimal health and longevity by simply adding a handful of blackberries to your bowl of ice cream or half a tin of Heinz baked beans to your eggs and bacon breakfast.

If you’re serious about doing the best for your physical and mental health (and isn’t it just bizarre that we humans even have to question this?!) then any option less than a non-SOS WFPB diet 39 will be causing harm to your body, whether you’re aware of it now or not.


References

  1. Plant Protein, Fibre & Nuts Lower Cholesterol & Blood Pressure []
  2. Butyrate – Why Dietary Fibre is So Important []
  3. Vegan Pregnancy & Parenting []
  4. BBC News: The lifesaving food 90% aren’t eating enough of. By James Gallagher. Health and science correspondent, BBC News. [] []
  5. The Lancet. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses Andrew Reynolds, PhD, Prof Jim Mann, DM, Prof John Cummings, MD, Nicola Winter, MDiet, Evelyn Mete, MDiet, Lisa Te Morenga, PhD. Published:January 10, 2019DOI:https://doi.org/10.1016/S0140-6736(18)31809-9. []
  6. Clemens R, Kranz S, Mobley AR, et al. Filling America’s fibre intake gap: summary of a roundtable to probe realistic solutions with a focus on grain-based foods. J Nutr. 2012;142( 7): 1390S– 401S. []
  7. McMahan CA, Gidding SS, Malcom GT, et al. Pathobiological determinants of atherosclerosis in youth risk scores are associated with early and advanced atherosclerosis. Pediatrics. 2006;118( 4): 1447– 55. []
  8. Trumbo PR, Shimakawa T. Tolerable upper intake levels for trans fat, saturated fat, and cholesterol. Nutr Rev. 2011;69( 5): 270– 8. []
  9. Akhondzadeh S, Sabet MS, Harirchian MH, et al. Saffron in the treatment of patients with mild to moderate Alzheimer’s disease: a 16-week, randomized and placebo-controlled trial. J Clin Pharm Ther. 2010;35( 5): 581– 8. []
  10. Whitehead A, Beck EJ, Tosh S, Wolever TM. Cholesterol-lowering effects of oat ß-glucan: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014;100( 6): 1413– 21. []
  11. Silva FM, Kramer CK, De Almeida JC, Steemburgo T, Gross JL, Azevedo MJ. Fibre intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Nutr Rev. 2013;71( 12): 790– 801 []
  12. Streppel MT, Arends LR, van ’t Veer P, Grobbee DE, Geleijnse JM. Dietary fibre and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med. 2005;165( 2): 150– 6. []
  13. Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011– 2012. NCHS Data Brief. 2013;( 133): 1– 8. [] []
  14. Threapleton DE, Greenwood DC, Burley VJ. Response to letter regarding article, “Dietary fibre intake and risk of first stroke: a systematic review and meta-analysis,” Stroke. 2013;44( 9): e110. []
  15. van de Laar RJ, Stehouwer CDA, van Bussel BCT, et al. Lower lifetime dietary fibre intake is associated with carotid artery stiffness: the Amsterdam Growth and Health Longitudinal Study. Am J Clin Nutr. 2012;96( 1): 14– 23. []
  16. Am J Clin Nutr. 2003 Dec;78(6):1085-91. Dietary fiber and progression of atherosclerosis: the Los Angeles Atherosclerosis Study. Wu H1, Dwyer KM, Fan Z, Shircore A, Fan J, Dwyer JH. []
  17. Scientific Research: High Fibre Diets and Alzheimer’s . Ian James Martins, W. M. A. D. Binosha Fernando. Disease https://www.scirp.org/journal/PaperInformation.aspx?PaperID=42787 []
  18. Aune D, Chan DS, Lau R, et al. Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2011;343: d6617. []
  19. Patyar S, Patyar RR. Correlation between sleep duration and risk of stroke. J Stroke Cerebrovasc Dis. 2015;24( 5): 905– 11. []
  20. Aune D, Chan DS, Greenwood DC, et al. Dietary fibre and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol. 2012;23( 6): 1394– 402. []
  21. Nutr J. 2018; 17: 99. Dietary fiber intake and reduced risk of ovarian cancer: a meta-analysis. Bowen Zheng, Hui Shen, Hedong Han, Ting Han, Yonghong Qincorresponding. []
  22. Chandra V, Ganguli M, Pandav R, et al. Prevalence of Alzheimer’s disease and other dementias in rural India: the Indo-US study. Neurology. 1998;51( 4): 1000– 8. [] []
  23. Ann Oncol. 2003 Jan;14(1):162-7. Fibre intake and laryngeal cancer risk. Pelucchi C1, Talamini R, Levi F, Bosetti C, La Vecchia C, Negri E, Parpinel M, Franceschi S. []
  24. Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990– 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380( 9859): 2224– 60. []
  25. Delahaye F. Should we eat less salt? Arch Cardiovasc Dis. 2013;106( 5): 324– 32. []
  26. American Heart Association. Understanding Blood Pressure Readings. http:// www.heart.org/ HEARTORG/ Conditions/ HighBloodPressure/ AboutHighBloodPressure/ Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp. March 11, 2015. Accessed March 11, 2015. []
  27. BNJ: Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 2013; 347. []
  28. Cochrane Database of Systematic Reviews. Dietary fibre for the primary prevention of cardiovascular disease. Cochrane Systematic Review – Intervention Version published: 07 January 2016. Louise HartleyMichael D MayEmma LovemanJill L ColquittKaren Rees. []
  29. Go AS, Bauman MA, Coleman King SM, et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. J Am Coll Cardiol. 2014;63( 12): 1230– 8. []
  30. Walker AR, Walker BF. High high-density-lipoprotein cholesterol in African children and adults in a population free of coronary heart disease. Br Med J. 1978;2( 6148): 1336– 7. []
  31. Eur J Epidemiol. 2013 Feb;28(2):119-30. doi: 10.1007/s10654-013-9783-1. Epub 2013 Feb 21. Dietary fiber consumption and risk of stroke. Zhang Z, Xu G, Liu D, Zhu W, Fan X, Liu X. []
  32. Am J Epidemiol. 2015 Jan 15;181(2):83-91. doi: 10.1093/aje/kwu257. Epub 2014 Dec 31. Association between dietary fiber and lower risk of all-cause mortality: a meta-analysis of cohort studies. Yang Y, Zhao LG, Wu QJ, Ma X, Xiang YB. []
  33. Arch Intern Med. Arch Intern Med. 2011 Jun 27; 171(12): 1061–1068. Dietary fiber intake and mortality in the NIH-AARP Diet and Health Study. Yikyung Park, Sc.D, Amy F. Subar, Ph.D., Albert Hollenbeck, Ph.D, Arthur Schatzkin, MD. []
  34. Greger, Michael; Stone, Gene. How Not To Die: Discover the foods scientifically proven to prevent and reverse disease (Air Side Edt) (p. 189). Pan Macmillan. Kindle Edition. []
  35. Dewell A, Weidner G, Sumner MD, Chi CS, Ornish D. A very-low-fat vegan diet increases intake of protective dietary factors and decreases intake of pathogenic dietary factors. J Am Diet Assoc. 2008;108( 2): 347– 56. []
  36. MedGenMed. 2007; 9(3): 46. Published online 2007 Aug 31. PMCID: PMC2100124. We Can Prevent and Even Reverse Coronary Artery Heart Disease. Caldwell B. Esselstyn, Jr., MD, Preventive Medicine Consultant. []
  37. Eaton SB, Konner M, Shostak M. Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective. Am J Med. 1988;84( 4): 739– 49. []
  38. Are We More Plant-Eater or Meat-Eater? []
  39. T Colin Campbell. Centre for Nutrition Studies: Living a Whole Food, Plant-Based Life []