"Is the Fiber Theory Wrong?"
Fiber-containing foods may not only help prevent heart disease,
but help treat it as well.
Heart patients who increase their intake of fiber
after their first heart attack reduce their risk of a second
and live longer than those who don't.
But what if we really don’t want to have a heart attack
in the first place?
If seven grams of fiber gets us a 9% reduced risk,
would 77 grams a day drop our risk 99%?
Well, that’s about what they used to eat in Uganda,
a country in which coronary heart disease,
our #1 killer, was almost non-existent.
Heart disease was so rare
among those eating these traditional plant-based diets.
There were papers published like this:
“A Case of Coronary Heart Disease in An African”....?
After 26 years of medical practice they finally recorded
their first case of coronary heart disease
in a judge consuming a partially Westernized diet,
having fiber-free foods like meat, dairy, and eggs
displace some of the plant foods in his diet.
Were there so few cases
because Africans just didn’t live very long?
No, the overall life expectancy was low because of diseases
of childhood, like infections,
but when they reach middle age they had the best survival,
thanks in part to our #1 killer being virtually absent.
Of course now, diets have Westernized across the country,
and it gets to now be THEIR #1 killer as well.
From virtually non-existent to an epidemic.
Some blame this change on too much animal fat,
others blame it on too little fiber,
but they both point to the same solution,
a diet centered around unrefined plant foods.
In fact sometimes it’s easier to convince patients
to improve their diets by eating more of the good foods
to kind of crowd out some of the less healthy options.
The ‘dietary fiber hypothesis,’ first proposed in the 70’s,
zeroed in on fiber as THE dietary component
that was so protective against chronic disease.
And since then, evidence has certainly accumulated
that those who eat lots of fiber appear protected
from several chronic conditions,
but maybe fiber is just a marker
for the consumption of foods as grown,
whole unprocessed plant foods, the only major source fiber.
So maybe all these studies showing fiber is good
are really just showing that eating lots of unrefined plant foods are good.
Fiber is but one component of plant foods,
and to neglect the other components—
like all the phytonutrients—
may be to seriously limit our understanding.
Why did Drs. Burkitt, Trowell, Painter, Walker—
the fathers of the fiber theory—
place all their bets on fiber?
One possible explanation for this is that they were doctors,
and we doctors like to think in terms of magic bullets.
That’s how we’re trained— you know like "one pill-one operation".
They were clinicians, not nutritionists,
and so they developed a reductionist approach.
The problem with that approach
is that if we reach the wrong conclusion,
we may come up with the wrong solution.
Burkitt saw disease rates skyrocket
after populations went from eating whole plant foods
to refined plant and animal foods,
but instead of telling people that we should go back
to eating whole plant foods,
he was so convinced fiber was the magic component,
his top recommendation was to eat whole grain bread—
but they never used to eat any kind of bread in Uganda—
and sprinkle some spoonfuls of wheat bran on to your food.
But studies to this day associating high fiber intake
with lower risk of disease and death
relate only to fiber from food intake
rather than from fiber isolates or extracts.
It is not at all clear
whether fiber consumed as a supplement is beneficial.
In retrospect, maybe it was a mistake to isolate fiber
from the overall field of plant food nutrition.
The evidence supporting the value of fruits, vegetables, and whole grains,
as opposed to only fiber, has proved to be much more consistent.
Whole plant foods are what's of fundamental importance in our diet.
Fiber is just one of the many beneficial components
of fruits, vegetables, nuts, grains, and beans.
Much of the effort on defining fiber and studying the fiber isolate
would have been better applied to a whole-plant-food approach.
What would have happened if Burkitt and others
had instead emphasized the value of plant foods?
The value of eating unrefined plant food,
which incorporates fiber and phytonutrients,
might have been the focus of attention
rather than just isolated fiber,
which leads people to shop in this aisle for their fiber,
instead of this aisle.