- Robert B Baron, professor of medicine and associate dean
- 1Division of General Internal Medicine, Department of Medicine, School of Medicine, University of California, San Francisco, CA 94143-0474, USA
One of my strongest memories from medical school is the image of two collections of stool projected in a guest lecture by Denis Burkitt. One, the stool of an African schoolboy, was large and moist; the other, that of an English schoolboy, was small and dry. Dr Burkitt, who was widely recognised for his work describing a unique cancer of the jaw in African children, went on to argue that diet, particularly one high in dietary fibre, could prevent many of the diseases common in Western countries.
In the years since, dozens of studies have investigated the association between dietary fibre and chronic disease. The linked paper by Threapleton and colleagues (doi:10.1136/bmj.f6879) is an important addition to this literature.1
The investigators performed a state of the art meta-analysis of 22 cohort studies that related intake of dietary fibre with coronary heart disease and cardiovascular disease. Consistent with most other studies, the meta-analysis showed a consistent inverse association between intake of dietary fibre and first coronary heart disease and cardiovascular disease events. For both outcomes, every 7 g per day intake of total dietary fibre was associated with a significant …