Intended for healthcare professionals

Rapid response to:

Clinical Review Science, medicine, and the future

Nutritional genomics

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7351.1438 (Published 15 June 2002) Cite this as: BMJ 2002;324:1438

Rapid Response:

Food for thought?

Food for thought?

30th June 2002

Editor

In the recent review of nutritional genomics, Elliot and Ong retread
old ground with the statement that a diet of fruit and vegetables prevents
cancer1,2. The evidence from recent studies, however, suggests
otherwise3,4.

The widespread acceptance of a link between fibre intake and a
reduced incidence of cancer was probably due to observations by the
British surgeon, Dr Dennis Burkett in the early 1970’s. However, new
evidence disputes this. The recent study by Fuchs of 88,000 nurses over 16
years found no protective effect of fibre on the development of colon
polyps and cancer development4. In fact, evidence from this suggested
eating a significant amount of vegetables may actually increase the colon
cancer risk by 35%. Further more, the European Cancer Prevention
Organisation Study Group reported soluble dietary fibre supplements
probably have a deleterious effect on adenoma recurrence5.

The message regarding dietary fibre and health includes the possible
benefit from antioxidants in fruit and vegetables in reducing death from
coronary heart disease, and it seems likely that this message has taken
precedence over the benefits or otherwise to the G.I. tract6.

The effects of fibre on the gut are complex, but it is time to
acknowledge that current evidence no longer supports the old assumption
that fibre protects against bowel cancer3.

Peter Thatcher
Gastroenterology SpR

drpgthatcher@btinternet.com

George Bird
Consultant Gastroenterologist

georgebird@lineone.net

The Maidstone Hospital
Hermitage Lane
Maidstone
Kent

1 Elliott R, Ong T J. Nutritional genomics. BMJ 2002;324:1438- 42.
(15 June.)

2 Block G, Patterson B, Subar A. Fruit, vegetables, and cancer
prevention: a review of the epidemiological evidence. Nutr Cancer
1992;18:1-29.

3 Goodlad R. Dietary fibre and the risk of colorectal cancer. Gut
2001;48:587-9.

4 Fuchs C, Giovannucci E, Colditz G et al. Dietary fiber and the risk
of colorectal cancer and adenoma in women. N Engl J Med 1999;340:169-76.

5 Bonithon-Kopp C, Kronborg O, Giacosa A, et al. Calcium and fibre
supplementation in prevention of colorectal adenoma recurrance: a
randomised intervention trial. Lancet 2000;356:1300-6.

6 Kmietowicz Z. Healthier eating will help combat heart disease. BMJ
1997;314:921. (29 March.)

Competing interests: No competing interests

01 August 2002
Peter G Thatcher
Gastroenterology SpR
George Bird.
Maidstone General Hospital ME16 9QQ