Fibre and prevention of chronic diseasesBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6938 (Published 10 November 2011) Cite this as: BMJ 2011;343:d6938
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Fibre and Preventionof Chronic Diseases
BMJ 2011; 343; 1075
Although a high intake of fibre from cereals and a high consumption of wholegrain foods is shown to be significantly associated with a reduced risk of colorectal cancer it is also shown that this protective action is not related to the actual fibre component but to other components. I was working with Denis Burkitt in the MRC External Unit in the 1970s and early 1980s when he was collecting information on a worldwide basis about the relationship between the intake of dietary fibre and diseases. He was particularly interested in its relationship to diverticular disease and to colorectal cancer. My remit at the time was the collecting of information about the relationship between staple diets, their fibre content, and the prevalence of duodenal ulceration. Information was obtained from many countries including India, China, parts of Africa and Malaysia. A low prevalence of duodenal ulceration was found in areas where the staple diet was based on unrefined wheat or maize, soya, certain millets or certain pulses. A high prevalence was found in areas where the staple diet was principally milled rice, refined wheat or maize, yams, cassava, sweet potato or green bananas. The picture suggested that the low prevalence was related to a high fibre content in the diet, but there were discrepancies. For instance there was a high prevalence of duodenal ulceration in the highlands of Ethiopia around Addis Ababa where the staple food was Teff, which had a very high fibre content. This suggested that another factor other than the fibre was responsible for the low prevalence.
The diets and individual foods from low prevalence areas were investigated using several rat peptic ulcer models, and the results confirmed the ulcero-protective activity of the foods predominating in the lower duodenal ulcer prevalence areas. The experiments showed that the protective activity lay in the lipid component of these foods[2,3]. In cereals the lipid lay in outer fibrous coat, the germ and the bran. This lipid fraction was protective in both gastric ulcer and duodenal ulcer models. It was active when given orally or intramuscularly and it also promoted ulcer healing. It was protective against aspirin produced gastric ulceration. The activity was found to lie in the phospholipid and sterol fractions of the lipid, and their nature was subsequently identified. The clinical importance of the ulcero-protective effect of this combination of phospholipids and phytosterols may lie, not only in relation to the possible prevention and treatment of peptic ulceration, but also in the prevention of gastroduodenal ulceration associated with the taking of NSAIDs. Wheat germ or wheat bran oil would be a ready source of this combination.
1) Tovey F I, Staple diets and duodenal ulcer prevalence. International Health 2009: 1: 124-132.
2) Jayaraj AP, Tovey FI, Lewin MR, Clark CG. Duodenal ulcer prevalence: Experimental evidence for the possible role of dietary lipids. J Gastroenterol Hepatol 2000; 15: 610-6.
3) Jayaraj AP, Tovey FI, Clark CG, Hobsley M. Dietary factors in relation
to the distribution of duodenal ulcer in India as assessed by studies in
rats. J Gastroenterol Hepatol 2001; 16: 501-5.
4) Jayaraj AP, Tovey FI, Hobsley M. Duodenal ulcer prevalence: Research into the nature of possible protective dietary lipids. Phytother Res 2003; 17: 391-8.
5) Tovey FI, Capanoglu D, Langley GJ, Herniman J, Bor S, Ozutemiz O, Hobsley M, Bardhan KD, Linclau B. Dietary Phytosterols Protective against Peptic Ulceration. Gastroenterology Research 2011, 4(4): 149-56.
Competing interests: No competing interests