Diet with Fiber

Let's hear it for bran!

"Man is what he eats," says an old German proverb that has proved to be prophetic. Until about 1900, man was what he could get to eat, whether in Boston or Bangkok, and his food was nearly all prepared at or near his eating place. Then came the explosion of the food-processing industry, and humanity came to be distinguished not only by what it ate but by some new diseases related to foods. The most conspicuous dietary change in developed countries over the past 75 years has been an alpine increase in the consumption of hard fats, sugar and superrefined foods from which virtually all natural roughage--in nutritional parlance, fiber--has been removed. A prime example: the cottony white bread consumed by most Americans.

Alarms over these fiber-poor diets began sounding almost a decade ago. In 1969, Surgeon-Captain Thomas Cleave of Britain's Royal Navy wrote a scathing indictment blaming the increased consumption of sugar and other refined carbohydrates (like bleached flour) for a host of diseases, from diabetes and diverticulosis to varicose veins and possibly colon cancer. British Surgeon Denis P. Burkitt followed with a recommendation for dwellers in developed countries to increase their fiber consumption toward the almost 1 oz. per day consumed by Africans he studied. Some eminent nutritionists have protested that the Britons' claims were gross exaggerations. At the fifth Western Hemisphere Nutrition Congress in Quebec last month, one authority summed up current biochemical knowledge about fiber, and another explored its medical aspects in the hope of ending some of the fracas.

Dietary fiber, said Dr. Ruth M. Kay of the University of Toronto, consists of those parts of edible plants that are resistant to the human digestive enzymes, so that they pass through the system virtually unchanged until they encounter bacteria in the large bowel. There are three basic kinds of fiber. The simplest is cellulose; the four-chambered stomach of cattle can readily digest this form, but the single human stomach cannot. Next comes a group of polysaccharides, consisting of complex sugar chains. The third type is lignin, which not even intestinal bacteria can degrade. Fiber of any kind provides little caloric nourishment; its main value is in absorbing water so that the contents of the digestive tract are bulky, loose and easily excreted. Grandma knew this when she advised her family to eat more fruits and vegetables in order to avoid constipation. These are good foods indeed, said Kay, but the most useful water absorber and stool loosener is coarse wheat bran, which soaks up three to four times its own weight in water.

Dr. Martin Eastwood of Edinburgh spelled out in Quebec the effects of fiber consumption on several ailments. One of the most common illnesses relieved by fiber is diverticulosis, a disorder rarely seen until about 1920, in which partly digested food moving sluggishly through the large bowel accumulates in small pockets where the intestinal wall is weak. Trapped in these chambers, bacteria may multiply and cause painful acute infection, or diverticulitis. Until about five years ago, the standard treatment for these conditions, which now affect an estimated 40% of Americans over the age of 40, was a bland diet with no fibrous roughage. That is wrong, said Eastwood. Enlightened specialists today prescribe a high-fiber diet for victims of diverticular disease, in an effort to keep the bowel's contents bulky and moving toward easy, effortless elimination. His prescription is the same for patients with the ill-defined but discomforting "irritable bowel syndrome."

For most patients with diverticular disease and resulting constipation, he prescribes the following: "First, a handful of bran a day with milk and sugar and with added raisins or cooked fruit for improved taste and texture. During the first week the patient will pass more wind and feel some discomfort--but this, like the wind, will pass. Then during the second week the patient can increase the amount of bran to two handfuls per day, and stay on that for the remainder of his days." Other aids: apples, oranges, raw carrots and cabbage.

In simultaneous editorials, the two leading British publications for doctors have extolled the virtues of dietary fiber while noting its limitations. Said the British Medical Journal: "Cleave saw that the same refining process which leads to underfilling of the colon and all its consequences leads also to overfilling of the mouth--that is, to overnutrition and all its consequences." Lancet noted evidence that increased intake of certain dietary fibers may eventually be shown to help control diabetes and reduce insulin requirements. Whether fiber will help, as Burkitt and Cleave have suggested, to retard coronary disease or prevent colon cancer remains highly questionable, though under intensive study. But for most people, breakfast bran, plus fruits and vegetables, will eliminate both the need for laxatives and much intestinal discomfort.

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