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The Cholesterol Myth
Part 3: The Bran Wagon
The tragedy of science is the slaying of a beautiful hypothesis by an ugly
fact.
T H Huxley
The belief that regular bowel movement is important for health is very ancient.
But the present
theory is based on Dr. Dennis Burkitt's discovery that relatively few rural
black Africans suffer
from cancer of the colon. He attributed this to their relatively crude diet.
The theory was that, as fibre made food travel through the gut faster, it
allowed less time for
cancer-inducing agents to form. This, of course, presupposed that food became
carcinogenic in
the gut and there was no evidence that it did. Neither was there any evidence
that moving food
through the intestine at a faster rate decreased the risk of colon cancer.
Moreover, the rural
Africans' lifestyle was far from that of the Western city dweller: their diet
is different, but also
they were not exposed to so many pollutants, toxins or mental stresses. Indeed,
there were many
factors that could have been responsible for a difference in disease patterns.
Other communities
- the Mormons of Utah, for example - also enjoyed a low incidence of colon
cancer yet they ate
a low-fibre diet.
So the theory was unsubstantiated at the time and it was to be disproved in
practice later as the
rural Africans moved into towns and adopted a Western style low fibre diet.
Their incidence of
colon cancer has remained low and this has continued with the second
generation. Nevertheless,
these later findings were not publicised. Burkitt's theories caught the
attention of the media.
Always ready to exploit a good story, they expanded what was at best a very
weak hypothesis
into a treatment dogma that teaches that fibre is a panacea for all manner of
illnesses.
Commercial interests were quick to see the potential in the recommendation and
jump on the
bran wagon. Burkitt's recommendation was based on vegetable fibre, but bran
(cereal fibre) has
a far higher fibre content and bran was a practically worthless by-product of
the milling process
that, until then, had been thrown away. Almost overnight, it became a highly
priced profit
maker. Although totally inedible, backed by Burkitt's fibre hypothesis, bran
could now be
promoted as a valuable food. But Dr. Hugh Trowell, Burkitt's partner and
another strong
advocate of dietary fibre, stated in 1974 that:
"A serious confusion of thought is produced by
referring to the dietary fibre hypothesis as the bran hypothesis, for many
Africans do not
consume cereal or bran"
Fibre and coronary heart disease
The idea that fibre could protect against heart attacks was
hypothesised by Trowell in 1972, again based on research on rural Africans. The
dietary
intervention trials mentioned earlier, however, concluded that increasing
dietary fibre had no
beneficial effect on heart disease.
Fibre and other diseases.
It may be useful at this stage to consider the claims for fibre in
curing or preventing other diseases. For example, bran has been a popular way
to manage
irritable bowel syndrome (IBS) for about thirty years, despite the fact that no
placebo-controlled
study of bran in IBS has yet shown any convincing beneficial effect. A study,
published in 1994,
found that while fruit fibre was effective, bran only made the situation worse.
Far from being a
cure for IBS, they found that it was the bran that was causing it! Bran also
caused bowel
disturbances, abdominal distension and pain.
Moreover, there is no direct evidence that an increase of fibre by itself will
prevent or cure
the other diseases. With respect to colon cancer, Burkitt's theory was
questioned with the
suggestion that the low cancer rates in rural Africans may be due to their high
early death rates
from other causes.
There is also a growing scepticism in the USA that lack of fibre causes cancer;
some studies
even suggesting that a fibre-enhanced diet
increases
the risk of colon cancer.
Other adverse effects
Tests into the supposed benefits of dietary fibre soon showed that there could
be other harmful side
effects. All the nutrients in food are absorbed through the gut wall and this
takes time. Fibre, by
speeding food through the gut faster so that less nutrients are absorbed,
inhibits the absorption of
iron, calcium, phosphorus, magnesium, energy, proteins, fats and vitamins A, D,
E and K. This
happens with all types of fibre although with a normal Western-style,
nutrient-rich diet, the loss
caused by vegetable fibre intake is unimportant. More importantly, phytate
found in cereal fibre
(bran) also binds with calcium, iron and zinc making them indigestible, which
in turn causes
malabsorption. One study, for example, showed that subjects absorbed more iron
from white bread
than from wholemeal bread even though their intakes of iron were fifty percent
higher with the
wholemeal bread. Bran has also been shown to cause faecal losses of calcium,
iron, zinc,
phosphorus, nitrogen, fats, fatty acids and sterols, thus depleting the body of
these materials.
These findings are a cause for concern in several sections of the population
who are at
considerable risk from eating too much fibre - and bran fibre in particular:
-
The incidence of
osteoporosis
(brittle bone disease) is increasing and now affects one in
two post-menopausal women, one in five of whom will die as a direct result.
Osteoporosis is
also increasingly affecting men. Osteoporosis is caused by several factors, but
lack of calcium
is the basic problem. Bran both inhibits the absorption of calcium from food
and depletes the
body of the calcium it has. Moreover, zinc, which bones need to heal, is
another mineral
whose absorption is adversely affected by bran.
-
Sufferers from
Alzheimer's Disease
(senile dementia) are found to have abnormal
amounts of aluminium in their brains. Tests on the people of Guam and parts of
New Guinea
and Japan, who get Alzheimer's disease at a much younger age, suggest that it
is lack of
calcium, causing a hormonal imbalance that permits the aluminium to penetrate
the brain.
-
Infants may suffer similar
brain damage
if fed soy-based baby milk as this too has a high
phytate content, inhibiting the absorption of zinc, which is essential for
proper brain development.
-
Vitamin deficiency diseases such as
rickets
that were common in Britain until a diet high
in dairy products and meat was advocated are on the increase again. The
situation is getting so
bad here that doctors suggest that vegetarian-based fad diets should be
classified a form of
child abuse.
-
In the UK, USA, Canada and South Africa the intake of 'anti-nutrients' such as
dietary
fibre that impair the absorption of iron, accompanied by a low intake of meat
(another result
of the diet-heart recommendations), is producing a real risk of
iron deficiency anaemia.
-
Depression, anorexia, low birth weight, slow growth, mental retardation
, and
amenorrhoea
are associated with deficiencies of zinc and the first five of these are also
associated with a deficiency of iron.
-
Lastly, excess fibre affects the
onset of menstruation, retards uterine growth
and, later,
is associated with
menstrual dysfunction
.
Because of the phytate, Professor David Southgate, arguably the world's leading
authority on
the effects of fibre, concludes that infants, children, young adolescents and
pregnant women
whose mineral needs are greater should be protected from excessive consumption
of fibre.
Writing of the
colon cancer
risk, Drs. H. S. Wasan and R. A. Goodlad of the Imperial Cancer
Research Fund stated in 1996:
"Until individual constituents of fibre have been shown to have, at the very
least,
a non-detrimental effect in prospective human trials, we urge that restraint
should be shown in adding fibre supplements to foods, and that unsubstantiated
health claims be restricted." . . . "Specific dietary fibre supplements,
embraced as nutriceuticals or functional foods, are an unknown and potentially
damaging way to influence modern dietary habits of the general population."
Until fibre can be shown not to be detrimental they suggest that
"restraint should be shown in adding fibre supplements to foods, and that
unsubstantiated health claims should be restricted".
January 1999 saw the publication of the largest trial into the effects on fibre
on colon cancer
ever conducted. After studying 88,757 women for sixteen years, doctors at the
Brigham and
Women's Hospital and Harvard Medical School say that
"No significant association between fiber intake and the risk of
colorectal adenoma was found." . . . "Our data do not support the existence of
an important protective
effect of dietary fiber against colorectal cancer or adenoma."
Summary
Bran is bad news. While there is not too much harm from fruit fibre, the usual
bran that is pushed at us - wheat bran - should be avoided like the plague it is.
References:
D P Burkitt,
et al.
Some geographical variations in disease patterns in East and Central Africa.
E
Afr Med J
. 1963; 40: 1.
H C Trowell. Fibre and irritable bowels.
BMJ.
1974; 3: 44.
- Dietary fibre, ischaemic heart disease and diabetes mellitus.
Proc Nutr Soc.
1973; 32: 151.
C Y Francis, P J Whorwell. Bran and irritable bowel syndrome: time for
reappraisal.
Lancet
1994;
344: 39.
F Swain,
et al.
Comparison of the effects of oat bran and low-fiber wheat on serum lipoprotein
levels and blood pressure.
New Eng J Med.
1990; 322(3): 147.
W E Connor. Dietary fiber - nostrum or critical nutrient?
New Eng J Med.
1990; 322 (3): 193.
E Marshall. Diet Advice, with a Grain of Salt and a Large Helping of Pepper.
Science.
1986; 231:
537.
M J Lichtenstein,
et al.
Heart rate, employment status and prevalent ischaemic heart disease
confound relationship between cereal fibre intake and blood pressure.
J Epid Comm Hlth.
1986;
40(4): 330.
D Norman,
et al.
The impact of dietary fat and fibre on intestinal carcinogenesis.
Prev Med.
1987;
(4): 554.
I MacDonald. Nonsense and non-science in nutrition..
Proc Nutr Soc.
1983; 42: 513
Anon.
BMJ
. 1986; 292: 494.
J L Kelsay. A review of research on effect of fibre intake on man.
Am J of Clin Nutr.
1978; (31):
142.
K Kaneko,
et al.
Effect of fibre on protein, fat and calcium digestibilities and fecal
cholesterol
excretion.
J Nutr Sci Vitaminol
(Tokyo). 1986; 32(3): 317.
D Kritchevsky.
Fibre and cancer.
In
Dietary Fibre: Basic and Clinical Aspects.
(G V Vahouny
and D Kritchevsky eds.) p427. Plenum, NY. 1986.
-
Dietary studies of cancer of the large bowel in the animal model
. Ibid p469.
H S Wasan, R A Goodlad. Fiber-supplemented foods may damage your health.
Lancet
1996; 348:
319-20.
C S Fuchs,
et al.
Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women.
N Eng
J Med
1999; 340: 169.
G Gerutti,
et al.
Phytic acid in bran and in 'natural' foods.
Bolletino Chimico Farmaceutico,
Milan.
J Stevens,
et al.
Effect of psyllium gum and wheat bran on spontaneous energy intake.
Am J Clin
Nutr.
1987; 46: 812.
Editorial. The Bran Wagon.
Lancet.
1987; i: 782.
Y P Suri. The Bran Wagon.
Lancet.
1987; ii: 42.
G S Bindra and R S Gibson. Iron status of predominantly lacto-ovo-vegetarian
East Indian
immigrants to Canada: a model approach.
Am J Clin Nutr.
1986; 44: 643.
J R Turnlund,
et al.
A stable isotope study of zinc absorption in young men: effects of phytate and
alpha-cellulose.
Am J Clin Nutr.
1984; 40: 1071.
B Sandstrom,
et al.
The effects of vegetables and beet fibre on the absorption of zinc in humans
from composite meals.
Br J Nutr.
1987; 58 (1): 49.
L Hallberg,
et al.
Phytates and the inhibitory effect of bran on iron absorption in man.
Am J Clin
Nutr.
1987; 45(5): 988.
R Balasubraminian, et al. Effect of wheat bran on bowel function and fecal
calcium in older adults.
J Am Coll
Nutr
. 1987; 6(3): 199.
J Hallfisch,
et al.
Mineral balances of men and women consuming high fibre diets with complex or
simple carbohydrate.
J Nutr
. 1987; 117(2): 403.
Fractured neck of femur: prevention and management.
A report of the Royal College of
Physicians, London. 1989.
Editorial: Why so many fractured hips?
Lancet.
1989; 1: 57.
A M Fehily. Dietary determinants of bone mass and fracture risk: a review.
J Hum Nutr and Diet
.
1989; 2: 299.
M J Wargovich, A R Baer. Basic and Clinical Investigations of Dietary Calcium
in the Prevention
of Colorectal Cancer.
Prev Med.
1989; 18: 672.
BBC. Horizon:
The Poison That Waits
. BBC2 broadcast 16 Jan 1989.
N Bishop, M McGraw and N Ward. Aluminium in infant formulas.
Lancet.
1989; i: 490.
B E Golden, M H N Golden. Plasma zinc, rate of weight gain and the energy cost
of tissue
deposition in children recovering from malnutrition on cows' milk or a soya
protein based diet.
Am J Clin Nutr
. 1981; 34: 892.
A Prasad. The role of zinc in gastrointestinal and liver disease.
Clin Gastroenterol.
1983; 12: 713.
P Aggett, N Davies. Some nutritional aspects of trace elements.
J Inter Metab Dis.
1983; 6(2): 22.
M Hambidge. The role of zinc and other trace metals in paediatric nutrition and
health.
Paediat
Clin N Am.
1977; 24: 95.
D Bryce-Smith, R Simpson. Anorexia, depression and zinc deficiency.
Lancet.
1984; ii: 1162.
V Fonesca, C Harvard. Electrolyte disturbances and cardiac failure with
hypomagnesaemia in
anorexia nervosa.
BMJ.
1985; 291: 1680
N Meadows,
et al.
Zinc and small babies.
Lancet
. 1981; ii: 1135.
D Bryce-Smith. Environmental chemical influences on behaviour and mentation.
John Jeyes
lecture.
Chem Soc Rev.
1986; 15: 93.
A McMichael,
et al.
A prospective study of serial maternal zinc levels and pregnancy outcome.
Early Human Development.
1982 (Elsevier); 7: 59.
D Addy. Happiness is: iron.
BMJ.
1986; 292: 969
E M Luk'ianova. Diagnosis of vitamin D deficiency rickets.
Pediatriia.
1988;(3):15.
R Adelman. Nutritional rickets.
Am J Dis Child.
1988; 142(4): 414.
M R Clements. The problem of rickets in UK Asians.
J Hum Nutr Diet
, 1989; 2: 105.
R E Hughes. A new look at dietary fibre.
Hum Nutr Clin Nutr.
1986; 40c: 81.
R E Hughes, E Johns. Apparent relation between dietary fibre and reproductive
function in the
female.
Ann Hum Biol.
1985; 12: 325.
T Lloyd,
et al.
Inter-relationships of diet, athletic activity, menstrual status and bone
density in
collegiate women.
Am J Clin Nutr.
1987; 46: 681.
D A T Southgate. Minerals, trace elements and potential hazards.
Am J Clin Nutr.
1987; 45: 1256.
H S Wasan, R A Goodlad. Fiber-supplemented foods may damage your health.
Lancet
1996; 348:
319-20.
C S Fuchs,
et al.
Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women.
N Eng
J Med
1999; 340: 169.
See also www.Cholesterol-and-Health.org.uk, an easy to read website about this whole topic from what cholesterol is, why you need it, and how it is made in the body, to what happens if you take cholesterol-lowering drugs such as statins.
Last updated 18 September 2000
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