Elsevier

The Lancet

Volume 348, Issue 9023, 3 August 1996, Pages 319-320
The Lancet

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Fibre-supplemented foods may damage your health

https://doi.org/10.1016/S0140-6736(96)01401-8Get rights and content

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What is fibre?

The complexity of dietary “fibre” is highlighted by the lack of a universally acceptable scientific definition, reflected also in disagreement on the methodology of its quantification in our food. The term “dietary fibre” was originally applied to ingested plant cell-wall remnants (roughage), but the definition can also be expanded to include any non-starch polysaccharide or even protein not degraded by endogenous mammalian secretions. These substrates can be fermented by bacteria in the

Cell proliferation and cancer

Cell division in the gastrointestinal tract is the largest and second-fastest cell-renewal system in the body. Stem cells at the base of each crypt give rise to all the other cells in the epithelium. Although rates of colonic crypt-cell proliferation are less than half those in the small intestine, there is more intracolonic variation in cell turn-over than in the small bowel, which may reflect local trophic influences, including dietary constituents, and provides some clues to the

Fibre and cell proliferation

Many carbohydrates can stimulate epithelial-cell proliferation throughout the gastrointestinal tract, and distal atrophy associated with fibre-free diets can be reversed by the addition of dietary fibre. These actions were originally attributed to the mechanical properties of dietary bulk, but it is now known that cell division in the large bowel mucosa is mainly stimulated by SCFAs produced by bacterial fermentation.8 There is no proliferative response to fermentable fibre in the colon of

Conclusions

The presence of nutrients in the intestinal lumen influences epithelial proliferation, and fermentable fibre substrates can stimulate proliferation in the colon. The overall significance of this is unclear, but in view of the general lack of benefit in experimental human studies and the detrimental effects seen in animal models of carcinogenesis, caution in the use of nutritional fibre supplements is advisable. Until individual constituents of fibre have been shown to have, at the very least, a

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