Fiber, Dietary

You may recall that hormone replacement therapy (HRT) was all the rage until the summer of 2002. Then, in a flash - after 15 million women were told to stop it - the rage turned into outrage: HRT had been found to increase the risk of breast cancer by 26%, heart attack by 29%, stroke by 41% [1], and ovarian cancer by 58%[2]. The initial reasoning in favor of hormone replacement therapy seemed well-intentioned and bulletproof:

This method of qualitative analysis is called deductive reasoning, made famous by the immortal character of Sherlock Holmes. Deductive reasoning uses a core assumption - low hormones cause aging and diseases - to arrive at the end result - replacing lost hormones [with patch or pill containing estrogen and progesterone.] will defer aging and prevent disease.

Deductive reasoning works well only when the core assumptions are correct. In this case the core assumption (that low hormones are villains) was wrong, and so were the results - more deaths and disease, not less.

The investigators had also reported that there were-no clear benefits for those taking estrogen plus progestin on any of the quality of life measures-[3], that -older women taking combination hormone therapy had twice the rate of dementia, including Alzheimer's disease.-[4], and that women over fifty had -two-fold higher- [5] risk of developing venous thrombosis. Venous thrombosis is the precursor to pulmonary embolism - the blockage of return blood flow to the lungs by wayward blood clots.

As expected, the renouncement of HRT was a huge success - by 2003, breast cancer rates alone were down 7%, and have kept dropping ever since. And, ironically, for the first time in many years the life expectancy of American women nudged up as well - a stern lesson to those would-be Gods so eager to challenge Mother Nature.

This catastrophic outcome of hormone replacement therapy brings up a troublesome question: If well-meaning doctors, top-flight researchers, meticulous pharmacists, inquisitive media, and stringent government overseers - irony implied and intended - could get it so wrong on HRT, can they get it wrong again on another, even grander-scale health improvement scheme?

Yes, they can! The scheme in question is omnipresent dietary fiber. This time around, though, it isn't just middle-aged postmenopausal women who are hooked -on fiber.- It's almost all Americans, of both genders and of all ages.

Just like with HRT in the mid-sixties, the promoters of fiber had applied the same Scherlokian reasoning to -deduct- its health benefits:


And there were plenty of other seemingly bulletproof reasons to take fiber: it's safe because it's natural; fast stools prevent constipation; and a clean colon prevents colon cancer. A trifecta! If not for one pesky question:

-But what would happen, Holmes, if bulky stools don't actually move faster? -I don't want to know, Dr. Watson.

Background

There are two kinds of dietary fiber - soluble and insoluble. Both kinds are indigestible, and, nutritionally speaking, useless - not an iota of vitamins, minerals, or proteins between them. Once inside the body, both fibers whip up noxious gases, toxic alcohols, and irritating acids - the common byproducts of bacterial fermentation, which, in turn, cause equally common flatulence, bloating, abdominal cramps, and diarrhea.

For these reasons French and Italian chefs meticulously remove skins from eggplants, peppers, and tomatoes before adding them to a dish. Doting mothers in most of the world still scrupulously peel plums, apples, and pears before giving them to their children, and resourceful winegrowers from Napa Valley to the Rhne valley spit out skins while checking the ripeness of their grapes. That's because all skins are made from insoluble fiber.

Soluble fiber isn't as easy to spot and spit. It's a polysaccharide, which attracts water and condenses into a gel-like state, just like gelatin. Once jellied, it slows down the intestinal propulsion and absorption of digested nutrients, including glucose, essential amino and fatty acids, vitamins, minerals, and microelements. At best, a dubious benefit, but true.

Insoluble fiber, a cellulose, is chemically similar to toilet paper -which also happens to be a cellulose. Just like toilet paper, insoluble fiber absorbs water and expands up to five times its original weight.[7] The expansion of fiber makes stools larger and heavier. For this reason, medical professionals call fiber a bulking agent, and from this point on, it turns into a proverbial wrecking ball!


Insoluble fiber: The ball gets rolling, the toll gets going

The anal canal stands firmly between the bowels and toilet bowl - sometimes too firmly. The bulked-up stools require straining to expel them because their size may exceed the regular aperture (opening) of the anal canal. The straining, even if moderate, may cause a gradual enlargement of internal hemorrhoids, which line up along the anal canal. The enlarged hemorrhoids further constrain an already narrow pathway. Eventually, the passing of large stools causes pain and anal fissures (as the skin tears). The pain and bleeding leads to an incomplete emptying of the bowels.

This incomplete emptying causes an inadvertent retention of stools, which, in turn, become impacted (large, hard, and dry), and difficult to expel. Impacted stools cause constipation, not the other way around. The term impacted stools is preferred over constipation, because for most people constipation means poor frequency of stools rather than poor quality. Thus, from a health perspective, having impacted stools regularly is just as bad as being irregular, or constipated.

Impacted stools and straining cause diverticular disease - the bulging of the intestinal walls from excessive inward and outward pressure from straining and impacted stools. The bulges (diverticula) may trap stale stools and cause exceptionally painful inflammation. This condition is called diverticulitis, and may require surgery. Left untreated, it may cause colon perforation and peritonitis. Few people survive this ordeal.

The large intestine can easily retain 5 to 10 lb of impacted stools before they become noticeable. Long-term impaction causes irreversible stretching of the large intestine. The extreme outcome of this condition is called megacolon. The walls of an enlarged colon and rectum lack tonus - which is needed to propel large stools and complete defecation. The lack of tonus causes fecal impaction, essentially an immovable plug. This fecal impaction requires manual or surgical removal of impacted stools to remove the obstruction and prevent necrosis, perforation, and other complications.

This unpleasant procedure completes the vicious circle of indignities brought upon by that extra helping of fiber eaten a few decades ago. All along you may still remain perfectly -regular- -because by now, you are an expert strainer, depend on laxatives, or both. Unfortunately, all laxatives have serious side effects. All are habit-forming, and gradually lose punch. So the victim goes back for more fiber...

And, of course, impacted stools do not -move faster,- either with or without fiber. The transit time for a normal stool ranges from 24 to 48 hours, depending on how often you move your bowels. But once the large intestine is filled with impacted stools from end to end, the transit time slows down to several days, if not weeks. Only the young and very healthy may experience faster colon emptying after adding fiber, because it acts as a laxative and, for a while, stools don't have a chance to get impacted. But only for a while.

You can determine an approximate transit time of impacted stools by using the following straight math: The length of the large intestine is about 5 feet (150 cm). If an observed length of daily stools is a sizable 1 foot (30 cm), then the transit time is five days (150 / 30 = 5). If you move bowels every other day, then it is ten days. So much for speed.

And don't expect the myth of -fiber keeps the colon cleaner- to be true, either. Fiber is fiber - no matter its solubility. Unless it causes profuse diarrhea, it ferments 24/7 inside the large intestine with all of the usual after-effects: flatulence, bloating, and cramping. All three result from copious gases, acids, and alcohols produced by bacterial fermentation.

This process isn't any different from turning grapes into vinegar - except that your colon isn't a stainless steel tank! The acids and alcohols produced by fermentation cause inflammation of the intestinal lining, which is just as delicate and sensitive as the lining inside your mouth.

The intestinal inflammation interferes with the absorption of gases back into the bloodstream, and you end up even more bloated, more flatulent, and more miserable. This, of course, describes the classical symptoms of irritable bowel syndrome, or IBS.

At a certain point, intestinal inflammation stops not only gases from assimilating, but also fluids - water, bile, chyme, and digestive juices. Blocked digestive fluids cause diarrhea until the intestines are flushed out clean from all the rot.

That too has a ruinous outcome - the straining to contain diarrhea enlarges hemorrhoids and harms the anal canal all the same as large stools. Even worse, the exceptionally astringent bile, acidified gastric juices, and flesh-eating proteolytic enzymes inflame unprotected mucosa inside the large intestine and skin around the anus. That causes hard-to-heal perineal ulcers, fissures, and fistulas. (Normally, bile, enzymes, and gastric juices get neutralized long before reaching the large intestine.)

After the diarrhea subsides, fiber is commonly recommended to restore -formed- stools. Not surprisingly, the symptoms of IBS - bloating, flatulence, cramping, and constipation - come back and cause diarrhea again. More fiber again- More diarrhea- And again... And again-

If you are totally down on your luck, you may end up getting ulcerative colitis or Crohn's disease, collectively known as inflammatory bowel disease, or IBD. In addition to the usual calamities - severe bleeding, colon perforation, anorexia - the IBD raises the risk of colorectal cancer 32 times.[8] That's 3,200%. In this context, gutting out affected intestines may be considered a life-saving surgery. What would you rather have: an indiscreet colostomy bag or a nice funeral?

Even if you get spared from IBD, you may still - as so many do - develop precancerous polyps, and, to top it all off, colorectal cancer. Ironically, dietary fiber is recommended as a primary preventive of polyps and cancer too, even though study after study has demonstrated the complete futility of this -hit and never miss- approach.

Interestingly, irritable bowel syndrome, ulcerative colitis, Crohn's disease, polyps, and colon cancer affect Ashkenazi Jews more than any other ethnic group in the United States.

This aberration is happening because bread and cereals, especially from whole wheat, are the primary sources of fiber in the mainstream American diet. But besides fiber, wheat flour also contains gluten - a highly allergic plant protein. Ethnic groups that hadn't historically consumed much wheat lack the enzymes needed to break down gluten - hence these severe food allergies.

The intestinal inflammation caused by an allergy to gluten is called celiac disease, or sprue. Inflammation ALWAYS precedes ulcerative colitis and Crohn's disease. So what do concerned people usually do after getting diagnosed with any of these? They, of course, listen to their parents, consult their doctors, research the Internet, and- consume even more whole wheat bread, more bran-fortified cereals, and more fiber because that's what everyone is recommending.

It's also worth noting that the female reproductive organs reside side-by-side with the small and large intestines inside a tightly packed abdominal cavity. It's common knowledge that the uterus is swollen and highly sensitive before and during periods. The unremitting pressure on the uterus from the intestines, expanded by large stools and gases, may easily cause the symptoms of premenstrual syndrome (PMS) and dysmenorrhea (menstrual pain).

According the National Institutes of Health, -An exact cause of PMS has not been identified.-[9] How could it be, if they are still looking at the wrong organs and wrong causes? Feel free to add PMS and menstrual cramps to the long list of ailments suffered by unwitting and unsuspecting victims of dietary fiber.

Men aren't off the hook either. When expansion room inside the abdominal cavity is exhausted, inward pressure from abdominal muscles may protrude the small intestine past the inguinal canal into the scrotum. Vigorous laughing, coughing, or straining may cause inquinal hernias just as easily as heavy lifting. Unlike PMS, inquinal hernia requires -repair- surgery.

Here are the telling stats for those who are in denial:
Constipation is -is one of the most common gastrointestinal complaints in the United States.- (Source: The National Institutes of Health, NIH)

-Hemorrhoids are very common in both men and women. About half of the population have hemorrhoids by age 50.- [10] (Source: NIH)

-About half of all people over the age of 60 have diverticulosis.- (Source: NIH)

-Irritable bowel syndrome (IBS) affects approximately 10-15% [25-40 million] of the general population.-[11] (Source: The International Foundation for Functional Gastrointestinal Disorders)

Over one million Americans[12] are affected by ulcerative colitis and Crohn's disease. (Source: Crohn's and Colitis Foundation of America)

-About 25 percent to 40 percent of ulcerative colitis patients must eventually have their colons removed because of massive bleeding, severe illness, rupture of the colon, or risk of cancer.- [13] (Source: NIH)

-Colorectal cancer is one of the most commonly diagnosed cancers in the U.S.- In 2003 (the latest available data) 141,526 people were diagnosed and 55,783 had died from colorectal cancer.[14] (Source: Centers for Disease Control and Prevention, CDC)

-PMS is estimated to affect up to 75% of women during their childbearing years.- [15] (Source: National Institutes of Health, NIH)

The prevalence of hernias: 4.5 million people, 800,000 new cases per year. (Source: NIH)


Ironically, after reading these stats, the die-hard advocates of fiber would retort in an instant:

-They [the sick] deserve it because they don't consume enough fiber.

So let's, for argument's sake, add even more fiber into the mix to see what happens next.

Soluble fiber: A killer food, literally

Thanks to the incredible adaptability and resiliency of our internal organs, the wreckage from insoluble fiber takes decades to knock you down for good. And once you learn about its perils, it's easy to avoid. Not so with soluble fiber. In the immediate realm, it's far more harmful than insoluble because it's so insidiously stealthy.

Soluble fiber is widely used as an artificial stabilizer and volumizer (filler) in all kinds of processed foods, such as yogurt, cream cheese, sour cream, ice cream, preserves, jellies, candies, snack bars, canned soups, frozen dinners, sauces, dressings, and endless others.

All traces of soluble fiber are always expertly concealed from scrutiny behind obscure names such as agar-agar, algae, alginate, -glucan, cellulose gum, carrageen, fructooligosaccharides, guaran, guar gum, hemicellulose, inulin, Irish moss, kelp, lignin, mucilage, pectin, oligofructose, polydextrose, polylos, resistant dextrin, resistant starch, red algae, and others.

The damage from soluble fiber is accomplished by slowing down the intestinal absorption of water, gases (produced normally during digestion), and essential nutrients from foods including carbs, proteins, fats, vitamins, minerals, and microelements. This property (malabsorption) lies behind soluble fiber's inflammatory, diarrheal, laxative, bloating, cramping, flatulence, and malnutrition side effects, just as described in medical references:

-Colonic bacteria ferment unabsorbed carbohydrates into CO2, methane, H2, and short-chain fatty acids (butyrate, propionate, acetate, and lactate). These fatty acids cause diarrhea. The gases cause abdominal distention and bloating.-[16] (Source: The Merck Manual of Diagnosis and Therapy).

The soluble fiber (either natural from food, laxatives, or additives) is especially incendiary for young children, because their tiny intestines need only tiny amounts of fiber to induce inflammation and diarrhea. The natural soluble fiber in juices, purees, fruits, vegetables, legumes, and grains is just as harmful, particularly for toddlers.

According to the Centers for Disease Control and Prevention:

--diarrhea remains one of the most common pediatric illnesses. Each year, children less than 5 years of age experience 20-35 million episodes of diarrhea, which result in 2-3.5 million doctor visits, greater than 200,000 hospitalizations, and 325-425 deaths.- [17]

No wonder pediatricians are in short supply...

Metamucil - one of the most ubiquitous laxatives out there - is made from powdered psyllium seed husks, an abundant source of soluble fiber. A single adult dose of Metamucil contains 3.4 grams of fiber[18]. Two medium apples contain 3 g of soluble fiber. For a three-year-old weighing 35 lbs, two apples will have about the same -punch- as four capsules of Metamucil for adults weighing 140 lbs. Add to the mix one orange (1.8 g of soluble fiber) and one kiwi (2.4 g), and that's the equivalent of almost nine capsules of Metamucil for adult per pound of body weight.

Try taking nine Metamucils throughout the day and see what happens a day or two after tomorrow. Actually, you don't even have to try it - just read Metamucil's web site:

-Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.-

Think about it: overdosing children with laxatives may get parents into family court - but stuffing them senseless with more fiber than that which equals a safe dose of laxatives is considered good parenting, good nurturing, and good doctoring. The ensuing diarrhea is commonly -diagnosed- as food poisoning or -stomach bug,- and usually gets -treated- with the BRAT-like diet, antibiotics, or both.

BRAT stands for banana, white rice, applesauce, and toast. White rice is harmless - almost pure starch with 0.4% fiber. Bananas and apples are abundant sources of soluble fibers well known for their diarrheal properties - respectively sorbitol and pectin. The gluten in toast causes intestinal inflammation. Consequentially, the BAT in BRAT whips up even stronger diarrhea.

What do well-meaning parents do? It's back for more antibiotics to wipe out the remnants of bacteria to stop fermentation, instead of simply excluding fiber. (The BRAT diet has been out of vogue for some time now, but what replaced it is even worse - a regular unrestricted diet, and this time around with more fiber.)

There are many good reasons to suspect that fiber is behind insulin-dependent diabetes (juvenile, IDDM1). The pancreatic duct terminates in the duodenum, the first section of the small intestine that comes right after the stomach. The duodenum is particularly small in young children, and can be easily obstructed by fiber. This obstruction, even brief, may block the pancreatic duct. The ensuing pancreatitis (inflammation of the pancreas) may cause the destruction of the insulin-producing beta cells in the islets of Langerhans. Without insulin-producing cells this child is condemned to a life of blood sugar monitoring, insulin injections, and all that follows. By age 40, the mortality rate among children affected by type I diabetes is twenty times higher[19] than in the general population.

Also, it's almost certain that fiber, particularly soluble, is behind the epidemic of autism. According to the CDC, -560,000 individuals between the ages of 0 to 21 have an ASD [autism spectrum disorder] and -between 1994 and 2004, the number of 6 to 17-year-old children classified as having an ASD in public special education programs increased from 22,664 to 193,637.-[20] That's an 850% jump just in 10 years. Autism wasn't even on the radar just a few generations ago.

This dramatic increase parallels fiber's ascent to prominence and its wholesale addition to children's nutrition - particularly with fortified wheat cereals, a main source of dietary iron and folic acid in the American diet. Iron deficiency happens to be -an important cause of decreased attention span, alertness, and learning -- both in young children and in adolescents-[21] and folic acid deficiency causes -diarrhea, depression, and confusion.-[22] (Sources: National Institutes of Health, The Merck Manual).

In this context, the connection between autism and fiber is absolutely transparent: the soluble fiber in processed food, fruits, and juices; gluten in cereals, bread and pasta; and lactose, casein (milk's protein) and stabilizers from fiber in processed dairy commonly cause intestinal inflammation. This prevents the absorption of iron, folic acid, essential amino and fatty acids, and other critical nutrients, which play a critical role in cognitive development. A well-established fact is that children with autism often experience severe gastrointestinal disorders, and that further supports this conclusion.

Similarly, soluble fiber may be easily linked to stunted growth, rickets, scoliosis, depression, asthma, hyperactivity, attention deficit disorder, common food allergies, and God knows what other pediatric diseases caused by -hidden malnutrition.- Even if parents are providing all of the right nutrients to children, unbeknownst to them, these nutrients aren't digested because of fiber's interference with intestinal absorption.

Interestingly, the companies that market products with soluble fiber - from Atkins Nutritionals to Procter & Gamble, the maker of Metamucil - knowingly mislead the public by referring to fiber as -net carbs- or -zero carbs.- Once inside the large intestine, almost all soluble fiber and up to 50% of insoluble fiber gets fermented by intestinal bacteria. The resulting short chain fatty acids are utilized just like any other fats, and provide -in the range of 1.5 to 2.5 kcal/g-[23] of energy. This is up to 60% more than zero, and quickly ads up, especially when fiber intake is high. (SOURCE: Food and Nutrition Board, Dietary Reference Intakes).

Grown-ups have their nemesis too. Consider the -natural- remedies for regularity, such as beets, prunes, and plum juice. All are concentrated sources of pectin, a soluble fiber, and sorbitol, a glucose derivative. Just like pectin, sorbitol is a potent hyperosmotic laxative and diarrheal agent, hence its -softening- effect on impacted stools.

All would be fine, if not for one little headache: excess dietary sorbitol sneaks into the cells, and causes heart attacks, strokes, kidney failure, deafness, blindness (retinopathy) and loss of nerve sensitivity (neuropathy), including anal neuropathy. Once that happens, you'll no longer experience the urge to defecate - although, next to blindness, it's a minor aggravation.

Oh, yes - peripheral neuropathy from sorbitol is also a contributing factor to foot amputations among diabetics. Over 80,000 rotting limbs get chopped off annually in elective surgery.[24] Just imagine the indignity- deaf, blind, and unable to walk to the bathroom.

Doctors and fiber: How the livestock feed became health food

Hold on, Mr. Monastyrsky. Everything you are saying is the complete opposite of what everyone else is saying. Are you really implying that most medical professionals are so incompetent? This just doesn't make any sense, considering that most doctors, nutritionists, and dietitians follow these dietary guidelines themselves. What on earth is going on?

Yes, it may not make any sense to you in the same way that Newton's laws may not make any sense to a brilliant fourth-grader, but that doesn't mean that they are any less true. By questioning entrenched doctrines and restating some long-accepted, indisputable facts of human anatomy, physiology, biochemistry, and digestion in support of my position, I am not implying anything. As to why -everyone else is saying- the complete opposite of these well-known facts - that's a good question and deserves an explanation.

For starters, the average practitioner of the medical arts knows about forensic nutrition (my field of expertise) as much as I know about his or her chosen specialty. In other words, from little to none, simply because medical fields are so highly specialized. Besides, nutrition per se isn't an art form (like medicine), but a sizable branch of biology with little wiggle room.

If this still surprises you, look at it from this perspective: To all intent and purpose, before splitting into their respective specialties, ophthalmologists and gastroenterologists went to similar medical schools. They took similar licensing board exams, and did similar internships. So, would you go to an eye doctor (who can see just as well) for an anal exam? No? Then why would you expect a rank-and-file physician, even a gastroenterologist, to know much about fiber - at best a footnote in a brief crash course in nutrition a few decades ago?

Second, few if any mainstream practitioners stray far from prevailing doctrines in order to protect themselves from ridicule, spurious lawsuits, and loss of license and income. Not surprisingly, most doctors practice -defensive medicine,- and are thoroughly cemented to the dominant sources of medical information In fiber's case, most of this information happens to be wrong.

Third, the writers and editors who develop medical textbooks aren't necessarily top experts in their field, nor are they the best thinkers or top-flight researchers. And they are just as -defensive- and conservative in their work as their core readers. And for exactly the same reasons, none of them are really bad or circumspect.

Fourth, doctors move their bowels too. Accordingly, their private observations of their own bathroom experiences concur with reference information and help them form strong personal biases, which then cloud their own medical judgments and impact negatively on their advice to patients. In other words, if you doctor sees his/her own large stools all of the time, or has stools every other day, and he/she is still alive, in his/her mind this isn't going to kill you either. A little straining here, a little hemorrhoid there - what's the big deal? By the time it becomes a -big deal,- most doctors are well past their prime, and not in the mood or shape to write books or conduct research regarding someone else's stools.

Fifth, the experts on fiber! While working on this essay, I came across an interesting comment attributed to Andrew S. Grove, the co-founder of Intel: -When everybody knows that something is so, it means that nobody knows nothin'.- And that pretty much sums up all you need to know about the experts. Am I an expert on fiber? Of course not - I am an -expert- in forensic nutrition who stumbled into the fiber minefield by accident. How otherwise would I dare to question -the experts on fiber-?

Sixth, don't discount the institutional profit motive. Digestive disorders reliably deliver hundreds of billions of dollars in revenue to hospitals, diagnostic labs, imaging centers, drugstores, and pharmaceutical companies. According to the Centers for Disease Control and Prevention, in 2004 (the latest available statistic) digestive symptoms resulted in 41.3 million visits to doctors, 15.1 million visits to emergency rooms, and 3.6 million visits to hospital outpatient departments.[25] And that's before adding up tens of millions of pediatric problems, millions of colonoscopies, hundreds of thousands of surgeries, rehabilitation, and the costs of over-the-counter and prescription drugs to treat chronic colorectal disorders. With so much upside, the status quo will remain quo for as long as it pays.

History of ascent: Damn the torpedoes, let's make a buck

Ironically, the perpetrators of fibermania are just as affected by its follies as are the perpetrated. That's why, if you ask doctors what (beside losing a license) is their biggest fear, most would tell you: becoming a patient. Fortunately, this leaves us with reasonable hope that the facts presented in this essay will not be brushed under the rug - physicians, particularly in the United States, represent a top tier of the intellectual elite and aren't patsies. That was the case with hormone replacement therapy, and this will be the case with fiber. Or so I hope.

In hindsight, fiber's ascent from cows' chew to gut savior isn't surprising. Most contemporary allopathic medicine is built on good intentions, cause-and-effect evidence, and deductive reasoning. If 'bleeding' the patient reduces body temperature, as physicians used to think, then let's treat high fever with bloodletting. If mercury kills bacteria in nature, let's kill them in the body. If electric shocks knock a person motionless, let's treat psychotic patients with electric shocks. If the menopause lowers hormones, let's replace lost hormones.

Only later does it become self-evident that all these methods cause more harm than good: bloodletting literally bleeds a person to death, hence the lowering of body temperature; mercury kills bacteria, but also poisons the body; electric shocks calm down a crazed person, but also causes irreversible brain damage; replacement hormones alleviate hot flashes and mood swings, but also cause heart attacks and strokes, and so on.

When piles of corpses become too hard to conceal, barbaric old methods get exposed and replaced with new, less barbaric ones: bloodletting is replaced with anti-inflammatory agents, mercury with antibiotics, electric shocks with mind-altering drugs, and missing sex hormones with painkillers and antidepressants. As before, the intentions are perfectly good, because the problems at hand are pressing and urgent. And by the time new side effects start popping up, they are already someone else's problem.

Surely, it wasn't difficult to connect -good- fiber with -bad- stools. All one had to do is to look down into the chamber pot. So it's really hard to blame the -early adopters- for making a virtue out of necessity. Unlike harsh senna leaves or leaky and toxic mineral oil, natural fiber sources were cheap, plentiful, effective, and initially problem-free, especially when used in moderation. In fact, the most famous early promoters of fiber - Sylvester Graham (1794-1851), Dr. John Harvey Kellogg (1852-1943), Dr. Thomas Latimer Cleave (1906-1983), Dr. Denis Burkett (1911-1993) - were the luminaries of their time. But so was the heralded Dr. Robert Wilson, who advanced the idea of HRT in his book Feminine Forever, first published in 1966.

Without a doubt, these -gentlemen- couldn't have known back then, or didn't care to learn, fiber's long-term side effects. They also hadn't anticipated that natural fiber in fruits, vegetables, breads, and grains, which they themselves had been mostly consuming and recommending, would soon be broadly replaced with processed food - such as cereals with added fiber, bran-fortified breads, fiber supplements, and fiber-based laxatives. And they couldn't know that these processed foods and supplements would contain many times more fiber and be more harmful than a natural diet.

And the pioneers of fibermania couldn't imagine in their wildest dreams that in addition to being a harmful and addictive laxative, fiber would also become a so-called antidote to cancer, an alleged savior from heart disease, a panacea for diabetes, a weight loss enabler, and cure-for-all miracle food. Never mind that all of these -benefits- are just a pack of willful lies:
Q. Is it true that fiber speeds up stools?
A. -There is little or no relationship between dietary fiber and whole gut transit time;- (Source: Rome II: The Functional Gastrointestinal Disorders, one of the most respected and authoritative textbooks on clinical gastroenterology; First published in 2000; [26])
Q. Is it true that fiber helps people with constipation?
A.-Those with defecation disorders or slow transit respond [to fiber] much less favorably. Those with severe colonic inertia may not be helped by fiber, since there is decreased smooth muscle contractile activity.- (Source: ibid; the euphemism -much less favorably- in politically correct medicalese means -much worse-- KM.)
Q. Is it true that fiber prevents colon cancer?
A. -For years, Americans have been told to consume a high-fiber diet to lower the risk of colon cancer - mainly on the basis of results from a number of relatively small studies. Unfortunately, this recommendation now seems mistaken, as larger and better designed studies have failed to show a link between fiber and colon cancer.- (Source: Harvard School of Public Health, first original reporting in 1999)(27), (28)
Q. Is it true that fiber prevents heart disease?
A. -The rate of CHD [cardio-vascular disease] mortality was reported to be inversely associated with fiber intake across 20 industrialized nations, but adjustment for fat intake removed the association.- (Source: American Heart Association, first reported in 1997;) (29)
Q. Is it true that fiber prevents diabetes?
A. -Fiber intake has also been linked with the metabolic syndrome, a constellation of factors that increases the chances of developing heart disease and diabetes.- (Source: Harvard School of Public Health, [30])
Q. Is it true that fiber is effective for weight loss?
A. Fermentable and nonfermentable fiber supplements did not alter hunger, satiety or body weight in a pilot study of men and women self-selected diets- (source: A report by Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, study reported in 2003 [31])
Never underestimate the temptations of greed. When it comes to fear-mongering, buck-hoarding, and stock-propping, anything goes - even though, as you've just seen, it's been known for years what -bull-.- it all was.

REFERENCES

Click the [link] to view the source site or document in new window (when available). The references for this essay were compiled in September of 2007. Some of the links may not match at a later date because publishers may revise their web sites. In this case, try searching cached pages on Google, or contact the respective publishers.

1. Hormone Replacement Therapy, MedlinePlus Medical Encyclopedia (A service of the National Institutes of Health); [link]

2. The Effects of Estrogen plus Progestin on Gynecologic Cancers and Associated Diagnostic Procedures; The Women's Health Initiative Participant (sic) Website; [link]

3. Effects of Estrogen plus Progestin on Health-related Quality of Life; The Women's Health Initiative Participant Website; [link]

4. Rates of Dementia Increase Among Older Women on Combination Hormone Therapy; National Institute on Aging (NIA); [link]

5. Hormone Therapy and Risk of Venous Thrombosis in the Women's Health Initiative Trial of Estrogen Plus Progestin; The Women's Health Initiative Participant Website; [link]

6. James C. Whorton, Inner Hygiene: Constipation and the Pursuit of Health in Modern Society, p. 228

7. -The primary health benefits of insoluble fiber relate to its water-binding capacity which reduces [speeds-up - KM] transit time in the large bowel.- Nutrition Fact Sheet: Dietary Fiber; Northwestern University NorthwestNutrition web site; [link]

8. Ulcerative Colitis; NIH Publication No. 03-1597 April 2003; [link]

9. Premenstrual syndrome; MedlinePlus Medical Encyclopedia (A service of National Institutes of Health); [link]

10. National Digestive Diseases Information Clearinghouse, a service of the National Institutes of Health; Hemorrhoids; NIH Publication No. 02 - 3021; Feb. 2002;[link]

11. About Irritable Bowel Syndrome (IBS); International Foundation for Functional Gastrointestinal Disorders; [link]

12. Crohn's and Colitis Foundation of America, About Crohn's disease; [link]

13. Ulcerative Colitis; NIH Publication No. 03-1597 April 2003;[link]

14. Colorectal (Colon) Cancer Statistics; Centers for Disease Control and Prevention;[link]

15. Premenstrual syndrome; MedlinePlus Medical Encyclopedia (A service of National Institutes of Health); [link]

16. Malabsorption, The Merck Manual of Diagnosis and Therapy, 18th Edition (on-line);

17. The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. Centers for Disease Control and Prevention; MMWR 1992;41; (No. RR-16):(inclusive page numbers); [link]

18. Metamucil Fiber FAQ; What is the dosage/serving size for Metamucil?Procter & Gamble; [link]

19. Enrico Portuese, MPH, Trevor Orchard, MD, Diabetes in America, 2nd Edition, Mortality Ib Insulin-Dependent Diabetes, Chapter 10, p. 221;[link]

20. Autism Information Center; Prevalence of Autism Specter Disorders; Centers for Disease Control and Prevention; [link]

21. Iron deficiency anemia - children; MedlinePlus Medical Encyclopedia (A service of National Institutes of Health); [link]

22. Ibid;

23. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients) (2005) Food and Nutrition Board, National Academies Press; [link]

24. National Diabetes Fact Sheet; United States, 2005; Centers for Disease Control and Prevention; page 7; [link]

25. Digestive Disorders; National Center for Health Statistics; a service of CDC;[link]

26. Functional Constipation; C3: p. 389; Rome II: The Functional Gastrointestinal Disorders by Douglas A. Drossman (editor); [link]

27. Fiber. Start Roughing It; The Harvard School of Public Health Nutrition Source;[link]

28. Fuchs CS, Giovannucci EL, Colditz GA, et al. Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med 1999; 340:169-76; [link]

29. Linda Van Horn, PhD, RD; Circulation. 1997;95:2701-2704. The American Heart Association;[link]

30. Fiber. Start Roughing It; The Harvard School of Public Health Nutrition Source;[link]

31. The American Society for Nutritional Sciences J. Nutr. 133:3141-3144, October 2003;[link]

http://knol.google.com/k/fiber-dietary