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Fiber Menace? (Part II)

Last week I wrote about Konstantin Monastyrsky, author of the book “Fiber Menace” and the eponymous website, www.fibermenace.com.  I said that my skeptical alarms were going off because Monastyrsky was crying out against mainstream science, accusing scientists of participating in a massive conspiracy to cover up the truth about the “fiber menace.”  Mr. Monastyrsky himself left a couple of comments defending himself and looking forward to part II.  I’m pretty sure you’re not going to like what I’m about to say, Konstantin.

To be blunt, Mr. Monastyrsky’s website is rife with half-truths, distortions, and deceptive (ab)use of sources, making his claims on the subject of fiber at the very least in the category of “not proved,” and at worst he is disseminating what could be some very poor medical advice.  This is a long post, but it only covers some of the misinformation on Mr. Monastyrsky’s website.    

 A perfect example is the reference he left in our comments section, to an article from the Harvard School of Public Health that he seems to like quoting (http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fiber-full-story/index.html#3 ).  Monastyrsky uses the following excerpt: “Fiber intake has also been linked with the metabolic syndrome, a constellation of factors that increases the chances of developing heart disease and diabetes.”  Sounds pretty bad.  But here’s the full quote:

Fiber intake has also been linked with the metabolic syndrome, a constellation of factors that increases the chances of developing heart disease and diabetes. These factors include high blood pressure, high insulin levels, excess weight (especially around the abdomen), high levels of triglycerides, the body’s main fat-carrying particle, and low levels of HDL (good) cholesterol. Several studies suggest that higher intake of cereal fiber and whole grains may somehow ward off this increasingly common syndrome (emphasis mine).

The Harvard paper references these studies: http://www.ncbi.nlm.nih.gov/pubmed/14747241?dopt=Citation and http://www.ncbi.nlm.nih.gov/pubmed/12145012?dopt=Citation.

In fact, if you really want to learn something about fiber, that Harvard article is an excellent place to start.  On to the meat of the post – or shall we say the fiber?

The heart of fibermenace.com is the section called “Top 12 myths about Fiber.”  A full discussion of all 12 points would take up a whole lot of space and time, but let’s take a look at my favorites, shall we? 

Myth #1: For maximum health, obtain 30 to 40 g of fiber daily from fresh fruits and vegetables.  The website shows a picture of 10 pieces of fruit and 10 tablespoons of sugar, enough to give any diabetic fits, both literally and figuratively.  Luckily, the truth is not so dire.  What happened to the vegetables?  They have far less sugar than fruit.  And what about whole grains?  High in fiber, low in sugar – check, for examples, the nutrition tables provided by the American Dietetic Association at www.eatright.com.  In any case, everything I’ve read about fruit and fiber says to be careful about having too much fruit, and that different fruit gets assimilated in different ways by the body – and fruit brings in other valuable nutrients as well.

Myth#2: Fiber reduces blood sugar levels and prevents diabetes, metabolic disorders, and weight gain. Here Monastyrsky claims that by slowing down the assimilation of sugars into the blood, the diabetic is “…fooling no one but a glucose meter.”  The sugar we eat still gets assimilated into the bloodstream eventually.  But for a diabetic, that’s exactly the point – to keep blood sugar from spiking too high.  It’s the spike in blood sugar that is dangerous for the diabetic.

Let’s jump ahead to Myth#5: Insoluble fiber promotes a healthy digestive tract and reduces cancer risks.  Now Monastyrsky abuses his sources.  First, he cites this study (http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=10770979&query_hl=1).  The study shows that a low fat, high fiber diet has no effect on the recurrence of colorectal adenomas.  This recurrence is a precursor to most major bowel cancers.  Fair enough, but this is a very narrow piece of the cancer puzzle.  The study only looks at patients who have already had colorectal adenomas, and so are already at a high risk for bowel cancer.  So the dietary change doesn’t help at that point.  Monastyrsky then goes on to cite the article from the Harvard School of Public Health (http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fiber-full-story/index.html) again, which indeed expresses the idea that fiber does little to prevent colon cancer.  Score one for Konstantin… temporarily.  The rest of the article goes on to contradict just about everything on the Fiber Menace website!  Here’s a pithy quote:

Long heralded as part of a healthy diet, fiber appears to reduce the risk of developing various conditions, including heart disease, diabetes, diverticular disease, and constipation. Despite what many people may think, however, fiber probably has little, if any effect on colon cancer risk.  

In Myth#6: Fiber offers protection from breast cancer, Monastyrsky calls the very idea “a blatant, preposterous lie.”  He cites a study of Mexican women with high carbohydrate intake (http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=15298947&query_hl=5).  But hold on – the study is talking about carbohydrates, not fiber.  Suddenly Monastyrsky is conflating fiber (which is a carbohydrate) with all carbohydrates.  Even the study he cites shows that the highest correlation with breast cancer is with sucrose and fructose – which are basically two names for sugar.  Many studies of the effects of carbohydrates exclude fiber from the total count of carbohydrates consumed.  Bottom line on breast cancer from my searches – mixed conclusions for fiber, as it appears to help prememopausal women and hurt postmenopausal women.  This is far from a blatant, preposterous lie.

The beat goes on with heart disease and diverticular disease.  Monastyrsky quotes a paper written by Linda Van Den Horn, PhD RD, of the American Heart Association thusly: 

The rate of CHD [nb: coronary heart disease] mortality was reported to be inversely associated with fiber intake across 20 industrialized nations, but adjustment for fat intake removed the association. Similarly, a 20-year cohort study of 1,001 middle-aged men in Ireland and Boston reported a significant inverse association between fiber intake and risk of CHD, but the association diminished when other risk factors were controlled.

 Sounds like fiber doesn’t help, doesn’t it?  Here is the concluding paragraph of Van Den Horn’s paper (http://circ.ahajournals.org/cgi/content/full/95/12/2701 ):

The greatest impact on lowering total and LDL cholesterol is derived from reduced intakes of saturated fat and cholesterol as well as weight reduction in obese persons. Diets high in complex carbohydrates and fiber are associated with reduced mortality rates from CHD and other chronic diseases. Fiber found in oats, barley, and pectin-rich fruits and vegetables provides adjunctive lipid-lowering benefits beyond those achieved by reductions in total and saturated fat alone. The AHA recommends a total dietary fiber intake of 25 to 30 g/d from foods, not supplements, to ensure nutrient adequacy and maximize the cholesterol-lowering impact of a fat-modified diet (emphasis mine again). Current dietary fiber intakes among adults in the United States average about 15 g, or half the recommended amount.

 What does the Harvard article link to?  This: (http://www.ncbi.nlm.nih.gov/pubmed/8627965?dopt=Citation )

Our results suggest an inverse association between fiber intake and MI (nb: myocardial infarction. You know, heart attack). These results support current national dietary guidelines to increase dietary fiber intake and suggest that fiber, independent of fat intake, is an important dietary component for the prevention of coronary disease.

On diverticular disease, Monastyrsky spends a lot of time ridiculing the notion that fiber helps, but a study linked to by that Harvard paper says the following ( http://www.ncbi.nlm.nih.gov/pubmed/9521633?dopt=Citation ):

Our findings provide evidence for the hypothesis that a diet high in dietary fiber decreases the risk of diverticular disease, and this result was not sensitive to the use of different analytic techniques to define dietary fiber. Our findings suggest that the insoluble component of fiber was significantly associated with a decreased risk of diverticular disease, and this inverse association was particularly strong for cellulose. 

By the way, both the above studies, on MI and diverticular disease, show as much as a 40% reduction.

I think I may just stick with my doctor’s advice and eat a diet high in fiber, but low in non-fiber carbs.  What do you think?

 

 

10 comments to Fiber Menace? (Part II)

  • Exzyleph

    Is it just me, or has somebody managed to embed a large number of hidden advertisement links in this blog? If you check the HTML, you’ll find links to the kind of stuff you usually find in SPAM-mails.

  • Jon Blumenfeld

    You’re right. What the heck is all that stuff?

    edit: It’s in previous posts, too.

  • SidBhatt

    It’s on *every* page. Someone managed to get it into the WordPress template, I think.

  • petrucio

    Looks to me like it’s stuff you need to enable to show buttons to ‘Digg it’, send to SlashDot, etc. Neat idea, actually.

    Or is it something else that I missed?

  • SidBhatt

    Nope, petrucio, you missed it. There were hundreds of spam links at the bottom of the HTML source of the page. Looks like the admins removed them.

  • Jon,

    As they say, the proof is in the pudding. Here is what I suggest:

    1. Write down your detailed medical history as of May 29, 2008.

    2. Heal yourself with high fiber.

    3. Collect your medical history on May 29, 2009.

    4. Publish the results in part 3 then.

    Good luck!

    Konstantin Monastyrsky

  • The claim that a high fiber diet can “heal you” is unwarranted. A diet high in fiber will contribute to optimal health. That is what nutrition is all about. It won’t cure diseases, and no knowledgeable doctor or nutritionist would claim that. Since you characterize the “pro-fiber” position in that way, you’re either misinformed or being dishonest. I’ll give you the benefit of the doubt and suggest that you rethink this false dichotomy between fiber being panacea or poison.

    I would be far more interested in a genuine reply to Jon’s work. You clearly misused some important quotations. Instead you give this meaningless challenge. The studies have been done: personal testimonials are not going to provide any new information. Health and nutrition are far too complex for a single case to reveal anything meaningful. If you don’t understand why this is, I would suggest you read up on basic research methods.

    -P

  • DLC

    Jon . . . dunno how you did it, but you dug up someone who is a contrarian regarding what I had thought to be fairly well-settled.
    I generally am a bit more skeptical of dietary studies, because some of them have been either poorly done, misquoted or both. However, there is plenty of evidence to suggest eating modestly more dietary fiber is somewhat better for you.
    (note the lack of superlatives here.)
    This doesn’t mean that as a diabetic you cannot enjoy that special treat or whatever, it just means you should only enjoy carefully and not pig out on it!

    Oh.. and I noted no spam-like links in the page, but I’m reading this a day late, so perhaps it’s been fixed?

  • Jon Blumenfeld

    As to my personal medical history, I’m perfectly willing to share, but of course I would hardly be considered a controlled study. I’m a single data point – but here’s what we know so far. A month ago, I had an a1c above 11. Triglycerides 775. That’s right. Blood glucose around 250. Blood pressure 130/92. Weight 222.

    After getting my diagnosis, I radically changed my diet and began taking metformin and antara. I also began to exercise more. Thursday I saw my doctor. We won’t be doing the bloodwork for a couple of months, so I don’t have a new a1c or triglycerides, but my blood sugar is down into the normal range on a regular basis (between 95 – 125). Blood pressure 130/80. Weight now 215 – and falling.

    Is this due to increased fiber? Who knows? But I have certainly increased my fiber intake while decreasing calories, fats, and overall carbs.

    I’ll be happy to update all this in the future, but as psamathos says, this isn’t about me – its about you, Mr. Monastyrsky.

  • Jon,

    Please chew on this:

    » Is it true that fiber speeds up stools?

    “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;

    » Is it true that fiber helps people with constipation?

    “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.)

    » Is it true that fiber prevents colon cancer?

    “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)

    » Is it true that fiber prevents heart disease?

    “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)

    » Is it true that fiber is effective for weight loss?

    “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])

    Excerpted from here: Dietary Fiber: The Bull’s S..t in The China Shop; http://www.gutsense.org/gutsense/chinashop.html

    Konstantin Monastyrsky

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