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The role of fiber in its ability to lower total cholesterol and LDL-cholesterol has been well established. This effect has been documented even in patients already on a standard cholesterol-lowering diet. There is considerable support in the literature for addition of fiber in the treatment of hyperlipidemia.
The role of dietary fiber in colon and breast cancer is slightly less clear. There are many studies that suggest that increase in stool bulk secondary to increases in fiber in the diet are associated with decreases in incidence of colon polyps, colon cancer and breast cancer, though there is one study that argues against this in colon polyps, a cancer precursor. There are also studies that suggest that there is a protective effect of phytic acid, possibly as well as flavenoids and lignans, high levels of which are found in wheat bran. It is thought that phytic acid changes the bacterial enzymes present in stool in a protective way, independent of stool bulk. It should be noted that multiple studies also emphasize the importance of low saturated fat and exercise in the prevention of cancer.
Fiber and Cholesterol
Tillotson JL et al. Relation of dietary fiber to blood lipids in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial. Am J Clin Nutr 1997 Jan;651(1S):327S-337S.
Brown L et al. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999 Jan;69(1):30-42.
Jenkins DJ et al. Combined effect of vegetable protein (soy) and soluble fiber added to a standard cholesterol-lowering diet. Metabolism 1999 Jun;48(6):809-16.
Jenkins DJ et al. The effect on serum lipids and oxidized low-density lipoprotein of supplementing self-selected low-fats with soluble-fiber, soy, and vegetable protein foods. Metabolism 2000 Jan;49(1):67-72.
Anderson JW et al. Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia. Am J Clin Nutr 2000 Jun;71(6):1433-8.
Fiber and Cancer
Martinez ME et al. Association of diet and colorectal adenomatous polyps: dietary fiber, calcium, and total fat. Epidemiology 1996 May;7(3):264-8.
Le Marchand L et al. Dietary Fiber and colorectal cancer risk. Epidemiology 1997 Nov;8(6):658-65.
Challier B et al. Garlic, onion and cereal fiber as protective factors for breast cancer: a French case-control study. Eur J Epidemiol 1998 Dec;14(8):737-47.
Fuchs CS et al. Dietary fiber and the risk of colorectal cancer and ademona in women. N Engl J Med 1999 Jan 21;340(3):169-76.
Role of dietary fiber in colon cancer: an overview. Am J Med 1999 Jan 25;106(1A):16S-19S.
Ferguson LR et al. Protection against cancer by wheat bran: role of dietary fiber and phytochemicals. Eur J Cancer Prev 1999 Feb;8(1):17-25.
Mason JB et al. Nutritional strategies in the prevention of colorectal cancer. Curr Gastroenterol Rep 1999 Aug;1(4):341-353.
Cohen LA. Dietary fiber and breast cancer. Anticancer Res 1999 Sep-Oct;19(5A):3685-8.
Reddy BS. Prevention of colon carcinogenesis by components of dietary fiber. Anticancer Res 1999 Sep-Oct;19(5A):3681-3.
Pietinen P et al. Diet and the risk of colorectal cancer in a cohort of Finnish men. Cancer Causes Control 1999 Oct;10(5):387-96.
Reddy BS. The Fourth De Witt S. Goodman lecture. Novel approaches to the prevention of colon cancer by nutritional manipulation and chemoprevention. Cancer Epidemiol Biomarkers Prev 2000 Mar;9(3):239-47.
Schatzkin A et al. Lack of effect of a low=fat, high-fiber diet on the recurrance of colorectal adenomas. Polyp Prevention Trial Study Group. N Engl J Med 2000 Apr 20;342(16):1149-55.
Slattery ML. Diet, lifestyle and colon cancer. Semin Gastrointest Dis 2000 Jul;11(3):142-46.
Whiteley LO et al. Are dietary fiber-induced alterations in colonic epithelial cell proliferation predictive of fiber's effect on colon cancer? Nutr Cancer 2000;36(2):131-149.
Reddy BS et al. Preventive potential of wheat bran fractions against experimental colon carcinogenesis: implications for human colon cancer prevention. Cancer Res 2000 Sep 1;60(17):4792-7.
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