Fiber and the Intestinal Microflora

  • Martin H. Floch
Part of the Topics in Gastroenterology book series (TGEN)


During the past decade, the importance of fiber substances in the diet has been reawakened by epidemiologists. The theories and information brought forth by Burkitt and Trowell,1 Cleave et al.,2 Spiller and Amen,3 and Walker4 have postulated that fiber in the diet is essential in the prevention of a series of degenerative diseases that include constipation, carcinoma of the colon, diverticular disease of the colon, appendicitis, diabetes mellitus, hiatus hernia, cholelithiasis, varicose veins, and hemorrhoids. This is truly a diverse list that can only be tied together by the theories postulated by Birkitt and Trowell. There are four texts published within the past decade that contain almost all of the recent information regarding these theories and the factual information in the field.1–3,5 In this section we can only outline available and pertinent information. There is enough information available now to indicate that fiber in the diet is an essential factor for normal intestinal function, which in turn may be essential for the prevention of a whole series of degenerative diseases. Early in this century, Metchnikoff6 proposed that toxic products within the intestine caused much of our disease. The present work on fiber substances may well prove him correct within the coming decades.


Bile Acid Bile Salt Wheat Bran Uronic Acid Neutral Detergent Fiber 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Burkitt DP, Trowell HC: Refined Carbohydrate Foods and Disease. New York: Academic Press, 1975.Google Scholar
  2. 2.
    Cleave TL, Campbell GD, Painter NS: Diabetes, Coronary Thrombosis and the Saccharine Disease. ed 2. Bristol: John Wright, 1969.Google Scholar
  3. 3.
    Spiller GA, Amen RJ: Fiber in Human Nutrition. New York: Plenum Press, 1976.CrossRefGoogle Scholar
  4. 4.
    Walker ARP: Colon cancer and diet, with special reference to intakes of fat and fiber. Am J Clin Nutr 29: 1417, 1976.Google Scholar
  5. 5.
    Spiller GA: Topics in Dietary Fiber Research. New York: Plenum Press, 1978.CrossRefGoogle Scholar
  6. 6.
    Metchnikoff E: Prolongation of Life. New York: GP Putnam, The Knickerbocker Press, 1908.Google Scholar
  7. 7.
    Trowell H: Definition of dietary fiber and hypotheses that it is a protective factor in certain diseases. Am JClin Nutr 29: 417, 1976.Google Scholar
  8. 8.
    Holloway WD, Tasman-Jones C, Lee SP: Digestion of certain fractions of dietary fiber in humans. Am J Clin Nutr 31: 927, 1978.Google Scholar
  9. 9.
    Southgate DAT: Determination of carbohydrates in foods. II. Unavailable carbohydrates. J Sci Food Agric 20: 331, 1969.CrossRefGoogle Scholar
  10. 10.
    Van Soest PJ, McQueen RW: The chemistry and estimation of fibre. Proc Nutr Soc 32: 123, 1973.CrossRefGoogle Scholar
  11. 11.
    Hellendorn EW: Enzymatic determination of the indigestible residue (dietary fibre) content of human food. J Sci Food Agric 26: 1461, 1975.CrossRefGoogle Scholar
  12. 12.
    Anderson JW, Chen WL: Plant fiber. Carbohydrate and lipid metabolism. Am J Clin Nutr 32: 346, 1979.Google Scholar
  13. 13.
    Cummings JH: What is fiber?, in Spiller GA, Amen RJ (eds): Fiber in Human Nutrition. New York: Plenum Press, 1976.Google Scholar
  14. 14.
    Cummings JH: Dietary fibre. Gut 14: 69, 1973.CrossRefGoogle Scholar
  15. 15.
    Kelsay JL: A review of research on effects of fiber intake on man. Am J Clin Nutr 31: 142, 1978.Google Scholar
  16. 16.
    Church CF, Church HN: Food Values of Portions Commonly Used, ed 12. New York: JP Lippincott Co, 1975.Google Scholar
  17. 17.
    Paul AA, Southgate DAT: McCance and Widdowson’s The Composition of Foods, ed 4. New York: Elsevier/North-Holland Biomedical Press, 1978.Google Scholar
  18. 18.
    Dorfman SH, Ali M, Floch MH: Low fiber content of Connecticut diets. Am J Clin Nutr 29: 87, 1976.Google Scholar
  19. 19.
    Trowell HC: Ischemic heart disease and dietary fiber. Am J Clin Nutr 25: 926, 1972.Google Scholar
  20. 20.
    Robertson J: Change in the fibre content of the British diet. Nature (London) 238: 290, 1972.CrossRefGoogle Scholar
  21. 21.
    Hardinge MG, Chambers AC, Crooks H, et al: Nutritional studies of vegetarians. III. Dietary levels of fiber. Am J Clin Nutr 6: 523, 1958.Google Scholar
  22. 22.
    Bingham S, Cummings JH, McNeil NI: Intakes and sources of dietary fiber in the British population. Am J Clin Nutr 32: 1313, 1979.Google Scholar
  23. 23.
    Kelsay JL, Behall KM, Prather ES: Effect of fiber from fruits and vegetables on metabolic responses of human subjects. I. Bowel transit time, number of defecations, fecal weight, urinary excretions of energy and nitrogen and apparent digestibilities of energy, nitrogen, and fat. Am J Clin Nutr 31: 1149, 1978.Google Scholar
  24. 24.
    McConnell AA, Eastwood MA, Mitchell WD: Physical characteristics of vegetable foodstuffs that could influence bowel function. J Sci Food Agric 25: 1, 1974.CrossRefGoogle Scholar
  25. 25.
    Cummings JH, Hill MJ, Jenkins DJA, et al: Changes in fecal composition and colonic function due to cereal fiber. Am J Clin Nutr 29: 1468, 1976.Google Scholar
  26. 26.
    Fuchs HM, Dorfman S, Floch MH: The effect of dietary fiber supplementation in man. II. Alteration in fecal physiology and bacterial flora. Am J Clin Nutr 29: 1443, 1976.Google Scholar
  27. 27.
    Floch MH, Fuchs H-M: Modification of stool content by increased bran intake. Am J Clin Nutr 31: 185, 1978.Google Scholar
  28. 28.
    Cummings JH, Southgate DAT, Branch W, et al: Colonic response to dietary fibre from carrot, cabbage, apple, bran, and guar gum. Lancet 1: 5, 1978.CrossRefGoogle Scholar
  29. 29.
    McCance RA, Widdowson EM: Mineral metabolism on dephytinized bread. J Physiol 101: 304, 1942.Google Scholar
  30. 30.
    McCance RA, Widdowson EM: Mineral metabolism of healthy adults on white and brown bread dietaries. J Physiol 101: 44, 1942.Google Scholar
  31. 31.
    McCance RA, Walsham CM: The digestibility and absorption of the calories, proteins, purines, fat and calcium in wholemeat wheaten bread. BrJNutr 2: 26, 1948.Google Scholar
  32. 32.
    Ismail-Beigi F, Reinhold JG, Faraji JG, et al: Effects of cellulose added to diets of low and high fiber content upon the metabolism of calcium, magnesium, zinc and phosphorus by man. J Nutr 107: 510, 1977.Google Scholar
  33. 33.
    James WPT, Branch WJ, Southgate DAT: Calcium binding by dietary fiber. Lancet 1: 638, 1978.CrossRefGoogle Scholar
  34. 34.
    Heaton KW, Pomare EW: Effect of bran on blood lipids and calcium. Lancet 49, 1974.Google Scholar
  35. 35.
    Ismail-Beigi F, Faraji B, Reinhold JG: Binding of zinc and iron to wheat bread, wheat bran, and their components. Am J Clin Nutr 30: 1721, 1977.Google Scholar
  36. 36.
    Reinhold JG: Zinc and mineral deficiencies in man: The phytate hypothesis, in Charez A, Bourges H, Basta S (eds): Procedures of the 9th International Congress of Nutrition, Mexico, 1975, vol 1, p 115.Google Scholar
  37. 37.
    Eastwood M, Mowbray L: The binding of the components of mixed micelle to dietary fiber. Am J Clin Nutr 29: 1461, 1976.Google Scholar
  38. 38.
    Eastwood MA, Hamilton D: Studies on the absorption of bile salts to nonabsorbed components of diet. Biochim Biophys Acta 152: 165, 1968.CrossRefGoogle Scholar
  39. 39.
    Eastwood MA, Girwood RH: Lignin: A bile-salt sequestering agent. Lancet 2: 1170, 1968.CrossRefGoogle Scholar
  40. 40.
    Birkner HJ, Kern F: In vitro adsorption of bile salts to food residues, salicylazosulfaphyridine, and hemicellulose. Gastroenterology 67: 237, 1974.Google Scholar
  41. 41.
    Hellendoorn EW: Fermentation as the principle cause of the physiological activity of indigestible food residue, in Spiller GA (ed): Topics in Dietary Fiber Research. New York: Plenum Press, 1978.Google Scholar
  42. 42.
    Floch MH, Gershengoren W, Elliot S, et al: Bile acid inhibition, of intestinal microflora-A function for simple bile acids? Gastroenterology 61: 228, 1971.Google Scholar
  43. 43.
    Drasar BS, Hill MJ: Human Intestinal Flora. New York: Academic Press, 1974.Google Scholar
  44. 44.
    Maier BR, Flynn MA, Burton GC, et al: Effects of a high beef diet on bowel flora: A preliminary report. Am J Clin Nutr 27: 1470, 1974.Google Scholar
  45. 45.
    Ellington T, Conn HO, Floch MH: Lactulose in treatment of chemic portal-systemic encephalopathy. N Engl J Med 281: 408, 1969.CrossRefGoogle Scholar
  46. 46.
    Finegold SM, Sutter UL, Sugihara PT, et al: Fecal microbial flora in Seventh Day Adventist populations and control subjects. Am J Clin Nutr 30: 1781, 1977.Google Scholar
  47. 47.
    Reddy BS, Wynder EL: Metabolic epidemiology of colon cancer: Enzymatic activity of fecal flora. Am J Clin Nutr 29: 1455, 1976.Google Scholar
  48. 48.
    Jenkins DJA, Leeds AR, Newton C, et al: Effect of pectin, guar gum, and wheat fibre on serum-cholesterol. Lancet 1: 1116, 1975.CrossRefGoogle Scholar
  49. 49.
    Kay RM, Truswell AS: Effect of citrus pectin on blood lipids and fecal steroid excretion in man. Am JClin Nutr 30: 171, 1977.Google Scholar
  50. 50.
    Keys A, Grande F, Anderson JT: Fiber and pectin in the diet and serum cholesterol concentration in man. Proc Soc Exp Med Biol 106: 555, 1961.Google Scholar
  51. 51.
    Truswell AS, Kay RM: Absence of effect of bran on blood lipids. Lancet 1: 922, 1975.CrossRefGoogle Scholar
  52. 52.
    Tarpila S, Miettinen TA, Metsaranta L: Effects of bran on serum cholesterol, faecal mass, fat, bile acids and neutral sterols, and biliary lipids in patients with diverticular disease of the colon. Gut 19: 137, 1978.CrossRefGoogle Scholar
  53. 53.
    Munoz JM, Sandstead HH, Jacob RA, et al: Effects of some cereal brans and textured vegetable protein on plasma lipids. Am J Clin Nutr 32: 580, 1979.Google Scholar
  54. 54.
    Sacks FM, Castelli WP, et al: Plasma lipids and lipoproteins in vegetarians and controls. N Engl J Med 292: 1148, 1975.CrossRefGoogle Scholar
  55. 55.
    Palumbo PJ, Briones ER, Nelson RA: High fiber diet in hyperlipemia. JAMA 240: 223, 1978.CrossRefGoogle Scholar
  56. 56.
    Editorial: Serum-cholesterol and the soya bean. Lancet 1: 291, 1977.Google Scholar
  57. 57.
    Sirtori CR, Agradi E, Conti F, et al: Soybean-protein diet in the treatment of type-II hyperlipoproteinemia. Lancet 1: 275, 1977.CrossRefGoogle Scholar
  58. 58.
    Kiehm TG, Anderson JW, Ward K: Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men. Am J Clin Nutr 29: 895, 1976.Google Scholar
  59. 59.
    Jenkins DJA, Leeds AR, Gassull MA, et al: Decrease in postprandial insulin and glucose concentrations by guar and pectin. Ann Intern Med 86: 20, 1977.Google Scholar
  60. 60.
    Haber GB, Heaton KW, Murphy D, et al: Depletion and disruption of dietary fibre. Lancet 1: 679, 1977.CrossRefGoogle Scholar
  61. 61.
    Raskin P, Unger RH: Hyperglucagonemia and its suppression. E Engl J Med 9: 433, 1978.CrossRefGoogle Scholar
  62. 62.
    Pomare EW, Heaton KW, Low-Beer TS, et al: The effect of wheat bran upon bile salt metabolism and upon the lipid composition of bile in gallstone patients. Am J Dig Dis 21: 521, 1976.CrossRefGoogle Scholar
  63. 63.
    Glober GA, Klein KL, Moore JO, et al: Bowel transit-times in two populations experiencing similar colon-cancer risks. Lancet 2: 80, 1974.CrossRefGoogle Scholar
  64. 64.
    Glober GA, Nomura A, Kamiyama S, et al: Bowel transit-time and stool weight in populations with different colon-cancer risks. Lancet 2: 110, 1977.CrossRefGoogle Scholar
  65. 65.
    International Agency for Research on Cancer, Intestinal Microecology Group: Dietary fibre, transit-time, fecal bacteria, steroids, and colon cancer in two Scandinavian populations. Lancet 2: 207, 1977.Google Scholar
  66. 66.
    Graham S, Dayal H, Swanson M, et al: Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst 61: 709, 1978.Google Scholar
  67. 67.
    Aries V, Crowther JS, Drasar BS, et al: Bacteria and the aetiology of cancer of the large bowel. Gut 10: 334, 1969.CrossRefGoogle Scholar
  68. 68.
    Hill MJ: The effect of some factors on the fecal concentration of acid steroids, neutral steroids and urobilins. J Pathol 104: 239, 1971.CrossRefGoogle Scholar
  69. 69.
    Drasar BS, Hill MJ: Intestinal bacteria and cancer. Am J Clin Nutr 25: 1399, 1972.Google Scholar
  70. 70.
    Reddy BS, Mastromarino A, Wynder EL: Further leads on epidemiology of large bowel cancer. Cancer Res 35: 3403, 1975.Google Scholar
  71. 71.
    Reddy BS, Mastromarino A, Gustafson C, et al: Fecal bile acids and neutral sterols in patients with familial polyposis. Cancer Res 38: 1694, 1976.Google Scholar
  72. 72.
    Reddy BS, Martin CW, Wynder EL: Fecal bile acids and cholesterol metabolites of patients with ulcerative colitis, a high-risk group for development of colon cancer. Cancer Res 37: 1697, 1977.Google Scholar
  73. 73.
    Moscovitz M, White C, Barnett RN, et al: Diet, bile acids, and neutral sterol excretions in carcinoma of the colon, control subjects and in liver metastases. Dig Dis Sci 24: 246, 1979.Google Scholar
  74. 74.
    Crowther JS, Drasar BS, Hill MJ, et al: Fecal steroids and bacteria and large bowel cancer in Hong Kong by socio-economic groups. BrJCancer 34: 191, 1976.Google Scholar
  75. 75.
    Hill MJ: Metabolic epidemiology of dietary factors in large bowel cancer. Cancer Res 35: 3398, 1975.Google Scholar
  76. 76.
    Hill MJ, Drasar BS, Williams REO, et al: Fecal bile-acids and clostridia in patients with cancer of the large bowel. Lancet 1: 535, 1975.CrossRefGoogle Scholar
  77. 77.
    Goldin B, Gorbach SL: Colon cancer connection: Beef, bran, bile and bacteria. Viewpoints Dig Dis 10: 1, 1978.Google Scholar
  78. 78.
    Vargo D, Moskovitz M, Floch MH: Fecal bacteria flora in cancer of the colon. Gut,1980 (in press).Google Scholar
  79. 79.
    Finegold SM, Attebery HR, Sutter VL: Effect of diet on human fecal flora: Comparison of Japanese and American diets. Am J Clin Nutr 27: 1456, 1974.Google Scholar
  80. 80.
    Reddy BS, Weisburger JH, Wynder EL: Effects of high risk and low risk diets for colon carcinogenesis on fecal microflora and steroids in man. J Nutr 105: 878, 1975.Google Scholar
  81. 81.
    Fleiszer D, Murray D, MacFarlane J, et al: Protective effect of dietary fibre against chemically induced bowel tumours in rats. Lancet 2: 552, 1978.CrossRefGoogle Scholar
  82. 82.
    Alcantara EN, Speckmann EW: Diet, nutrition and cancer. Am J Clin Nutr 29: 1035, 1976.Google Scholar
  83. 83.
    Huang CTL, Gopalakrishna GS, Nichols BL: Fiber, intestinal sterols, and colon cancer. Am J Clin Nutr 31: 516, 1978.Google Scholar

Copyright information

© Plenum Publishing Corporation 1981

Authors and Affiliations

  • Martin H. Floch
    • 1
    • 2
  1. 1.Yale University School of MedicineUSA
  2. 2.Department of Medicine, Section of Gastroenterology and NutritionNorwalk HospitalUSA

Personalised recommendations