Dietary fiber and prevention of cardiovascular disease.

In 1867, the great American artist Winslow Homer created a woodcarving depicting a man standing alone, wielding a scythe against an endless field of wheat as tall as the man himself. The work is entitled The Veteran in a New Field. This image comes to mind when I contemplate the history of dietary fiber and disease prevention. The idea that dietary fiber from foods like whole grains may have healthpromoting effects has been around a long time. Yet even in the age of genomics, proteomics, high-tech imaging and the emphasis on discovery of “new” novel risk factors for heart disease, we return to the role of dietary fiber, and it remains keenly relevant today. In 1971, British surgeon Denis Burkitt revitalized interest in dietary fiber by providing epidemiologic evidence that it may be protective against disease (1). Not only were his observations—that the high-residue content of the diet of black African populations compared to white African populations consuming a “Western”-type diet—consistent with a protective effect against colon cancer, but also his work stimulated research into the role of dietary fiber in the etiology of other diseases, including cardiovascular disease.