Should we eat more fibre?

Controversy continues over the role of dietary fibre in health, and whether or not a standard fibre intake should be recommended for the UK. In this review an attempt is made to consider the evidence for and against making such a recommendation. In doing so, it is clear that many problems exist in studies examining the role of fibre in disease, such as the inherent inadequacies of epidemiological studies and distrust of such studies by some circles, or the lack of uniformity in definition of dietary fibre and in its chemical analysis. The effect of fibre on faecal bulking is given as an example of experimental verification of epidemiological findings which has led to the widespread use of fibre in treating diverticular disease and constipation. Evidence of beneficial effects for cancer of the colon and ischaemic heart disease are far less convincing. Few harmful effects of fibre have been documented, apart from continuing disagreement regarding fibre and mineral balance, a question which remains to be solved. On weighing the evidence, it is suggested that recommending higher-fibre intakes in the UK is a favourable guideline. The type of fibre to be recommended is discussed, based on new evidence of the mode of action of different types of fibre in the gastrointestinal tract, and the amount of fibre considered, in relation to intakes in other countries and in the past in the UK.