Fiber poverty – Food Pharmacy

Dr. Khosro Ezaz-Nikpay

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Fiber poverty

We often think of poverty as financial poverty affecting parts of humanity. There is however a type of poverty that affects most of humanity and affluence does not provide any protection. What I’m talking about is fiber malnourishment that has increased significantly over the past 50 years across the world.

Historically, in most parts of the world human nutrition contained a significant amount of fiber. Traditional diets contained some meat, but mostly plant matter, which is the source of fiber. As our diets have become more protein and fat rich, easy to cook because of more processed ingredients, and more delicious for example by the copious addition of sugar and salt, fiber has steadily receded.

“Poverty is relatively cheap to address and incredibly expensive to ignore” – Clint Borgen

With devastating consequences: Today we over-eat fat by 80-130%, protein by 50-100%, sugar and simple carbs by over 80%, but we under-consume fiber and complex carbs by over 50%. This fiber poverty reduces our lifespan by many years and increases our risk of dying by 10% on average. 

Over the past century we have made great strides in reducing disease (e.g., antibiotics, sewage treatment) and infant mortality (mother’s nutrition and health) mostly reducing mortality in the young, the decline in fiber consumption has made us sicker as we age. Many of the diseases of the affluent countries can be traced back to deficiency in fiber consumption.

Many cancers (e.g., bowel, pancreas, breast, kidney), cardiovascular disease (e.g., strokes, heart attacks), and inflammation are directly linked to lower fiber consumption. People who eat adequate amounts of fiber (at least 30-35g per day) live healthier and longer lives. The impact is so large that you might as well ignore all other nutrition advice if you don’t get enough fiber.  

While many people have heard about fiber being generally good, most are unsure about the best sources and the scale of its benefits. In contrast to various diets (most are relaunched every decade), where there is scant evidence for any long-term health benefit or various supplements, where there is ample evidence for their uselessness (and I’m being generous as some have a detrimental impact on our health), the evidence for the benefits of fiber is vast and supported by dozens of meta analyses. 

What sets fiber apart is that it is affordable and therefore within reach of the entire population and not just the affluent. And if we all would consume 10g more a day, the impact in terms of healthy years added to our lives through higher fiber consumption is more than any other positive action I can think of.

Unfortunately, in my dealings with health authorities in the UK, USA and Sweden, the level of awareness of fiber is dismal and even many trained nutritionists ignore its benefits and rather talk about sexier topics such as protein, or some exotic ingredient, superfruit, or expensive supplement. Governments have spent billions on protecting the population from Covid-19, however a fraction of that spent on promoting fiber would save more lives (including Covid-19).

So the solution is simple: Increase your fiber consumption. It is easy to fit into your lifestyle (as opposed to most diets, which is the main reason why they don’t work), and fun: A sprinkling of seeds or herbs, some fresh fruit and vegetables as a snack, avocado instead of butter, popcorn instead of nachos. Once you add those 10g or more there is no need for calorie counting, just count the years you will get to spend as vigorously as you wish.

This is a guest post. Any opinions expressed are the writer’s own.

  1. Sproesser, G., Ruby, M.B., Arbit, N. et al. Understanding traditional and modern eating: the TEP10 framework. BMC Public Health 19, 1606 (2019).
  2. See my new book “Fiber for life” for a broad analysis and evidence or check the compendium website and blog for up to date insights (available on Akademibokhandeln, Amazon, Bookshop, Waterstones)
  3. For every 10g less fiber consumed per day, we increase our risk of dying by ca. 10%.  And across much of the world, people consume at least 10 g a day less than we should, see for example, Yang, Y., Zhao, L. G., Wu, Q.J., Ma X., Xiang Y. B. (2015), Association between dietary fibre and lower risk of all-cause mortality: a meta-analysis of cohort studies; Am J Epidemiol, 181 (2): 83–91.
  4. A meta analysis is an analysis of multiple studies in order to ensure that we do not rely on the results of a single piece of evidence that may be due to luck or bad study design.  In general, the more studies and the more meta analyses there are the more one can trust the evidence, and Fiber has more evidence behind it than most other health related topics including pharmaceuticals
  5. There are obviously dangerous things such as smoking that can avoid, but to my knowledge there is no drug or other concoction on earth that can compete with fiber in terms of prolonging life.



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