THE MAN WITH ONE EYE AND HIS DISCOVERIES – PART 2
Picture taken from John H.
Cummings and Amanda Engineer. Denis Burkitt and the origins of the
dietary fibre hypothesis. Nutrition
Research Reviews (2018), 31, 1–15
Burkitt
resigned his surgical post in Mulago Hospital in 1964. But he stayed in Kampala
for two years as the external scientific staff of the Medical Research Council.
He observed that the incidence of some cancers varied considerably in different
locations. He was primarily interested
in continuing research in occurrence and distribution of cancer in Africa. But he left Africa mainly because of the
changes occurring in post- independent Uganda and returned to London on 14 February, 1966 and continued
to work with the Medical Research Council for 10 years.
He
never had the idea that diet could have a role in cancer or other diseases. His
idea changed when he got introduced to Peter Cleave, a retired Naval Medical
Officer, by Sir Richard Doll. This paved the way for his next great contribution
to cancer and medicine. Cleave believed that many Western diseases were caused
by inadequate fibre consumption. Burkitt was convinced by Cleave’s research and
conclusions as Burkitt had not seen these diseases in African medical practice.
Like
the similar approach used in Burkitt lymphoma, he used questionnaires and personal
visits to test Cleave’s hypothesis. He acquired extensive data on the dietary
habits of populations around the world. In 1969, he started his research to complement
the epidemiological evidence he got. He studied the effect of different diets on bowel
behaviour, including stool characteristics and bowel transit time. He studied the
relationships between diet and the incidence of various disease like obesity, diabetes,
ischemic heart disease, diverticular disease,
bowel cancer, haemorrhoids, hiatus hernia, varicose veins. Over the next 5 years, he accumulated enough evidence which convinced
him that lack of fibre was a determinant of bowel cancer risk and
many other diseases.
He
regularly went to Africa, while doing these studies. He met a biochemist, Alec
Walker, in South Africa in 1969. Walker had studied the diets of black and
white South African prisoners. He came
to the conclusion that the African prisoners who consumed a diet high in fibre
had a low incidence of diseases such as colon cancer, obesity, gall stones and
diabetes compared with their white fellow prisoners who took a refined diet.
Walker had also studied bowel transit times and stool weights. Walker and
Burkitt shared research findings and published together.
Burkitt
presented a paper on his nutritional findings at a meeting in Kampala in 1970.
His old colleague, Hugh Trowell, had also attended the conference. He had
previously studied nutrition and in 1960, had published a list of diseases
rarely seen in Africa but which were prevalent in economically developed countries
in a book named 'Non Infective
Diseases' in Africa. Burkitt and Trowell began to work together and
they published a number of papers and books on nutrition.
Burkitt
used his very high international profile to propagate high fibre diets and exposed
the risks of unhealthy Western diets which was rich in fat, sugar and salt and low
in fibre. He gave lectures around the
world and published regularly on diet. His crusade on the importance of dietary
fibre changed the diet of the Western world. Burkitt
came to be known as ‘The Fibre Man’.
There
was a dearth of literature about fibre written by nutritionists and medical
scientists over many years. But how did Burkitt make an hypothesis relating
diet and major diseases of Western Culture over a period of only six years?
Will see about
the people who instilled the fibre concept in Burkitts mind in the coming posts.
References:
1.
Davis Coakley. Denis Burkitt and his contribution to
haematology/oncology. British Journal of
Haematology. 2006:135; 17–25.
2.
John H.
Cummings and Amanda Engineer. Denis
Burkitt and the origins of the dietary fibre hypothesis. Nutrition
Research Reviews (2018), 31,
1–15
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