Aspects of the epidemiology of diverticular disease and ischemic heart disease.

Abstract

Diverticular disease (DD) of the colon is common in populations where the intake of cereal fiber in the diet has been reduced dramatically for several decades. Also it has been shown that the addition of fiber in the form of wheat bran relieves the symptoms of the uncomplicated forms of the disease. Both diverticular and ischemic heart disease (IHD) have become major problems of the industrial nations of the Western world in this dentury. Consequently, it has been suggested that a deficiency of dietary fiber may play a part in the causation of IHD. The historical emergence and the geopraphical distribution of both DD and IHD are discussed and are shown to support this contention. New data regarding their prevalence in rural Africa and Asia have been obtained from over 170 hosptals, together with details of the radiological incidence of diverticulosis in India and South Africa. Admittedly the incidence of both diseases is known in very few countries with any degree of accuracy, but it is still crystal clear that DD and IHD appeared on the clinical scene together and that they are very closely associated geographically. Frequently they are found together in the same patient. This paper proposes that fiber deficiency may help to cause not only diverticulosis but also IHD.