Foreword<br > by<br >Denis P. Burkitt. M.D.<br >In January， 1977 I first visited Nathan Pritikin and exam-<br >ined his work. This visit and follow-up visits in January，<br >1978 and 1979， convinced me that good results were<br >being achieved in the cardiovascular diseases and some<br >other diseases that were being specifically investigated.<br > My colleague， Dr. Hugh Trowell， and I were impressed<br >by the similarities between the dietary and exercise regime<br >being recommended by him and his staff and the style of<br >life practiced in communities in the third world who have<br >minimal prevalences of many diseases that are character-<br >istic of modern Western culture.<br > Nathan Pritikin has put maximu~ emphasis on re-<br >duction of fat and cholesterol intake， bikl~ almost inevitably<br >his low fat diet of unrefined foods is higll in fibre rich car-<br >bohydrates. There is almost invariably a reciprocal rela-<br >tionship between the amount of fat and fibre consumed.<br >There is now good epidemiological， clinical， and in some<br >eases experimental， evidence indicating a relationship be-<br >tween fibre-depleted diets and prevalences of such com-<br > mon diseases as large bowel cancer， gallstones， varicose<br >veins， hemorrhoids， diverticular disease of the colon， ap-<br > pendicitis and hiatus hernia.<br > It might be best in our present state of knowledge to<br > consider fibre as potentially protective against these dis-<br > eases. This does not rule out the possibility of several<br > eauses. All of these diseases have been shown to have<br >l:their maximum prevalences in communities in which， as a<br >fdirect result of an inadequate fibre intake， intestinal con-<br >trent is small in volume and firm in consistency and slow<br > in its transit through the bowel. Hypotheses that are con-<br > sjstent with epidemiological and other evidence have been<br > formulated to explain the relationship between fibre-de-<br > diets and these diseases. Although there is<br > no<br > way<br >[ xvii<br ><br >