2 Development of the Dietary Fiber Hypothesis of Diabetes Mellitus*

Diabetes mellitus and obesity were extremely rare diseases in East African blacks when I started treating medical patients in Nairobi Hospital, Kenya, in 1930. After teaching medicine for nearly 30 years in East Africa, I reviewed the rising incidence of diabetes in sub-Saharan urban blacks and suggested that “their high-carbohydrate low-fat diets are protective and that low-carbohydrate high-fat diets predispose. African diets are usually high in their fiber content but in towns refined flours, sugar, and fats form a large part of the diet which may contain little fiber.”