At the heart of such behavioural change lies dietary modification. However, regardless of therapeutic choice for obesity management, ultimately, weight loss stems from behavioural change at an individual level. Important advances have been made in recent years regarding our understanding of appetite and metabolic regulation, metabolic surgical and medical therapeutic approaches to obesity. Obesity has a substantial and diverse impact on psycho-social functioning, work productivity and global healthcare expenditure. In addition to multi-morbidity, obesity also associates with premature mortality as evidenced by data from the Framingham Heart Study. Global obesity prevalence has tripled over the last half century, with current rates of obesity and overweight affecting 650 million and 1.9 billion people respectively. Such lifestyle factors also contribute towards weight gain and obesity, which represent a particularly important contributor to chronic ill health, including >50 medical conditions (such as type 2 diabetes mellitus (T2D), dyslipidaemia, hypertension, obstructive sleep apnoea and cardiovascular disease). In recent decades, much evidence supports an important role for our lifestyles in the development of such inflammatory and dysmetabolic processes, such as, for example, our sleep, physical activity and diet. Underlying much of this chronic disease burden are pathological pathways that implicate inflammation and metabolic dysfunction (including insulin resistance). In our modern-day, 21st century world, chronic diseases predominate. If implemented successfully, this strategy would likely result in substantial future health benefits for the population. Given the plethora of scientific evidence that corroborate the multiple and varied health benefits of dietary fibre, and the risks associated with a diet that lacks fibre, the optimization of fibre within our diets represents an important public health strategy to improve both metabolic and overall health. Conclusions: Multiple factors contribute to our fibre-impoverished modern diet. The gut microflora functions as an important mediator of the beneficial effects of dietary fibre, including the regulation of appetite, metabolic processes and chronic inflammatory pathways. Dietary fibre intake also correlates with mortality. Dietary fibre intake associates with overall metabolic health (through key pathways that include insulin sensitivity) and a variety of other pathologies that include cardiovascular disease, colonic health, gut motility and risk for colorectal carcinoma. Results: In the Western world, our diets are impoverished of fibre.

Data Sources: We performed a narrative review, based on relevant articles written in English from a PubMed search, using the terms ‘dietary fibre and metabolic health’. Objective: To explore the current medical literature on the health benefits of dietary fibre, with a focus on overall metabolic health. Over recent decades, there has been a transformation in our understanding of the health benefits of dietary fibre. This includes increased ingestion of ultra-processed foods that are typically impoverished of dietary fibre, and associated reduction in the intake of fibre-replete plant-based foods. Over recent decades, our diet within Westernised societies has changed radically from that of our hominid ancestors, with implications for our co-evolved gut microbiota.

Background: Dietary fibre consists of non-digestible forms of carbohydrate, usually as polysaccharides that originate from plant-based foods.

Does fiber help digestion