THE DOC AND CHEF SHOW EP. 11: COLON CANCER // SUPPORTING SCIENCE AND THE RECIPE
Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. In 2023, approximately 153,020 individuals will be diagnosed with CRC and 52,550 will die from the disease.[1] Although CRC rates have been declining in older adults, they have been on the rise in patients younger than age 50.[2] This led the U.S. Preventative Services Task Force to change its recommendations in May 2021 for colon cancer screenings to begin at age 45.[3]
Colon cancer, like many types of cancer, is a complex disease with multiple factors contributing to its development. The exact cause of colon cancer is not always clear, but several risk factors have been identified that increase the likelihood of developing this disease. Here are some of the key factors and causes associated with colon cancer:[4]
1. Age: The risk of colon cancer increases with age. Most cases are diagnosed in individuals over the age of 50.
2. Family History: A family history of colon cancer or colorectal polyps (noncancerous growths in the colon or rectum) can increase the risk of developing the disease. This suggests a genetic predisposition to colon cancer.
3. Inherited Genetic Mutations: Certain inherited genetic mutations, such as those found in Lynch syndrome or familial adenomatous polyposis (FAP), greatly increase the risk of colon cancer. Individuals with these gene mutations have a significantly higher likelihood of developing the disease at a young age.
4. Personal History: Individuals who have previously had colorectal cancer or certain types of polyps are at an increased risk of developing colon cancer.
5. Diet: A diet high in red and processed meats and low in fiber may contribute to an increased risk of colon cancer. Conversely, diets rich in fruits, vegetables, and whole grains have been associated with a lower risk.
6. Lifestyle Factors: Several lifestyle factors can increase the risk of colon cancer, including smoking, excessive alcohol consumption, and physical inactivity.
7. Inflammatory Bowel Diseases (IBD): Chronic inflammatory conditions of the colon, such as Crohn's disease and ulcerative colitis, are associated with an increased risk of colon cancer, particularly if the inflammation is long-standing and widespread.
8. Obesity: Being overweight or obese is a risk factor for colon cancer, particularly in men.
9. Type 2 Diabetes: Some studies suggest a link between type 2 diabetes and an increased risk of colon cancer.
10. Certain Medications: Long-term use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be associated with a reduced risk of colon cancer in some individuals.
11. Radiation Exposure: In rare cases, exposure to high levels of radiation, such as radiation therapy for previous cancers, may increase the risk of colon cancer.
Although there are many risk factors for developing CRC, lifestyle, especially diet, plays a very important role. Here are some foods and dietary factors that have been associated with an increased risk of colon cancer:[5]
1. Red and Processed Meats:
Red meat: Consumption of red meats such as beef, pork, and lamb, especially when cooked at high temperatures (grilled, fried, or broiled), has been associated with a higher risk of colon cancer.
Processed meats: Processed meats like bacon, sausage, hot dogs, and deli meats often contain preservatives and additives and are linked to an increased risk of colon cancer. These meats may also be high in saturated fats and salt.
2. High-Fat Diets: Diets high in saturated fats, especially from animal sources, have been associated with an increased risk of colon cancer.
3. Low-Fiber Diets: Diets that are low in dietary fiber, particularly from fruits, vegetables, and whole grains, may contribute to a higher risk of colon cancer.
4. Low Calcium Intake: Inadequate intake of calcium, which is found in certain leafy greens, has been associated with an increased risk of colon cancer.
5. Excessive Alcohol Consumption: Heavy alcohol consumption has been linked to an elevated risk of colon cancer. Limiting alcohol intake is advisable for overall health.
6. Sugar-Sweetened Beverages and Sugary Snacks: High consumption of sugary drinks and snacks may contribute to an increased risk of colon cancer, as they are associated with obesity and insulin resistance.
7. Low Vitamin D Levels: Low levels of vitamin D, which can result from insufficient sun exposure or inadequate dietary intake, have been linked to a higher risk of colon cancer.
8. High Salt Intake: Diets high in salt, often found in processed and salty foods, may increase the risk of colon cancer.
A healthy diet and lifestyle choices
These significant role in reducing the risk of colon cancer. Here are some foods and dietary factors that have been associated with a lower risk of colon cancer:[6]
1. Fruits and Vegetables: Eating a variety of fruits and vegetables, particularly those high in fiber and antioxidants, can help reduce colon cancer risk. Examples include broccoli, kale, spinach, carrots, berries, and citrus fruits.
2. Whole Grains: Foods rich in whole grains like whole wheat, oats, brown rice, quinoa, and wholegrain cereals are high in fiber and may lower the risk of colon cancer.
3. Legumes: Beans, lentils, and peas are excellent sources of fiber and plant-based protein. They are associated with a lower risk of colon cancer.
6. Nuts and Seeds: Nuts and seeds, such as almonds, walnuts, flaxseeds, and chia seeds, are good sources of healthy fats, fiber, and antioxidants.
7. Garlic and Onions: These Allium vegetables contain compounds that may have anticancer properties and may be associated with a reduced risk of colon cancer.
8. Turmeric: Curcumin, a component of turmeric, has shown potential anticancer effects and may help protect against colon cancer.
9. Green Tea: Green tea contains polyphenols, including epigallocatechin gallate (EGCG), which have been studied for their potential protective effects against colon cancer.
10. Berries: Berries like strawberries, blueberries, and raspberries are rich in antioxidants and fiber and may have a protective effect against colon cancer.
11. Probiotics: Fermented foods containing probiotics support a healthy gut microbiome, which can play a role in colon health.
Many of these foods are high in fiber, and as previously noted, low fiber intake is associated with an increased risk of developing CRC. In fact, for every ten grams of fiber added to your diet, your risk of suffering from colon cancer is lowered by around 10%! [7]The recommended daily intake of fiber is 30-40 grams per day. This well above the average fiber intake among Americans, which is around 16 grams per day for males and 13 grams per day for females.[8] Increasing fiber intake can have other health benefits, including reducing the risk of certain diseases such as heart disease, high blood pressure, type 2 diabetes, and can aid in weight management.[9]
So, what is fiber?
Fiber is a type of carbohydrate found in plant-based foods that cannot be digested or absorbed by the human body. Instead of being broken down and absorbed like other nutrients, fiber passes through the digestive system relatively intact.[10] Dietary fiber can act as prebiotics. Prebiotics are non-digestible fibers that serve as a food source for beneficial bacteria in the gut, promoting their growth and activity. These beneficial bacteria, often referred to as probiotics, play a crucial role in maintaining a healthy gut microbiota.[11]
There are two main types of dietary fiber:
1. Soluble Fiber: This type of fiber dissolves in water to form a gel-like substance in the digestive tract. Soluble fiber can help regulate blood sugar levels and lower cholesterol levels. Good sources of soluble fiber include oats, barley, legumes (beans, lentils), fruits (such as apples, oranges, and berries), and some vegetables (such as carrots and Brussels sprouts).
2. Insoluble Fiber: Insoluble fiber does not dissolve in water and adds bulk to the stool, helping to prevent constipation and promote regular bowel movements. It can help maintain a healthy digestive system. Good sources of insoluble fiber include whole grains (such as wheat, brown rice, and quinoa), wheat bran, nuts, seeds, and many vegetables (such as broccoli, cauliflower, and celery).
Both soluble and insoluble fiber are important for overall health, and a well-balanced diet should include a variety of foods that provide both types of fiber. It is recommended to gradually increase fiber intake to allow the digestive system to adjust and to drink plenty of water throughout the day to support proper digestion and prevent discomfort.
In summary, following a high fiber, low-fat plant-forward and eliminating red and processed meats can significantly reduce the risk of developing CRC. Individuals concerned about their risk of colon cancer should consult with a healthcare professional for personalized guidance and recommendations, especially if they have a family history of the disease or other risk factors. Regular screenings and early detection through colonoscopy and other screening methods are crucial for colon cancer prevention and early intervention.
[1] CA Cancer J Clin. 2023 May-Jun;73(3):233-254.
[2] American Society of Clinical Oncology Educational Book 40 (April 21, 2020) e75-e88
[3] https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
[4] https://www.cancer.org/cancer/types/colon-rectal-cancer/causes-risks-prevention/risk-factors.html
[5] J Gastrointest Oncol. 2022 Aug;13(4):2020-2032
[6] J Cancer Prev. 2022 Dec 31;27(4):208-220
[7] BMJ. 2011 Nov 10;343:d6617
[8] Nutr Rev. 2020 Aug 1;78(Suppl 1):29-36
[9] Nutrients. 2020 Oct 21;12(10):3209
[10] Nat Rev Gastroenterol Hepatol. 2021 Feb;18(2):101-116
[11] Gut Microbes. 2017 Mar 4;8(2):172-184
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Chickpea Chicken Salad
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