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Healthy Inside and Out: How Diet and Lifestyle Impact Colorectal Cancer

Diet and lifestyle play a large role in colorectal cancer (CRC) prevention and prognosis. Dietary factors such as consumption of meat, sugary drinks, and alcohol, and lifestyle factors such as western diet patterns, being overweight or obese, physical inactivity, and smoking can add to the risk of CRC.

Diet and the Risk of CRC

A systematic review of multiple research studies has shown that a diet high in red and processed meats and low in fiber is a prominent risk factor for CRC and can lead to DNA damage, gut epithelial damage, cell proliferation, and genotoxicity from the nitrates that are added as a preservative. A diet high in red meat and processed food can be damaging for CRC patients and survivors and can increase the risk of mortality. 

Including fiber, vegetables, and fruits in the diet is definitely healthy and can also prevent CRC. The Mediterranean diet—which includes fruits, vegetables, fish, and whole grains is a healthy preventive option to adopt in your food habits.

Research also points to a significant relationship between the consumption of processed meat and the development of early-age onset CRC (EAO-CRC), which developed among those younger than 50 years. A rapidly rising cancer across the globe, about 20% of EAO-CRC cases can be attributed to family history, and the remaining to other factors including diet and lifestyle.

  • Consumption of two or more sugary beverages per day doubles the risk of developing EAO-CRC in women 
  • An increase in consumption of sugary beverages in adolescence is associated with a 32% increased risk of developing EAO-CRC  
  • Consumption of sugary drinks is also known to increase the risk of mortality in CRC patients 
  • Alcohol consumption (greater than 14 drinks per week) also increases the risk of developing CRC.

Lifestyle Habits and the Risk of CRC

It is a well-known fact that a healthy lifestyle promotes health and well-being, while an unhealthy lifestyle can lead to health problems. Physical activity is important for overall health and studies point to physical inactivity and a sedentary lifestyle as major risk factors for CRC. Women who reported little to no physical activity after the age of 20 had a heightened risk of developing EAO-CRC.

Reduced physical activity can contribute to several different health problems, the most evident being obesity. Obesity modifies the gut microbiota leading to an increase in inflammation that damages the intestinal barrier. Obese and overweight individuals have a 42% higher risk of developing EAO-CRC than those at a healthy weight (an individual is considered to be a healthy weight if their BMI is between 18.5 and 24.9). There is also a correlation between obesity and the development of metabolic syndrome, which is a combination of multiple conditions that increase the risk of heart disease, stroke, and diabetes. Metabolic syndrome has been identified as a leading comorbidity in the development of EAO-CRC.

Smoking is also a significant risk factor in multiple cancers including CRC. Current smokers are at a higher risk of developing EAO-CRC, while past smokers may find their risk reduced. 

It is important to understand the significant role of diet and lifestyle in disease development. Maintaining a healthy diet, such as increasing fruit, vegetable, and fiber intake as well as decreasing one’s consumption of red meat, processed meat, and sugary beverages can prevent CRC. This, coupled with a healthy and active lifestyle can significantly reduce the risk of developing CRC. 

 

Abigail Parker is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.

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Have You Had Your Fiber Yet? Food Habits and the Risk of Colorectal Cancer

We learn time and again that prevention is the best medicine, and this holds true for colorectal cancer (CRC). It is estimated that 50% of CRC cases can be prevented with diet and lifestyle modifications. Previous studies that looked at the relationship between CRC development and nutrition concluded that there is a strong correlation between diet and the development of certain types of cancer, specifically CRC. 

A recent study published in Preventive Medicine Reports investigated the impact that an insufficient diet plays in the development and prevalence of certain cancers as well as the effect that race and ethnicity has on diet.  Wholegrains, dietary fiber, non-starchy fruits, and vegetables, dairy products, milk, cheese, dietary calcium, coffee, and calcium supplements were found to be associated with preventing cancer development. The study examined population attributable factors and the number of excessive cases diagnosed in Texas in 2015 that were attributed to an inadequate diet, defined as a diet that does not meet or conform to the national or global dietary recommendations. 

With a diverse study population, the researchers had the opportunity to explore how race and ethnicity play into diet and thus contribute to the prevalence of cancers, specifically colorectal cancer (CRC).  

The study found:

  • While men were more likely than women to not follow guidelines on red and processed meat consumption.
  • Women were more likely to miss dietary recommendations on fiber and calcium intake.
  • A significant correlation between processed meats consumption and the prevalence of CRC and a connection between red meat consumption and the prevalence of CRC. 

There has been additional research conducted to show that there is a link between dietary fiber intake, and dietary calcium intake and the prevention of CRC. Looking at the racial and ethnic difference the study found that Non-Hispanic Whites consumed higher than the recommended dietary intake of red and processed meats. While it was found that Non-Hispanic Blacks were the most likely to have insufficient fiber and calcium intake.

In the Texas population, the authors found:

  • 3.3% of all new cancers (>3,428) could be attributed to an inadequate diet 
  • 34% of new CRC cases can be attributed to dietary insufficiencies 

The authors describe a similar correlation identified in an Australian population, where:

  • 17.6% of CRCs were related to an insufficient fiber level in diet 
  • 17.7% of CRCs were attributed to red and processed meats 
  • Men had a higher proportion of cancers attributable to an insufficient diet than women 
  • Excess consumption of processed meat contributed to 1,002 new cancer cases and red meat consumption contributed to 379 additional cancer cases 

This study along with multiple other studies conducted in relation to dietary factors and their contribution to cancer highlight the importance of diet—especially insufficient fiber intake and excess red or processed meat intake—on overall cancer burden.

 

Abigail Parker is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.

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Increased Risk of CRC in Patients with Slow-Transit Constipation

Slow-transit constipation (STC) is reported to occur in 15-30% of people in the U.S. The most widely accepted definition of STC is two or fewer bowel movements per week or straining at stool more than 25% of the time. Research continues to point to STC as a risk factor for colorectal cancer (CRC).

A study published in 2020 that looked at 2,165 patients (median age 54 years), found that the cumulative probability of CRC was 0.2% 5 years after STC diagnosis and 0.4% 10 years after STC diagnosis. This was not significantly different (p=0.575) than among those without STC diagnosis. However, this may be due to the small number of patients (5) who were diagnosed with CRC.

Although the authors of the 2020 study did not find a significant difference among those with and without STC diagnosis, it is well established that STC increases CRC risk. Gurérin et al. in their 2014 study of over 100,000 patients identified a statistically significant risk of CRC among those with STC:

  • 56% higher for CRC
  • 260% higher for benign neoplasm
  • 256% higher for benign neoplasm in colon
  • 262% higher for anal and rectal polyps

Current management options for STC range from dietary counseling, pharmacological therapy, and surgery. 

While the etiology of STC remains unclear, there is increasing evidence that it is caused by an imbalance in the gut microbiome. Zhang et al. in their 2021 review published in Gastroenterology Report found that gut microbiota may play a major role in modulating colonic motility, secretion, and absorption. However, there is still much research needed to understand how the gut microbiome modulates movement of fecal matter through the small intestine and colon.

Conversations about the role of the gut microbiome in CRC development were a part of the Early-Age Onset Colorectal Cancer Summit held by the Colon Cancer Foundation in May 2022.

 

Gargi Patel is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.

 

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Dietary Mindfulness Can Reduce the Risk of Colorectal Cancer

A recently conducted systematic electronic search investigated keywords relating to colorectal cancer (CRC) and nutrition to define the association between diet and CRC. We summarize their findings here. 

What Can Change in My Dietary Habits?

According to the World Cancer Research Fund and American Institute of Cancer Research, 50% of CRC cases can be prevented by dietary and lifestyle modifications. While previous research studies concluded that high-fat and high-calorie diets had a carcinogenic effect, new research is showing that there is a specific role for nutrients such as fiber, vitamins, and minerals on intestinal metabolism. Consuming whole grains, dietary fiber, and dairy products decreases the risk of CRC, while consuming red and processed meats and fats increases the risk of CRC. Dietary interventions have increasingly been used over the past decade to reduce the occurrence and progression of CRC.

While there are some dietary habits that can reduce the risk of CRC, others can increase that risk. High-risk diets include those with red and processed meats, and diets made up of high fats and high carbohydrates. 

  • Processed meats are categorized as Group 1, meaning they are carcinogenic 
  • Red meats are categorized as Group 2A, meaning they are most likely to be carcinogenic 

Growth hormones in red and processed meats may be responsible for their carcinogenic effects. It is recommended that individuals limit the intake of red meats to 12-18 oz each day, and processed meats should be completely avoided. Many components of our diet may help prevent CRC: dietary fiber intake, for example, is inversely related to CRC development. Vitamins and minerals also play an important role in CRC prevention. 

  • Vitamins E and C have been shown to have a direct tumor suppressing effect on CRC 
  • Vitamin D has been shown to reduce the risk of developing CRC 
  • Calcium and selenium have also been shown to have an inverse effect on CRC

However, more research is needed to fully understand the role that fiber, vitamins, calcium, and selenium play in CRC development. 

There has also been significant interest in the role of gut microbiota (the bacteria in our gut) on CRC development. Research findings so far indicate that the microbiome and microbial metabolite health is pivotal to the prevention of several diseases such as CRC. The Mediterranean diet has positive effects on protecting individuals against CRC. Thus, nutritional therapies that are based on epigenetically active nutrients are likely to represent a good research direction.

In summary, dietary factors have a strong influence on CRC development. Consuming whole grains, dietary fiber, and dairy products can reduce the risk of CRC. Evidence also points to a role for vitamins in preventing CRC development. Ultimately, it is important to remember that future dietary recommendations will need to consider each person individually—looking at their cultural identities, risk factors, and the interaction between nutrients and the microbiota.

 

Abigail Parker is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Increased Risk of CRC in Patients With Slow-Transit Constipation

Slow-transit constipation (STC) is reported to occur in 15-30% of people in the U.S. The most widely accepted definition of STC is two or fewer bowel movements per week or straining at stool more than 25% of the time. Research continues to point to STC as a risk factor for colorectal cancer (CRC).

A study published in 2020 that looked at 2,165 patients (median age 54 years), found that the cumulative probability of CRC was 0.2% 5 years after STC diagnosis and 0.4% 10 years after STC diagnosis. This was not significantly different (p=0.575) than among those without STC diagnosis. However, this may be due to the small number of patients (5) who were diagnosed with CRC.

Although the authors of the 2020 study did not find a significant difference among those with and without STC diagnosis, it is well established that STC increases CRC risk. Gurérin et al. in their 2014 study of over 100,000 patients identified a statistically significant risk of CRC among those with STC:

  • 56% higher for CRC
  • 260% higher for benign neoplasm
  • 256% higher for benign neoplasm in colon
  • 262% higher for anal and rectal polyps

Current management options for STC range from dietary counseling, pharmacological therapy, and surgery. 

While the etiology of STC remains unclear, there is increasing evidence that it is caused by an imbalance in the gut microbiome. Zhang et al. in their 2021 review published in Gastroenterology Report found that gut microbiota may play a major role in modulating colonic motility, secretion, and absorption. However, there is still much research needed to understand how the gut microbiome modulates movement of fecal matter through the small intestine and colon.

Conversations about the role of the gut microbiome in CRC development were a part of the Early-Age Onset Colorectal Cancer Summit held by the Colon Cancer Foundation in May 2022.

 

Gargi Patel is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.

 

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Do Young Diabetes Patients Need Early CRC Screening?

A large cohort study that evaluated Swedish family inpatient and outpatient cancer registries found that those who had diabetes had an increased risk of colorectal cancer (CRC)—the magnitude of risk was similar to having a family history of CRC.

The study had a long timeline and follow-up was conducted between 1964-2015. The 12,614,256 individuals included in the study were born after 1931; 559,375 of them had diabetes and 162,226 had CRC. The authors queried the risk of developing CRC among those who had diabetes and found that:

  • 9-fold greater risk of CRC before 50 years among those diagnosed with diabetes before 50 years (range, 1.6-2.3)
  • 9-fold higher risk of CRC before age 50 years among those diagnosed with diabetes before 50 years who also had a family history of CRC (range, 4.1-12)
  • Lifetime risk of CRC before age 50 years among diabetic patients (0.4%) was similar to those with just a family history of CRC (0.5%). It was double that of the average population (0.2%).

This study confirms the positive association between early-onset diabetes and early-onset CRC and makes a case for earlier CRC screening among young adults with diabetes.

Results from the South Australian Young Onset (SAYO) CRC study identified a similar correlation between personal and family history of diabetes and CRC risk. The study cohort included 50 unrelated young adults up to age 55 years diagnosed with CRC (23-54 years), and 253 controls without CRC (18-54 years). Personal and family history of diabetes was documented in this entire population. The study found:

  • 24% of CRC patients also suffered from type II diabetes compared with 5% of the control group
  • 51% of young adults with CRC had at least one first-degree relative with type II diabetes
  • All patients with a personal history of type II diabetes also had first-degree relatives with type II diabetes
  • 44% of CRC patients under 45 years and 60% of CRC patients 45-54 years had a first-degree relative with type II diabetes

These findings create a very strong case for raising awareness among young adults with diabetes of their increased risk of early-onset CRC, especially if there is a family history of diabetes, so they can initiate CRC screening earlier than the USPSTF recommendation of 50 years.

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Diet and Nutrition to Prevent Colon Cancer

You can help significantly decrease your chances of colorectal cancer through proactive action related to your diet.

Maintaining a Healthy Weight Helps Prevent Colon Cancer

One of the best things you can do is to get yourself to a healthy weight and maintain it within a designated range. By maintaining a healthy weight you won’t just be proactively protecting yourself from colon cancer, you’ll also be making an investment in your overall health.

What to Eat to Beat Colon Cancer and Help Prevent it

Some of the best foods to be eating to lower your chances of contracting colon cancer include, chicken, fish, fruits, and whole grains.

Foods that you should avoid eating in excess include red meats and anything that is rich in refined sugars.

The Link Between Obesity and Colon Cancer

A strong link has been identified between obesity and colon cancer. Diet choices have a profound impact on how susceptible you are to contracting colon cancer.

It’s important to remember that making healthy choices with what you eat and how much affects much more than your susceptibility to contracting colon cancer. Your diet affects your overall health. It’s also important to remember that portion size is just as important as the food that you choose to eat. You can eat red meat without increasing your chance of getting colon cancer if you do it in moderation.

Someone who enjoys a steak every couple of weeks or so for dinner with a salad is not going to have a particularly high risk of getting colon cancer. Conversely, someone who eats steak, pork, sausage, and bacon in large quantities every single day or even every other day, will greatly increase their chances of having colon cancer.

Eating red meats in small amounts and in limited frequency is perfectly fine. No one needs to be panicking about eating a steak every now and again. No matter what you eat, your portion size is vital. Larger portion sizes are unhealthy and will put weight on fast.

You shouldn’t commit to a healthy diet just to decrease your chances of contracting colon cancer, you should want to eat healthy to feel better about yourself and increase your overall health. If you exercise and maintain a healthy diet, you won’t just be limiting your chances of getting colon cancer. You will feel better, and eliminate your susceptibility to countless other health problems.

How Does a Poor Diet Increase Your Chances of Contracting Colon Cancer?

Some of you might be wondering exactly how a poor diet increases your chances of contracting colon cancer. Obviously foods that are rich in fats aren’t good for you, but why does such delicious food have to make you more susceptible to such a horrible disease?

Studies have shown that when mice were fed a diet consisting of foods that were high in fats, they exhibited aggressive cell growth of stem-like cells that encourage mutation. This aggressive cell growth is typically coupled with the development of cancerous tumors along the intestine.

The unfortunate mice who were tested offer us invaluable insights into the factors that affect one’s chances of developing colon cancer. Their sacrifice, while trivial compared to the totality of scientific inquiry, is significant and it can save lives, human lives.

Further Recommendations

With so much information out there on the internet, it can be difficult to distinguish genuinely useful information from inaccurate drivel. For example, fiber supplements and antioxidant vitamins do not reduce one’s chances of having colon cancer, nor does it affect polyps.

Calcium, on the other hand, does have an effect on polyps and helps reduce polyp recurrence. Another thing that can help you is regular exercise. If you’re going to make the effort to maintain a healthy diet, you should double down and add exercise to the mix.

By exercising, eating healthy, and consuming the recommended amount of calcium, you can reduce your chances of contracting colon cancer significantly. Although these lifestyle changes can give you much better odds, it’s still imperative that you schedule regular screenings. If you aren’t being screened for colon cancer, you can still contract if and all of your efforts will be for naught, especially if it isn’t detected early on, hence the importance of regular screenings.

 

 

 

 

 

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2020 Global Colon Cancer Challenge

The 2020 Challenge has gone virtual during this unprecedented time. By going virtual you can still raise awareness and fund colorectal cancer research sorely needs now more than ever.  Our goal is to collectively take 1.8 million steps a day (representing 1.8 Million diagnoses per year). This will enable us to cover 41,672 miles OR ~ 83 Million steps! Most importantly we hope each of you will join us in meeting the American Heart Association’s recommended 10,000 steps per day. Let’s “Take Action Together To Defeat Colorectal Cancer!” Sign up today!

Learn why Sanjay and his family are participating in the 2020 Virtual Challenge.

The bery family did it’s own virtual event in Harry Dunham their local park in Basking Ridge, New Jersey. The kids ran 5 k and seema/ Sanjay walked 3.2 k, wearing their Colon Cancer Challenge. 2020 was the 12th year that Bery Colon Cancer Helpers participated in this Challenge — the locations have varied over the years from Central Park, Citi Field, Randall’s Island, and now Harry Dunham park.

After each Challenge the BCCH (bery colon cancer helpers) would go to a le Pain Quoitden ( a Belgium cafe chain ) in Manhattan for tartine lunch. We replicated that by creating our own le pain quoitden in our own kitchen (do not miss the cookbook in the 4th picture) and making our own open-faced tar-tine. Donate today. 

 

If you are interested in fundraising, signing up or becoming a sponsor of the Global Colon Cancer Challenge please follow the links below.

We are extremely excited to continue the legacy of the physical Colon Cancer Challenge by going virtual this year. Next year the physical Colon Cancer Challenge will return stronger than ever! In the meantime please stay safe and help us reach our goal of 1.8 million steps per day.

 

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What Causes Colon Cancer?

Predicting when or if colon cancer will develop is not possible, but predicting due to high risk factors can save lives. Early detection through screening can prevent cancer and keep it at a treatable stage.

General Causes

 While many different factors can lead to colon cancer, the exact cause is unknown. Being aware of the factors and whether or not you are at a higher risk can help save your life.

Age

All though the majority of colon cancer cases are  found in people aged 45 and up, there is an increase in colorectal cancer cases in those under 45. The risk is higher as you age. Screening starts at age 50 and continues for the next 25 years.

Overweigh

 Years of obesity can also increase your chances of developing colon cancer.

Inflammatory Bowel Disease (IBD)

 If you have ever had ulcerative colitis or Crohn’s disease, these diseases can increase your chances of developing colorectal cancer.

Type II Diabetes

 Not only can diabetes increase your risk for colon cancer it can also have an effect on your prognosis.

 Lifestyle

 The way you live can also increase your chances of developing colon cancer.

Diet

Overeating, carrying extra weight and the types of foods you eat can contribute not only to poor health but to colon and other types of cancers. Not only the food but also the way they are prepared.

Avoid red meat and any types of processed meats, like deli meat, hot dogs, and all types of red meat. Avoid eating burnt meat or other foods and try to avoid grilling, frying, and broiling meats.

Try to increase fresh fruits and vegetables, more plant-based foods, and avoid dairy, all processed foods, and sweets.

Smoking and Drinking

Cigarettes are one of the worst things you can do to damage your health. Combine it with excessive drinking, you increase your health risks and your cancer risks.

Exercise

Try to stay active, even walking in the evening or to work, taking the stairs or some type of stationary exercise equipment in the home can help with your overall health and keep cancer risks lowered.

Even for those with mobility concerns, you can find exercises you can do online or from books and magazines.

Genetics

The same way we can inherit a strong chin or a good head of hair, we can also inherit bad genes. If there has been colorectal cancer in your family, then your doctor will likely recommend you get screened earlier.

Inherited syndromes can also be a factor that increases your chances of developing colon cancer. The two most common are familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC).

Your ethnic background can also be a factor. African Americans have the highest incidence of colorectal cancer in the United States. Ashkenazi Jews also have a higher risk of developing the disease.

If you have no other risks, yet are in one of those ethnic groups you should consider getting a screening earlier than the normal recommendation.

Prevention

Taking care of your health is important, in particular, as we age. Taking plenty of exercise doesn’t mean you have to run a marathon. It just means getting off the couch or out of your desk chair regularly.

Try walking to work or part of the way home, if possible. Take the stairs when possible and invest in a bike, either stationary or mobile.

Our diets are one of the biggest ways we can prevent disease and poor health. It is all tied together, our diets, the amount we eat, what we eat, plus the impact on our bodies and the environment.

Eating a diet high in fiber, low in fat and avoiding meat can increase your health, your life expectancy and give you much more energy and a more enjoyable lifestyle.

Try to avoid stress. It is not always easy and some stresses in our lives are unavoidable, but avoid the ones you can and find other ways of coping with stress other than turning to carbs, smoking, and alcohol.

Relaxing with yoga, a warm bath before bed, and turning off all your devices can make a big difference. Getting a good night’s sleep can help start your day and it plays a big part in our overall health.

Consider a walk after a big meal, to help move it through your body. Even a walk after a stressful day at work can drop your stress and blood pressure considerably.

Worrying about family, money, your job is going to happen, to try to avoid stressing about things you have no control over. Turn off the news and your social media before you go to bed.

Try reading, relaxing, stretching, and listening to soft music with low lighting. Don’t overeat, stop smoking, eat more fiber, and take care of yourself. Colon cancer can be detected early, but there is no reason you should encourage it along.

 

 

 

 

 

 

 

 

 

 

 

 

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Staying Healthy Around The Holidays

During the holiday season, it can be difficult to stay healthy and keep your lifestyle and fitness goals. However, maintaining a healthy diet and staying active is a key component to helping fight early age onset colon cancer. Find a way to balance the holiday season with your loved ones and also keeping your health a priority with these simple tips.

 

Eat mindfully

While it can be easy to get carried away with holiday eating, make sure to balance your plate with whole foods, fruits and vegetables. A diet full of fresh fruits and vegetables are linked to decreasing your risk of early age onset colorectal cancer and shouldn’t full off of your plate during the holidays. There’s nothing wrong with treating yourself with a few sweets, but make sure to balance the rest of your meal.

 

Stay hydrated

The holiday season often brings copious amounts of alcohol. Try limiting yourself to only having a glass or two a night. Alcohol has links to colon and rectal cancer, so make sure to drink in moderation. Make sure to up your water content, too.

 

Stay connected through activities

Consider adding a new family tradition by incorporating activities that get you on your feet. After dinner, go for a walk around your neighborhood with your family or add a few exercises to your evenings while you watch TV together. Find small ways to get moving together while enjoying each other’s company.

 

While you’re focusing on your health this holiday season, also consider giving the gift of life by donating to the Colon Cancer Foundation. Donate today to support colon cancer patients, survivors and the research that helps us understand more about this deadly disease.

 

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