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Western Diet and the Risk of Colon Cancer

by Jennifer Wider, M.D.

Women who fill their diets with red or processed meats, french fries, white bread and sugary desserts may have an increased risk of colon cancer, according to Major Dietary Patterns and the Risk of Colorectal Cancer in Women from the February 10, 2003 issue of the Archives of Internal Medicine.

Researchers followed more than 76,000 women for 12 years to determine how their dietary patterns affect the risk for colon and rectal cancers. They identified two main patterns: the "prudent" diet consisting primarily of fruit, vegetables, fish and whole grains and the "Western" diet consisting mainly of red meat, fried foods, refined grains and desserts. The results revealed a significant association between the Western diet and the risk of colon cancer.

The "Western diet" has been linked to an increased risk of colon cancer for several reasons. According to Teresa Fung, ScD, RD, LDN, lead researcher and assistant professor at the department of nutrition at Simmons College, in Boston, Massachusetts, "Red meats are cooked in high heat and may generate nitrosamines, which may be carcinogenic. Many processed meats are preserved with nitrites, and may also be converted to nitrosamine in the gut." In other words, the processes of cooking or preserving meat may produce cancer-causing chemicals.

In addition, consuming white bread rather than whole-wheat may make a difference. Dr. Fung explains, "Refined grains may increase insulin levels. Insulin, being a mitogen, may promote the carcinogenic process if transformed cells already exist." More simply, the consumption of refined grains like pasta or white bread can raise insulin levels in the body. Insulin can cause cell division and potentially turn pre-cancerous cells into cancerous ones.

While other studies have suggested an association between dietary habits and colorectal cancer, none have the scientific validity of this current study. "This is the first, large prospective study to look at dietary patterns and colon cancer," explains Walter Willett, MD, DrPH, one of the key researchers and Professor of Epidemiology and Nutrition and Chair, Department of Nutrition, at the Harvard School of Public Health. A prospective study means that the data about dietary patterns was collected while the participants were healthy, before any diagnosis of cancer was made. According to Dr. Willet, because the study was "prospective and large, the findings are more credible than the findings of prior studies."

Colon cancer is the third most common cancer among men and women in the United States and the second leading cause of total cancer death in the U.S., according to data from the American Gastroenterological Association. More women over the age of 75 will die of colorectal cancer than from breast cancer. Despite these numbers, many women do not consider colorectal cancer a major threat to their health.

The American Cancer Society recommends a variety of screening tests in the prevention of colorectal cancer. For women and men over the age of 50, an annual fecal occult blood test should be performed at the doctor's office to look for blood in the stool. Every five years, a flexible sigmoidoscopy is recommended, and every ten years, a colonoscopy should be performed. Colorectal cancer is highly treatable if detected in the early stages. Employing proper screening methods can not only find the disease early but also prevent it by finding and removing pre-cancerous polyps.

The findings of this study underscore the importance of dietary habits, along with regular screening, in the prevention of cancer. According to Dr. Willett, patients can also: "reduce the risk of colon cancer by staying lean and exercising regularly, avoiding cigarette smoking and high alcohol consumption (greater than 2 drinks per day)." Dr. Willett also points out that "there is quite strong evidence that a RDA multiple vitamin will reduce the risk, probably by ensuring adequate intake of folic acid."

The Society for Women's Health Research is the nation's only not-for-profit organization whose sole mission is to improve the health of women through research. Founded in 1990, the Society brought to national attention the need for the appropriate inclusion of women in major medical research studies and the resulting need for more information about conditions affecting women. The Society advocates increased funding for research on women's health, encourages the study of sex differences that may affect the prevention, diagnosis and treatment of disease, and promotes the inclusion of women in medical research studies. Dr. Donnica Moore has been a member of the Society since 1990 and is a past member of its Board of Directors.

Created: 3/6/2003  -  Jennifer Wider, M.D.
Reviewed: 3/6/2003  -  Donnica Moore, M.D.

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