Author: Frank W. Jackson, M.D.
Please refer to the essay on Colon Cancer and Polyps which describes these entities in detail. This essay describes the dietary steps you can take which may reduce your chance of getting colon cancer or polyps. No one is certain which of the following points are most important. Some are easy, such as ingesting enough calcium or taking a prebiotic powder. Some are more difficult, such as getting your weight under control and reducing your consumption of red meat. Taken together, a fairly good case and set of recommendations can be made to reduce your risk. These recommendations may be appropriate for those who have never had colon cancer or polyps as well as those who have.
Red meat is as American as apple pie. It is hard to realize how little red meat was available hundreds of years ago when plant foods were the basis of the diet in Europe and likely the New World Indians as well. With the domestication and breeding of farm animals, the industrialization of farming, and the availability of cheap corn feed, red meat is as common and as cheap, no, cheaper than bottled water.
The adult body needs perhaps only 50 grams of protein a day. Much of it can be obtained from plant foods. But meat tastes so good. We humans are true omnivores and given a choice, most of us will pick the tasty, fat dripping, red meat every time.
But for colon cancer prevention, it is best to modify the intake. Take smaller portions, perhaps a piece of meat about the size of a deck of cards. Reduce the frequency of red meat ingestion to 3 or 4 times a week or to whatever you feel comfortable with. For the real meat lover, this is as hard a decision to make as anything else in this essay.
Prebiotics and Plant Fiber
Prebiotics are the soluble fiber which go through the gut unchanged and then are used by good colon bacteria as a fuel source for their own growth. These bacteria then make short chain fatty acids or butyrates. This substance renders the colon acidic and is a fuel source for the health of the colon’s own cells. The bacteria that live in our colon rely on the prebiotic fiber we eat to make substances that maintain the health of our own colon. Scientists call this mutualism. I call it amazing.
One of the possible benefits of this process is to make the colon cells less likely to turn into precancerous and cancerous cells. So what are these prebiotic soluble plant fibers? The ones we know most about are inulin and oligofructase, which are found in:
Psyllium, found in bowel supplements such as Metamucil are fermented by colon bacteria. It will reduce cholesterol, but other health benefits have still not been demonstrated. There are other plant fibers that are suspected of being prebiotic fibers as well, but the science on these is still not certain.
The bottom line is that almost any plant food can be a benefit to the colon. The prebiotic foods and dietary supplement powders have the most science behind them.
Sulforaphane and Those Gassy Vegetables
Cruciferous vegetables such as cabbage, broccoli, Brussels sprouts and cauliflower are felt by many to be gassy. This is probably not true as they do not have an excessive amount of soluble fiber, which the colon’s bacteria need to make colon gas. What they do have is a lot of sulfur. Sulfur is what certain other colon bacteria use to make the smelly sulfide gases in colon gas and flatus.
But, there is an extraordinary payoff here. Sulforaphane is a key ingredient in these vegetables. In broccoli sprouts, it is exceptionally high. This is a powerful anti-cancer substance. The regular ingestion of these vegetables has been found in many medical studies, to be associated with a reduced cancer risk in many organs of the body. In the laboratory and in animal testing, sulforaphane has been found to have strong anti-cancer properties. While there are still no definitive human trials on cruciferous vegetables, most nutrition experts recommend these.
Calcium and Vitamin D
Calcium is one of the most common elements in the body. Yet, we still need a regular ingestion of at least 1200 mg of calcium a day. Milk can provide much of this. The calcium in vegetables is not as readily available to the body. Colon cancer risk seems to be greater when a low amount of calcium is ingested. So, adequate calcium intake in the form of milk, dairy products, shellfish and vegetables is recommended. Many physicians are now recommending calcium carbonate supplements up to 1200 mg a day to keep calcium intake at a good level.
Vitamin D has always been associated with calcium and strong bones. However, considerable new research on this vitamin has uncovered some remarkable findings.
- Most tissues in the body, including colon cells, have receptors or attachment points for vitamin D. Hmm, that’s interesting. Why should there be vitamin D receptors on so many cells in the body beyond bone cells?
- Vitamin D controls, either directly or indirectly, over 200 genes responsible for healthy cell growth. If enough vitamin D is not present, some of these cells may get a bit disorganized.
- There is now significant research to suggest an anti-cancer effect with vitamin D.
- There is recognition that vitamin D deficiency is widespread, especially in the temperate weather zones where sun exposure is variable. Sunlight makes vitamin D in the skin.
This is startling information. The blood level of vitamin D should be above 30 ng/ml. National experts are not in agreement on the amount of vitamin D needed to reach this level. Many experts think that 400 IU a day is too low and that at least 800-1200 IU a day should be taken. Toxicity from too much vitamin D is very rare. Check with your physician.
Overweight and Obesity
Obesity gets blamed for just about everything. A 2007 analysis of many published medical studies found that being overweight is a colon cancer risk factor for both men and women. The heavier you are, the higher the risk. So, for whatever other reason you might want to lose weight, decreasing the risk of colon cancer is worthwhile in and by itself.
In the past, it has been demonstrated that aspirin was able to reduce the risk of recurrent polyps in the colon. However, it was uncertain whether the risk of cancer was changed. Now we know that, indeed, regular aspirin, as little as two times a week, has shown a beneficial reduction in risk. Of course, aspirin should not be used unless there is concurrence with your physician as bleeding tendencies can occur with its use.
Multivitamins and Folate
There is medical research evidence that demonstrates that those people who take a multiple vitamin daily, especially with adequate amounts of the vitamin, folate, have less colon cancer.
Smoking and Excessive Alcohol
Is there any disease or disorder where smoking cigarettes and excessive alcohol are not implicated? Sad to say, the same holds true for polyps and colon cancer. Smokers and those who use excessive alcohol do have increased risk of colon cancer.
There is no one magic dietary bullet, no one simple step to take. It is very difficult for scientists to tease out an isolated lifestyle or dietary factor on any health question within a free living population. However, one thing is now rather clear. The western type of diet with large portions of animal meat, little fiber, low intake of vegetables, and possible low intake of vitamin D and calcium all seem to be major factors. The amount of solid information percolating into the medical literature has reached a point where a reasonable balanced colon cancer and polyp prevention program can be outlined.
- As hard as it is, control your weight. Overweight people have more colon cancer.
- Reduce red meat, saturated and trans-fats in the diet.
- Take 1200 mg of calcium each day using milk or calcium carbonate supplements.
- Take vitamin D at least 800 IU/day. Some experts say 1200 IU/day. Check with your physician.
- Eat cruciferous vegetables.
- Daily aspirin, but only if discussed with your physician.
- Daily multiple vitamin with adequate folate.
- No smoking or excessive alcohol.
- Prebiotics – eat these in food or take a dietary supplement, preferably ours (products).
And don’t forget to get your regular colonoscopy.
© Frank W. Jackson, M.D.