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Colon Polyps and Cancer Dietary Therapy
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 Please refer to my essay on Colon Cancer and Polyps which discusses these entities in detail. The following information describes dietary steps which may reduce your chance of getting colon cancer or polyps. No one is certain which of these points is 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
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:
- wheat
- onions
- garlic
- leeks
- artichokes
- bananas
Psyllium, found in bowel supplements such as Metamucil are fermented by colon bacteria. It will reduce cholesterol, but other health benefits have 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.
For a full essay on prebiotics, please click here.
Sulforaphane and Those Gassy Vegetables
Cruciferous vegetables such as cabbage, broccoli, Brussels sprouts and cauliflower are felt by many to be gassy. In addition, these foods have a moderate amount of sulfur. The more sulfur you ingest, the more of it is available to colon bacteria 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 them.
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.
Aspirin
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.
Summary
 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.
- Take daily aspirin, but only if discussed with your physician.
- Take a daily multiple vitamin with adequate folate.
- Stop smoking and/or drinking excessive alcohol.
- Prebiotics - eat these in food or take a dietary supplement, preferably ours (products).
And don't forget to get your regular colonoscopy.
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Medical References
Colorectal cancer (CRC) is the third most common form of cancer.
Current treatments including chemotherapy, radiotherapy and surgery are
all associated with a high risk of complications and are not always
successful, highlighting the need to develop new treatment strategies.
The ingestion of probiotics, prebiotics or combinations of both
(synbiotics) represents a novel new therapeutic option. Probiotics and
prebiotics act to alter the intestinal microflora by increasing
concentrations of beneficial bacteria such as lactobacillus and
bifidobacteria, and reducing the levels of pathogenic micro-organisms.
This strategy has the potential to inhibit the development and
progression of neoplasia via mechanisms including; decreased intestinal
inflammation, enhanced immune function and anti-tumorigenic activity,
binding to potential food carcinogens including toxins found in meat
products, and a reduction in bacterial enzymes which hydrolyse
precarcinogenic compounds, such as beta-glucuronidase. There is
substantial experimental evidence to suggest that probiotics and
prebiotics may be beneficial in the prevention and treatment of colon
cancer, however to date there have been few conclusive human trials.
Probiotics and prebiotics have the potential to impact significantly on
the development, progression and treatment of colorectal cancer and may
have a valuable role in cancer prevention.
Colon cancer remains a significant global health concern. The impact of
specific dietary components on colon tissue likely depends on a host of
genomic processes that influence the growth, development, and
differentiation of the epithelial cells at the colon crypt surface,
where the balance between proliferation and differentiation is
maintained possibly through the Wnt (beta-catenin/T-cell factor)
signaling pathway. A loss of balance caused by either genetic mutations
or environmental factors such as dietary habits can modulate the risk
for the formation of aberrant crypt foci and ultimately the development
of colon cancer. Evidence exists that butyrate reduces the number and
the size of aberrant crypt foci in the colon. Butyrate is a natural
histone deacetylase inhibitor as well as a molecule involved with
enhanced TGF-beta-induced SMAD3 phosphorylation, increased
IFN-gamma-mediated apoptosis, and altered expression of the intestinal
muc2 gene that is responsibl e for mucin synthesis. Other dietary
components, such as vitamin D and (n-3) fatty acids, may regulate
proliferative properties of colon progenitor cells as well as the
differentiation of subcellular lineages. Although these findings are
intriguing, there are uncertainties that remain to be resolved
including the optimal exposure needed to bring about an effect, the
appropriate timing of administration, and if nutrient-nutrient and
nutrient-gene interactions determine the overall response. The expanded
use of high-throughput technologies, knowledge about the expression of
genes and protein fingerprints, and metabolomic profiling will assist
in addressing these issues and ultimately in determining the
physiological significance of bioactive food components as cancer
protectants.
While the fundamental metabolic function of calcium is to serve as a
second messenger, coupling intracellular responses to extracellular
signals, nutritional deficiency of calcium is manifested at a higher
level of organization: 1) depletion of the calcium nutrient reserve; 2)
inadequate complexation of digestive byproducts; and 3) collateral
effects of hormones produced primarily to compensate for low calcium
intake. The first mechanism contributes to the osteoporosis problem,
the second to kidney stones and colon cancer, and the third to
hypertension, preeclampsia, obesity, and insulin resistance, among
others. Adequate calcium intakes (1000-1500 mg/d) in adults have been
shown in controlled trials to lower the risk of osteoporotic fractures,
kidney stones, obesity, and hypertension. The best source of calcium is
dairy foods, largely because the disorders concerned depend upon
multiple nutrients, not just calcium, and dairy provides a broad array
of essential nu trients in addition to calcium, and at low cost.
Colon cancer remains a significant global health concern. The impact of
specific dietary components on colon tissue likely depends on a host of
genomic processes that influence the growth, development, and
differentiation of the epithelial cells at the colon crypt surface,
where the balance between proliferation and differentiation is
maintained possibly through the Wnt (beta-catenin/T-cell factor)
signaling pathway. A loss of balance caused by either genetic mutations
or environmental factors such as dietary habits can modulate the risk
for the formation of aberrant crypt foci and ultimately the development
of colon cancer. Evidence exists that butyrate reduces the number and
the size of aberrant crypt foci in the colon. Butyrate is a natural
histone deacetylase inhibitor as well as a molecule involved with
enhanced TGF-beta-induced SMAD3 phosphorylation, increased
IFN-gamma-mediated apoptosis, and altered expression of the intestinal
muc2 gene that is responsibl e for mucin synthesis. Other dietary
components, such as vitamin D and (n-3) fatty acids, may regulate
proliferative properties of colon progenitor cells as well as the
differentiation of subcellular lineages. Although these findings are
intriguing, there are uncertainties that remain to be resolved
including the optimal exposure needed to bring about an effect, the
appropriate timing of administration, and if nutrient-nutrient and
nutrient-gene interactions determine the overall response. The expanded
use of high-throughput technologies, knowledge about the expression of
genes and protein fingerprints, and metabolomic profiling will assist
in addressing these issues and ultimately in determining the
physiological significance of bioactive food components as cancer
protectants.
BACKGROUND & AIMS: Long-term data on the risk of colorectal cancer
according to dose, duration, and consistency of aspirin therapy are
limited. METHODS: We conducted a prospective study of 47,363 male
health professionals who were ages 40-75 years at enrollment in 1986.
Biennially, we collected data on aspirin use, other risk factors, and
diagnoses of colorectal cancer. We confirmed all reports of colorectal
cancer through 2004 by review of medical records. RESULTS: During 18
years of follow-up, we documented 975 cases of colorectal cancer over
761,757 person-years. After adjustment for risk factors, men who
regularly used aspirin (>/=2 times per week) had a multivariate
relative risk (RR) for colorectal cancer of 0.79 (95% confidence
interval, [CI], 0.69-0.90) compared with nonregular users. However,
significant risk reduction required at least 6-10 years of use (P for
trend = .008) and was no longer evident within 4 years of discontinuing
use (multivariat e RR, 1.00; CI, 0.72-1.39). The benefit appeared
related to increasing cumulative average dose: compared with men who
denied any aspirin use, the multivariate RRs for cancer were 0.94 (CI,
0.75-1.18) for men who used 0.5-1.5 standard aspirin tablets per week,
0.80 (CI, 0.63-1.01) for 2-5 aspirin tablets per week, 0.72 (CI,
0.56-0.92) for 6-14 aspirin tablets per week, and 0.30 (CI, 0.11-0.81)
for >14 aspirin tablets per week (P for trend = .004). CONCLUSIONS:
Regular, long-term aspirin use reduces risk of colorectal cancer among
men. However, the benefit of aspirin necessitates at least 6 years of
consistent use, with maximal risk reduction at doses greater than 14
tablets per week. The potential hazards associated with long-term use
of such doses should be carefully considered.
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