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Health News Archive 17 - Colon Health
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Two Large Studies Confirm High Fiber Diets Reduce Colon Cancer Risk

Two studies published in the May 2003 issue of The Lancet concluded that fiber consumption has a negative impact on the development of colon cancer. Results from the European Prospective Investigation into Cancer (EPIC), the largest study to ever investigate the association between diet and cancer risk, show that individuals who consume the highest amount of fiber have almost half the risk of colon cancer than those who consume the least amount. Another study in the same issue of the journal obtained similar results.

The EPIC study followed 519,978 European participants from ten countries, aged 24 to 75 for four and a half years. During this period, 1065 cases of colon cancer were diagnosed. The researchers discovered that those whose dietary fiber consumption was in the top 20 percent, at 35 grams per day, experienced a 40 percent lower risk of developing colon cancer than subjects who consumed an average of 15 grams per day dietary fiber. 

The second study, which was part of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, compared 33,971 patients without polyps with 3591 patients who had one or more polyps and found that those whose fiber intake was highest had a 27 percent lower risk of polyps than those whose intake was lowest. Colon polyps are frequently precursors of colon cancer.

It was noted by the American Institute for Cancer Research that a study appearing in the International Journal of Epidemiology which found no association between fiber intake and colon cancer incidence in women involved a population with low fiber intake. Women who consumed the highest amounts of fiber in this study had intakes equivalent to those in the EPIC study’s low fiber group.

In an accompanying commentary in The Lancet, authors Lynnette Ferguson and Philip Harris of the University of Auckland, New Zealand, wrote, "Whatever the reasons for the results reported by the two studies, eating a diet rich in plant foods, in the form of fruit, vegetables, and whole-grain cereals, probably remains the best option for reducing the risk of colon cancer, and for more general health protection."

Source: Lancet, May 3, 2003

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Ginger Compound Prevents Growth of Colorectal Cancer Cells

Research results presented at the American Association for Cancer Research's Second Annual International Conference on Frontiers in Cancer Prevention Research in October 2003 showed that gingerol, a compound found in ginger that gives the spice its flavor, slowed the growth of human colorectal cancer cells.

Dr. Ann Bode and Dr. Zigang Dong of the University of Minnesota's Hormel Institute in Austin, Minnesota fed 500 micrograms of [6]-gingerol three times weekly to a group of twenty mice before and after injecting them with human colorectal tumor cells. Control mice injected with the cancerous cells received no [6]-gingerol. Tumors began to appear fifteen days after the mice received the cancer cells, with 13 tumors appearing in the control mice compared to four in the group that received [6]-gingerol. Twenty-eight days after receiving the injections, all the mice in the control group had measurable tumors, compared to thirty-eight days for the treatment group. After forty-nine days, 12 of the 20 treated mice still did not have tumors that had reached the size of one cubic centimeter, with tumors averaging half this size, while all of the control mice had already reached this point.

Dr Bode summarized, “Plants of the ginger family have been credited with therapeutic and preventive powers and have been reported to have anticancer activity. The substance called [6]-gingerol is the main active compound in ginger root and the one that gives ginger its distinctive flavor. . . These results strongly suggest that ginger compounds may be an effective chemopreventive and/or chemotherapeutic agent for colorectal carcinomas. It's difficult to know if the ginger-treated mice would have lived longer than the non-ginger treated mice if left to die of their tumors, but it looks that way.”

A new study is being planned that will administer ginger to mice after their tumors have progressed to a certain size.

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Beta-Carotene Supplements Reduce Risk of Colon Cancer Among Non-Smokers and Non-Drinkers

BACKGROUND: The use of beta-carotene supplements has yielded mixed results in the prevention of lung cancer. Although supplements may reduce the risk of lung cancer among people who do not smoke tobacco or drink alcohol, it may increase the risk of lung cancer among those who do smoke or drink. Few studies have investigated the action of beta-carotene supplements in preventing other types of cancer, and this is the first major study focusing on beta-carotene supplements and colorectal cancer.

RESEARCH: Researchers tracked the risk of adenoma recurrence for four years in 864 subjects who previously had a cancerous colorectal adenoma removed and were free of polyps at the beginning of the study. Researchers at the Department of Medicine, Dartmouth Medical School, in New Hampshire led the multicenter double-blind, placebo-controlled clinical trial of antioxidants for the prevention of colorectal adenomas.  A total of 707 patients completed follow-up exams and provided smoking and alcohol use data. After 3 months on placebo, subjects received either beta-carotene supplements (25 mg), a combination of vitamin C (1,000 mg) and vitamin E (400 mg), a combination of beta-carotene, vitamin C and vitamin E, or placebo daily.

RESULTS: The researchers wrote, "Among subjects who neither smoked cigarettes nor drank alcohol, beta-carotene was associated with a marked decrease (44 percent) in the risk of one or more recurrent adenomas."

However, there was a modest increase in adenoma recurrence in subjects who smoked cigarettes (36%) or drank alcohol (13%). Those who smoked and consumed more than one alcoholic drink daily had a substantial increase (107%) in adenoma recurrence. In general, the findings are consistent with a study showing that patients with colon polyps had low tissue levels of carotenoids. (See Carotenoids in Colon Tissue study below)

IMPLICATIONS: This study found that people at risk for recurrence of colorectal cancer benefited significantly from beta-carotene supplements if they did not smoke or drink alcohol. However, smoking or a combination of smoking and regular alcohol consumption increased the risk of adenomas. The researchers warned, "Our data suggest that ethanol [alcohol] intake may counter a protective effect of beta-carotene on neoplasia in the bowel."

Baron JA, Cole BF, Mott L, et al, "Neoplastic and antineoplastic effects of beta-carotene on colorectal adenoma recurrence: results of a randomized trial," Journal of the National Cancer Institute, 2003;95:717-722.

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Turmeric Shown to Benefit IBD - Ulcerative Colitis and Crohn’s

Turmeric (Curcuma longa) is a traditional Indian curry spice previously shown to reduce the incidence of colon cancer in animals. New research indicates that curcumin, the active ingredient of turmeric, may also help to reduce and/or prevent ulcerative colitis and Crohn’s disease -- two forms of inflammatory bowel disease (IBD). According to the National Institutes of Health, two million Americans suffer from ulcerative colitis and Crohn’s, characterized by chronic ulceration of the bowels, abdominal pain, digestive problems, diarrhea and constipation.

Current drug treatments for inflammatory bowel disease are expensive and present significant side effects, inspiring researchers from the Jack Bell Research Center at Vancouver General Hospital in British Columbia to search for alternative treatments that are more effective and more affordable.

After pre-treating mice with curcumin, the researchers induced colitis by exposing the animals to dinitrobenzene sulfuric acid (DNB). After five days, the researchers measured a clear reduction in intestinal inflammation in mice pretreated with curcumin versus untreated mice. Curcumin was also revealed to improve intestinal cell function in DNB-induced colitis while reducing mucosal ulceration and proliferation of inflammatory cells.

The team also noted that when animals were pretreated with curcumin, there was a clear reduction in DNA binding, proving that curcumin inhibits NF-kappa B activation in the colon.

Am J. of Physiology-Gastrointestinal and Liver Physiology, July 2003.

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Low Carotenoids in Colon Tissues May Increase Risk of Cancer

BACKGROUND: A low intake of antioxidant carotenoids is associated with an increased risk of developing colorectal cancer. It may be possible to increase levels of these carotenoids in precancerous colon polyps, thereby reducing the likelihood of the polyps becoming cancerous.  This small study was performed at the Center of Internal Medicine, University of Hohenheim, in Stuttgart, Germany, and published February, 2003 in Clinical Nutrition

RESEARCH: Researchers analyzed levels of several carotenoids in intestinal biopsy samples from seven men and women with colon polyps and five people without polyps. The carotenoids included alpha-carotene, beta-carotene, lutein, lycopene, zeaxanthin, and beta-cryptoxanthin. However, for technical reasons, alpha-carotene levels could not be reliably measured.

RESULTS: Biopsies showed that patients with polyps had significantly lower levels of all of the carotenoids compared with patients without polyps. In addition, carotenoid levels were lower in polyps compared with nearby unaffected tissues.

  • beta-carotene: 0.37 vs 0.19
  • Lycopene: 0.34 vs 0.21
  • beta-cryptoxanthin: 0.14 vs 0.09
  • zeaxanthin: 0.18 vs 0.09
  • Lutein: 0.18 vs 0.13

IMPLICATIONS: In discussing the results of their study, the researchers wrote that they assume that the lower levels of carotenoids in polyps were the result of "local carotenoid depletion," possibly caused by increased free-radical stresses. The researchers also recommended a clinical study in which subjects would receive supplementation of a number of carotenoids to determine whether these antioxidants, as a group, might help prevent colorectal cancer.

Muhlhofer A, Buhler-Ritter B, Frank J, et al, "Carotenoids are decreased in biopsies from colorectal adenomas," Clinical Nutrition, 2003;22:65-70.

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Vitamins May Reduce Colon Cancer Risk Over Time

Taking multivitamins may modestly reduce a person's chances of getting colorectal cancer, but not right away. There is a long interval between the start of taking multivitamins and when the apparent protective effect kicks in, the research team reports in the October 2003 issue of the American Journal of Epidemiology..

These new findings come from the Cancer Prevention Study II Nutrition Cohort, in which researchers examined the relationship between current and past use of multivitamins and the occurrence of colorectal cancer among more than 145,000 predominantly white, middle-aged or elderly adults.

"This study was conducted to follow-up on a report from the Harvard Nurse's Health Study, indicating that prolonged multivitamin use might substantially reduce risk of colon cancer," said Dr. Eric J. Jacobs from the American Cancer Society in Atlanta, Georgia.

At enrollment in 1992-1993, participants provided information on current use of multivitamins. All of the subjects had also provided information on multivitamin use some 10 years earlier in 1982, as part of another study. This allowed the investigators to examine the potential effects of past use of vitamins, without relying on what people recalled. Roughly half of the group reported no multivitamin use, 8 percent said they took a multivitamin regularly (four or more times per week) only in the past, and 19 percent said they regularly took a multivitamin only recently.

During follow-up from 1992 to 1997, 797 cases of colorectal cancer were detected.  After adjusting for "health conscious" behaviors, participants who were regular multivitamin users 10 years before the start of the study had an approximately 30 percent less risk of developing colorectal cancer. Those who had only recently begun to use multivitamins "were not at reduced risk," Jacobs said.

"Our study, together with results from previous studies, provides limited evidence that some component in multivitamins may modestly reduce risk of developing colorectal cancer," Dr. Jacobs said. The exact component or components of multivitamins that may be protective remain unclear.

The researcher emphasized, however, that the American Cancer Society does not currently recommend using multivitamins for cancer prevention, as the evidence is "insufficient. In contrast, the ACS strongly recommends that all Americans 50 and over get a screening test for colorectal cancer," Dr. Jacobs said. "Colorectal cancer screening has been proven to substantially reduce the risk of dying from colorectal cancer."

SOURCE: American Journal of Epidemiology, October 1, 2003.

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Calcium Supplements Associated with Decreased Risk of Colon Cancer

Researchers studied more than 60,000 men and more than 60,000 women already participating in an American Cancer Society study of nutrition and cancer prevention.  The participants were between 50 and 74 years of age when they enrolled in the study in 1992 and 1993.  These findings were published in Cancer Causes and Control in 2003.

By 1997, 421 men and 262 women in the group had developed colorectal cancer.  Researchers found that people who received calcium primarily from food did not have a lower risk of developing colon cancer than people who did not take supplements.  Risk started to decrease with as little as 700 mg of total calcium a day and taking more than 1,200 mg a day did not seem to give any greater protection.  The greatest reduction in risk was seen in people whose calcium came primarily from supplements rather than from diet. 

Source: Cancer Causes and Control, 2003;14;1-12.

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Calcium, Vitamin D, and Folate may Inhibit Colon Cancer

According to published research in Nature Reviews Cancer, "Recent findings have indicated that dietary calcium, vitamin D, and folate can modulate and inhibit colon carcinogenesis."

"Supporting evidence has been obtained from a wide variety of preclinical experimental studies, epidemiological findings and a few human clinical trials. Important molecular events and cellular actions of these micronutrients that contribute to their tumor-modulating effects are discussed," " wrote Dr. S.A. Lamprecht and colleagues, at the Rockefeller University, Strang Cancer Prevention Center.

The researchers noted: "Important molecular events and cellular actions of these micronutrients that contribute to their tumor-modulating effects are discussed. They include a complex series of signaling events that affect the structural and functional organization of colon cells."

Source: Chemoprevention of colon cancer by calcium, vitamin D and folate: Molecular mechanisms. Nat Rev Cancer, 2003;3(8):601-614).

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Probiotics Improve Irritable Bowel Syndrome Symptoms

New research indicates that Bifidobacterium, the good intestinal bacteria found in probiotic supplements can significantly improve symptoms in irritable bowel syndrome (IBS) patients.

In a double-blind, placebo-controlled study, researchers studied the effects of probiotics on 77 patients (64% female) with IBS. After the subjects spent two weeks without any medication, they were randomized to receive either a placebo, Lactobacillus spp or Bifidobacterium spp, for 8 weeks, once daily. IBS symptoms were recorded daily throughout the entire study.

Compared to patients consuming the placebo, subjects receiving Bifidobacterium experienced significantly reduced pain, bloating, and bowel movement difficulty. Incorporating all symptoms, the researchers noted significant improvement in response to Bifidobacterium for all weeks of the study. Improvement was greater with Bifidobacterium than with placebo and Lactobacillus. The patients taking Bifidobacterium also experienced an improved quality of life. Four weeks after the patients discontinued treatment, both symptoms and quality of life returned to baseline.

Source: Quigley E, O'Mahony L, McCarthy J, et al. Probiotics for the irritable bowel syndrome (IBS): A randomized, double-blind, placebo-controlled comparison of Lactobacillus and Bifidobacterium strains. Gastroenterology. 2002;122:A-59.

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