Leena Watts
Diet is thought to play a significant role in the development of colorectal cancer, particularly when combined with other factors such as excess calorie intake, weight gain, physical inactivity, and unhealthy behaviours like smoking and excessive alcohol consumption. Studies have found a correlation between diets high in red and processed meats, animal fats, and alcohol, and an increased risk of colorectal cancer. On the other hand, plant-based diets rich in fruits, vegetables, whole grains, and fibre are associated with a lower risk. While the exact mechanisms are still being studied, maintaining a healthy diet and lifestyle can help reduce the chances of developing colorectal cancer.
| Characteristics | Values |
|---|---|
| High intake of animal fats | Causes chronic inflammation, obesity, type 2 diabetes, and colorectal cancer |
| Red and processed meats | Increase the risk of colorectal cancer |
| Plant-based diets | High in fruits, vegetables, and whole grains are associated with a lower risk of colorectal cancer |
| Alcohol | Has been linked to colorectal cancer |
| Fibre intake | Inversely related to the risk of colorectal cancer |
| Vitamin D, calcium, and folate | Reduce the risk of colorectal cancer |
| High body fat percentage | Increases the risk of colorectal cancer |
| Smoking | Increases the risk of colorectal cancer |
| Family history of cancer | Increases the risk of colorectal cancer |
| High-calorie intake | Increases the risk of colorectal cancer |
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What You'll Learn
Red meat and processed meat
Research has shown that eating even small amounts of processed meat increases bowel cancer risk. The nitrite and nitrate preservatives used in processed meats produce N-nitroso chemicals (NOCs) when digested, which can damage the cells lining the bowel and lead to cancer. These same NOCs are also formed when a chemical called haem, found naturally in red meat, is broken down in the gut.
Additionally, cooking methods can further increase the risk of cancer. High-temperature cooking methods, such as grilling, pan-frying, and barbecuing, can produce harmful compounds like heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). These compounds are potent carcinogens that can increase the risk of bowel cancer.
The correlation between red meat consumption and bowel cancer has been observed in several studies. One large cohort study found that women who consumed beef, pork, or lamb as a main dish every day had a relative risk of colon cancer 2.49 times higher than those who consumed these meats less than once a month. Another study published in the International Journal of Epidemiology found that people who ate red or processed meat four or more times a week had a 20% higher risk of colorectal cancer than those who indulged twice a week or less.
To reduce the risk of bowel cancer, it is recommended to limit red meat consumption to no more than one serving per day or two servings 3-4 times per week. It is also advised to cut out processed meats altogether or keep them to a minimum. Making substitutions, such as using chicken or turkey mince instead of beef or pork, can help reduce the risk of cancer associated with red and processed meat consumption.
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Alcohol consumption
Several studies have shown a positive correlation between alcohol consumption and bowel cancer. The risk of developing bowel cancer increases with each alcoholic drink consumed. Even one standard drink per day (10 grams of alcohol) can increase the risk of bowel cancer. Moderate drinkers of beer (two glasses per day) or wine (1.5 glasses per day) have been shown to increase their risk of bowel cancer compared to occasional or non-drinkers.
The link between alcohol and bowel cancer is evident in both men and women, although stronger evidence exists for men. The mechanism by which alcohol increases the risk of bowel cancer may be related to its ability to help harmful chemicals, such as those in tobacco, enter the cells lining the mouth, throat, and oesophagus. Alcohol can also limit the ability of these cells to repair damage to their DNA caused by these chemicals.
In addition to increasing the risk of bowel cancer, alcohol consumption is associated with an increased risk of other types of cancer, including pancreatic, throat, and mouth cancer. Alcohol use accounts for about 5% of all cancers and 4% of all cancer deaths in the United States.
It is important to note that the federal government's Dietary Guidelines for Americans do not recommend that individuals who do not drink alcohol start drinking. For those who do drink, it is advised to do so in moderation, limiting consumption to two drinks or less per day for men and one drink or less per day for women.
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High-fat diets
Gut Microbiome
The gut microbiome refers to the diverse population of microorganisms, primarily bacteria, that inhabit the digestive tract. These microbes play crucial roles in digestion, metabolism, and immune function. Research has shown that high-fat diets can alter the composition of the gut microbiome, leading to an imbalance in the types and quantities of certain bacteria. Specifically, a high-fat diet increases the levels of specific gut bacteria, such as Ileibacterium valens and Ruminococcus gnavus. These bacteria have been implicated in the development of colorectal cancer by modifying bile acids.
Bile Acid Metabolism
Bile acids are digestive molecules produced by the liver and secreted into the gut. They aid in the digestion and absorption of cholesterol, fats, and nutrients. High-fat diets can alter bile acid metabolism by influencing the types and concentrations of bile acids in the gut. The modified bile acids produced by certain gut bacteria have been shown to increase inflammation and inhibit the replenishment of intestinal stem cells. Intestinal stem cells are essential for repairing cellular damage and maintaining the health of the intestinal lining. When stem cell replenishment slows down, the risk of mutations increases, providing a favourable environment for the development of colorectal cancer.
Obesity and Inflammation
Obesity is a well-known risk factor for colorectal cancer. High-fat diets contribute to obesity by providing excess calories and promoting fat accumulation in the body. Obesity is associated with systemic, low-grade inflammation throughout the body, including the gut. This chronic inflammation can further increase the risk of colorectal cancer, as inflammation is a known driver of cancer development.
Recommendations
To reduce the risk of bowel cancer associated with high-fat diets, it is advisable to adopt healthy dietary practices and limit the intake of high-fat foods. Switching to a low-fat diet can help prevent colorectal cancer by reducing the impact on the gut microbiome and bile acid metabolism. Additionally, increasing the consumption of plant-based foods, such as fruits, vegetables, whole grains, and legumes, can provide protective effects due to their high fibre content and anti-inflammatory properties.
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Fibre intake
Increasing fibre intake can be beneficial in several ways. Firstly, it can help to dilute fecal carcinogens and reduce the transit time of stools, thereby lowering the risk of cancer. Fibre is also fermented by bacteria in the colon, producing short-chain fatty acids with anticarcinogenic properties. This process boosts gut health and further reduces the risk of cancer.
Studies have found a significant inverse relationship between fibre intake and the risk of colorectal cancer. For example, a large European study showed that a high intake of dietary fibre was associated with a reduced risk of large-bowel cancer. Similarly, a study of Africans who consumed a high-fibre diet found lower rates of colorectal cancer. Another study suggested that doubling fibre intake among those with a low average intake could reduce the risk of colorectal cancer by 40%.
Good sources of fibre include leafy green vegetables such as kale, spinach, and broccoli, as well as whole grains like wholemeal bread, couscous, quinoa, brown rice, and oats. It's important to note that the outer layer of whole grains is rich in fibre, so refined versions of these foods, such as white bread, have lower fibre content.
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Vitamin and mineral levels
Diet is estimated to contribute to about one-third of preventable cancers, which is about the same amount as smoking. Research has shown that inadequate intake of essential vitamins and minerals can lead to DNA damage and increase the risk of developing cancer.
Vitamin D and calcium deficiencies have been linked to an increased risk of colorectal cancer. Studies have shown that vitamin D and calcium supplements can help reduce the risk of colorectal cancer. In addition, diets rich in folate, a type of B vitamin, may also help prevent colorectal cancer. Folate, vitamin B6, and vitamin B12 deficiencies can cause DNA damage and lead to cancer. However, one study found no association between genetically predicted circulating levels of folate and vitamins B6 and B12 and colorectal cancer.
Vitamin B12 has been linked to an increased risk of lung cancer and possibly epithelial ovarian cancer. High serum vitamin B12 status has also been associated with inflammatory bowel disease, which, in turn, increases the risk of colorectal cancer.
Zinc and selenium are two other minerals that have been studied for their potential association with colorectal cancer. However, the evidence is inconclusive.
A plant-based diet rich in fruits and vegetables, whole grains, and fibre is associated with a lower risk of colorectal cancer. These foods provide essential vitamins and minerals that may help protect against the development of cancer.
In summary, maintaining adequate levels of vitamins and minerals through a healthy, balanced diet may help reduce the risk of bowel cancer.
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Frequently asked questions
Eating lots of red meat can increase your risk of bowel cancer. This includes beef, pork, lamb, and goat. If you eat red meat, try to cut down to 70g or less of red meat (cooked weight) each day to reduce your risk.
A plant-based diet high in fruits, vegetables, and whole grains is associated with a lower risk of colorectal cancer. Leafy greens are packed with fiber and nutrients and benefit the gastrointestinal tract. Beans, peas, and lentils are also key parts of a balanced diet.
Moderate to heavy drinking (two or three glasses a day) can make you 20% more likely to get bowel cancer, and heavy drinking can raise your chances by 40%.
