12 December 2011

Fiber No Panacea for Colon Cancer, Studies Suggest. Part 1

Posted by Jody under: Preventative Medicine .

Cancer of the colon and rectum (colorectal cancer, or CRC) is the second most common cancer, as well as the second leading cause of cancer death, in the United States. Much research has focused on diet as a means of preventing CRC. Of dietary factors, the one that has attracted the most attention is dietary fiber — especially cereal fiber. Two new studies published in the April 20 issue of the New England Journal of Medicine fail to support a major role for fiber — whether from whole foods or from fiber supplements — in preventing CRC.

Two theories might explain how fiber might help prevent CRC. One is that fiber speeds the passage of waste through the bowel, so potential cancer-causing agents have less contact with it. The second is that, since fiber attracts and holds water, water would dilute any cancer-causing agents.

While both these theories sound reasonable, and animal studies have indeed indicated that fiber might be helpful in preventing CRC, human studies have not strongly supported these theories.

Both of the new investigations focused on people who had had colorectal adenomas — often called polyps — removed within 6 months of the beginning of the study. Polyps, while not necessarily cancerous themselves, sometimes become so. They are therefore seen as possible precursors to cancer, and their removal has been shown to lower the risk of subsequent development of invasive CRC. The investigations reported in the Journal thus studied individuals considered to have an increased risk of developing CRC.

In the first study, researchers from the Polyp Prevention Trial Study Group investigated approximately 1,900 men and women 35 years of age and older, over a four-year interval. Subjects were assigned at random to either an intervention group (958 people) or a control group (947 people). Those in the intervention group received intensive counseling about following a diet that was low in fat and high in fiber. The increased fiber intake in the intervention group was derived from increased consumption of whole grains, legumes, and various fruits and vegetables. People in the control group were simply given brochures about healthy eating, but were not assigned any dietary changes.

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