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By Karen Alexander, Oncology Wellness Specialist


Colorectal Cancer Risk & Pro-Inflammatory Diet

Inflammation plays an important role in cancer development. Inflammation can be caused by injuries, infections, obesity and a poor diet, among other factors. A poor diet may be involved directly or indirectly with aggravating and perpetuating a chronic inflammatory body state. The dietary factors that may be involved include an increase in the Omega 6/Omega 3 fatty acid ratio, a high intake of saturated fatty acids (SFA) and refined carbohydrates, trans fatty acids intake, a lower intake of Vitamins D and K, imbalanced intake of antioxidants, high intake of anti-nutrients (e.g. lectines, saponins) and an altered intake of dietary fiber.

According to an article published in JAMA last week, there is an association between a pro-inflammatory diet and risk of colorectal cancer (CRC). The study included two different populations: 46,804 men from the Health Professionals Follow-up Study (1986-2012) and 74,246 women from the Nurses’ Health Study (1984-2012). The studies followed these participants for 26 years and examined the associations between dietary inflammation pattern and colorectal cancer risk. They also assess the association of alcohol and body weight with CRC risk in order to reduce mistakes during the analysis of the information. This is because alcohol and obesity are well known for increasing the risk of CRC. The authors found a link between pro-inflammatory diet, inflammation and CRC development. Diet modulates inflammation and may thus be a crucial modifiable factor in CRC prevention. The pro-inflammatory diets may be more effective among overweight/obese men, lean women or men, and women who do not consume alcohol. The authors concluded that inflammation is a potential mechanism linking dietary patterns and colorectal cancer development, and strategies to reduce the adverse role of a pro-inflammatory diet may reduce colorectal cancer risk.

CRC is the third most commonly diagnosed cancer among men and women in the United States. CRC incidence and mortality rates have been declining due to changes in modifiable risk factors such as lifestyle changes, screening tests protocols, reduction in smoking, use of aspirin, and the improvements in treatment options. However, there were still 139,992 people in the United States diagnosed in 2014 with colorectal cancer, including 73,396 men and 66,596 women.

In previous bulletins we have discussed the anti-inflammatory role of certain dietary patterns. A prudent dietary pattern characterized by higher intake of fruit, vegetables, legumes, whole grains, poultry, and fish, is associated with reduced body inflammation, while a Western dietary pattern (high intake of red and processed meat, sweets and desserts, potatoes, French fries, and refined grains) is associated with high body inflammation. The Mediterranean Diet is a good example of a prudent dietary pattern and is characterized by a high consumption of plant foods, whole-grain cereals, legumes, fish, nuts, olive oil as the main fat source, and low consumption of meat, processed meat, bakery and sweets.

  • For recipes, educational materials, cookbooks and other resources for starting a Mediterranean diet please click here.   
  • For a list of anti-inflammatory foods please click here.  

The American Institute for Cancer Research is an organization founded to increase awareness of the relationship between cancer and diet. This organization publishes updates on the most recent information worldwide for the most common types of cancer. In 2017 they published a new update on lifestyle and colorectal cancer prevention which includes strong evidence that:

  • Being physically active decreases the risk of colon cancer
  • Consuming wholegrains decreases the risk of colorectal cancer
  • Consuming foods containing dietary fiber decreases the risk of colorectal cancer
  • Consuming dairy products decreases the risk of colorectal cancer
  • Taking calcium supplements decreases the risk of colorectal cancer
  • Consuming red meat increases the risk of colorectal cancer (over 18 oz. or 500 grams per week)
  • Consuming processed meat increases the risk of colorectal cancer (including bacon)
  • Consuming approximately two or more alcoholic drinks per day increases the risk of colorectal cancer
  • Being overweight or obese increases the risk of colorectal cancer

For more detailed information about the colorectal cancer report from the AICR please click here

Recipe of the Week: Salmon with Sesame-Ginger Quinoa

1 1/2 tablespoons toasted sesame oil
1 tablespoon grated peeled ginger, plus 1 inch thinly sliced
1 cup quinoa, rinsed
Kosher salt
3 heads baby bok choy (about 12 ounces), trimmed and thinly sliced
1 red jalapeno pepper, seeded (1/2 minced, 1/2 thinly sliced)
3 scallions, thinly sliced
4 6-ounce skinless center-cut salmon fillets (preferably wild)
3 tablespoons low-sodium soy sauce
Juice of 1 lemon
1/4 cup fresh cilantro, torn

Heat 1/2 tablespoon of sesame oil in a medium saucepan over medium heat. Add the grated ginger; cook until slightly softened, 1 minute. Add the quinoa; cook, stirring occasionally, until lightly toasted, 2 minutes. Add 1 1/4 cups water and 1/4 teaspoon salt. Bring to a boil, and then reduce the heat to medium low. Cover and cook until the water is absorbed and the quinoa is tender, about 12 minutes.
Add the bok choy, minced jalapeno and half of the scallions to the quinoa. Cook covered, until the bok choy wilts, about 7 minutes.
Meanwhile, bring 3/4 cup water, the sliced ginger and sliced jalapeno to a boil in a large skillet over medium heat. Add the salmon. Cover and cook until just cooked through, 5 minutes. Transfer to a plate using a slotted spatula. Stir the soy sauce, lemon juice, remaining scallions and 1 tablespoon sesame oil into the poaching liquid.
Fluff the quinoa; season with salt. Serve with the salmon; drizzle with the soy sauce mixture and top with the cilantro.

*Recipe via the Food Network

Enjoy your weekend,

Karen Alexander, BSND, MSCN

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