Running head: REVIEW OF DIETARY PATTERNS AND COLORECTAL CANCER 1

Dietary Patterns And Incidence Rate Of Colorectal Cancer Among Middle Aged Adults

Adisa Rajkovic

University Of North Florida

Dietary Patterns And Incidence Rate Of Colorectal Cancer Among Middle Aged Adults
 There is to be an expected 50,260 deaths by colorectal cancer during the year 2017.

American Cancer Society (ACS) showed a lifetime risk for developing colorectal cancer (CRC)

to be 4.7% in men and 4.4% in women (American Cancer Society, 2017). These alarming

numbers make this third most commonly diagnosed cancer a nationwide public health issue

(Bernstein et al., 2015). Why are these numbers so alarmingly high ? Does diet have a direct

impact on the risk of development? How can we decrease the risk factors over a lifetime?

Extensive research has shown associations between dietary patterns and the increased risk of

developing colorectal cancer. Etiology of diet role in colorectal cancer has bridged the gap that

dietary patterns are in fact a determinant of health and risk of CRC development (Sansbury et al.,

2009).

Current research and knowledge about the patterns of food consumption show diets high in

vegetables, fruits and fiber to attain protective factors (Giovannucci, 2003). Studies have now

have highlighted relations to high red and processed meat consumption to CRC especially to

processed meat (Aykan, 2015). Following studies in this review took different approaches to

observe the relationship with diet and increase risks of CRC, from red and processed meat diets

to well known nutrition indexes like the Mediterranean Index, Healthy Diet Index and

Inflammatory Diet Index. Through extensive studies and literature reviewed there is enough

evidence to safely assume and solidify the major role dietary patterns play in the health of middle

aged American men and women

Meat provides the main source of protein in majority of diets amongst the larger portion of

the population linking the rise of colorectal cancer findings to the consumption. Most all studies
identify meat into three categories red, white and processed; red meat having more myoglobin

and processed meats being such as cold cuts, sausages and others that have undergone a process

to extend their shelf life (Boada et al., 2016). Food and Agriculture Organization estimated the

average world consumption of meat from 30 kg in 1980 to 41 kg per person in the year 2005

(Boada et al., 2016). Interestingly Bailey published an article evaluating age-related disparities in

secular trends in CRC incidence in the United States, observing rise of colorectal cancer from

1992 to 2005 from 1.5% in men to 1.6% in women ( Bailey et al, 2015). These two separate

findings boldly connect the effect of red and processed meat consumption has on the body.

World Health Research Fund supported their 2007 statement that higher consumption of red and

processed meat significantly increased the relative risk of colorectal cancer . Four years later

reportings backed this claim up with a substantial evidence showing per 50g increase in daily

processed meat consumption, the relative risk (RR) increased by 18%; per 100 g increase in daily

red meat consumption, the RR increased by 17%(Aykan, 2015). Similar finding were reported in

a cohort study concluding frequency of low meat meat diet intake to be consistent with decreased

risk of colorectal cancer (Flood et al.,2008).

Evidence shows 70% of CRC cases could be prevented through changes in diet patterns and

60% of those cases occur in developed countries where food is plentiful (Steck et al., 2015).

Literature typically categorizes diet patterns into two categories; exploratory which define

groupings of patterns analytically based on the consumption patterns within a study population

or priori dietary patterns which are based on existing evidence like dietary guidelines (Steck et

al., 2015). A systematic review study observed three most studied priori diets in relation to CRC;

Mediterranean Diet Score, Healthy Eating Index and Dietary Inflammatory Index. Evaluation of

the cohort study involving MDS in association to CRC demonstrated an epic 28% RR decrease
for participants in highest quartile of MDS compared to those in ranked in the low quartile (Steck

et al., 2015). The HEI was based off of the MyPyramid and US Dietary Guidelines using a

energy density method to calculate consumption of each food component. Following this a

cohort study revealed 35% high risk of CRC to those who did not comply with HEI compared to

men and women who scored high on the HEI showed 20-30% lower risk of CRC (Steck et al.,

2015).

Correspondingly studies in prevention of colorectal cancer show that certain foods and diets

act a protective factor in the risk of developing colorectal causing tumors. Understanding CRC

pathogenesis is observing the development of tumors in the colon and rectum region in relation

(Bernstein et al., 2015). Pabby published an article that took CRC at a different approach,

looking at adenoma polyps as a precursor for CRC (Pabby et al., 2005). Adenomatous polyps

are noncancerous growths within the colon and rectum, they are said to be associated with

greater risk of cancers if greater than one centimeter in size. To observe the risk of adenoma

polyp occurrence The Polyp Prevention Trial was designed to test the effects of three certain

diets; low-fat, high fiber and high fruit and vegetable diet. In participants who were labeled as

super compliers meaning those that adhered strictly to the diets showed that consistent

adherence lowered the odds of adenoma recurrence by 30% (Pabby et al., 2005). Now when

looking into the protective factors of each of these diets inconsistent results were present for just

high fiber and low fat diet as opposed to when combined with a high fruit and vegetable diet.

The purpose of this review was to identify the relationship between dietary patterns and

incidence of colorectal cancer among middle aged adults living in the United States. In

conclusion after reviewing the 5 different articles that approached the effects of various diets in

relation to colorectal cancer, all have had one bold topic in common. All shared in common the
potency of red and processed meat have on the anatomy of the human body. In this review

literature has confirmed the accuracy of my hypotheses and supported it with substantial

evidence findings through various studies conducted over the years.The ACS itself has now

classified processed meat as a carcinogen and not many people are aware of this because it is not

considered as a public health concern. Public health practitioners can use the evidence and result

presented to further their knowledge in the nutrition aspect of medicine. There are many factors

that play in the role of our health as people but despite being active and watching the amount of

food you consume to keep within a certain caloric intake thats suggested by the Dietary

Guidelines for American. Risk of developing CRC continues to rise because of the quality of

food we are consuming not just the quantity. More emphasis should be put on what a healthy diet

is for each individual being and this can be accomplished by health practitioners taking the

initiative to gain detailed knowledge by keeping up with current studies and research. Continuing

to update dietary guidelines that coincide with cancer research to keep the public knowledgeable

in making decisions that will positively impact their health and hopefully eradicate preventable

cancers along with other chronic illnesses.

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