Bowel Cancer Prevention -Diet and exercise

Bowel Cancer Prevention
The World Cancer Research Fund estimated that 43 per cent of bowel cancers could be prevented by appropriate lifestyle changes.

Diet for Protection


Diets high in fat and cholesterol (especially from animal sources) have been linked to increased colon cancer risk. High-fibre diets, however, have shown a protective effect.
Among populations that consume a diet high in fat, protein, calories, alcohol, and meat (both red and white) and low in calcium and folate, colorectal cancer is more likely to develop than among populations that consume a low-fat, high-fibre diet.
Diets high in vegetables, fruits, and whole grains have been linked with lower risk of colon cancer.
Diets high in processed and/or red meats have been linked with a higher risk.
American Cancer Society recommends that you eat a healthy diet, with an emphasis on plant sources. This includes the following:
• Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
• Eat 5 or more servings of a variety of vegetables and fruits each day.
• Choose whole grains rather than processed (refined) grains.
• Limit your intake of processed and red meats ( < 500g /week)

Fruit and Vegetables
Most Australians eat only half the amount of fruit and vegetables recommended for good health
One serve of vegetables (75 grams) is, for example, 1 medium potato, or 1 cup salad vegetables, or ½ cup of cooked vegetables, ½ cup cooked legumes (dried beans, peas or lentils).

Beans and other pulse vegetables, such as kidney beans, lentils and chick peas only count once a day, however much you eat.

Why are fruit and vegetables protective?

The reason why fruit and vegetables have so many benefits is that they contain a wide variety of substances known to have health benefits including carotenoids, vitamin C, vitamin E and dietary fibre. They also contain many complex plant components - phytochemicals - such as flavonoids. Some of the vitamins and phytochemicals are also antioxidants, destroying harmful free radicals in the body.

The benefits of fruit and vegetables stem not only from the rich cocktail of individual components, but also the interactions between these components. This is why dietary supplements containing isolated vitamins or minerals do not appear to have the same beneficial effects as fruit and vegetables themselves

They found consumption of brassica vegetables such as Brussels sprouts, cabbage, cauliflower and broccoli decreased the risk of cancer in the proximal colon – the first part of the large intestine.
These vegetables (also known as cruciferous vegetables) are high in fibre, vitamin C, antioxidants and other micronutrients, and have previously been identified as reducing the risk of various cancers.
Dark yellow vegetables and apples were found to be associated with a reduced risk of cancer in the distal colon, which is closer to the rectum. Both total fruit and vegetable intake and total vegetable intake also appeared to decrease the risk.
However while fruit and vegetable intake was clearly beneficial in terms of bowel cancer risk, the same does not apply to fruit that is processed and consumed as juice.
The study found high consumption of fruit juice increased the risk of cancer in the rectum
Fibre and Wholegrains.
Just three serves or 90 grams of wholegrain foods each day can reduce the risk of bowel cancer by 20 per cent.
The findings come from a review (published in the British Medical Journal - BMJ 2011;343:d6617) of 25 previous studies investigating any links between fibre in food and bowel cancer risk.
The researchers also found every 10 gram intake of total and cereal fibre reduced the risk of bowel cancer by 10 per cent.

What is fibre?

Fibre is indigestible plant material such as cellulose, lignin and pectin, found in fruits, vegetables, grains and beans. There are two types of fibre – soluble and insoluble.

The soluble fibre in foods such as apples, citrus fruits, oats, dried peas, beans and lentils, dissolves in water, forming a thick gel in your stomach, slowing the rate of digestion and absorption. In moderation, these fibres feed the intestinal bacteria and nourish the cells of the large intestine, which is believed to stimulate healing and reduce the development of cancer.

Insoluble fibre from foods such as wheat bran, whole grains and some vegetables does not feed bacteria well. However, it is believed to deactivate intestinal toxins and a high intake may decrease the risk of bowel cancer.

How much fibre is enough?

Reports suggest women should be eating 25g of fibre each day and men 30g of fibre each day, yet most of us probably eat around 10-12g
How do you build fibre into your diet?

• Replace lower fibre foods with high fibre foods.
• Eat vegetables and fruit raw, whenever possible. Boiling too long can cause up to one half of the fibre to be lost in the water. Steam or stir-fry them, if you cook them.
• Replace fruit or vegetable juice with the whole fruit – fruit skins and membranes are a particularly good source of fibre.
• Always start your day with a bowl of high-fibre cereal – one that has five or more grams per serving.
• Add fresh fruit to your cereal for an extra fibre dose. Sprinkle wheat germ or bran on top of cold cereals. Mix wheat germ or bran with hot cereals while they are cooking.
• Add bran cereal to muffins, breads and casseroles.
• Buy and eat only whole grains
• Eating more fibre


How to get 90 grams of wholegrains into your day:
Wholegrain foods
Approx amount of wholegrains
Wholemeal bread (2 slices)
30-40g
Wholegrain breakfast cereal (30-45g serve)
15-30g
Porridge (1/3 cup raw rolled oats)
30g
Brown rice (1 cup cooked)
65g
Wholegrain pasta (1 cup cooked)
55-65g
Muesli bar
10-15g

Try substituting the lower fibre foods in your diet for the high fibre alternatives to the left.
HIGHER FIBRE FOODS

LOWER FIBRE FOODS

Whole grain breads – e.g., 100% whole wheat, cracked wheat, multigrain, pumpernickel or dark rye

White bread

Whole grain cereals containing bran, oatmeal, barley, bulgar, cracked wheat; also shredded wheat, multigrain or granola cereals

Refined cereals

Foods made with whole grain flours – e.g., whole wheat, rye, graham (e.g. biscuits, muffins, cookies)

Foods made with white flour

Whole grain pastas, brown rice or wild rice

Refined pastas, instant or polished rice

Fresh fruits and vegetables (especially if eaten with the skin and membranes when appropriate)

Fruit juice

Salads made from a variety of raw vegetables

Plain lettuce salads

Baked beans, cooked lentils and split peas

Meat, fish, poultry

Nuts, popcorn, seeds, dried fruit

Crisps and similar snacks









Physical Activity for Protection

Research indicates that exercising can decrease colon cancer risk by up to 40%. Exercise also tends to reduce the incidence of other risk factors for colon cancer, like obesity and diabetes.
It is recommended that to help reduce the risk of cancer, you should aim to engage in physical activity everyday, in any way, for 30 minutes or more.
It is also evident that being obese can significantly increase your chances of developing bowel cancer. 1 in 2 Australian adults is overweight. Irrespective of your height or build, if your waistline is getting bigger it could mean you are at increased risk of chronic diseases.
There are tremendous benefits to getting even a small amount of physical activity each day, both mentally and physically. Being active gives you more energy, helps you sleep better, reduces the risk of depression and can help to prevent a range of chronic diseases.
You don’t have to exercise to the point of collapse in order to get health benefits. Start out by making small changes, and as you get used to them, gradually add more changes or activities. Aim to build up to 30 minutes (or more) of moderate-intensity physical activity every day.
A good example of moderate-intensity activity is brisk walking; that is, at a pace where you are able to talk comfortably, but not sing.

If you’re worried you don’t have the time, keep in mind that you don’t have to do it all at once – you can accumulate your 30 minutes or more of moderate-intensity activity by combining a few shorter sessions of about 10 to 15 minutes each throughout the day. Research has shown that accumulated short bouts of moderate-intensity activity are just as effective at improving health factors such as blood pressure and blood cholesterol.

Getting motivated and keeping momentum:
• Schedule 30-minutes of physical activity as part of your daily activities - don't let anything else take priority.
• Use exercise as a stress management technique - walk to clear your head and help you make decisions about work and home.
• Exercise with a friend or family member. It’s sometimes easier when you have someone else encouraging you, and is easier to keep the "exercise habit" going because you've made a commitment.
• Be a role model for your kids. Involving children in your physical activity regime is a great way to instil healthy habits and prevent childhood obesity.
• Track your progress by keeping an exercise log and recording your weekly activity.
• Motivate yourself by remembering how good you feel after you've completed a workout and how good you feel knowing that you are taking care of yourself.




The 30-Minute Exercise Guide

Exercising doesn’t have to mean expensive gym membership and treadmills, alternatives can include -

• Washing your car
• Washing windows or floors
• Vacuuming
• Walking or jogging to work
• Walking the dog
• Running up and down stairs
• Cycling with the kids
• Swimming or water aerobics
• Aerobics or keep fit classes

Vitamins and Minerals for Protection

Some studies suggest that taking a daily multi-vitamin containing folic acid, or folate, may lower colorectal cancer risk, but not all studies have found this. In fact, some studies have hinted that folic acid might help existing tumours grow. More research is needed in this area.
Some studies have suggested that vitamin D, which you can get from sun exposure, in certain foods, or in a vitamin pill, can lower colorectal cancer risk. Because of concerns that excessive sun exposure can cause skin cancer, most experts do not recommend this as a way to lower colorectal cancer risk at this time.
Other studies suggest that increasing calcium intake may lower colorectal cancer risk. Calcium is important for a number of health reasons aside from possible effects on cancer risk. But because of the possible increased risk of prostate cancer with high calcium intake, it may be wise for men to limit their daily calcium intake to less than 1,500 mg per day until further studies are done.
Calcium and vitamin D may work together to reduce colorectal cancer risk, as vitamin D aids in the body's absorption of calcium. Still, not all studies have found that supplements of these nutrients reduce risk.
A few studies have looked at a possible link between a diet high in magnesium and reduced colorectal cancer risk. Some, but not all, of these studies have found a link, especially among women. More research is needed to determine if this link exists.
High levels of vitamin D - the vitamin that forms in the skin after exposure to sunlight and is commonly associated with strong bones - appears to be protective against bowel cancer.
A systematic review of nine published studies on vitamin D and bowel cancer confirmed that people with the highest intake of vitamin D were less likely to develop bowel cancer than people with a lower intake.
While small quantities of vitamin D are found in fish and fortified dairy products, most dietary vitamin D comes from nutritional supplements. The best natural source of vitamin D in Australia is from sun exposure rather than diet. The review also looked at a further nine studies comparing blood levels of vitamin D in its active form (25-hydroxyvitamin D) against bowel cancer risk and found high levels of this active form were also found to be associated with a lower risk of bowel cancer.




Smoking Alcohol and Obesity


If you smoke, giving up will reduce your risk of developing bowel cancer, as well as many other types of cancer.
Avoiding excessive alcohol intake may also help lower your risk of colorectal cancer. The American Cancer Society recommends no more than 1 drink per day for women or 2 per day for men.
Obesity raises the risk of colon cancer in both men and women, but the link seems to be stronger in men





Bowel Cancer Symptoms

Some of most common symptoms include a change in bowel habit (eg. constipation, and bleeding), black bowel motions, fatigue headaches or shortness of breath from iron deficiency and anaemia mucus discharge, and discomfort or pain in the lower abdomen.
Advance symptoms include weight loss.
Those with symptoms should see a doctor and often require colonoscopy and blood tests not just faecal occult blood screening.

Know your Family History

Your family history (immediate and extended) can impact your chances of developing colorectal cancer. It's important to take time to learn your family history and relay the information to your doctor. In general, you're at increased risk if you have relatives who:
• were diagnosed with colorectal cancer or polyps,
• developed colorectal cancer before age 60,
• died from bone or liver cancer since they may have resulted from undiagnosed colorectal cancer
• Those with close or several family members with bowel cancer should have regular colonoscopy and may benefit form preventative medicine such as aspirin or anti inflammatory medications.