Protect Your Colon Part Two

December 11, 2014 Written by JP       [Font too small?]

There is often disagreement about the safety and validity of medical tests in the holistic, health community. Perhaps the best examples are the use of mammography to detect breast cancer and the PSA blood test to ferret out prostate cancer. However, colonoscopies tend to be less controversial for a number of reasons. Firstly, there really isn’t any alternative, stand alone test currently available. Secondly, the documented benefits of colonoscopies far outweigh the low risk of significant side effects. Lastly, as I stated in part one of this column, colonoscopies not only detect potential malignancies, they also remove questionable growths while still benign. For these reasons, integrative health experts such as Dr. Andrew Weil and Dr. Stephen Sinatra endorse this particular test.

My review of the medical literature strongly substantiates the role that diet and exercise play in reducing colorectal cancer (CRC) incidence. But, select dietary supplements, likewise, confer a great deal of hope. In fact, numerous studies validate the incorporation of several food-based ingredients as adjuncts to a healthful dietary plan and exercise routine. Sadly, the news about supplementing to protect colon health hasn’t yet been robustly endorsed or explained by mainstream medical sources. That’s why I’m writing this now!

Curcumin and ginger, two related spice extracts have both shown promise in reducing risk factors linked to CRC. One trial found that 4 grams of curcumin, an extract from turmeric root, taken daily reduced the number of aberrant crypt foci or pre-polyps by 40%. Ginger, given at a dosage of 2 grams daily, lowers inflammation and normalizes cell growth in people at increased risk for colorectal cancer. Supplementing with a high dosage of calcium and Vitamin D (2,000 mg calcium carbonate & 800 IU Vitamin D) reduces DNA damage and alters specific genetic signaling commonly present in those with CRC. According to a study in the July 2010 issue of the journal Gut, EPA, a purified form of fish oil, decreased colon polyp counts by over 22% and polyp size by about 30%. Another trial reports that an identical dosage and form of fish oil, 2 grams/day of EPA free-fatty acids, positively affects new cell growth and enhances the healthy elimination of cells (apoptosis). A final supplement worth considering is concentrated green tea extract (GTE). A 12 month, placebo-controlled study using 1,500 mg/day of GTE discovered that GTE reduced the risk of colon polyps by over half compared to a placebo. Additionally, the size of newly detected polyps were smaller in the participants taking the green tea capsules. Currently, it’s unknown exactly how GTE confers this protective effect. However one study hints that it may do so by rapidly reducing inflammation (prostaglandin E2) in colon tissue.

Thanks to modern research and traditional wisdom, food-based supplements, such as calcium with Vitamin D, curcumin, fish oil, ginger and green tea extract, are relatively well known. They’re inexpensive and safe to use in most circumstances. The key is to make sure that you’re using them appropriately. This means employing them as supplements to other healthy lifestyle factors, such as diet and exercise. Also, it’s advisable to follow the dosing patterns that have been found effective and safe in peer-reviewed studies. The hard work has already been done by the researchers. Why not put it to full use? My final recommendation is to keep your health care team advised about any supplements you add to your regimen. On occasion, some supplements may not interact well with certain medications and/or need to be temporarily discontinued prior to a colonoscopy.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Effects of Ginger Supplementation on Cell-Cycle Biomarkers in (link)

Study 2 - Effect of Ginger Root on Cyclooxygenase-1 & 15-Hydroxyprostaglandin (link)

Study 3 - A Randomized Clinical Trial of the Effects of Supplemental Calcium(link)

Study 4 - Effects of Supplemental Vitamin D and Calcium on Oxidative DNA (link)

Study 5 - Eicosapentaenoic Acid Reduces Rectal Polyp Number and Size (link)

Study 6 - Eicosapentaenoic Acid (EPA) Reduces Crypt Cell Proliferation (link)

Study 7 - Effects of Different Doses of Fish Oil on Rectal Cell Proliferation (link)

Study 8 - Effects of Fish Oil on Rectal Cell Proliferation, Mucosal Fatty Acids (link)

Study 9 - Green Tea Extracts for the Prevention of Metachronous Colorectal (link)

Study 10 - Ingestion of Green Tea Rapidly Decreases Prostaglandin E2 Levels (link)

High Dosage Curcumin May Reduce Pre-Polyp (ACF) Formation

Source: Cancer Prev Res March 2011 4; 354 (link)

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Posted in Alternative Therapies, Food and Drink, Nutritional Supplements

13 Comments & Updates to “Protect Your Colon Part Two”

  1. Gianfranco F. Says:

    Hi JP,

    Is there a way of incorporating ginger in your cooking?

    Paul

  2. JP Says:

    Hi, Gianfranco.

    An easy way to incorporate ginger is into teas. All you need to do is peel and slice fresh ginger and brew it with your choosen tea. Mrs. Healthy Fellow enjoys the flavor very much when I add it to hibiscus tea. Personally, I like the addition of fresh ginger to green or white tea as well. Grated ginger can also add some freshness and spiciness to marinaades and salad dressing. Another option is to add fresh ginger to homemade juices or blended smoothies.

    I hope this helps!

    Be well!

    JP

  3. Kat Says:

    I love ginger, it has so many good benefits. Especially now when the cold season has started, ginger is great for fighting a common cold or flu. I have been making a ginger tea every day. I never peel the ginger though. I just slice the fresh ginger and then boil it. I also tried to eat it raw but it is too spicy.
    I have never tried to juice it or blended in a smoothie. I will try that next time.

  4. JP Says:

    Update: Keep an eye on your Vitamin D level …

    http://www.ncbi.nlm.nih.gov/pubmed/25646565?dopt=Abstract

    Nutr Cancer. 2015 Feb 3:1-7.

    Serum 25-Hydroxy Vitamin D and Survival in Advanced Colorectal Cancer: A Retrospective Analysis.

    Higher serum 25-hydroxy vitamin D [25(OH)D] levels are associated with decreased colorectal cancer (CRC) incidence. In this retrospective study of Stage IV CRC patients, we evaluate whether 25(OH)D levels at diagnosis correlate with survival. Stored sera from carcinoembryonic antigen (CEA) measurements obtained between February 2005 and March 2006 were screened. The first 250 patients with CEA ±30 days of Stage IV CRC diagnosis were included. Serum 25(OH)D levels were determined and categorized as adequate ≥30 ng/mL, or deficient <30 ng/mL. Multivariable Cox regression models controlling for albumin and Eastern Cooperative Oncology Group performance status were used to investigate whether higher 25(OH)D levels were associated with prolonged survival. A total of 207 patients (83%) were vitamin D-deficient (median = 21 ng/mL), with deficiencies significantly more likely among non-Hispanic black patients (P = 0.009). Higher levels were associated with prolonged survival in categorical variable analysis: adequate vs. deficient, hazard ratio = 0.61, 95% confidence interval = 0.38-0.98, P = 0.041. A majority of newly diagnosed Stage IV CRC patients are vitamin D-deficient. Our data suggest that higher 25(OH)D levels are associated with better overall survival. Clinical trials to determine whether aggressive vitamin D repletion would improve outcomes for vitamin D-deficient CRC patients are warranted.

    Be well!

    JP

  5. JP Says:

    Update: More support for maintaining an optimal Vitamin D level …

    http://cancerpreventionresearch.aacrjournals.org/content/early/2015/03/26/1940-6207.CAPR-14-0470.abstract

    Cancer Prev Res (Phila). 2015

    Circulating Vitamin D Levels and Risk of Colorectal Cancer in Women.

    Observational data on the association between circulating 25(OH)D and colorectal cancer risk are limited in women. To determine whether prediagnostic levels of 25(OH)D were associated with risk of incident colorectal cancer in the Women’s Health Study (WHS), we conducted a nested case-control study using 274 colorectal cases and 274 controls. Each case was matched to a control by age, ethnicity, fasting status at the time of blood collection, time of day when blood was drawn, and month of blood draw. Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for colorectal cancer by 25(OH)D quartiles. Mean plasma 25(OH)D was lower in cases versus controls (21.9 vs 23.9 ng/mL, p=0.01). In multivariable-adjusted logistic regression models, plasma 25(OH)D was significantly and inversely associated with odds of colorectal cancer (quartile 4 [Q4] versus quartile 1 [Q1]: OR (95% CI): 0.45 (0.25-0.81), ptrend 0.02). Additionally, we observed a somewhat lower risk of colorectal cancer mortality after adjustment for matching variables, randomization treatment and other risk factors (Q4:Q1 OR[95%CI]: 0.40(0.17-0.97); ptrend 0.05). In this cohort of healthy women, we found a significant inverse association between prediagnostic 25(OH)D levels and risk of incident colorectal cancer, and a borderline significant inverse association between prediagnostic 25(OH)D levels and colorectal cancer mortality. These results support a possible association between plasma 25(OH)D and risk of colorectal cancer in women.

    Be well!

    JP

  6. JP Says:

    Update 05/18/15:

    http://www.plefa.com/article/S0952-3278%2814%2900145-8/abstract

    Prostaglandins Leukot Essent Fatty Acids. 2015 Mar;94:1-11.

    Dietary n-3/long-chain n-3 polyunsaturated fatty acids for prevention of sporadic colorectal tumors: a randomized controlled trial in polypectomized participants.

    To address preventive effects of n-3 PUFAs/LC n-3 PUFAs on CRTs, a randomized controlled trial was conducted. One-hundred four experimental group participants were advised to increase intake of n-3 PUFAs, including fish/shell fish, fish oil supplements and perilla oils, and to decrease consumption of n-6 PUFAs and fats/oils as a whole for 24 months. One-hundred one control group participants were only cautioned to reduce consumption of fats/oils as a whole. Random allocation was satisfactorily attained, and participants sufficiently complied with our regimen. Intakes, plasma concentrations, and compositions of the RBC and sigmoid colon membranes of n-3 PUFAs, LC n-3 PUFAs, EPA and DHA increased, and the ratios of n-6 PUFAs/n-3 PUFAs and AA/LC n-3 PUFAs decreased without any adverse response. Twenty-four months after the intervention, the multivariate-adjusted hazard ratio (95% confidence intervals) was estimated to be 0.805 (0.536-1.209) with a signal towards the reduced CRT incidence.

    Be well!

    JP

  7. JP Says:

    Updated 09/19/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26380892?dopt=Abstract

    Nutr Cancer. 2015 Sep 18:1-8.

    Fish Oil Supplementation and Quality of Life in Stage II Colorectal Cancer Patients: A 24-Month Follow-Up Study.

    Research suggests that cancer survivors have an interest in lifestyle changes following a diagnosis. However, few studies have prospectively investigated whether these changes result in positive outcomes. The objective of this study was to examine the associations between fish oil supplementation and quality of life (QoL), cancer recurrence, and all-cause mortality in Stage 2 colorectal cancer (CRC) patients following diagnosis. Four hundred fifty-three patients were enrolled from the North Carolina Cancer Registry from 2009 to 2011. Data on demography, treatment, and health behaviors were collected at diagnosis, 12-, and 24 mo postdiagnosis. Generalized estimating equations were performed to examine fish oil supplementation in relation to QoL, recurrence, and all-cause mortality. An increase in fish oil supplementation over 24 mo postdiagnosis was associated with an increase in the physical component score of the 12-item Medical Outcomes Short Form (β = 2.43, 95% CI: 0.10-4.76). Supplementation showed no association with the Functional Assessment of Cancer-Colorectal, cancer recurrence or mortality across the 24-mo follow-up. This study suggests that fish oil supplementation may improve symptom-related QoL (i.e., physical functioning) in Stage 2 CRC patients following diagnosis. Future research should address the dose-dependent effects of this relationship.

    Be well!

    JP

  8. JP Says:

    Updated 09/19/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26373257?dopt=Abstract

    Public Health Nutr. 2015 Sep 16:1-11.

    A dose-response meta-analysis reveals an association between vitamin B12 and colorectal cancer risk.

    OBJECTIVE: The current meta-analysis evaluated the association between vitamin B12 intake and blood vitamin B12 level and colorectal cancer (CRC) risk.

    DESIGN: The PubMed and EMBASE databases were searched. A dose-response analysis was performed with generalized least squares regression, with the relative risk (RR) and 95 % CI as effect values.

    SETTING: The meta-analysis included seventeen studies.

    SUBJECTS: A total of 10 601 patients.

    RESULTS: The non-linear dose-response relationship between total vitamin B12 intake and CRC risk was insignificant (P=0·690), but the relationship between dietary vitamin B12 intake and CRC risk was significant (P<0·001). Every 4·5 μg/d increment in total and dietary vitamin B12 intake was inversely associated with CRC risk (total intake: RR=0·963; 95 % CI 0·928, 0·999; dietary intake: RR=0·914; 95 % CI 0·856, 0·977). The inverse association between vitamin B12 intake and CRC risk was also significant when vitamin B12 intake was over a dosage threshold, enhancing the non-linear relationship. The non-linear dose-response relationship between blood vitamin B12 level and CRC risk was insignificant (P=0·219). There was an insignificant association between every 150 pmol/l increment in blood vitamin B12 level and CRC risk (RR=1·023; 95 % CI 0·881, 1·187).

    CONCLUSIONS: Our meta-analysis indicates that evidence supports the use of vitamin B12 for cancer prevention, especially among populations with high-dose vitamin B12 intake, and that the association between CRC risk and total vitamin B12 intake is stronger than between CRC risk and dietary vitamin B12 intake only.

    Be well!

    JP

  9. JP Says:

    Updated 09/24/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26390877?dopt=Abstract

    Cancer Causes Control. 2015 Sep 21.

    Association between magnesium intake and risk of colorectal cancer among postmenopausal women.

    PURPOSE: Data relating to magnesium intake and colorectal cancer (CRC) risk in postmenopausal women are incomplete. We investigated the association between total magnesium intake and the risk of CRC in an ethnically diverse cohort of postmenopausal women enrolled in the Women’s Health Initiative.

    METHODS: Self-reported dietary and supplemental magnesium were combined to form total magnesium intake. Invasive incident CRC was the primary outcome. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CI).

    RESULTS: During an average follow-up of 13 years (1,832,319 person-years), of the 140,601 women included for analysis, 2,381 women were diagnosed with CRC (1,982 colon cancer and 438 rectal cancer). After adjustment for potential confounding variables, an inverse association was observed in the highest quintile of total magnesium intake compared to the lowest quintile for risk of CRC (HR 0.79, 95 % CI 0.67, 0.94, p trend < 0.0001) and colon cancer (HR 0.80, 95 % CI 0.66, 0.97, p trend < 0.0001). A borderline significant inverse association was detected in the highest versus the lowest quintile of total magnesium intake for rectal cancer (HR 0.76, 95 % CI 0.51, 1.13, p trend < 0.001).

    CONCLUSIONS: Findings from this study support the hypothesis that magnesium intake around 400 mg/day from both dietary and supplemental sources is associated with a lower incidence of CRC in postmenopausal women.

    Be well!

    JP

  10. JP Says:

    Updated 12/10/16:

    https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/div-classtitlesupplementation-with-brazil-nuts-and-green-tea-extract-regulates-targeted-biomarkers-related-to-colorectal-cancer-risk-in-humansdiv/37D6248021F7CD3E35D4833569E23A49

    Br J Nutr. 2016 Dec 7:1-11.

    Supplementation with Brazil nuts and green tea extract regulates targeted biomarkers related to colorectal cancer risk in humans.

    Se and green tea have been shown in epidemiological, observational and preclinical studies to be inversely related to the risk of developing colorectal cancer (CRC). However, there are limited studies to evaluate their regulatory effects on genes/proteins that relate to CRC oncogenesis in human subjects, such as selenoproteins, WNT signalling pathway, inflammation and methylation. This study examined the effects of supplementation of Se using Brazil nuts and green tea extract (GTE) capsules, alone and in combination, on targeted biomarkers. In total, thirty-two volunteers (>50 years of age) with plasma Se≤1·36 µmol/l were randomised to one of three treatment groups: nine to Se (approximately 48 µg/d) as six Brazil nuts, eleven to four GTE capsules (800 mg (-)-epigallocatechin-3-gallate) and twelve to a combination of Brazil nuts and GTE. Blood and rectal biopsies were obtained before and after each intervention. Plasma Se levels, rectal selenoprotein P (SePP) and β-catenin mRNA increased significantly in subjects consuming Brazil nuts alone or in combination, whereas rectal DNA methyltransferase (DNMT1) and NF-κB mRNA were reduced significantly in subjects consuming GTE alone or in combination. None of the interventions significantly affected rectal acetylated histone H3 or Ki-67 expression at the protein level or plasma C-reactive protein. Effects of the combination of Brazil nuts and GTE did not differ from what would be expected from either agent alone. In conclusion, supplementation of Brazil nuts and/or GTE regulates targeted biomarkers related to CRC oncogenesis, specifically genes associated with selenoproteins (SePP), WNT signalling (β-catenin), inflammation (NF-κB) and methylation (DNMT1). Their combination does not appear to provide additional effects compared with either agent alone.

    Be well!

    JP

  11. JP Says:

    Updated 02/17/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28209333

    Clin Nutr. 2017 Jan 29.

    Green tea extracts for the prevention of metachronous colorectal polyps among patients who underwent endoscopic removal of colorectal adenomas: A randomized clinical trial.

    OBJECTIVES: To determine the preventive effect of green tea extract (GTE) supplements on metachronous colorectal adenoma and cancer in the Korean population.

    MATERIALS AND METHODS: One hundred seventy-six subjects (88 per each group) who had undergone complete removal of colorectal adenomas by endoscopic polypectomy were enrolled. They were randomized into 2 groups: supplementation group (0.9 g GTE per day for 12 months) or control group without GTE supplementation. The 72-h recall method was used to collect data on food items consumed by participants at baseline and the 1-year follow-up during the past 48 h. Follow-up colonoscopy was conducted 12 months later in 143 patients (71 in control group and 72 in the GTE group).

    RESULTS: Of the 143 patients completed in the study, the incidences of metachronous adenomas at the end-point colonoscopy were 42.3% (30 of 71) in control group and 23.6% (17 of 72) in GTE group (relative risk [RR], 0.42; 95% confidence interval [CI], 0.21-0.87). The number of relapsed adenoma was also decreased in the GTE group than in the control group (0.7 ± 1.1 vs. 0.3 ± 0.6, p = 0.010). However, there were no significant differences between the 2 groups in terms of body mass index, dietary intakes, serum lipid profiles, fasting serum glucose, and serum C-reactive protein levels (all p > 0.05).

    CONCLUSION: This study of GTE supplement suggests a favorable outcome for the chemoprevention of metachronous colorectal adenomas in Korean patients.

    Be well!

    JP

  12. JP Says:

    Updated 04/22/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28430159

    Mar Drugs. 2017 Apr 21;15(4).

    Efficacy of Low-Molecular-Weight Fucoidan as a Supplemental Therapy in Metastatic Colorectal Cancer Patients: A Double-Blind Randomized Controlled Trial.

    BACKGROUND: Low-molecular-weight fucoidan (LMF) is widely used as a food supplement for cancer patients. However, all of the studies are in vitro or were conducted using mice. Therefore, powerful clinical evidence for LMF use is relatively weak. This study aimed to evaluate the efficacy of LMF as a supplemental therapy to chemo-target agents in metastatic colorectal cancer (mCRC) patients.

    METHODS: We conducted a prospective, randomized, double-blind, controlled trial to evaluate the efficacy of LMF as a supplemental therapy to chemotarget agents in patients with metastatic colorectal cancer (mCRC). Sixty eligible patients with mCRC were included. Finally, 54 patients were enrolled, of whom 28 were included in the study group and 26 in the control group. The primary endpoint was the disease control rate (DCR), and secondary endpoints included the overall response rate (ORR), progression-free survival (PFS), overall survival (OS), adverse effects (AEs), and quality of life (QOL).

    RESULTS: The DCRs were 92.8% and 69.2% in the study and control groups, respectively (p = 0.026), in a median follow-up period of 11.5 months. The OS, PFS, ORR, AEs, and QOL did not significantly differ between the two groups.

    CONCLUSION: This is the first clinical trial evaluating the efficacy of LMF as a supplemental therapy in the management of patients with mCRC. The results indicate that LMF combined with chemotarget agents significantly improved the DCR.

    Be well!

    JP

  13. JP Says:

    Updated 09/01/17:

    http://onlinelibrary.wiley.com/doi/10.1111/ajco.12758/abstract

    Asia Pac J Clin Oncol. 2017 Aug 31.

    Strain-specific probiotic (microbial cell preparation) and omega-3 fatty acid in modulating quality of life and inflammatory markers in colorectal cancer patients: A randomized controlled trial.

    AIM: Colorectal cancer patients on chemotherapy usually have elevated levels of inflammatory markers and experience numerous side effects from chemotherapy thereby leading to poor quality of life. Omega-3 fatty acid and microbial cell preparation (MCP) have been known to provide significant benefits in patients on chemotherapy. The aim of this study was to determine the effect of supplementation of omega-3 fatty acid and MCP in quality of life, chemotherapy side effects and inflammatory markers in colorectal cancer patients on chemotherapy.

    METHODS: A double-blind randomized study was carried out with 140 colorectal cancer patients on chemotherapy. Subjects were separated into two groups to receive either placebo or MCP [30 billion colony-forming unit (CFUs) per sachet] at a dose of two sachets daily for 4 weeks, and omega-3 fatty acid at a dose of 2 g daily for 8 weeks. Outcomes measured were quality of life, side effects of chemotherapy and levels of inflammatory markers such as interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein.

    RESULTS: The supplementation with MCP and omega-3 fatty acid improved the overall quality of life and alleviated certain side effects of chemotherapy. The supplementation with MCP and omega-3 fatty acid also managed to reduce the level of IL-6 (P = 0.002). There was a significant rise in the placebo group’s serum TNF-α (P = 0.048) and IL-6 (P = 0.004).

    CONCLUSION: The combined supplementation with MCP and omega-3 fatty acid may improve quality of life, reduce certain inflammatory biomarkers and relieve certain side effects of chemotherapy in colorectal patients on chemotherapy.

    Be well!

    JP

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