Abstract
Epidemiologic studies have identified two dietary factors, a relatively high intake of fat and a relatively low intake of fibre, that are associated with colon cancer in humans. However, a recent study has shown a low risk of large bowel cancer in a rural Finnish population with a high dietary intake of fat, but also a high intake of fibre. Observations in humans and studies in animals have indicated that dietary fibre may protect against colon carcinogenesis by binding bile acids in the intestinal tract, by a direct effect on the colonic mucosa and by an indirect effect on the metabolism of carcinogens. The strength of protection varies with the type of fibre.
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- Aries V., Crowther J. S., Drasar B. S., Hill M. J., Williams R. E. Bacteria and the aetiology of cancer of the large bowel. Gut. 1969 May;10(5):334–335. doi: 10.1136/gut.10.5.334. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Armstrong B., Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer. 1975 Apr 15;15(4):617–631. doi: 10.1002/ijc.2910150411. [DOI] [PubMed] [Google Scholar]
- Bauer H. G., Asp N. G., Oste R., Dahlqvist A., Fredlund P. E. Effect of dietary fiber on the induction of colorectal tumors and fecal beta-glucuronidase activity in the rat. Cancer Res. 1979 Sep;39(9):3752–3756. [PubMed] [Google Scholar]
- Burkitt D. P. An epidemiologic approach to cancer of the large intestine: the significance of disease relationships. Dis Colon Rectum. 1974 Jul-Aug;17(4):456–461. doi: 10.1007/BF02587020. [DOI] [PubMed] [Google Scholar]
- Burkitt D. P. Epidemiology of cancer of the colon and rectum. Cancer. 1971 Jul;28(1):3–13. doi: 10.1002/1097-0142(197107)28:1<3::aid-cncr2820280104>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
- Correa P. Comments on the epidemiology of large bowel cancer. Cancer Res. 1975 Nov;35(11 Pt 2):3395–3397. [PubMed] [Google Scholar]
- Cruse P., Lewin M., Clark C. G. Dietary cholesterol is co-carcinogenic for human colon cancer. Lancet. 1979 Apr 7;1(8119):752–755. doi: 10.1016/s0140-6736(79)91209-1. [DOI] [PubMed] [Google Scholar]
- Cummings J. H., Hill M. J., Jenkins D. J., Pearson J. R., Wiggins H. S. Changes in fecal composition and colonic function due to cereal fiber. Am J Clin Nutr. 1976 Dec;29(12):1468–1473. doi: 10.1093/ajcn/29.12.1468. [DOI] [PubMed] [Google Scholar]
- Dales L. G., Friedman G. D., Ury H. K., Grossman S., Williams S. R. A case-control study of relationships of diet and other traits to colorectal cancer in American blacks. Am J Epidemiol. 1979 Feb;109(2):132–144. doi: 10.1093/oxfordjournals.aje.a112668. [DOI] [PubMed] [Google Scholar]
- Drasar B. S., Irving D. Environmental factors and cancer of the colon and breast. Br J Cancer. 1973 Feb;27(2):167–172. doi: 10.1038/bjc.1973.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ehrich M., Aswell J. E., van Tassell R. L., Wilkins T. D., Walker A. R., Richardson N. J. Mutagens in the feces of 3 South-African populations at different levels of risk for colon cancer. Mutat Res. 1979 Aug;64(4):231–240. doi: 10.1016/0165-1161(79)90092-x. [DOI] [PubMed] [Google Scholar]
- Enig M. G., Munn R. J., Keeney M. Dietary fat and cancer trends--a critique. Fed Proc. 1978 Jul;37(9):2215–2220. [PubMed] [Google Scholar]
- Enstrom J. E. Cancer and total mortality among active Mormons. Cancer. 1978 Oct;42(4):1943–1951. doi: 10.1002/1097-0142(197810)42:4<1943::aid-cncr2820420437>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
- Fiala E. S. Investigations into the metabolism and mode of action of the colon carcinogens 1,2-dimethylhydrazine and azoxymethane. Cancer. 1977 Nov;40(5 Suppl):2436–2445. doi: 10.1002/1097-0142(197711)40:5+<2436::aid-cncr2820400908>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
- Fleiszer D., Murray D., MacFarlane J., Brown R. A. Protective effect of dietary fibre against chemically induced bowel tumours in rats. Lancet. 1978 Sep 9;2(8089):552–553. doi: 10.1016/s0140-6736(78)92885-4. [DOI] [PubMed] [Google Scholar]
- Freeman H. J., Spiller G. A., Kim Y. S. A double-blind study on the effect of purified cellulose dietary fiber on 1,2-dimethylhydrazine-induced rat colonic neoplasia. Cancer Res. 1978 Sep;38(9):2912–2917. [PubMed] [Google Scholar]
- Goldin B. R., Gorbach S. L. The relationship between diet and rat fecal bacterial enzymes implicated in colon cancer. J Natl Cancer Inst. 1976 Aug;57(2):371–375. doi: 10.1093/jnci/57.2.371. [DOI] [PubMed] [Google Scholar]
- Graham S., Dayal H., Swanson M., Mittelman A., Wilkinson G. Diet in the epidemiology of cancer of the colon and rectum. J Natl Cancer Inst. 1978 Sep;61(3):709–714. [PubMed] [Google Scholar]
- Gregor O., Toman R., Prusová F. Gastrointestinal cancer and nutrition. Gut. 1969 Dec;10(12):1031–1034. doi: 10.1136/gut.10.12.1031. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Haenszel W., Berg J. W., Segi M., Kurihara M., Locke F. B. Large-bowel cancer in Hawaiian Japanese. J Natl Cancer Inst. 1973 Dec;51(6):1765–1779. doi: 10.1093/jnci/51.6.1765. [DOI] [PubMed] [Google Scholar]
- Haenszel W., Correa P., Cuello C. Social class differences among patients with large-bowel cancer in Cali, Colombia. J Natl Cancer Inst. 1975 May;54(5):1031–1035. [PubMed] [Google Scholar]
- Hill M. J., Drasar B. S., Hawksworth G., Aries V., Crowther J. S., Williams R. E. Bacteria and aetiology of cancer of large bowel. Lancet. 1971 Jan 16;1(7690):95–100. doi: 10.1016/s0140-6736(71)90837-3. [DOI] [PubMed] [Google Scholar]
- Hill M. J. The etiology of colon cancer. CRC Crit Rev Toxicol. 1975 Oct;4(1):31–82. doi: 10.1080/10408447509163834. [DOI] [PubMed] [Google Scholar]
- Hirayama T. Epidemiology of breast cancer with special reference to the role of diet. Prev Med. 1978 Jun;7(2):173–195. doi: 10.1016/0091-7435(78)90244-x. [DOI] [PubMed] [Google Scholar]
- Howell M. A. Deit as an etiological factor in the development of cancers of the colon and rectum. J Chronic Dis. 1975 Feb;28(2):67–80. doi: 10.1016/0021-9681(75)90063-6. [DOI] [PubMed] [Google Scholar]
- Jensen O. M., Mosbech J., Salaspuro M., Jhamäki T. A comparative study of the diagnostic basis for cancer of the colon and cancer of the rectum in Denmark and Finland. Int J Epidemiol. 1974 Jun;3(2):183–186. doi: 10.1093/ije/3.2.183. [DOI] [PubMed] [Google Scholar]
- Kay R. M., Truswell A. S. The effect of wheat fibre on plasma lipids and faecal steroid excretion in man. Br J Nutr. 1977 Mar;37(2):227–235. doi: 10.1079/bjn19770024. [DOI] [PubMed] [Google Scholar]
- LEMON F. R., WALDEN R. T., WOODS R. W. CANCER OF THE LUNG AND MOUTH IN SEVENTH-DAY ADVENTISTS. PRELIMINARY REPORT ON A POPULATION STUDY. Cancer. 1964 Apr;17:486–497. doi: 10.1002/1097-0142(196404)17:4<486::aid-cncr2820170410>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
- Lemon F. R., Walden R. T. Death from respiratory system disease among Seventh-Day Adventist men. JAMA. 1966 Oct 10;198(2):117–126. [PubMed] [Google Scholar]
- Lyon J. L., Gardner J. W., Klauber M. R., Smart C. R. Low cancer incidence and mortality in Utah. Cancer. 1977 Jun;39(6):2608–2618. doi: 10.1002/1097-0142(197706)39:6<2608::aid-cncr2820390646>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
- Modan B., Barell V., Lubin F., Modan M. Dietary factors and cancer in Israel. Cancer Res. 1975 Nov;35(11 Pt 2):3503–3506. [PubMed] [Google Scholar]
- Nigro N. D., Bull A. W., Klopfer B. A., Pak M. S., Campbell R. L. Effect of dietary fiber on azoxymethane-induced intestinal carcinogenesis in rats. J Natl Cancer Inst. 1979 Apr;62(4):1097–1102. [PubMed] [Google Scholar]
- Oiso T. Incidence of stomach cancer and its relation to dietary habits and nutrition in Japan between 1900 and 1975. Cancer Res. 1975 Nov;35(11 Pt 2):3254–3258. [PubMed] [Google Scholar]
- Phillips R. L. Role of life-style and dietary habits in risk of cancer among seventh-day adventists. Cancer Res. 1975 Nov;35(11 Pt 2):3513–3522. [PubMed] [Google Scholar]
- Reddy B. S., Hedges A. R., Laakso K., Wynder E. L. Metabolic epidemiology of large bowel cancer: fecal bulk and constituents of high-risk North American and low-risk Finnish population. Cancer. 1978 Dec;42(6):2832–2838. doi: 10.1002/1097-0142(197812)42:6<2832::aid-cncr2820420644>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
- Reddy B. S., Narisawa T., Maronpot R., Weisburger J. H., Wynder E. L. Animal models for the study of dietary factors and cancer of the large bowel. Cancer Res. 1975 Nov;35(11 Pt 2):3421–3426. [PubMed] [Google Scholar]
- Reddy B. S., Watanabe K., Sheinfil A. Effect of dietary wheat bran, alfalfa, pectin and carrageenan on plasma cholesterol and fecal bile acid and neutral sterol excretion in rats. J Nutr. 1980 Jun;110(6):1247–1254. doi: 10.1093/jn/110.6.1247. [DOI] [PubMed] [Google Scholar]
- Reddy B. S., Weisburger J. H., Wynder E. L. Effects of high risk and low risk diets for colon carcinogenesis on fecal microflora and steroids in man. J Nutr. 1975 Jul;105(7):878–884. doi: 10.1093/jn/105.7.878. [DOI] [PubMed] [Google Scholar]
- Spiller G. A., Chernoff M. C., Hill R. A., Gates J. E., Nassar J. J., Shipley E. A. Effect of purified cellulose, pectin, and a low-residue diet on fecal volatile fatty acids, transit time, and fecal weight in humans. Am J Clin Nutr. 1980 Apr;33(4):754–759. doi: 10.1093/ajcn/33.4.754. [DOI] [PubMed] [Google Scholar]
- Staszewski J., McCall M. G., Stenhouse N. S. Cancer mortality in 1962-66 among Polish migrants to Australia. Br J Cancer. 1971 Dec;25(4):599–610. doi: 10.1038/bjc.1971.76. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stevens C. E. Physiological implications of microbial digestion in the large intestine of mammals: relation to dietary factors. Am J Clin Nutr. 1978 Oct;31(10 Suppl):S161–S168. doi: 10.1093/ajcn/31.10.S161. [DOI] [PubMed] [Google Scholar]
- Trowell H., Southgate D. A., Wolever T. M., Leeds A. R., Gassull M. A., Jenkins D. J. Letter: Dietary fibre redefined. Lancet. 1976 May 1;1(7966):967–967. doi: 10.1016/s0140-6736(76)92750-1. [DOI] [PubMed] [Google Scholar]
- Walters R. L., Baird I. M., Davies P. S., Hill M. J., Drasar B. S., Southgate D. A., Green J., Morgan B. Effects of two types of dietary fibre on faecal steroid and lipid excretion. Br Med J. 1975 Jun 7;2(5970):536–538. doi: 10.1136/bmj.2.5970.536. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Watanabe K., Reddy B. S., Weisburger J. H., Kritchevsky D. Effect of dietary alfalfa, pectin, and wheat bran on azoxymethane-or methylnitrosourea-induced colon carcinogenesis in F344 rats. J Natl Cancer Inst. 1979 Jul;63(1):141–145. [PubMed] [Google Scholar]
- Wattenberg L. W. Inhibition of chemical carcinogenesis. J Natl Cancer Inst. 1978 Jan;60(1):11–18. doi: 10.1093/jnci/60.1.11. [DOI] [PubMed] [Google Scholar]
- Wilson R. B., Hutcheson D. P., Wideman L. Dimethylhydrazine-induced colon tumors in rats fed diets containing beef fat or corn oil with and without wheat bran. Am J Clin Nutr. 1977 Feb;30(2):176–181. doi: 10.1093/ajcn/30.2.176. [DOI] [PubMed] [Google Scholar]
- Wynder E. L., Kajitani T., Ishikawa S., Dodo H., Takano A. Environmental factors of cancer of the colon and rectum. II. Japanese epidemiological data. Cancer. 1969 May;23(5):1210–1220. doi: 10.1002/1097-0142(196905)23:5<1210::aid-cncr2820230530>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
- Wynder E. L., Reddy B. Studies of large-bowel cancer: human leads to experimental application. J Natl Cancer Inst. 1973 May;50(5):1099–1106. doi: 10.1093/jnci/50.5.1099. [DOI] [PubMed] [Google Scholar]
- Wynder E. L., Shigematsu T. Environmental factors of cancer of the colon and rectum. Cancer. 1967 Sep;20(9):1520–1561. doi: 10.1002/1097-0142(196709)20:9<1520::aid-cncr2820200920>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
- Wynder E. L. The epidemiology of large bowel cancer. Cancer Res. 1975 Nov;35(11 Pt 2):3388–3394. [PubMed] [Google Scholar]