Is there a correlation between diet and colorectal cancer?

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John L. Marshall, MD
I get asked every day, "Doctor, what should I eat? What should I be doing differently to try and stay out of this trouble?" This is very popular cocktail conversation. Is there a correlation between what we eat and colorectal cancer?

John L. Marshall, MD (Continued)
Well, we start with how colon cancer forms. We know that for almost all cancers, colon included, these are genetic mistakes that happen within the cell. We are all mutating all the time. Sometimes those mutations, we keep them around for the spice of life. Sometimes those mutations though are so critical within our cell that the cell will shut down and stop and try to go over and fix that mutation before moving on. Sometimes, and probably by chance, that mutation happens in say the spell checker of the gene. Now we don't get that little squiggly line under our DNA that notifies our cell that something is up, so it doesn't make a decision. It doesn't go over and fix it or let it be, if you will. We think most of cancer occurs because of those events.

John L. Marshall, MD (Continued)
Now, for the most part they are random. I have plenty of cardboard eating, marathon running patients. On the other hand, those folks who gamble a little bit more often have a higher chance that one of those unusual genetic mutations will happen. We do believe diet plays a part in that. We're not really sure what it is about a high fiber low fat diet that's protective. It could be the high fiber. High fiber sort of waters down so to speak all that bad stuff we ate. It also sort of has a transient…your stool moves through your bowel faster so it has less time to interact with the wall of the bowel. The low fat piece may have something to do with actually bile salts, believe it or not. If you change your fat content in your diet, your liver changes the kind of bile salts it makes. They may be in fact different or more protective or less protective.

John L. Marshall, MD (Continued)
A high fiber low fat diet is our advice. A good balanced diet is the best thing you can do right now to stay out of my office.