Am I At Risk For Colon Cancer?

Transcript:

MELANIE: Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight and Wellness. We are a company specializing in life changing nutrition education and counseling. I am Melanie Beasley, a Licensed and Registered Dietitian, and I'm here with Kara Carper today.

KARA: It's great to be with you again, Melanie. My name is Kara Carper. I'm a Licensed Nutritionist and Certified Nutrition Specialist. We're going to be discussing the very important topic of colon cancer today. The American Cancer Society reports that colorectal cancer is the second most common cause of cancer deaths when you combine the numbers for both men and women. It's estimated that more than 148,000 new cases of colon cancer will be diagnosed. And over 56,000 Americans. unfortunately, will pass from colon cancer this year in 2024.

MELANIE: I feel like colon cancer has risen to the point that everybody knows somebody who has struggled or is struggling with colon cancer. So I think this is really timely. But Kara, 90 percent of colon cancer is thought to be preventable. And so we have to ask ourselves, why are these numbers on the rise in our country and when it comes to diagnosis and death rates?

KARA: So that brings us to our show title today: Am I at Risk for Colon Cancer?

MELANIE: Before we get too far into our topic, you and I had an interesting discussion before our show about the terms used for colon cancer. So I think that's important. I, it can be confusing. So we want to explain the different terms and what they mean. Kara had just stated that colorectal cancer is the second most common form of cancer for men and women combined in the U.S.

KARA: The colon is our large intestinal tract. So cancer that's diagnosed in the colon is called colon cancer.

MELANIE: And then the rectum is the last few inches of the large intestinal tract that's closest to the anus. Rectal cancer is technically a cancer that occurs in that specific area, not to be confused.

KARA: So that's really the only difference. So if you hear people talking about colon cancer, rectal cancer, and colorectal cancer, the difference just depends on the specific area of the large intestinal tract.

MELANIE: Yeah, it's good to clear that up.

KARA: Yeah, definitely. And just for simplicity, for the purpose of our podcast today, we will be referring to colon cancer, since they're sometimes used interchangeably.

MELANIE: Yep. And the risk factors and treatments are almost identical for colon and rectal cancer. And I want to briefly mention that if you have heard of anal cancer, that's different and we're not going to be addressing that today.

KARA: And just for listeners, because you might be curious now that we've brought up anal cancer, anal cancer occurs close to the outside of the anus where bowel movements are excreted when we go to the bathroom. And so the statistics and the content that we're going to be talking about today do not include anal cancer. Anal cancer is much rarer compared to colon cancer. And on the flip side, colon cancer is one of the most common types of cancer.

What puts you at higher risk for colon cancer?

MELANIE: And we did mention that 90 percent of colon cancer is thought to be preventable. So why has it become so prevalent? Well, the research has shown colon cancer rates have been increasing, but only for our older population. It's thought that more and more of our aging population are going in and getting checked and screened. So that's good news. So our awareness is on the rise. But we want to talk about making lifestyle and nutrition changes if you are having risk or you just want to be cautious.

KARA: What we're reading in the literature, Mel, is that there's a big concern about people ages 55 and under having those increased rates of colon cancer and the cancer rates for younger folks have been going up 1 to 2 percent every year since the 90s. So that's a really big shift, a really big increase.

MELANIE: 1 to 2 percent every year is actually a significant number. And again, we must ask the question, why? Why are Americans under the age of 55 being diagnosed more frequently with colon cancer? And when we know that screening is better than it's ever been before?

KARA: Well, doctors have many theories about this. One reason could be that people are not up to speed with the current recommendations for colon cancer screening. And so I will tell you what the current recommendations are. People with low risk or even average risk of cancer are supposed to be getting screened for colon cancer by the age of 45.

MELANIE: Yeah. The American Cancer Society says even if you don't have a family history or risk factors, you should get some sort of test by the age of 45.

KARA: Most of you listeners have heard about the colonoscopy test, and that's a little more invasive, but it gives more information in the screening. And plus, if you do go in and you opt for the less invasive stool testing or blood testing, and if anything comes back even slightly abnormal, you're going to need to get a follow up colonoscopy right away anyway. Personally, for me, it makes the most sense to do a colonoscopy right away just to get a baseline, like a benchmark for the health of your colon.

MELANIE: It lets you know if there's polyps, lets you know if there's diverticulosis, which is a whole other show, but it, it, there is more information. So a good baseline with a colonoscopy is a great starting place and the newer guidelines say everyone should have a colon cancer test again by the age of 45. But what about people who are at a higher risk?

Well, the recommendation is to get tested and screened even earlier. And depending on the situation, screenings may need to be done more frequently. It's definitely something you all need to be aware of because colon cancer is very preventable and screening can save lives.

KARA: And like you had mentioned just a couple of minutes ago, 90 percent of colon cancer is thought to be preventable. Some things that put you at a higher risk factor for colon cancer are maybe an immediate family member had colon cancer.

Maybe you had a history of colon cancer in the past, or if you had an inflammatory bowel disease, like Crohn's or colitis, or an immediate family member had colon polyps, which Melanie just mentioned that, and that again is found during a colonoscopy.

MELANIE: So again, I think it's important to know , are you someone who's a polyp producer, right? Because that increases your percentage of risk. That's the clinical term. Well, there's also genetic conditions that can predispose someone for a higher risk of colon cancer. Ask your family members if you can, try to get a history from your parents, your siblings if they have colon cancer or colon polyps; a genetic marker, called Lynch syndrome, and all of those factors would put someone at a higher risk for colon cancer.

It's good information. It's not something you typically sit around and talk about at, you know, an Easter meal, Thanksgiving meal, but it's great to gather that information, you know, discreetly from a family member.

KARA: Yeah. Yeah. Over the phone, one on one conversation. If you're wondering what a colon polyp is, it's a small clump of cells that forms on the lining of the colon, or again, the large intestine, which is another name for the colon. And most polyps are harmless, but it is important to know if you are a polyp producer, because over time they can develop into colon cancer.

MELANIE: And I know the doctors are just great about watching those or removing them. But colon polyps tend to run in families and they have a genetic component and it can take 10 to 15 years for a small polyp to develop into cancer. So we don't want to be alarming anyone, but so you can see how preventable this really is when someone takes the time and initiative to get screened for that colon cancer at that young age.

KARA: And polyps are fairly common. 30 to 50 percent of adults will have them present. And like you just mentioned, Melanie, they can be safely removed, easily removed, or perhaps watched by your medical provider.

MELANIE: Yep. Hopefully we have convinced all of you to listen, and take this seriously. And if you are 45 years old or even younger and you have a risk factor or a family history, you want to be getting yourself checked, have a discussion with your doctor and we want to get your colonoscopy scheduled as soon as possible if you feel like you're past that point. But we want to take it seriously.

KARA: And I have a friend my age, fifties, who was recently diagnosed with stage one colon cancer. She's been really open about her situation, but it's been really challenging with the surgery and then the chemotherapy this past year. And of course it affects everything in your life. The biggest thing that she told me and she's been telling her friends and family is, “You need to make sure you're getting screened and get that colonoscopy if you're in your 40s”, or if you're older and you haven't gotten around to doing it, it's never too late to make that appointment.

MELANIE: And we had a nutritionist; she's a colon cancer survivor and we did a podcast on cancer and she tells her story and it was a random screening. She thought everything would be fine and she had colon cancer and she talks about her journey. It's fascinating. She's just so smart when it comes to colon cancer treatment.

KARA: That was a fabulous podcast. I will say you did a great job and it was Kelly McGraw.

MELANIE: Yeah.

KARA: Registered dietitian; that was very vulnerable and shared her story. And, it was a great podcast. You can even go to our website, weightandwellness.com. Just go to the search button and just type in podcast cancer and you should get a list and pretty short list and it will come up.

Symptoms that can indicate signs of colon cancer

MELANIE: It will come up. Yep. So there are symptoms that can indicate signs of colon cancer. Some of those are blood in the stool. That's a reason to contact your doctor. Other symptoms would be a big change in bowel habits such as diarrhea, constipation, stomach pain, lower quadrant pain, aches, cramps that don't go away. These are all symptoms.

KARA: Unexplained weight loss is another one. And so just introducing the rest of the podcast, we want to talk about nutrition and lifestyle choices that you can make to prevent this very common type of cancer, colon cancer. And I heard something interesting on a podcast discussing cancer prevention.

A doctor and scientist from Ireland named Denis Burkitt, was living in Uganda, Africa in the sixties for a short period of time, and what he observed is that people ages 40 to 60 had almost no diseases that other middle aged folks had in what he called high income countries in Europe. We think of that as like the Western civilization.

MELANIE: Yeah, it's fascinating. The population he observed in Africa was living in rural areas and they were eating indigenous foods, a hunter gatherer type of diet that didn't have any processed foods. They were only found in nature.

KARA: And so these people that he observed and studied in Africa had almost zero colon cancer, diverticulitis, diabetes, or asthma. And those specific diseases have been associated with countries or people that live in countries that have over processed foods, Western countries, or he calls them high income countries.

And sadly, Melanie, the United States falls into that category because we've done shows before talking about how the majority of our foods have become highly processed.

MELANIE: As the majority of our foods have become more and more processed, the disease in our country has flourished and become such a problem that I would say it's like 60 percent of people are dealing with some chronic illness at this time. So Burkitt published a paper in 1969 about his findings and the rural African population with very little disease were eating over 50 grams of fiber each day.

The average amount of fiber that Western countries were eating is, I would say, 15 grams per day, but I think it's even less than that, to be honest, less than a third of what the Africans were eating from real foods found in nature.

KARA: And so the neat thing is that even after Burkitt passed away, many other studies followed suit and show the same findings that fiber is so important for disease prevention and specifically colon cancer prevention.

MELANIE: We went to a conference, a medical conference last year, and they talked about a tribe that ate over a hundred grams of fiber a day.

KARA: Oh, interesting.

MELANIE: And they had almost no disease. They had no autoimmune diseases. I started looking at that thinking, what were they eating? Because it was fascinating. The American Journal of Clinical Nutrition has a published study that found high fiber diets were associated with significantly reduced risk of colon cancer.

KARA: And that makes sense.

MELANIE: So, I would say, here's my challenge to our listeners, just take a day and enter in your favorite app that will track fiber, everything you're eating. See where you land. Because if you're one of those people that's 15 grams or lower, you are putting yourself at risk. So that's my challenge.

Why is fiber so important?

KARA: And we're going to talk more about why that is, you know, all the benefits of fiber, what it's doing in the body that's so great. There's a lot of positive things that occur after eating high fiber.

First of all, it helps bulk up the stool and it speeds up what we call transit time. That's just the amount of time it takes from when you eat the food until the food comes out as a bowel movement. So a slower transit time is associated with a higher risk of colon cancer.

MELANIE: I would also say for people that struggle on the opposite spectrum of diarrhea, fiber is equalizer. So if you're worried, you're thinking, oh loose stool is an issue for me. I really don't need that. It's quite the opposite. The more fiber that you have, it's equalizer. So it helps speed up a slow transit time in people are constipated and it helps slow down transit time for people who have loose stools.

KARA: Great point. It's, it benefits both diarrhea and constipation.

MELANIE: And we're talking about a fibrous diet from food. You know, not running out and buying processed fiber, right? So when I meet with clients and we go over their health questionnaire, I always ask how frequently they're having a bowel movement. I've often coined the phrase as I, I am the poop police in my job.

KARA: Someone has to do it.

MELANIE: Someone has to do it, so when clients are embarrassed, I say this is what we talk about all day and most of them are surprised to hear that not having at least one bowel movement per day is considered being constipated and having regular good size bowel movements gets rid of carcinogenic toxins in the stool.

The less time that cancer causing microbes hang out in the colon, the better. We want them to pass through quickly and easily. It also helps to detox estrogens that we are exposed to chronically. So we're going to talk some more about that when we come back from break.

KARA: You're listening to Dishing Up Nutrition and our topic today is Am I at Risk for Colon Cancer? 90 percent of colon cancer cases are preventable. So why is colon cancer the second most common cause of cancer death in the United States? Gastroenterologists say that they hear a lot of reasons why people don't get screened earlier.

Most often it's due to anxiety or fear about getting a colonoscopy. And, you know, maybe folks have heard, oh, the prep's going to be a difficult, maybe they're afraid the procedure will be painful. Although there are different tests that can screen for colon cancer, such as blood or stool, the colonoscopy is really considered the gold standard when it comes to detection.

And so those GI doctors, they recommend that everyone gets at least a baseline colonoscopy and what they do if you haven't had one is they do use anesthesia and sedation. There's a bowel prep period a few days before this outpatient procedure. When we come back from break, Melanie will tell you where you can find an alternative method for bowel prep if you're interested.

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MELANIE: Welcome back. You're listening to our Dishing Up Nutrition weekly podcast. We're discussing colon cancer, how and when to screen for it and steps you can take for prevention. One possible reason that people resist getting a colonoscopy is because they're afraid of the procedure. They're afraid it'll be uncomfortable or painful or embarrassing and they don't want to deal with that bowel prep that's required for two to three days prior to the appointment.

Well, Kristi Kalinsky is a Registered and Licensed Dietitian at Nutritional Weight and Wellness and she wrote a great article June on 2023 and the title is “A Dietitian's Colonoscopy Prep”. In the article, Kristi shares how she modified the bowel prep that was required for three days leading up to her procedure and if you're interested in reading about her approach, be sure to check out the article at weightandwellness.com. And if you have questions for our front desk staff, you can call our office at 651-699-3438.

KARA: So before break, we were talking about fiber, the benefits of fiber, especially when it comes to prevention of colon cancer. And before we get back into that, I'd like to just share one quick, very interesting fact that I forgot to share regarding this scientist and doctor Burkitt.

MELANIE: Yeah.

KARA: He's the one who was in Uganda and noticed that this particular population eating indigenous foods had almost no diseases. Another thing that he found is they actually measured the stool on a daily basis of this population.

MELANIE: That's not a job anybody wants.

KARA: Nobody wants that job, but somebody did it. And this is so interesting. This population with no disease states, their feces weighed about two pounds per day. Now the average person with more risk of chronic disease is about four ounces per day.

MELANIE: Oh my goodness.

KARA: So that's a very big difference. So that just gets back to all the fiber they were eating, the bulking of the stool, the quicker transit time, not too quick for diarrhea, but a nice firm bulked up stool that weighed quite a bit.

MELANIE: Yep. It says a lot about the diet that they were eating and the hydration.

KARA: Absolutely; hydration. We'll talk more about that too.

How can we get more fiber?

MELANIE: So fiber is a binding agent, which means toxins bind to fiber and are more easily pulled out of the body when you go to the bathroom. So Kara, how can our listeners get more fiber? That's the big question. We know the average American gets less than 15 grams of fiber per day. And the studies we talked about found that 50 grams of fiber per day was the amount that greatly reduced the risk of colon cancer. Let's talk about how do we do that?

KARA: Yeah. And I'm glad that you mentioned a few minutes ago, you encouraged listeners or you challenged them to just use any kind of an app, a food tracking app to see where they're at on a daily basis.

MELANIE: There’s lots of free ones.

KARA: Yeah. So I actually started doing that in preparation for the show. I thought, how much fiber am I eating? And with all I know about food and health as a nutritionist, I typically eat all real food and a well rounded meal plan. But even for me, I've noticed it's challenging to get up to that 50 grams of fiber each day.

MELANIE: Yeah, it is challenging. I read a study, an article rather, I want to say about three months ago, that said the average orange that the American eats today, you would have to eat 10 of them to get the fiber that they used to have 10 years ago for one orange. So you'd have to eat 10 oranges to get the fiber than an orange had 10 years ago because the way they're manufacturing and hybridizing they’re less pith, which is where the fiber is, and more juice.

So you almost have to, it has to almost be a part time job to really get that 50 grams of fiber.

KARA: Yeah. You have to be very intentional. That's what I found personally.

MELANIE: Well, if someone is eating 10 or 15 grams of fiber, how can they increase it to 25-30 grams? Let's talk about that.

KARA: Yeah. So first of all, the best sources of fiber are going to be vegetables, vegetables, vegetables. Certain vegetables are very high in fiber, like sweet potatoes, beets, artichokes, brussels sprouts, greens. Think about collard greens, kale, and Swiss chard. Maybe some mustard greens or turnip greens, and beet greens. Those are all very, very rich in fiber.

MELANIE: Great in fiber. And there are so many ways to get fiber: asparagus, broccoli, cauliflower, carrots, celery. Any bit of fiber matters. It adds to that total.

KARA: It all adds up. Let's not forget about nuts and seeds, avocados, legumes, berries and apples. Melanie, a few weeks ago you had shared with me something called, I think it was a slurry, something that you whip up at home as a way to just make sure you're getting the adequate amount of daily fiber.

MELANIE: We can't know what we know and not come up with some of the things. So it is not of the faint of heart. So what I do is I mix equal parts of various fibers. This week I'm actually using basil seeds, which are similar to chia seeds, but they're a little higher in fiber and antioxidants, omega 3s.

KARA: Do they smell like basil?

MELANIE: They don't.

KARA: Okay.

MELANIE: They don't smell, they're very similar to a chia seed. So I mix equal parts, either basil or chia, and ground flax, psyllium husk or psyllium seed. Either one will do.

KARA: Powder or capsules?

MELANIE: Powders. All powders. In a container, I just do equal parts. I just dump it in. And then I also do an acacia fiber because it's a great prebiotic; not terribly high in fiber, but it's a great prebiotics. I mix it all together. And then I do two tablespoons for my husband and I every day as sort of a fiber boost. And I will mix his sometimes equal parts organic unsweetened applesauce. He prefers it that way. I just mix my electrolytes, whisk it together and down it.

KARA: Okay. So you're in like a water?

MELANIE: It's just water. It's just water and my electrolytes. So that gives it some flavor.

KARA: Sure.

MELANIE: And then I have these tiny little whisks and I just whisk it up and pound it.

KARA: Kind of like an egg beater whisk?

MELANIE: Yeah; a little egg beater whisk, but they make them really tiny that fit into a glass.

KARA: Oh, nice.

MELANIE: So that's my slurry. And I will change the variety of fiber. So you're getting a benefit of prebiotic because fibers feed the good bacteria in our gut, which also help prevent colon cancer. And each different fiber feeds a different strain of bacteria. So it's a win win.

KARA: Yeah. Thank you for sharing that. Do you by chance know how many grams of fiber are in that or approximately?

MELANIE: It really depends on the mix that I have. On the average, I'm getting about 10 grams.

KARA: 10. Okay. Okay. So that's going toward your ideal 50 grams per day.

MELANIE: Correct.

KARA: So I tracked…

MELANIE: But you can see, it sounds like a fiber bomb, but you can see you have to, between the nuts, the seeds, the vegetables, the greens, it really is something you have to be very focused.

KARA: Yeah, you really do. When I tracked mine, I found that I was consuming 45 grams of fiber on average. I thought I would just share what that looks like in a day. And so what I had on this one particular day was half of a sweet potato. I had that with my eggs for breakfast. Later on, I made a protein shake in the blender and I included a cup of kale, a cup of berries, half of an avocado, and an additional two tablespoons of ground flax.

MELANIE: That’s your fiber bomb.

KARA: That was my fiber bomb was that the protein shake made up probably half, or maybe a third of the fiber for the day. Later I had an apple as part of a snack and then for dinner, my fiber was two cups of steamed broccoli. So that was 45 grams exactly. And you can see that there's no room for processed foods or refined foods when we're striving for this 50 grams per day of fiber.

MELANIE: So what I'm hearing is you're not pounding a bunch of Citrucel, Metamucil, MiraLAX, I mean all of these fiber medicinals. You're not really taking those in because along with those come chemicals, artificial sweeteners, food dyes, propylene glycol, you know, all these things that we don't want to be putting in our body, even though it makes us feel like we can go to the bathroom. You're getting nutrients, micronutrients, macronutrients, bioflavonoids, all these powerhouse fighters that also fight colon cancer.

KARA: Yeah. Yeah.

MELANIE: Whereas when you just take a fiber supplement that you bought at a drugstore, you're not getting any of that. And that's critical and important to fight cancer as well.

KARA: Yeah. That's interesting. I just was looking at a label of one of the products that you just mentioned and I saw the propylene glycol. I saw the two different types of artificial dyes, colorings, and then I think I saw two artificial sweeteners: sucralose and aspartame.

MELANIE: Yeah. Yeah.

KARA: Which are not, none of those things are good for our bodies.

MELANIE: Our bodies have to, they're so busy fighting chemicals right now; to add more chemicals, sometimes it's hard to fight a cancer cell. So we don't want our bodies distracted with all of these add ins that are not food and the body has to detox. And there seems to be a misconception about how to get fiber from our food sources.

People have been led to believe that the best forms of fiber are bread or cereal, like brand cereal. And there are a couple problems with trying to get fiber from bread or cereal. We don't want to demonize any certain food, but almost all bread and cereal has been highly refined and processed and will spike your blood sugar and bombard your bodies with too many starchy carbohydrates.

So elevated blood sugar all the time, puts you at risk for cancer. So it's defeating the purpose there. And bread and cereal are made from grains, often gluten grains, which so many people are sensitive to now. Your plan and what you ate, Kara, I think is a great plan and what a great example.

KARA: And it was delicious, you know, and I, I didn't talk about every detail of the proteins and healthy fats and other things that I ate, but, it was a very delicious way to accumulate 45 grams of fiber.

MELANIE: And if you're somebody who likes like a chia pudding and, or like I said, the basil seeds that I use very similar to a chia is that two tablespoons is 15 grams of fiber.

KARA: Oh, that is high. I'm going to check that one out of that.

MELANIE: So I do a variety, but that's the fiber punch.

KARA: Basil seed.

MELANIE: Basil seed.

KARA: Basil seed. That's new to me. Interesting. And when looking at labels, I've noticed that most bread only contains one to two grams of fiber per slice. And I also looked at a common brand cereal label. Again, in preparation for the podcast, I inundated myself with fiber.

MELANIE: Your fiber knowledge.

KARA: I know everything now. I was shocked to see that in the ingredients there were two types of artificial sweeteners: artificial color and a thickening agent in this particular brand cereal.

MELANIE: Yeah. Yeah. No good. And if you're wanting a cancer prevention eating plan, then artificial sweeteners, colors, other chemicals, like we said, they just need to be avoided and we want that our source to be fruits and vegetables, nuts and seeds to remind us that organic is always the best choice.

KARA: And a great resource that our listeners can refer to, it's the website, EWG.org. And that stands for the Environmental Working Group. It's a great website loaded with information and you can search for two things we'll explain called the Clean 15 and the Dirty Dozen lists.

MELANIE: Yeah. I love that. And it's important to avoid pesticides as much as possible because you're on a cancer prevention plan. In the Clean 15, it's a list of those vegetables and fruits sprayed with the least amount of pesticides. And the dirty dozen is exactly what it sounds like. It has the highest amount of pesticides.

If you're in the grocery store and you're like, Oh, I can't remember, I don't have time to look at it, one of the little tips is if you can put your fingernail through the produce or the leafy green or the fruit or the vegetable, it almost always should be organic. It's a tender membrane that covers that plant that the pesticides penetrate.

KARA: I like that rule of thumb.

MELANIE: No pun intended.

KARA: You’re full of all kinds of good tips today.

MELANIE: Yes. Yes.

KARA: Every time we record together, you're full of great tips.

Eat organic produce as a part of a colon cancer prevention plan

MELANIE: A colon cancer prevention plan will have a lot of fresh, organic, produce, rich in fiber, vitamins that have, they have minerals, antioxidants, plant nutrients, just like that tribe that we were talking about. It's also important to look at the foods that you're eating and focus on the highest possible quality, again, especially in the animal protein that you're eating as well.

Does eating red meat increase cancer risk?

KARA: Absolutely. Another misconception that we hear and read about is that eating red meat increases risk of cancer. The problem with those claims is that the studies did not look at people who were eating organic, pasture raised or grass meat. The problem with those claims is that none of the studies looked at people who were eating organic, pasture raised, or grass fed meat. If someone's eating conventionally raised beef or pork, or even poultry, eggs, and dairy, you're, they're getting the trickle down effect of all the unhealthy things that the animal was exposed to.

MELANIE: In these studies also, they did not look at what were they eating when they were eating their burgers? Were they having French fries? Were they having buns? Were they having beers? And were they having soda? This was not a factor that was looked at. So if you just look at someone who’s in a tribe who's just eating free range, meat sources from animals, they're not getting those inflammatory foods.

So, if a cow is given antibiotics and hormones to fatten it up more quickly to go to slaughter, we end up consuming those same antibiotics and hormones if we eat the meat. And beef cattle that are not raised on pasture will have more inflammatory omega-6 fats and fewer anti-inflammatory omega-3 fats that they get from the grass.

KARA: And if the cattle were grazing on food that was not organic, so maybe that food had been sprayed with pesticides. We also get traces of those pesticides and genetically modified organisms as well.

MELANIE: We don't want the nasty residue of what the animal has consumed. So that's why looking for high quality animal proteins from your grocery store, food co-op, or local farmer is one of the best colon cancer prevention measures that you can take. Look for organic, pasture raised, grass fed, organic pasture raised eggs, organic grass fed dairy;

Wild caught organic fish and organic poultry. I always encourage my clients, even if you know your grocery store doesn't carry it, and you're going there for something else, always ask because the squeaky wheel gets oiled.

KARA: Yeah. It's like the supply and demand, right? If the demand is there, eventually the supply will hopefully be there.

MELANIE: Yes.

Consume quality fats & oils

KARA: And of course, the quality of your oils and fats that you're consuming is important. Refined process oils create more inflammation in the body. And if you think about it, all cancer is stemming from inflammation. So we want to do everything we can to reduce inflammation. Just keep it simple with the oils that you have in your kitchen:

Grass fed butter, organic unrefined coconut oil, olive oil and avocado oil. And of course, just eating avocados or guacamole, that's wonderful. And eating olives. We would recommend avoiding nuts and seeds that are roasted in any type of oil because that oil does get damaged in the process.

MELANIE: Yeah, that's a really good point. And so, yeah, that's a good point. It can be a little confusing when we say nuts and seeds, and then you'll look on a label and it'll say sunflower oil. Or some sort of seed oil. So it's so highly processed. It's not a cold pressed seed oil and seed oils turn into a trans-fat when they're heated at a high amount. So it can be confusing. We're saying eat nuts and seeds, but avoid seed oils. And I hope that clears it up for a lot of people.

KARA: Yeah. Thank you for mentioning that. Cause we, we don't want people to get confused about that. They're two totally different things.

The importance of supporting a healthy microbiome

MELANIE: We talked about the importance of getting adequate fiber from organic vegetables and fruit. Another benefit that fiber has in the intestinal tract is that it feeds the gut microbiome. I touched on that with my slurry. The microbiome is a term we use for trillions of bacterial microbes we all have in our intestinal tract and eating enough fiber also helps to feed the good bacteria, which in turn helps with that prevention plan because they protect us.

KARA: Yeah, and the prebiotics and the good bacteria are important when preventing colon cancer because we need enough good bacteria to ward off those bad pathogens that have been linked to colon cancer. There was an article published in the journal called Science Direct. The researchers were looking at certain species of good bacteria, which we also refer to as probiotics, to see which ones were protective specifically against colon cancer.

I was very pleased to read that many of the species of probiotic that I take were on the good protective list. And so the study summarized probiotics prevent colorectal cancer by reducing the presence of certain cancer causing bacteria in the colon.

MELANIE: Do you remember what some of those strains were?

KARA: I knew you were going to ask that. The names are very hard to pronounce. But two of the species that we frequently talk about with, I'm sure you talk about it with certain clients, maybe class members, would be the Lactobacillus species and the Bifidobacteria species. And those are both in the probiotic supplement I personally take by Nutrikey. It's called Biotic 7. So the 7 just stands for that it has 7 different strains.

Drink adequate water to lower colon cancer risk

MELANIE: Yeah, I like that variety in a probiotic. And drinking enough water is also associated with lower risk of colon cancer. So get those water bottles. It gets back to keeping the tissues in the colon hydrated and speeding up bowel transit time as well as flushing out toxins. So if I made my slurry and didn't drink enough water, so I always do two glasses of water after the slurry because I, you don't want to be taking a bunch of fiber and turning it into concrete, right? We want to hydrate it. So it becomes a soft stool.

KARA: If you're wondering how much water you should be drinking, here's a good goal to strive for is half of your body weight in ounces. For example, if you weigh 180 pounds, your goal would be to drink 90 ounces of pure water every day. So basically three of those 32 ounce bottles.

Vitamin D deficiency is common in people with colon cancer

MELANIE: So there's another important nutrient that we want to talk about before we wrap up our podcast. And that's vitamin D deficiency. It's very common in people with in colon cancer. So in the U.S., 42 percent of adults have a vitamin D deficiency.

The rate is even higher for kids. A study published in the Journal of the Public Library of Science investigated over 1300 adults and they looked at vitamin D levels, metabolic risks, and colon polyps.

KARA: The conclusion of the study was that they found vitamin D deficiency was significantly associated with the risk of colon polyps, especially in adults over 50 and in women. Remember, colon polyps can slowly grow and progress into colon cancer anywhere from 10 to 15 years after they first start growing. So this is really important information about vitamin D.

MELANIE: Yeah. And everyone really should be tested and know what your vitamin D level is. It's a simple blood test. And even if insurance doesn't cover or pay for it, it's not a terribly costly test. And in the study, they considered a vitamin D level of 20 as being low. We would consider 20 as being very low. Ideally vitamin D levels should be in the range between 50 and 80.

KARA: And that healthy level that you mentioned, 50 to 80 will reduce the risk of many other diseases as well; not just colon cancer, but heart disease, diabetes, even things like being low energy or having a mood disorder such as depression or anxiety.

MELANIE: Yeah.

KARA: We need vitamin D.

MELANIE: Body aches. It's terrible when the D is low, but your risk for cancer goes up significantly if you're running a low vitamin D. So if the doctor says you're fine, ask them, what was my level? Because I've had clients, they were told at 30 that they were fine and they were exhausted, their body ached, they were hurting and we were able to turn that around.

KARA: Yeah, it's important to know what exactly is that number and then you can be in charge of your health going forward.

MELANIE: And that we have, you know, living in a northern climate in Minnesota, we have people say, well, in the summer I don't take vitamin D. And I ask them, are you sitting in the sun during prime time around their lunch hour in a bikini for an hour? Because that's what it takes to get adequate vitamin D. So walking without sunscreen and getting a little face on your, a little on your face and your arms is really not adequate.

Liver is high in vitamin D. You can also get it from egg yolks and fatty fish. But really, if your level comes back low, the best option always is to take a vitamin D supplement to raise that level. And the amount to take depends on what your level is. But a safe daily dose for adults is 5,000 international units. And I have been a dietitian for over 35 years. Never ever have I ever seen someone have toxicity level from vitamin D.

KARA: And there really is that fear. I was just talking with someone about this recently, who is vitamin D came back at 20 and I will just share that their provider suggested 2,000 international units per day. And I put my nutritionist hat on and I said, when I was meeting with clients, that level 2,000 per day is just not enough to really get that up to that good, healthy 50 to 80 range that we want.

Summary

MELANIE: Agreed. So many risk factors with a low vitamin D. We've given you a lot of information on colon cancer prevention. You know, we want to start with a baseline colonoscopy if you haven't had one and you're over the age of 45 or you have a risk factor. We want to make sure that you're getting lots of fiber: 50 grams of fiber through great real food sources such as lots of vegetables that are organic and nuts and seeds and fruit.

Also pasture raised meats and wild caught fish, pasture raised eggs. And then of course, keep your vitamin D up. That's a great beginning plan. If you need help in how to achieve all of this information in one package, that's what we are here for. The nutritionists and dietitians are always at the ready to help people who just want a plan put together to simplify it.

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Because our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thank you for listening to Kara and I today and have a great day.