Flavonoids Found to Help Colorectal Health
By Greg Arnold, DC, CSCS, June 18, 2008, abstracted from “Dietary Flavonoids and Colorectal Adenoma Recurrence in the Polyp Prevention Trial” in the June 2008 issue of Cancer Epidemiology Biomarkers and Prevention
Colorectal cancer is the second leading cause of death from cancer (behind lung cancer) in the United States. It claims more than 55,000 Americans each year and poses a risk for nearly 1 in 4 Americans (80 to 90 million) because of age or other factors. It affects both men and women equally1.
Fortunately, a number of ways are available to help colon health, including calcium2, conjugated linoleic acid3, vitamin B64, green tea5, fiber6, olive oil7 apples8 and omega-3 fats9. Now a new study10 has found that flavonols, a group of over 5,000 compounds11 contained in almonds12 as well as fruits and vegetables13 that benefit colon health14, pancreas health15, and breast cell health16, may also help colorectal health.
In the study, researchers analyzed data on over 1,900 patients who participated in the Polyp Prevention Trail (PPT). This was a four-year randomized, multi-center, nutritional intervention trial that evaluated whether following a high-fiber diet (18 grams of fiber per 1,000 calories), high-fruit and high-vegetable (5 servings per day), and low-fat (no more than 20% of total calories) diet is effective in inhibiting colorectal adenoma recurrence17. The researchers found that total flavonoid intake did not significantly reduce the risk of having a recurrence of colorectal adenomas. However, there was a 36% reduced risk of having an advanced recurrence of adenomas in the highest flavonoid intake group (more than 106 mg per day) compared to the lowest intake (less than 51 mg per day).
When looking at specific flavonoids, they found that flavonols (more than 17.3 mg per day compared to less than 8.12 mg per day) and isoflavonoids (more than 0.133 mg per day compared to less than .045 mg per day) produced a 76% and 54% reduced risk of any recurrence, respectively. Flavonols are found mostly in apples, beans, broccoli, and onions while isoflavonoids are found mostly in bean and soy products.
For the researchers, “our data suggest that a flavonol-rich diet may decrease the risk of advanced adenoma recurrence.”
2 Meunier, P. J. (1999). "Calcium, vitamin D and vitamin K in the prevention of fractures due to osteoporosis." Osteoporos Int 9 Suppl 2: S48-52
3 Larsson SC. High-fat dairy food and conjugated linoleic acid intakes in relation to colorectal cancer incidence in the Swedish Mammography Cohort. Am J Clin Nutr 2005 82: 894-900
4 Theodoratou E. Dietary Vitamin B6 Intake and the Risk of Colorectal Cancer. Cancer Epidemiol Biomarkers Prev 2008 17: 171-182 doi: 10.1158/1055-9965.EPI-07-0621
5 Yong G. Prospective Cohort Study of Green Tea Consumption and Colorectal Cancer Risk in Women. Cancer Epidemiol Biomarkers Prev 2007 16: 1219-1223 doi: 10.1158/1055-9965.EPI-07-0097
6 Jacobs ET. Fiber, sex, and colorectal adenoma: results of a pooled analysis. Am. J. Clinical Nutrition, Feb 2006; 83: 343 – 349
7 Gill, C. I., A. Boyd, et al. (2005). "Potential anti-cancer effects of virgin olive oil phenols on colorectal carcinogenesis models in vitro." Int J Cancer 117(1): 1-7
8 Waldecker M. Histone-deacetylase inhibition and butyrate formation: Fecal slurry incubations with apple pectin and apple juice extracts. Nutrition 2008; 24(4): 366-374
9 Hall MN. A 22-year Prospective Study of Fish, n-3 Fatty Acid Intake, and Colorectal Cancer Risk in Men. Cancer Epidemiol Biomarkers Prev 2008 17: 1136-1143 doi: 10.1158/1055-9965.EPI-07-2803
10 Bobe G. Dietary Flavonoids and Colorectal Adenoma Recurrence in the Polyp Prevention Trial. Cancer Epidemiol Biomarkers Prev 2008 17: 1344-1353 doi: 10.1158/1055-9965.EPI-07-0747
11 Aherne SA, O'Brien NM. Dietary flavonols: chemistry, food content, and metabolism. Nutrition 2002;18:75–81
12 Milbury, P; Chen, CY; Dolnikowski, G; Blumberg, J; Determination of Flavonoids and Phenolics and Their Distribution in Almonds. J. Agric. Food Chem 2006; 54:5027-5033
13 Erdman JW Jr, Balentine D, Arab L, et al. Flavonoids and heart health: proceedings of the ILSI North America Flavonoids Workshop, May 31–June 1, 2005, Washington, DC. J Nutr (2007) 137:718S–37S
14 Rossi M. Flavonoids and Colorectal Cancer in Italy. Cancer Epidemiol Biomarkers Prev 2006 15: 1555-1558
15 Bobe G. Flavonoid Intake and Risk of Pancreatic Cancer in Male Smokers (Finland). Cancer Epidemiol Biomarkers Prev 2008 17: 553-562 doi: 10.1158/1055-9965.EPI-07-2523
16 Dietary flavonoid intake and Breast Cancer risk among women in the long island Breast Cancer study project”. Abstract #4014 at the 97th Annual Meeting of the American Association in Cancer Research.
17 Lanza E, Schatzkin A, Ballard-Barbash R, et al. The polyp prevention trial II: dietary intervention program and participant baseline dietary characteristics. Cancer Epidemiol Biomarkers Prev 1996;5:385–92
New fecal test for colon cancer
RanplexCRC is a diagnostic test that can detect 28 polymorphisms associated with colorectal cancer in a single stool sample. It does not require a hospital visit or dietary restrictions, while having greater sensitivity than the currently used Faecal Occult Blood (FOB) screening test. RanplexCRC may more accurately profile patients and reduce the number of patients for colonoscopy, saving time and resources and reducing patient discomfort.
Most sporadic colorectal cancers follow a well recognised progression from normal cells through adenoma (abnormal glandular growths) to cancer, driven by mutations in a small number of genes. RanplexCRC can simultaneously detect 28 mutations from four key genes in cancer or pre-cancer cells shed into the bowel. Selected mutations present in APC, KRAS, BRAF and Tp53, along with wild-type control sequences, are represented on 2 biochips detected using Randox's Biochip Array Analysers.
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Bowel (colorectal) cancer is the second largest cause of cancer mortality in the western world, but up to 90% curable if detected early. Unfortunately, most patients present with advanced disease, reducing their long term survival. National Screening programmes are being introduced throughout Europe, to reduce CRC mortality, using the FOB test. This cheap and non-invasive test detects blood in stool samples, which may be an indication of a tumour. Patients with a positive FOB test are then referred for colonoscopy. The FOB test, however, suffers from poor sensitivity, as not all tumours bleed (false negative test) and not all stool-blood is derived from tumours (false positive test). Many patients (up to 50%) may therefore be sent for colonoscopies unnecessarily. Colonoscopies are invasive, involve dietary restrictions and require the presence of a surgeon, so an intermediate test would benefit both the patient and the healthcare system. RanplexCRC provides the answer, filtering out false positives.
Randox is an international diagnostics company, headquartered in the UK. Randox develop, manufacture and market clinical diagnostic products worldwide. Core products are: Biochip Array Technology; clinical chemistry analysers and reagents; quality controls and EQA; environmental diagnostics; recombinant proteins and antibodies.