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Rather than being protective against colon cancer,
as previously thought, soluble
dietary fiber may actually increase the risk of adenomas,
which are a type of polyp that are most likely to become cancerous.
The fiber used in the study was from ispaghula husk,
which is very similar to psyllium, a fiber derived from plant husks that
is found in many bulk laxatives.
The authors note that their results should not discourage
people from eating a diet rich in plant foods, since these foods have
been shown to lower the risk of many other disorders such as heart disease
and other forms of cancer.
Researchers studied 665 patients from 10 countries
who were already at high-risk of cancer because they had polyps in their
colon.
Study participants were given either:
- 3.5 grams of ispaghula husk fiber
- 2 grams of calcium in supplement form
- Placebo
After 3 years, patients had a colonoscopy -- a procedure
in which a doctor examines the inside of the colon for growths.
The fiber supplemented group had a 67%
increased risk of having at least one adenoma developed during the 3-year
period in comparison with the control group.
Patients in the calcium group
had a 34% decreased risk.
"Our study...suggests that low-fat, high-fiber
diet...may not be effective strategies for the prevention of colorectal
adenoma recurrence," Dr. Claire Bonithon-Kopp, the study's lead
author, and colleagues conclude.
In an accompanying editorial, Dr. Bernard Levin from
M.D. Anderson Cancer Center in Houston, Texas points to the need to find
more effective therapies for colorectal adenomas. He notes that worldwide
about 875,000 of colorectal cancer are diagnosed annually, accounting
for approximately 8.5% of all new cancer cases. In addition, it is the
second most common cause of cancer deaths in the USA and the fourth most
commonly occurring cancer.
According to Dr. Levin, " ... it
seems likely from this report and other recent trials that supplementation
with dietary fiber is not of benefit in preventing recurrence of colorectal
adenoma."
The
Lancet October 14, 2000;356:1286-1287, 1300-1306
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