Research Into Diet and Cancer
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Can you imagine a research project that follows 520,000 people in ten different countries to discover the links between cancer and diet? It sounds impossible but it''s happening right now in Europe and is called EPIC - European Prospective Investigation into Cancer and Nutrition. Because this is a European based study, it has received very little publicity in the USA although it''s findings are being followed with interest by experts in the field. So far it it has published over 70 scientific papers on the relationship between diet and cancer.“We believe this study represents a unique opportunity to find and map the specific connections between diet and chronic disease that other, smaller studies have had a harder time detecting,” said Ritva Butrum, Ph.D., AICR Scientific Advisor. “It’s time this ambitious project got the US attention it deserves.”Elio Riboli, Ph.D., of Imperial College in London, is co-ordinating the project that began in 1992 and is receving substantial from the European Commission. The countries involved are:France
Studies into the relationships between diet and cancer work best, Butrum says, when two conditions are met:There are enough participants to allow a comparatively rare disease like cancer to show up in sufficiently large numbers of study subjects, and
The participants’ diets are different enough from each other to make comparing their intakes of specific foods possible. Unlike in American diet, which features uniformly narrow ranges of intake for many foods, the European diet is a study in contrasts.
“The fact that diets differ so greatly across Europe -- think of Norway vs. Greece, for example -- makes the continent a vast, living laboratory, perfect for studying the effect diet on disease,” says Dr Riboli.Unlike many large scale studies, this one doesn''t rely only on questionaires, participants keep food diaries and regularly have blood samples taken. “Collecting and storing blood samples is a daunting and expensive task, and that’s why US cohorts tend to stick to questionnaires only, or collect from small subsets of study participants,” said Butrum. “EPIC researchers have access to over half a million blood samples, and this vast store of data allows for an unprecedented level of analysis.”Specifically, the EPIC researchers are using the blood data to:Verify the diets of subjects by checking their self-reported dietary intake against blood levels of various food components;
Correlate blood levels of specific food components (such as carotenoids or fatty acids) with cancer rates;
Determine, through DNA analysis, how the subtle genetic differences that occur among individuals influence susceptibility to cancer;
Reveal, for the first time, the role of newly emerging factors that affect cancer risk, such as hormones other hormone-like substances in the blood
Major Findings Strengthen Diet-Cancer Link, More to Come
Already, nearly 40,000 cancer cases haveoccurred in the study population, a figure which will continue to rise as the study continues. The researchers have found that consumption of meat sharply increased risk of stomach cancer and esophageal cancer. For every 100 grams (about 3ozs) of meat eaten by subjects,the risk for stomach cancer more than tripled. In addition to total meat, intakes of red meat and processed meat were each independently associated with incidence of stomach cancer, though less strongly. The authors also found that the association between meat intake and stomach cancer was considerably stronger among subjects with populations of H. pylori bacteria in their stomachs. For every 100 grams of meat consumed by subjects with H. pylori, their risk of stomach cancer was 5 times higher. (Although about 2/3 of the world population is infected by H. pylori, in Europe and the U.S. the infection rate is thought to be closer to 25 percent.) Cancer and Obesity
Another recent finding from EPIC was published in the July 5, 2006 issue of the Journal of the National Cancer Institute. In this article, EPIC researchers found that two indicators of abdominal obesity, waist circumference and waist-to-hip ratio, were strongly associated with colon cancer risk in both sexes. Men with the largest waist circumference had 39% higher risk of colon cancer than men with the smallest, for example, while women with the largest waist circumference has a 48% higher risk than women with the smallest waists. Breast Cancer and Insulin Resistance
A study appearing in the August 1, 2006 issue of the International Journal of Cancer analyzed the blood of 1,141 EPIC participants with breast cancer and compared it to the blood of 2,204 matched subjects without breast cancer. Among women over 60 whose blood was given under “non-fasting” conditions, high levels of serum C-peptide a state of affairs that could reflect “insulin resistance,” long suspected of contributing to cancer risk was associated with a doubling of breast cancer risk. In a study scheduled for publication in September, EPIC researchers will report that risk for oral and pharyngeal cancers drop by 9 percent for every 80 grams of vegetables and fruits consumed per day. (Note: 80 grams is approximately a single serving. The average American consumes approximately 4 servings, or 320 grams, of vegetables and fruits per day.)Findings so Far
As these data begin to mount, Dr. Riboli is already noticing the emergence of some definite trends. “Certainly we can say that globally, diets that are high in fruits, vegetables, fiber and fish are associated with greater protection against cancer in general,” he says. "We also see that obesity and sedentary lifestyles are shaping up to be much larger factors in increasing cancer risk that was previously thought. Diets high in meat, especially processed meats such as cold cuts, hot dogs, bacon and sausage are also consistently associated with higher risk".Riboli admits that the associations between diet and cancer observed so far haven’t been uniformly strong, but points to the fact that the study only published its first results in 2001. As time goes on and occurrences of cancer increase in the study population, it’s likely that links will become easier to observe. He also stresses EPIC’s unique ability to analyze “multi-factoral” models overall dietary patterns in addition to links to specific foods in isolation such as fish, vegetables, meat, etc.
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