Colorectal cancer is the third most commonly diagnosed cancer, and the third leading cause of cancer death in men and women in the United States. A recent study published in the British Journal of Cancer, involving over 5,000 women from the Women’s Health Initiative study, has found a link between high blood sugar levels and colorectal cancer in postmenopausal women.¹

At the beginning of the study, and on several more occasions over 12 years, fasting blood sugar and insulin levels were measured. At the end of the 12-year study, 81 women out of over 5,000 had developed colorectal cancer. Women with the highest blood glucose levels were twice as likely to have developed colorectal cancer as the women with the lowest levels.

The next step, the researchers stated, is to find the mechanism, or to find out how high blood sugar leads to colorectal cancer. The lead researcher, Geoffrey Kabat, Ph.D., states, “It’s possible that elevated glucose levels are linked to increased blood levels of growth factors and inflammatory factors that spur the growth of intestinal polyps, some of which later develop into cancer.” Other studies have found a link between elevated insulin levels, which occur as a result of prolonged elevation of blood sugar levels, and colorectal cancer.²

Elevated blood sugar does a whole lot more than lead to colorectal cancer. High blood sugar leads to insulin resistance, metabolic syndrome, type 2 diabetes, gestational diabetes, heart disease, non-alcoholic fatty liver disease (NAFLD), Alzheimer’s disease, and more. Furthermore, insulin resistance increases fat deposition which will lead to further production of inflammatory cytokines and more inflammation throughout the body.

Maintaining healthy blood sugar levels is crucial for optimal health. I recommend a glucose and insulin tolerance test, measuring glucose and insulin at one and two hours. Also, the A1c test is will help to measure how well blood sugar levels are managed over time, as it’s a measure of your average blood sugar level for the past two to three months.

If your blood glucose and insulin levels are out of normal range, you’re in trouble. In fact, if you are overweight, or if you have abdominal fat, you’re in trouble. Belly fat is considered to be an organ of its own,³ churning out pro-inflammatory cytokines, and contributing to many different chronic diseases. If you are overweight or have belly fat, it’s likely you also have elevated blood sugar or insulin, or that you’re heading in that direction, which leads down a path of chronic disease.

The Standard American Diet (SAD) is high in grain-based carbohydrates and low in vegetable-based carbohydrates, high in refined sugars and low in fiber, and high in unhealthy fats and low in healthy fats. All of these factors contribute to poor health. Elevated blood sugar and insulin levels occur as a result of eating the SAD diet. Change your diet if it’s not high in vegetables, healthy fats, leans proteins, seeds and nuts. These foods will help protect against high blood sugar levels.

References

1. G.C. Kabat, et al., “A longitudinal study of serum insulin and glucose levels in relation to colorectal cancer risk among postmenopausal women.” Brit J Cancer.2011 Nov 29; advanced online pub.
2. M.J. Gunter, et al., “Insulin, insulin-like growth factor-I, endogenous estradiol, and risk of colorectal cancer in postmenopausal women.” Cancer Res. 2008 Jan 1;68(1):329-37.
3. E.E. Kershaw and J.S. Flier, “Adipose tissue as an endocrine organ.” J Clin Endocrinol Metab. 2004 Jun;89(6):2548-56.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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“In the future, when you walk into a doctor’s surgery or hospital, you could be asked not just about your allergies and blood group, but also about your gut type.” This is a quote from ScienceDaily (Apr. 21, 2011) referring to a recent article in Nature Magazine. The study, published in Nature, also uncovers microbial genetic markers that are related to traits like age, gender and body-mass index. These bacterial genes could one day be used to help diagnose and predict outcomes for diseases like colorectal cancer, while information about a person’s gut type could help inform treatment.  Researchers found that the combination of microbes in the human intestine isn’t random, and that human gut flora can settle into three different types of communities or ecosystems. 

I would call this important work just “a start,” and would like to present some basic molecular biology to indicate the magnitude of the problem of trying to classify bacterial communities.   We now know we have over 1000 species of bacteria in our intestinal tracts, all of whom have their own thousands of genes as well as their own epigenetic codes regulating their genes. 

Here’s a primer on the epigenetic code: The epigenetic code (or epigenome) is in part a group of enzymes and methyl groups that attach to, and act on, genes. This ongoing active process allows some genes to be expressed, and other genes to be silenced. 

The epigenome responds to most every stimulus coming to the gut bacterial cell’s surface receptors, ranging from food (which can be beneficial or harmful), good or poor hydration, eustress (good stress) or distress; other stimuli include competing or complementary bacteria, viruses and fungi which can team together in biofilms (like a microbial city) in the gut lumen. Other major factors which could affect epigenomic actions are the hormones, growth factors, vitamins, immune factors, and  cytokines which continuously send signals into the bacterial cells to affect epigenetic expression. The resultant expression of genes will then direct the bacterial cells to do what they were meant to do: namely, live in a harmonious symbiotic relationship with us, the host, or remain in a state of alert, which may cause them to stop aiding the host, and become more parasitic in nature.

The above mentioned article did not in their paper find a significant connection between diet and gut bacterial balance.  However, there are many studies that do.  I found one as recently as May 2011.  Here is the summary of the article: “After 4 weeks, weight-loss diets that were high in protein but reduced in total carbohydrates and fiber resulted in a significant decrease in fecal cancer-protective metabolites and increased concentrations of hazardous metabolites. Long-term adherence to such diets may increase risk of colonic disease.”¹ 

The article points out that a low fiber, high protein diet causes biochemical changes to occur on a bacterial level.  First, without adequate amounts of soluble fiber the beneficial gut bacteria cannot produce short chain fatty acids (SCFAs), especially butyrate, which is the choice food of the colonic lining epithelial cells, and a preventer of damaged colonic cells from becoming cancerous.  In addition, the action of the gut bacteria on cooked meat creates increased proportions of branched-chain fatty acids, and concentrations of phenylacetic acid and N-nitroso compounds, which can lead eventually to inflammation and cancer of the colon. 

The source of bacterial production of both beneficial SCFAs as well as harmful chemicals comes from epigenetic and genetic changes which lead to the production of these chemicals. I believe we are proving daily that lifestyle changes including: a healthy, 80 percent plant-based diet, good hydration, sleep, exercise, elimination, and stress reduction all help to program our bacterial biomass as much as it does our bodies. Remember there are about 100 trillion bacteria and we have only about 10 trillion cells so we are outnumbered at least 10 to 1 in terms of genes and metabolic activity, so we need to take care of our “guests” as well as ourselves! Just as important as what bacteria are in our guts, is what else passes through and affects our guts. We must be able to step back and look at the entire picture, rather than simplifying it to “three gut types.”  

1. W.R. Russell, et al., “High-protein, reduced-carbohydrate weight-loss diets promote metabolite profiles likely to be detrimental to colonic health.” Am J Clin Nutr. 2011 May;93(5):1062-72. Epub 2011 Mar 9.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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allergies, bacteria, beneficial, biofilms, butyrate, chemicals, colon, colorectal cancer, diet, elimination, epigenetic, epigenetic code, epithelial cells, exercise, fiber, food, fungi, good hydration, gut bacteria, gut bacterial balance, gut lumen, gut type, harmful, healthy, hormones, human gut flora, immune, inflammation, Intestine, lifestyle, low-fiber, metabolic activity, metabolites, microbes, parasitic, protein, short-chain fatty acids, sleep, soluble fiber, stress, stress reduction, symbiotic, Virus, vitamins

Notable News – I know I sound like a broken record when it comes to red meat, but  believe me, it’s really bad for you. On top of being loaded with saturated fat, studies confirm that red meat increases your risk of developing lung cancer and colorectal cancer, and now it’s being blamed for yet another health problem – prostate cancer.  I know, you were probably bought up on steaks, burgers, hotdogs and  bologna sandwiches – good all-American diet – but it’s time to rethink red meat.

Guys, listen up! Eating red meat (in addition to processed meats, which are loaded with cancer-causing nitrates) has been associated with a 9 percent increase in prostate cancer, and a 28 percent increase in advanced prostate cancer. That’s pretty scary stuff if you ask me!

Not to mention, cooking red meat to the point of charring it (you know, like when you see those black grill marks on your steak?) adds dangerous carcinogens called HCAs (short for heterocyclic amines). Makes me want to reach for that glass of red wine – at least there’s some healthy proanthocyanadins there!

Need any more reasons to avoid red meat? I don’t think so!

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carcinogens, colorectal cancer, lung cancer, nitrates, processed meats, prostate cancer, red meat, saturated fat