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Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber.
Am J Gastroenterol. 1999 May; 94(5):1373-80.AJ

Abstract

OBJECTIVE

To investigate whether the rarity of colon cancer in black Africans (prevalence, < 1:100,000) can be accounted for by dietary factors considered to reduce risk, and by differences in colonic bacterial fermentation.

METHODS

Samples of the adult black South African population were drawn from several rural and urban regions. Food consumption was assessed by home visits, food frequency questionnaires, computerized analysis of 72-h dietary recall, and blood sampling. Colonic fermentation was measured by breath H2 and CH4 response to a traditional meal, and to 10-g of lactulose. Cancer risk was estimated by measurement of epithelial proliferation indices (Ki-67 and BrdU) in rectal mucosal biopsies. Results were evaluated by comparison to measurements in high-risk white South Africans (prevalence, 17:100,000).

RESULTS

Epithelial proliferation was significantly lower in rural and urban blacks than whites. The diets of all the black subgroups were characterized by a low animal product and high boiled maize-meal content, whereas whites consumed more fresh animal products, cheese, and wheat products. Blacks consumed below RDA quantities of fiber (43% of RDA), vitamin A (78%), C (62%), folic acid (80%) and calcium (67%), whereas whites consumed more animal protein (177% of RDA) and fat (153%). Fasting and food-induced breath methane production was two to three times higher in blacks.

CONCLUSIONS

The low prevalence of colon cancer in black Africans cannot be explained by dietary "protective" factors, such as, fiber, calcium, vitamins A, C and folic acid, but may be influenced by the absence of "aggressive" factors, such as excess animal protein and fat, and by differences in colonic bacterial fermentation.

Authors+Show Affiliations

Gastrointestinal Clinic, Groote Schuur Hospital and University of Cape Town Observatory, South Africa.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10235221

Citation

O'Keefe, S J., et al. "Rarity of Colon Cancer in Africans Is Associated With Low Animal Product Consumption, Not Fiber." The American Journal of Gastroenterology, vol. 94, no. 5, 1999, pp. 1373-80.
O'Keefe SJ, Kidd M, Espitalier-Noel G, et al. Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber. Am J Gastroenterol. 1999;94(5):1373-80.
O'Keefe, S. J., Kidd, M., Espitalier-Noel, G., & Owira, P. (1999). Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber. The American Journal of Gastroenterology, 94(5), 1373-80.
O'Keefe SJ, et al. Rarity of Colon Cancer in Africans Is Associated With Low Animal Product Consumption, Not Fiber. Am J Gastroenterol. 1999;94(5):1373-80. PubMed PMID: 10235221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber. AU - O'Keefe,S J, AU - Kidd,M, AU - Espitalier-Noel,G, AU - Owira,P, PY - 1999/5/11/pubmed PY - 1999/5/11/medline PY - 1999/5/11/entrez SP - 1373 EP - 80 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 94 IS - 5 N2 - OBJECTIVE: To investigate whether the rarity of colon cancer in black Africans (prevalence, < 1:100,000) can be accounted for by dietary factors considered to reduce risk, and by differences in colonic bacterial fermentation. METHODS: Samples of the adult black South African population were drawn from several rural and urban regions. Food consumption was assessed by home visits, food frequency questionnaires, computerized analysis of 72-h dietary recall, and blood sampling. Colonic fermentation was measured by breath H2 and CH4 response to a traditional meal, and to 10-g of lactulose. Cancer risk was estimated by measurement of epithelial proliferation indices (Ki-67 and BrdU) in rectal mucosal biopsies. Results were evaluated by comparison to measurements in high-risk white South Africans (prevalence, 17:100,000). RESULTS: Epithelial proliferation was significantly lower in rural and urban blacks than whites. The diets of all the black subgroups were characterized by a low animal product and high boiled maize-meal content, whereas whites consumed more fresh animal products, cheese, and wheat products. Blacks consumed below RDA quantities of fiber (43% of RDA), vitamin A (78%), C (62%), folic acid (80%) and calcium (67%), whereas whites consumed more animal protein (177% of RDA) and fat (153%). Fasting and food-induced breath methane production was two to three times higher in blacks. CONCLUSIONS: The low prevalence of colon cancer in black Africans cannot be explained by dietary "protective" factors, such as, fiber, calcium, vitamins A, C and folic acid, but may be influenced by the absence of "aggressive" factors, such as excess animal protein and fat, and by differences in colonic bacterial fermentation. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10235221/Rarity_of_colon_cancer_in_Africans_is_associated_with_low_animal_product_consumption_not_fiber_ DB - PRIME DP - Unbound Medicine ER -