Colorectal Cancer Prevention

Whole grains are the seeds of cereal plants including wheat, rye, barley, oats and rice. There is strong evidence that eating plenty of wholegrains and dietary fibre can reduce your risk of colorectal cancer. A review of 6 studies which included 8,320 people showed that eating 90g of wholegrains every day reduces the risk of bowel cancer by 17%! Fruit and vegetables also contain fibre and a range of different vitamins, minerals and antioxidants so choose all colours of the rainbow to get the most benefit! Wholegrains and fibre can protect us against cancer as they are rich in vitamins and minerals, can bind to other compounds that can cause cancer stopping them from causing damage, help regulate our blood sugar levels, dilute the contents of our poo and help us to open our bowels more often. This reduces the time that toxins are in contact with the lining of our bowel, therefore reducing the risk of damage.

Tips on how to increase your intake of wholegrains, fruit and vegetables:

Choose high fibre cereals such as All Bran, porridge, Fruit and Fibre, Weetabix or homemade granola with lots of nuts and seeds for breakfast. Porridge is also a good option. Add fresh fruits to your breakfast cereal such as banana, berries, dried cranberries or raisins. Choose fresh fruit, a handful of nuts or seeds, an oat-based cereal bar, oat or wholegrain rice cakes or crackers with nut butters or salad as a snack. Mix nuts, seeds and fruit into yogurt. Have a wholemeal sandwich at lunch with carrot sticks and hummus or fruit after. Try homemade vegetable soup with rye bread – make a large batch and freeze it. Have brown pasta/rice/spaghetti with a variety of vegetables at dinner time. Add pulses and beans to dishes instead of red meat. Eat sweet potato and white potatoes with the skins on as most of the fibre is found in the skin.3. Be a healthy weight and as lean as possible – Aim to have a healthy weight and body mass index (the healthy BMI range is between 18.5-24.9kg/m²).

There is strong evidence that having a high level of body fat and being overweight or obese can increase the risk of colorectal cancer. When people are overweight or obese, there is more insulin present in the body and more fat cells which can stimulate the body’s inflammatory response and promote the growth of cancer cells. Being a healthy weight also reduces your risk of other chronic health conditions such as other cancers, heart disease, diabetes and stroke. It is easy for your weight to gradually creep up as eating just 100 calories per day more than you need can increase your weight by around 11lbs a year! Your BMI is based on your height and weight and can be worked out by dividing your weight in kilograms by your height (in metres) squared.

Tips to lose weight:

Aim for a steady realistic weight loss of 0.5 – 2lbs per week

Start the day with a healthy breakfast option and aim for three regular meals per day.

Increase your intake of wholegrains, fruit and vegetables as these foods are high in fibre which keeps you feeling fuller for longer and are lower in calories so make healthy snacks.

Minimise your alcohol intake or avoid it completely as it provides ‘empty calories’.

Do regular physical activity as outlined above to burn off extra calories to aid weight loss.

At mealtimes, aim to have ½ your plate filled with salad/vegetables/fruit, ¼ filled with a lean protein food (eg. grilled, baked or poached chicken/fish/turkey/eggs) and ¼ filled with a wholegrain carbohydrate food (brown or wholegrain bread/pasta/rice/spaghetti/potatoes with skins on). Watch you portion sizes!

Aim to drink 2L of fluid per day. Avoid high calorie/sweetened/full sugar drinks and choose water or low calorie/diet versions of squash or fizzy drinks or tea/coffee without sugar instead. Limit fruit juice to one 150ml glass per day and choose ‘skinny’ hot milky drinks where possible.

Keep a food and activity diary and monitor your weight weekly to track your progress and keep you focused.

Make two or three realistic changes to begin with (eg. I will have 3 portions of fruit every day) and once these become a habit, make another small change.

The occasional slip up is normal – just start again to get back on track.

Calcium is important at all ages for strong bones and teeth. Adults need 700mg of calcium per day and this is higher in people with other conditions like osteoporosis. There is strong evidence that consuming dairy products can reduce the risk of colorectal cancer.

Tips to get enough calcium:

Aim for 3 portions of dairy per day such as 200ml glass of milk, a matchbox sixe of cheese and a medium 120g pot of yoghurt.

Choose low fat options, as they have the same calcium content but less calories if you are trying to lose weight.

Choose calcium enriched products wherever possible, including lactose-free alternative products (rice/oat/almond/soya milk and yoghurt), bread and cereals.

If you dislike dairy products, eat more fish and calcium fortified cereals and bread. You may need to consider taking a calcium supplement if you cannot get enough calcium from your diet.5. Drink alcohol in moderation, if at all

There is strong evidence that drinking >30g or 2 drinks of alcohol per day causes colorectal cancer. Any increase in alcohol intake can increase the risk of cancer so try limit it as much as possible. It is thought to cause cancer as it is broken down into a chemical called acetaldehyde by our liver which can damage cells, it can induce oxidative stress through increased production of reactive oxygen species which damages our cells, increases levels of hormones, can increase the absorption of other cancer-causing chemicals such as tobacco and can interfere with our body’s ability to repair our DNA or genes. Alcoholic drinks contain a lot of calories too so this can contribute to weight gain and more body fat which we know is strongly linked to increasing cancer risk. One large 250ml glass of wine contains about 190 calories which is similar to a butter croissant or packet of crisps!

Tips to cut down on alcohol:

Set a limit for how much alcohol you will drink or money you will spend on a night out Alternate between an alcoholic and non-alcoholic drink (eg. have a glass of water or diet soda drink in between). Use diet versions of drinks to mix with spirits and dilute it more than usual. Try white wine as a spritzer mixed with sparkling water or add soda water and a no-added sugar lemon or lime squash to gin. Try to reduce the size of your drink – choose a half pint, small can, small glass or single measure. Use a smaller wine glass. Sip your drink slowly to make it last longer. Let friends and family know if you are trying to cut down so they can support you.

There is strong evidence that eating processed meats (such as bacon, sausages, chorizo, ham, salami, burgers) can increase your risk of colorectal cancer. This may be due to the nitrates and nitrites that are added to foods to preserve them which are broken down into harmful compounds by our body which can cause cancer. Eating too much red meat can also be harmful as haem, the compound that gives meat its red colour, can also be broken down in our body to form cancer causing compounds that could damage the lining of our bowel.

Tips to reduce our processed and red meat intake:

Aim for no more than 3 portions of red meat per week (~ 350–500g cooked weight). One portion is about size of the palm of your hand. Use more beans, pulses, lentils, poultry, eggs, fish and tofu instead. Keep some days meat-free.

Following a healthier lifestyle including a healthy balanced diet, regular physical activity and being a healthy weight can improve your overall health as well as reduce your risk of cancer, so try to make small changes using the tips and advice above that you can continue long term within your day to day life.