- New research adds to the growing body of evidence suggesting that environmental factors, including the consumption of red meat and sugar, may contribute to the rising occurrence of colorectal cancer among young people.
- The research revealed that individuals under 50 years old diagnosed with colorectal cancer had lower levels of citrate—a byproduct of food conversion to energy—compared to older patients.
- The study also found significant differences in protein and carbohydrate metabolism, indicating that the consumption of red meat and sugar could potentially play a role in the development of colorectal cancer in younger age groups.
A new study is suggesting that eating red meat and sugar may contribute to colorectal cancer among young people.
According to the researchers, there has been a significant surge in the diagnosis of colorectal cancer among younger individuals over the past two to three decades.
The exact reason behind this alarming trend has remained unclear, as the majority of cases are not associated with genetic or hereditary factors, even among the younger population.
However, with the recent data obtained, there is now supporting evidence for the hypothesis that environmental factors may be responsible for this increase.
Researchers also discovered that individuals below the age of 50, who were diagnosed with colorectal cancer, had reduced levels of citrate. Citrate is produced during the conversion of food into energy and was found to be lower in comparison to older individuals diagnosed with colorectal cancer.
The findings of the research were presented at the annual meeting of the American Society of Clinical Oncology (ASCO) on June 3, 2023. The study is yet to be published in a peer-reviewed scientific journal.
Dr. Suneel Kamath, senior author of this research and a gastrointestinal oncologist at Cleveland Clinic, told Medical News Today that “our study used a technology called metabolomics, the study of breakdown products and production building blocks for our bodies, to look for differences in colorectal cancer in young people versus people that are older that developed colorectal cancer.”
“Because metabolomics measures how each individual interacts with the exposures in our environment like diet, air quality, etc., it is a way to bridge the gap between our nature (determined by genetics) and nurture (determined by our exposures). We found that a carbohydrate breakdown product called citrate (also called citric acid) is found at higher levels in older people with colorectal cancer compared to young-onset colorectal cancer.”
— Dr. Suneel Kamath
To conduct their study, the research team utilized samples from the Cleveland Clinic BioRepository, focusing on patients diagnosed with stage I–IV colorectal cancer.
They categorized the patients into two groups based on age: those younger than 50 years and those older than 60 years.
The study included 170 participants diagnosed with colorectal cancer, with 66 individuals having young-onset colorectal cancer and 104 having average-onset colorectal cancer.
Through association analyses, the researchers identified several metabolites that displayed differing levels between the two groups, including citrate and cholesterol.
They observed significant alterations in metabolic pathways related to carbohydrate and protein metabolism in young-onset colorectal cancer compared to average-onset colorectal cancer.
These findings indicate that factors such as excessive consumption of sugar-sweetened beverages or red meat as well as obesity, which contribute to an excess of energy, may be risk factors for the development of colorectal cancer at a younger age.
Dr. Leonard Augenlicht, professor of medicine and cell biology at the Albert Einstein College of Medicine, who was not involved in the research, told MNT that this research highlights a critical issue: “the tremendous increase in earlier onset colorectal cancer in younger individuals of the U.S. and other populations.”
“There is a very rich literature that dietary patterns play a major role in colon cancer incidence in general. Compelling data come from population studies: the much higher incidence of colon cancer in populations of industrialized countries consuming a ‘western-style’ diet, and relatively rapid shifts in incidence as developing countries undergo westernization of their diet, or individuals migrate from low-incidence to higher incidence countries.”
— Dr. Leonard Augenlicht
“Thus, the study reported from the Cleveland Clinic is highly significant in potentially identifying major components of the ‘western-style’ diet that may be driving earlier onset of disease,” Dr. Augenlicht explained.
“The findings raise important questions. First, it appears that this was a study of the metabolome—small molecules derived from metabolism of more complex compounds—of banked tumor samples, comparing tumor tissue from younger vs. older patients,” he said.
“Thus, the study is highly informative for differences in the nature of the tumors with age, but not necessarily in how they got to be different – the dietary patterns that led to, and perhaps drove, this difference in tumors of younger vs. older individuals,” he added.
Dr. Augenlicht noted the importance of identifying the factors behind metabolomic differences related to cancer risk is challenging due to the complexity and variability of the human diet, as well as the interactive nature of nutrients in affecting cell programming.
Dr. Anton Bilchik, Ph.D., surgical oncologist and division chair of general surgery at Providence Saint John’s Health Center and chief of medicine and Director of the Gastrointestinal and Hepatobiliary Program at Saint John’s Cancer Institute, who was also not involved in the study, told MNT that “given the epidemic of young people being diagnosed with colorectal cancer, this topic is of enormous importance.”
Dr. Tejasav Sehrawat, resident physician at Yale, who was also not involved in the project, agreed, telling MNT that “colorectal cancer is one of the most prevalent cancers and unfortunately, even with screening programs, often still diagnosed in advanced stages.”
Dr. Kamath notes that “these findings, which are somewhat preliminary and should be studied further, suggest that focusing on reducing rates of obesity and also reducing red meat and sugar consumption in our diet could help with cancer prevention, especially for colorectal cancer.”
“It is important to note that this does not mean that ‘sugar feeds cancer’ in those that already have cancer, but reducing sugar consumption in healthy people without cancer could help prevent it from occurring in the first place,” Dr. Kamath explained.
Dr. Sehrawat pointed out that “most guidelines recommend limiting intake of red and processed meats, especially if prior history of cancer in the family. Furthermore, alcohol is a major GI carcinogen and intake needs to be avoided as much as possible as well.”
“There is correlation in some studies of obesity with a higher rate of colorectal cancer as well, so a balanced diet is in general a good idea,” Dr Sehrawat explained.
Dr. Bilchik agreed, saying “there is a clear association between red meat, processed food and colorectal cancer.”
“Starting at a young age a balanced diet including fresh fruit and vegetables limiting red meat and processed food should be strongly encouraged to reduce the chance of getting colorectal cancer.”
— Dr. Anton J. Bilchik
Dr. Kamath concluded that “these results could also help identify drugs that could target certain amino acid pathways and other metabolic pathways to help achieve better outcomes and survival for those with colorectal cancer.”
Ultimately, more research is needed.
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