A couple of weeks ago I posted on the large JAMA study showing that, contrary to what we’ve heard ad nauseum over the past decade, fiber consumption produced no protective effect against colon cancer. Now comes one of the more bizarre studies that I’ve ever read.
The British journal Colorectal Disease published a paper a few months ago with the promising title “Diet and colorectal cancer: implications for the obese and devotees of the Atkins diet.” Hey, now were getting somewhere thinks I when this little baby fell into my hands through the agency of the university inter-library loan department. Then I began to read it.
I don’t know if medical journals have the equivalent of slow news days or if this particular journal, which I hadn’t previously seen, is a lower tier journal, but I can’t figure how this paper got published. I’m glad it did because most people will only get to read the abstract (my university didn’t have a subscription to the journal, thus my reliance on inter-library loan), and the abstract implies much that isn’t developed in the paper. I’m sure many people writing articles on low-carb diets will in the future reference this paper as one that shows low-carb diets to reduce the risk of colorectal cancer. The paper, however, doesn’t really do that. In fact, it doesn’t do much of anything.
When we take a look at the abstract, we – as low-carb devotees – see some exciting stuff:
Colorectal cancer (CRC) is the second most common cause of cancer-related death in the Western world and its prevalence is increasing. Potential causes of this increase are changes in diet and the increases in obesity seen. This paper looks at the literature surrounding diet and obesity and the links to this increase in CRC. Heralded as a weight loss miracle we investigate whether the literature suggests the Atkins diet may actually do more harm than good by acting to increase an individual’s risk of CRC. Obesity has been demonstrated to be a major factor in the increase in CRC although links to changes in diet are more tenuous. Published studies on diet suggest the Atkins diet may help reduce rather than increase the risk of CRC.
As we go through the paper, however, excitement wanes.
Basically, the paper can be summarized pretty quickly. Here is the Cliff Notes version.
Obesity is a huge problem worldwide. Many people looking for a solution have tried the Atkins and other low-carbohydrate diets. These low-carbohydrate diets recommend meat accompanied by non-starchy vegetables. Studies have shown a correlation between meat consumption and colorectal cancer (CRC). Other studies have shown no correlation between meat consumption and CRC. Studies have shown that consumption of non-starchy vegetables and fruits are protective against CRC. Some studies have shown a correlation between fat consumption and CRC; others have shown no such correlation. some studies show that carbohydrate intake, especially of sugars and refined starches, increase the risk for CRC; these findings have not been confirmed in other studies. The paper then makes a strange comment:
The reduction in carbohydrate on this diet (Atkins) may result in less fruit and vegetables ingested and for this reason the Atkins diet may actually increase the risk of CRC. This should not be the case for the phases where more carbohydrate is permitted; the problem is that as with many diets, there tends to be high rates of noncompliance and the initial induction phase may deter people from eating fresh fruit and vegetable, despite some public health measures of encouragement to do otherwise. Of additional concern is that dieters may solely utilize the ‘induction’ phase of the Atkins diet plan as an effective weight loss strategy before reverting back to an unhealthy regime of sugary foods.
More Cliff Notes:
Once again studies have shown dietary fat to cause increased risk for CRC; others don’t. Most studies have shown that obesity is a risk factor for CRC. In fact, obesity is probably the most significant risk factor. Low-carbohydrate diets are lower in calories than non-diets. Consuming fewer calories brings about weight-loss. Weight-loss reduces risk for CRC. And, therefore, the Atkins and other low-carb diets are a go. As the authors conclude:
Until there is more conclusive evidence, it does not appear that the Atkins diet plan should be rejected. Indeed, from the current evidence it may actually be beneficial by reducing the risk of developing CRC; total energy intake may be a more significant risk factor and any diet conferring a decreased calorie intake would presumably decrease this risk.
There is so much data out there showing that low-carb diets reduce the risk of CRC in so many ways that it’s really a shame that this kind of wishy washy crapola uses up valuable ink.
Reading this paper makes me recall the one and only time I ever listened to Howard Stern when I heard him say the following to a Star Trek fanatic who had spent God only knows how much time trying to derive the language of Klingons:
It’s lame, Dude. It’s really lame.