Research Paper: High-Protein Diets and Colon Cancer

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[. . .] 001) reductions in fecal butyrate concentrations for the HPMC and HPLC diets, respectively. The reduction in butyrate concentrations would force epithelial cells to use alternate sources of energy, and lower the anti-inflammatory, anti-proliferative, anti-apoptotic, and anti-neoplastic activities normally present in a carbohydrate-balanced diet.

N-nitroso compound concentrations in fecal matter were increased by 3.6- (p < 0.001) and 5.4-fold (p < 0.001) for the HPMC and HPLC diets, respectively, as was the pH of the fecal-extracted water. These diet-induced changes suggest that high-protein low-carbohydrate diets increase the prevalence of compounds linked to colon cancer. Subjecting fecal extracts to high performance liquid chromatography and mass spectrometry produced a large amount of information. Overall, the most significant findings were a significant decrease in plant-derived indoles and phenolic compounds and their derivatives. Changes in bile acid concentrations showed no clear pattern. The authors interpreted this data as being consistent with high-protein low-carbohydrate diets decreasing the concentrations of cancer-protective metabolites and increasing those posing a hazard.

Overall fecal bacteria counts were lower in both high-protein diets (p < 0.012). Importantly, the prevalence of the butyrate producer Roseburial Eubacterium rectale were significantly (p < 0.001) reduced in subjects on the HPLC diet, which may explain the 50% reduction in fecal butyrate concentrations. The prevalence of the butyrate producer Faecalibacterium prausnitzii was unchanged and could therefore be one of the primary sources of the butyrate detected. The authors suggested that the decline in Roseburial E. rectale counts may have been driven by the increased pH and the reduction in fiber associated with the HPLC diet.

The authors concluded that the more moderate high-protein diet (HPMC) was able to maintain a relatively healthy profile in terms of butyrate concentration and bacterial diversity. This conclusion implies that less severe high-protein diets may help maintain a healthy intestinal environment, while still experiencing significant weight loss. This conclusion though, is undermined by the dramatic increase in N-nitroso compounds and phenyl acetic acids (PAA) detected in the fecal matter from subjects on the moderate high-protein diet. These compounds and their derivatives have been linked to an increased risk of colon cancer (reviewed by O'Keefe et al., 2007; Russell et al., 2011).

Critique

One of the main limitations of this study is the small sample size (N = 17), which may have prevented reaching statistical significance for some of the data derived from HPMC samples. Age is a contributing factor in colon cancer (O'keefe et al., 2007), and thus colon health, and it would have been interesting to see if stratification by age would have produced any interesting results, but the authors failed provide any information about the age of the subjects. The subjects were screened for recent anti-biotic use and a history of gastrointestinal problems, but the results may have achieved greater significance if the subjects were first acclimated to the same diet over a longer period of time, and with a defined probiotic dietary component. This type of approach could have established a more equivalent baseline intestinal environment across all subjects, prior to beginning the experimental phase of the study. Another source of significant noise in the data was probably the cross-over design, which required subjects to switch diets twice during the study. Despite these limitations, the significant values obtained argue in favor of concluding that high-protein low-carbohydrate diets increase the prevalence of risk factors associated with colon cancer. This concern though should probably be moderated by the serious risk factors associated with being morbidly obese.

Notes

O'Keefe, Stephen J.D., Chung, Dan, Mahmoud, Nevine, Sepulveda, Antonia R., Manafe, Mashudu, Arch, Judith et al. (2007). Why do African-Americans get more colon cancer than… [END OF PREVIEW]

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High-Protein Diets and Colon Cancer.  (2011, April 6).  Retrieved October 23, 2019, from https://www.essaytown.com/subjects/paper/high-protein-diets-colon-cancer/7383650

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