What evidence supports the recommendation that patients with diverticulosis avoid nuts, popcorn, and other high-residue foods? A patient comes to her physician for instructions consequent to the discovery of diverticular disease. She is cautioned to avoid high-residue foods, such as nuts, seeds, popcorn, and corn either on or off the cob, because the by-products of these foods might lead to trauma or obstruction at the diverticular opening in the colon, resulting in brisk bleeding or infection. For a long time, this clinical scenario has represented common practice. The problem is that the recommendation to avoid high-residue foods may seem rational at first glance, but it lacks empiric proof. In addition, one of the proscribed foods, nuts, actually has a number of health benefits.1 A REVERSAL OF A LONG-ACCEPTED PRACTICE A cohort study of 18 years’ duration that included 47,228 men, aged 40 to 75 years, addressed the practice of advising patients with diverticular disease to avoid high-residue foods.1 At the outset of the study, all participants were free of diverticula. During follow-up, there were 801 cases of diverticulitis and 383 episodes of diverticular bleeding in those enrolled. The surprising finding in this study was that there was an inverse association between the consumption of nuts and popcorn and the risk of diverticulitis. Compared with men who had the lowest intake of these foods, those with the highest intake of nuts had about a 20% decrease in the risk of diverticulitis and those with the highest intake of popcorn had about a 28% decrease. Corn, either on or off the cob, neither increased nor decreased the risk of diverticulitis. Finally, there was no association between any of the high-residue foods and diverticular bleeding. WHAT TO TELL PATIENTS Tell patients with diverticular disease that nuts and popcorn actually decrease the likelihood of diverticulitis and that nuts have a number of other health benefits. For most patients with this common malady, this will be welcome news.
Bacteria naturally present in the human gut could produce substances that help to protect against colon cancer and provide therapy for inflammatory bowel disease. In a paper published in the journal Microbiology, researchers from the University of Aberdeen Rowett Institute of Nutrition and Health and from the MTT Agrifood Research Institute in Finland report initial studies showing that bacteria in the human gut convert linoleic acid, a naturally-occurring fat in the diet, into a form called conjugated linoleic acid (CLA) which is absorbed by the gut wall.
There are different types of CLA and not all of them have beneficial effects. The "good" form of CLA is present in dairy foods such as milk and cheese," said Dr John Wallace of the Rowett Research Institute, "but eating lots of dairy foods won't necessarily help our gut health as most of the fats are digested in the small intestine before they get to the large intestine, where most of our gut bacteria are found." The results of these latest studies showed that several different forms of CLA are produced by gut bacteria. Fortunately, most was of the "good" kind, but Dr Wallace stressed that more extensive studies are needed. One subject produced small amounts of a CLA whose beneficial or otherwise effects are much less clear.
The implications are that, if small quantities of dietary linoleic acid can be delivered to the large intestine, the effects on gut health will be generally beneficial in most people. He added, "The results are of special interest for individuals using anti-obesity treatments that prevent the small intestine from absorbing fats. This means that those fats - including linoleic acid - will pass into the large intestine and the gut bacteria will produce CLA. It has to be the correct CLA, so it is important to understand how individuals produce different CLA. This must depend on which types of bacteria are present."
Labels: Cancer, IBD, Inflamatory Bowel Disorders, Irritable Bowel Syndrome
The following is a statement in response to the breaking news about Supreme Court Justice Ruth Bader Ginsburg being diagnosed with pancreatic cancer from Julie Fleshman, President and CEO of the Pancreatic Cancer Action Network, the only national organization creating hope in a comprehensive way through research, patient support, community outreach and advocacy for a cure.
"Our thoughts are with Justice Ginsburg as we learn of her pancreatic cancer diagnosis and subsequent surgery and we wish her well on her recovery.
"The diagnosis of pancreatic cancer in the early stages is encouraging news for all patients. However, only 20 percent of patients are diagnosed early enough to qualify for surgery. The incidental discovery of pancreatic cancer in Justice Ginsburg reminds us of the urgent need for additional research funding to find early detection methods for the fourth leading cause of cancer death in the United States.
"The Pancreatic Cancer Research and Education Act (H.R. 745) was introduced in Congress last week by U.S. Representatives Anna Eshoo (D-CA) and Ginny Brown-Waite (R-FL) and is the first substantive legislative effort dedicated to advancing pancreatic cancer research and addressing the critical needs facing our research community. Once enacted and fully funded it will provide a greater focus on this disease and will provide the National Cancer Institute with the tools it needs to develop the early diagnostic methods and treatments that are currently lacking for pancreatic cancer patients."
About the Pancreatic Cancer Action Network
The Pancreatic Cancer Action Network is the only national organization creating hope in a comprehensive way through research, patient support, community outreach and advocacy for a cure. The organization raises money for direct private funding of research--and advocates for more aggressive federal research funding of medical breakthroughs in prevention, diagnosis and treatment of pancreatic cancer.
The Pancreatic Cancer Action Network fills the void of information and options by giving patients and caregivers reliable, personalized information they need to make informed decisions. We create a sense of hope and community so no one has to face pancreatic cancer alone. The organization helps support individuals and communities all across the country work together to raise awareness and funds to find a cure for pancreatic cancer.
Pancreatic Cancer Action Network
http://www.pancan.org
Labels: Cancer, pancreatitis