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Table of Contents
Year : 2021  |  Volume : 4  |  Issue : 4  |  Page : 777-778

Toward precision nutrition in the fight against colorectal cancer

Department of Colorectal Surgery, The Royal Free Hospital, London NW3 2QG, UK

Date of Submission27-Oct-2021
Date of Decision01-Nov-2021
Date of Acceptance02-Nov-2021
Date of Web Publication29-Dec-2021

Correspondence Address:
Reza Mirnezami
The Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/crst.crst_243_21

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How to cite this article:
Mirnezami R. Toward precision nutrition in the fight against colorectal cancer. Cancer Res Stat Treat 2021;4:777-8

How to cite this URL:
Mirnezami R. Toward precision nutrition in the fight against colorectal cancer. Cancer Res Stat Treat [serial online] 2021 [cited 2022 Aug 20];4:777-8. Available from: https://www.crstonline.com/text.asp?2021/4/4/777/334189

Dietary factors have been linked with susceptibility to a variety of cancer types, leading to a growing international push to generate high-quality data regarding the impact of nutritional interventions on cancer outcomes. In the broadest sense, cancer “precision nutrition” implies that by increasing the consumption of certain anticancer foods and simultaneously decreasing the consumption of foods that exert the opposite effect, the risk of developing cancer can be minimized. Naturally, this represents a highly attractive avenue of investigation for health-care professionals and the wider public, since dietary interventions will generally be well tolerated, patient centered, patient driven, and cost effective.

In their article titled, “Dietary risk factors for colorectal cancer: A hospital-based case-control study,” Zargar et al. seek to explore the relationship between dietary variables and colorectal cancer incidence.[1] The authors used a food frequency questionnaire to define dietary practices among 100 patients with confirmed colorectal cancer and compared these practices with those of 100 hospital controls and 100 healthy controls. Increased dietary intake of fiber, fruits, and vegetables was found to be associated with a reduced risk of colorectal cancer. In contrast, an increased incidence of colorectal cancer was observed in individuals reporting greater consumption of alcohol, red meat, hot tea and pickled foods. Though the numbers are small, the study methodology is robust, and a number of novel observations have been made; specifically, though the consumption of hot tea and pickled food items are associated with an increased risk of esophagogastric cancer, however their association with lower gastrointestinal tract malignancies has not been reported elsewhere. Zargar et al., however, have not proposed any mechanisms for this association, and this perhaps should be expanded on further.

Hence, bearing these and other similar findings in mind, are colorectal cancer-directed precision nutrition strategies ready for prime time? The answer is probably both yes and no. The reason is that there remain a number of perplexing issues for cancer precision nutrition. Firstly, Zargar et al., like many before them, have not been able to define methods of cultivation, preparation, packaging, storage, and cooking (time, temperature, and style) – all of which are likely to impact the availability and concentration of bioactive compounds in particular foods believed to confer a protective effect. These details are not routinely collected in conventional food frequency questionnaires, and really what is required in the future is probably a far more comprehensive individual food chart, with these aspects also recorded. There is potential to customize the emerging wearable technologies and smart applications in order to capture these data in the future. It is also likely that dietary factors work in a combinatorial fashion and that the downstream metabolic product of the various pro- and anticarcinogenic food-based bioactive compounds will ultimately be what governs the cancer risk. Quantitatively defining this state of flux lies beyond the scope of current experimental and machine learning methods, and beyond the aims of the work presented by Zargar et al. In addition to these difficulties, it should be acknowledged that cancer risk will vary according to a myriad of factors, including geography, age, and sex. Thus, while consuming one orange a day may offer protection against colorectal cancer for a 30-year-old person living in South East Asia, will 2 or 3 be necessary to offer the same protection to a 70-year-old living in California? These, and many other questions, will need to be addressed before colorectal cancer precision nutrition can enter the clinical arena.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Zargar T, Kumar D, Sahni B, Shoket N, Bala K, Angurana S. Dietary risk factors for colorectal cancer: A hospital-based case-control study. Cancer Res Stat Treat 2021;4:479-85.  Back to cited text no. 1
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This article has been cited by
1 Authors' reply to Tripathi et al., Majumdar and Mirnezami
Tasneef Zargar, Dinesh Kumar, Bhavna Sahni
Cancer Research, Statistics, and Treatment. 2021; 4(4): 781
[Pubmed] | [DOI]


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