Abstract
Familial adenomatous polyposis, a premalignant autosomal dominant disorder, is characterized by a multitude of adenomatous polyps and progression to cancer in almost 100% of patients if not treated. In this issue, DeCosse et al. (7) present the results of a successful nutritional intervention trial in a group of patients with familial adenomatous polyposis. The patients, 58 adults, were entered in a randomized study in which they were treated with ascorbic acid (vitamin C) and a-tocopherol (vitamin E) coupled with a high-fiber (wheat bran) supplement or a low-fiber placebo in a double-blind protocol. A limited degree of polyp regression, which commenced about 6 months after study initiation, was observed in the high-fiber group. The mean daily intake of dietary fiber by the high-fiber group was 22.4 g/day, compared with 12.2 g/day in the low-fiber placebo group. High doses of ascorbic acid (4 g/day) or a-tocopherol (400 mg/day) in combination with the low-fiber placebo had no effect. The theoretical antecedents of this trial are founded on an analysis of epidemiologic surveys in which dietary fiber intake is identified as a significant life-style factor associated with reduced colon cancer risk (2). Worldwide trends in fiber consumption are inversely correlated with colon cancer
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