Metabolic epidemiology of colon cancer: dietary pattern and fecal sterol concentrations of three populations.

Abstract

The nutrient intake, fecal neutral sterol concentration, and bile acid concentration of populations with a varied risk for colon cancer development were investigated. High-risk populations in the metropolitan New York area and Malmo, Sweden, were compared with an intermediate-risk population in Umea, Sweden. The mean daily intake of protein and fat was comparable in all groups, but the total daily fiber intake was higher in Umea, as was the total daily stool output. There was no difference in the total fiber intake and stool output between Malmo and metropolitan New York. The fecal secondary bile acid concentration was lower in Umea than in the other two areas; no difference was observed between Malmo and metropolitan New York. These results suggest that high fiber intake may be considered protective against colon cancer even in a population with a high risk intake. A high dietary fiber intake may limit colon cancer risk by increasing stool bulk, and thus diluting and/or binding tumor promoters.