As a Multiple Sclerosis patient since I was a teenager, let me just say: all you “healthy diet” zealots aren’t helping. Your advice on which blended kale and gogi berry smoothie I should try is cringe and annoying. Normally, the person is right in front of me, and well-intentioned, so I typically smile and politely thank them with a non-committal gesture towards trying it someday.
But since this is all one-party and relatively anonymous, I’d like to take the opportunity to tell everyone that unless you have a PhD or MD in a relevant field, your thoughts about fiber are irrelevant and unwelcome to anyone actually suffering from the disease(s) in question.
I think this is probably due to people suffering from the just-world fallacy. Most folks like to believe that if you do the right things and consume the right stuff you'll have a long and healthy life when the fact of the matter is that luck/randomness plays a much larger role in your health than most people would like to admit.
One hundred percent. I work in film, and recently had an argument with a friend around this point. He's incredibly healthy, and frequently works a large number of unsociable hours. I was pointing out that filmmaking hours make no concession for family or age. He'd convinced himself that he'll have no more difficulty doing 80 hour weeks in his forties and fifties than he does in his mid thirties, because he 'takes care of himself'. The implication being that everyone could work those hours if they just ate better and held multiple martial arts belts as he does. It was no use pointing out that he'd confused cause and effect.
You can control your luck a bit though. Granted you could be in perfect health but roll a 1 five times in a row and get a heart attack when you are 40. Or you could be crushing junk food and alcohol but you just keep rolling 6s and make it to 80.
If you look at the sequence of events that happen to trigger a heart attack, it becomes really clear how big a role luck is, but still you can mitigate each step. Studying this stuff also makes your body seem like a walking time bomb.
The issue often manifests in victim blaming. They assume that because something bad has happened to someone then the someone must be guilty of some transgression. Its often done on an unconscious level and we have to check ourselves that we're not doing it.
You’re probably right but it’s also true that that is a very (probably unintended) cruel worldview that thought to the end claims all those suffering had it coming, and as such deserves to be called out and those having it should reconsider.
One should acknowledge the role genes/luck play in disease, while also admitting that there are a few foods about which there is more or less consensus they are very bad for your health. So you can roll your eyes if someone suggests eating kale sprouts will cure all your problems but don't just keep eating junk food as if the opposite of their take must be good.
This. I'm as exhausted as anyone about the latest macro/micro nutrient diet. But also, when I binge on a bag of potato chips, I assume (correctly) that I'll feel like shit later. Calorie dense food that's easily procured and eaten to excess was not part of our evolutionary path up to now. Every individual person is a cornucopia of variables though too, and one persons perfect diet would kill someone else. So advice is hard to give out, but there are clearly some broad guidelines to eating and health that help you mitigate bad dice rolls.
> one persons perfect diet would kill someone else
Besides allergies, that's not literally true, is it? Or would you say that allergies or severe intolerances are common enough that such dramatic diet fitness differences exist?
You're on a discussion forum where the topic is colon cancer. Surely you understand that people are going to discuss it?
It's a bit hard to tell from your post what you're saying. Certainly I can imagine being annoyed by constantly being given health advice from layman. But this is... a forum.
There's a bazillion ways to discuss a topic that don't involve giving advice with unearned confidence. Even just saying "My experience is that doing X helped" instead of "You should do X" is a massive massive difference.
That's fine. It's just unclear to me if the parent poster is being critical exclusively of people "irl" giving unsolicited advice or if they're speaking to the forum of users who come here explicitly to discuss topics like these.
If it's the former, I'm ambivalent. I don't give advice as a general rule. If it's the latter, I find that totally silly.
As someone who has worked in three different countries in a variety of positions, Americans conversed in that way in proportions far larger than other countries.
Now this may be due to sampling on my end, but I did find the difference extraordinary when asking the same questions to different people.
I'll echo this by saying that, as someone who has their MD, there is much we simply do not know. We're always updating our priors and have much to base our decisions off of, but we simply do not understand many things. Medicine is out here winging it with the best of intentions, but there are no "experts" in the grand scheme of things.
They need to lower the screening to 40. I just had mine at 40, turned out fine luckily. Did it without sedation which my doctor said was rare in US, but common outside of US. I found surprising, wasn't that big of a deal. Pain was probably at a 7/10 during the turns (like 3 times) but ok the rest of the time. A little uncomfortable. Some new sensations, some familiar (feeling like you are crapping your pants).
I walked in and walked out no issue and went on about my day. Prep was fine but would be hard if I didn't work at home.
With old school sedation I think it might be worth avoiding it. But with propofol you are out like a light, and then wake back up just as fast when they turn it off -- and it feels like you just had a nice nap. Aside from feeling a bit groggy for a few minutes, you just get up and walk out the door and go about your day. Personally, I do not think I'd volunteer for 7/10 pain just to avoid that.
My first colonoscopy was without anesthesia, and it was as described above. A little uncomfortable on the one bend, but I don't even think I would put it at 7/10 (perhaps a 4 or 5—but not a sharp pain, mind you).
Definitely enjoyed the following times with anesthesia because, of course 0/10 as far as I know. Also, anesthesia just trips my mind—how seemingly time travel (going forward in time) seems to be involved.
Sounds a bit like the transnasal esophagoscopy I opted for recently in lieu of an upper endoscopy. Thin tube through nose, then down into the esophagus. Uncomfortable while threading it through (chest pain, like swallowing a sharp tortilla chip), but ultimately not a big deal, and done in-office in about 15 minutes.
Which state did you have it done in if I may ask? I'm in Oregon and haven't been able to find a doc that does it without sedation. I can't be put under sedation for medical reasons, but I definitely need this procedure done sooner than later due to new GI problems.
I had a colonoscopy and esophagogastroduodenoscopy (thankfully not in that order) without sedation. Had it done in D.C.
My doc looked at me like I was crazy when I asked if it could be done without sedation, and reminded me that it would be uncomfortable, but otherwise didn't have any problem with it. I've endured 50k runs, brutal workouts, and traumatizing childhood neglect - I really can't see what the fuss is with mild discomfort that, by comparison, barely registers, and for such a short amount of time at that.
I too had esophagogastroduodenoscopy and the "sedation" I received as a barely noticeable dose of fentanyl. It was unpleasant to feel like I was drowning in saliva but it was quite bearable.
If I ever receive that procedure again, I will ask to skip the fentanyl microdose. The anesthesia and the buzz were not only underwhelming but for some reasons I started to feel the typical opioid warmth when the procedure was almost completed. Had they waited a few minutes after the IM injection I might have had another opinion on the usefulness on fentanyl during endoscopie because the last 30s were almost pleasant!
I don't really mind the pain itself, but I could see myself thinking the worst in that situation and imagining the strong pain meant the probe had punctured my colon.
I assume that's not actually a realistic risk, right?
North Carolina. And I wasn't actually aware that some doctors wouldn't do until after I had it done (reading about it online). I just called before my appointment to say I didn't need sedation. They said ok and wrote it down. They weren't really pushy during the appointment other than asking me why I didn't want sedation.
I thought it was going to be awkward but wasn't at all. We just chatted. It was him and an assistant. I was able to watch the TV of my colon while he was doing it.
For people who might be interested in following your advice, the conventional wisdom is that you should definitely look around when choosing the doctor. I.e. do not use a regular gastroenterologist who primarily does sedated colonoscopies, you want one who has experience with non-sedated ones. They have a better idea of what hurts and how to mitigate that.
Do you have specific risk factors that caused your doctor to recommend getting it at 40, or did you have to convince them? My understanding is that if the doctor doesn't order it, many insurance companies won't cover it.
There's an option which doesn't involve drinking any yucky fluids, just water. SuTab. You have two rounds of twelve pills that you drink with three cups of water at various intervals.
I've done it enough times that I'm totally fine with it: the electrolyte drink tastes like slightly bad-tasting Gatorade, which is hardly worth caring about.
And you get diarrhea-like bathroom runs half a dozen times maybe.
Yes it was annoying to get the runs and gross to drink the stuff the first few times, but people eat things like cow tongue or live octopus or whatever... I can handle some bad-tasting Gatorade and some diarrhea just fine, especially given the 5 years of peace-of-mind it buys me afterward.
I had a colonoscopy + upper endocoscopy a few months ago, age 29.
The prep was horrible, particularly the electrolyte drink they make you take the night before. I almost puked several times trying to get that stuff down.
Actual procedure was a breeze. I was sedated, and then I woke up and it was over.
There is going to be some big AHA moment tied so couple food practices. Like washing chicken in chlorine or something. I wonder how are the stats in other developed countries. The title says US.
Sugar is 50:50 fructose:sugar and "high"-fructose sugar is 55:45. The slight difference in fructose:sugar between the two is not significant in terms of health outcomes, unless you mean sugar in general.
I can't make sense of your comment, but whatever you're trying to get at is wrong: Table sugar is sucrose. Corn syrup is mostly glucose and contains no fructose. HFCS is commonly produced at 42% and 55% fructose formulations. I don't think HFCS is meaningfully more or less harmful than any other sugar, but chemically there's a significant difference.
Maybe instead of processing food to add more protein into it — even Starbucks sells "protein drinks" now — they should process food to have more fiber instead.
I usually stay out of health convos because it's just not my wheelhouse, but I think most people would benefit from extra fiber. It has an obvious direct benefit to your life the very next time you use the bathroom. I don't know if it is the answer to the rise of colon cancer; this is well studied and seems really easy to work with? We would surely know already. But I do know it's worth doing irrespective of that.
I mean, there's a well-documented link between colon cancer and inadequate fiber intake.
And it's also well-documented that the average Western diet is highly deficient in fiber and that this is a thing which has gotten much worse in the last 75 years.
There also seems to be at least some light evidence that there may be generational effects - that the starting point of your gut is already bad if your mother's was.
The mechanism behind why more fiber helps is pretty straightforward:
Insoluble fiber speeds up gut motility. Faster gut motility means less time for toxins to sit and absorb in your gut.
Also, fermentable fibers serve as substrate for gut microbes, producing short-chain fatty acids (butyrate is one - a primary fuel source for colonocytes - the cells that line your colon).
It also lowers colonic pH, inhibiting pathogenic bacteria.
Lastly, (although there are tons more benefits I'm not listing), soluble fiber is incredible for people trying to lose weight, as highly fibrous foods increase satiety, keeping you fuller for longer.
Uh, what? I have not made a presuppositional argument (I made no argument at all...). I made a statement about my epistemic state - ie: that I would "bet" on low fiber being the major contributor to colon cancer rates. Someone then asserted that it can't be that, and I asked "why?".
> Why would more fiber help?
Because there is an incredible amount of research into high fiber diets being good for your gut, including reduced colon cancer rates. This is the consensus of various organizations such as WHO - high fiber diets have lower risks of colon cancer.
My comment is that it is not ONLY low fiber diets. There are a lot of other risk factors involved. Will high fiber help - absolutely. Is it the be all end all - no I doubt it.
Western diet collapsed its fiber intake well over 80 years ago - it would have shown up already.
> My comment is that it is not ONLY low fiber diets.
Well, you said "can't" and I asked "why", which feels very reasonable to me. Your argument seems to be that it wouldn't account properly for the data - specifically, you're saying we would have seen colon cancer rates rise earlier.
> Western diet collapsed its fiber intake well over 80 years ago - it would have shown up already.
I don't really buy this for a lot of reasons. Probably the two most important are (a) ability to screen historically and (b) the timing isn't particularly "off" for the fiber argument. We did see it already, we've been seeing increases in color cancer risks for decades.
Now, I'm not married to it "just" being fiber whatsoever, but if I were to "bet" on the major contributing factor, naively, that's where my money would go. I think it's very reasonable to not place your bet there.
Should be a betting service for this kind of thing instead of sports betting. Maybe all the men betting sports might read and change their habits based on the betting outcomes (and improve their health).
I would also bet top reason is fiber but it isn't the only reason - multiple factors at play.
That seems like wishful thinking, IMO. Seems more likely we will find it’s due a complex constellation of genetics, diet, lifestyle factors like exercise, environmental exposure, etc associated eith a modern sedentary lifestyle
with no clear smoking gun or single preventative intervention.
It sort of reminds me of when Lesswrong was fixated on a hypothesis that lithium levels in the water supply was the cause of the obesity epidemic. There was a lot of enthusiasm for the idea at the time, and somewhat understandably as it would have been a single variable that could be tweaked for massive societal benefits.
But there wasn’t really any credible evidence to support it. Trying to reduce the complexity of human biology and lifestyle to single cause/effect relationship is an easy and tempting trap to fall into to explain unknowns in medicine.
The trend has been down, even for this cancer. Such that I agree there were probably some big AHA moments. But I assert they almost certainly happened 50 years ago.
My expectation is that it is less that there has been a growing trend of this cancer getting worse, and far more that we have gotten better at many other cancers. That is, overall, this is good news on progress. Not a scare headline.
I grew up in a fairly industrial area with lots of trades people around me. From my anecdata, I'd suspect you're right. We know more about some cancers and the causes and they are easier to prevent.
The choices, personal or otherwise, I have seen can't be good for your body, and some you're simply not allowed to make anymore.
Ironically, sitting on this laptop typing this might be as bad, but win some/lose some.
But some obvious examples?
Ever dip a shirt in benzene because it cools you down? Apparently it feels like Vicks, but doesn't leave that sticky feeling behind.
A good portion drank 6+ beers a day. I know they must have eaten, but some I never saw consume food. At all.
Some smoked a pack or two of cigarettes a day. Asbestos was in everything.
There was no ventilation/filtration for welders, painters, woodworkers, etc. If you could open the shop door it was a good day.
It has ticked up 1-2 per 100k over the past few decades for that group. Zoom the chart out, and you would probably be excused for assuming it is flat with some noise.
By all means, we should study this more. But the way folks are talking about this is a touch nuts.
It went up by 4 per 100k. And, since it was at 6 in 2000, that's a large increase.
>Zoom the chart out, and you would probably be excused for assuming it is flat with some noise.
That's true of all cancers, if not all statistics.
The concern here is two-fold:
(1) The people under 50 now will be over 50 in a decade or so. We can already see that the trend of colorectal cancer among those aged 50 to 64 was decreasing until 2012, but had since gone up. This will likely get worse. Early onset colorectal cancer is a canary in the coalmine.
(2) Unless this trend is caused by a specific chemical exposure or a purely dietary reason, the behavior/lifestyle/health conditions behind it are likely to lead to other types of cancers. Obesity and lack of exercise have been linked to a lot of cancers. I'm worried about losing progress across the board when these young people reach their 60s.
It was not true of all cancers two decades ago. Which is largely my point. Things are better than they were 50 years ago. Including this. Should we try and make sure we don't reverse that progress? Absolutely.
And it is notable that this research largely pointed to genetics as being ~20% of the cases of early onset results. That combined with how it presents in a very different way from older patients seems to point to us also getting better at spotting it.
All of which is good! It is progress. And I hope we get even better at it.
If you are merely noting it as a concern for "things to continue to watch," I'm fully with you. Read the rest of the comments on this post, though. Tons of people pointing at things that just don't present in the evidence. Fear that we will find that one killer ingredient/process to explain the uptick here; all while failing to acknowledge that we did find many such problems in the past and have made quite astounding progress on it.
Not saying it’s actually linked to cancer but it definitely does increase the risk of hemorrhoids, rectal prolapse and bleeding from straining. Which could mean chronic stress at a cellular level repairing damage over the long term.
> An estimated 95% of American adults and children fail to meet daily fiber recommendations, with intake often falling below 10 grams per 1,000 calories consumed
It's tempting to focus on some magic bad ingredient/practice to explain our bad health (like seed oils), but we don't exercise, we eat directly against dietary guidelines, and we eat foods that we know are bad for us.
Now add on to that the social media grifters and industry advocates who tell you that eating poorly is good for you.
I don't blame individuals just trying to live their life though. This is how we've let our whole food environment set up shop.
I don't think I need to enumerate every way our diets are bad in an HN comment, do I? You didn't even want to do it and you're the one gunning for it.
But processed meat consumption would be another good example of where we happily eat against dietary guidelines despite its link with colorectal cancer.
So many folks that have it say things like "I was super healthy! Did exercise, young, don't drink, etc." Then you dig deeper and realize the last vegetable meal they ate was a soggy brussel sprout their mom made them when they were 17 years old, and also eat cold cut turkey sandwiches every lunch because they're "healthy", and maybe have a tiny shred of lettuce in the sandwich. For breakfast, they eat pancakes or sugary foods, and dinner is just a piece of steak
You can quickly find historical availability & consumption data and I don't think it supports any trivially obvious hypotheses like these. You'll find headlines saying things like that we're at a low point in vegetable consumption going back to 1988, but I'm reading an NIH paper charting '70-'2010 and the patterns look stable, except for increases in total calories, in dairy, and in added dairy fats and oils.
Whatever's going on, it's probably going to end up being complicated and multifactorial.
To add to your point, not only will you find that the patterns of consumption look somewhat stable, but that this cancer did like all other cancers in the last 50 years and plummeted in incidence.
Let's keep in mind that this is the recommendation from the same government that recently declined to regulate dangerous pesticides [1] and relaxed regulations on additives [2].
The current US administration is not at all interesting in addressing America's unhealthy food.
Humans have relied on bread, pasta, rice, and tubers for most of their calories since time immemorial. Japanese people eat plenty of rice even today and they are very healthy.
"Food pyramid dumb, eat meat" is a very reductive take.
Also, MyPlate only used "grains" as a category, with a note to make half from whole grains...not just processed carbs. Big difference. And, vegetables are the biggest category.
Adding on to that, if you workout in ANY capacity, you need simple carbs.
> It's better than the "Food Pyramid" and "MyPlate" which were the gov standards when I was growing up.
Correct. The root of the problem is that corporate interests influence government regulation. [1] That hasn't changed. What has changed is which industry is offering the largest bribes.
"Guys, it's not the chemicals present in every packaged food you ever set your eyes on, or the pesticides every vegetable is grown in, it's just that you don't eat vegetables."
I can’t take hyperbolic appeals to the authority of chemical names = bad seriously. Let’s at least get specific and name a molecule with a known mechanism of action.
I think the people that dismiss this concern are just as bad and unscientific. It's a pretty decent Bayesian prior to assume that regular exposure to synthetic organic compounds in quantities or concentrations that hominids didn't receive exposure to in our evolution are likely to be potentially problematic. This is especially true when they don't occur naturally in any organisms biochemical processes and yet are active enough to interact with many of these things. This is OBVIOUSLY true for things used as pesticides / herbicides. We have evolved a natural aversion to areas where all the plants and animals are dead and rotting. There are good reasons for this to be a really good heuristic.
I'll go so far as to say that almost any pesticide or herbicide is likely to be bad for vertebrates and invertebrates alike. This is really likely the case for perservatives as well, for what should be obvious reasons.
It's really not that crazy to assume they're probably not good as a default assumption.
Go into a hardware store and almost every chemical, solvent, paint, etc. that you encounter is not good for you. Eat a salmon and enjoy billions of plastic particles. Open almost any prepackaged food and you'll be ingesting all manner of dyes, perservatives, anti-caking agents, etc. etc. etc. that simply weren't around in your food environment during our evolution. It's a surprisingly good baseline assumption that these things aren't likely to be good for you.
If you think about the study design and epidemiologic studies, it should be clear that it's going to be very difficult to prove harm in a lot of cases for things that are only a little harmful, or only harmful in combination, or harmful only after 20 years have passed since exposure, etc. ...except that the science is VERY clear: something (or lots of things) associated with "processed food" is really bad for you.
Sometimes I don't even want to reply to the crazy 'science or it didn't happen' people, but I do it just in case someone less terrible is reading and is on the fence.
It's amazing that we even have to write what you just did..
You don't have to take it seriously. If you think "mold inhibiting agent" on shredded cheese is good for you, keep eating it. It's probably been tested as safe and your body can't tell the difference.
Are you serious? Do you really think thats the reason that this is happening -- that people don't just eat their veggies? Fiber is important but, um, that's a pretty hot take.
Right but as I understand the problem of colon cancer its impacting people across the board in good health - not strictly this "core" US consistuency of high fat, high sugar, low fiber, high processed food.
It is also across normal BMI, "healthy" diet and regular exercising population. Thats what's concerning about the uptick.
No health issue is so easily reducible, but the impact of eating a diet of "actual food" and moving around even a little bit daily cannot be overstated.
The odds ratios for nearly all diseases and all-cause mortality shift so far from those two interventions it's almost unbelievable.
I lean toward "people got better at not dying from everything else." It's plausible to me that it just enabled existing factors to unfold on the time scales they unfold on for more people.
My handy heuristic for headlines like this: Is it a scary new trend that means something or did other factors suppressing its natural emergence decline? Or is it a matter of observation?
A recent real-world example was the detection of two different objects entering the solar system. The naive speculation was "they came on the same plane, so they must be alien!" But the reality is more mundane: the new detection method that found them, while flexible, started by looking at that plane. So of course both objects it detected were on that plane.
>I lean toward "people got better at not dying from everything else."
Unfortunately, that doesn't seem the be the case here, and the article goes into this. Deaths due to colorectal cancer under 50 simply used to be incredibly uncommon. Younger people were simply not screened for it. The rise is not solely relative to other forms of death, but in absolute terms has increased.
There could still be another factor other than lifestyle or chemicals in the food, the dominant opinions as of posting. Point (which I realize I forgot to make) is we don't know and latching on to pet theories, even really smart ones, has never done anyone any good in general, but especially when it comes to health.
>as we don't know and latching on to pet theories, even really smart ones, has never done anyone any good in general
I'd agree that really smart and plausible theories can turn out to be incorrect. But, I'm not sure I'd necessarily agree that plausible guesses aren't doing anyone any good. So long as theory is otherwise healthy (eg: eat vegetables and exercise regularly) then they might be doing some accidental good, and if they turn out to be correct, give people a bit of a head start.
The decline in mortality for so many other types of cancer has caused colon cancer to become the leading cause of cancer deaths under 50 in US. Eat more fiber.
If you have the symptoms, go get yourself checked out. I delayed my colonoscopy for YEARS, hell - I even delayed my doctors visit for years, and I had pretty much every symptom there is. My anxiety was through the roof when taking the blood test, and getting the colonoscopy - as I simply assumed they'd find something.
But, no. They didn't find a single thing. Blood and stool tests came back fine. Not even a polyp was found during the colonoscopy.
The only thing that kind of sucked, was the prep - there's no way around that. But the colonoscopy itself, no problem. I get some mild sedatives, but was completely awake during the procedure - even watched it on the screen.
Hank Green's visualization[0] a few weeks ago cite several statistically significant risk increases to CRC incidence (omitting ultra endurance athletes):
- Sugary drinks (≥2/day as teen) - 2x
- Sedentary lifestyle (>2hr TV/day) - 1.7x
- Childhood antibiotics (recurrent) - 1.5x
Have any studies tracked the growth of these behaviors in recent decades, potentially lining up with the increase in early onset CRC?
My step-brother had this around 40. He's okay now, but it was a terrible process involving surgery, carrying around a bag, and chemo which aged him significantly during treatment (from no gray hair to all gray in a couple years).
You would have never guessed he was an unhealthy guy by looking at him, but I do assume it has something to do with foods we consider normal in the US. I've taken a page out of Bryan Johnson's book and started eating well over 100% of recommended daily fiber intake (easy and enjoyable if you make some chia seed porridge every morning), and I will say my digestion has never been better. Keeping the system clear seems like a sane first line of defense to preventing this kind of thing.
This almost certainly speaks more to how much we have advanced on other cancers? The chart for total incidence shows it peaked in the 80s at about 70 per 100k and is down to about 40 per the same amount, now.
Such that, yes, we can still get better. But people here are reacting as if there is some damning evidence that just doesn't track with the data. Even with an uptick in younger people getting this, we still don't have a smoking gun on anything that is directly causal to this.
Also, holy crap, if you have rectal bleeding, don't ignore it! That that is listed as an early warning sign that people ignore is terrifying.
Ultra-marathoners have a 7x chance of getting colon cancer under 50. This is where it needs to be studied, maybe it's a common food or common supplement they are taking?
That's such a big disparity I'm very suspicious of that data, but there seems to be plenty of evidence that grossly excessive cardiovascular exercise is bad for you in various ways.
If people enjoy it and really get a lot out of it then I wouldn't judge them for doing it, but let's not pretend it's healthy, because all the evidence is that it isn't.
In terms of cardio being able to run a half decent 5k a couple of times a week is probably a good idea, any more volume than that is really not necessary and at some point becomes harmful
Claiming that distance running is unhealthy is wild. It can lead to injury, and there's such thing as overtraining. But to claim that it's broadly unhealthy is just wrong
Why wouldn't it be, you think the body was made to run all day? Most animals lay around all day with some bursts of activity. The exercise fad is just a peculiar neuroticism modern Westerners have.
Risk of stroke is the most obvious (and fairly concerning) one where there's solid data.
Also there's "distance running" as in running maybe 50k a week, that's probably okay, although as you get older it will increase your risk of stroke. But ultramarathons are a whole different ball game and almost certainly bad for you
I'm struggling to find it but I definitely remember reading a paper that claimed that aerobic exercise in over 60s decreased heart attack risk (which is good, obviously) but increased stroke risk.
I think the biggest risk though is acutely doing high intensity exercise (e.g. a marathon) whereas doing low intensity regular exercise (e.g. a 5k jogged at moderate pace 4x a week) is probably good.
So it's not "running is bad", it's more "running insane distances and/or running at insanely high intensity is bad", but the issue is a lot of people who get really into running end up doing one or both of those things.
One sign that marathons (let alone ultramarathons) may not be particularly healthy is that the first guy to do one famously died, and then subsequently people die doing them every single year. Yes the risk is low overall, but that doesn't mean it's actually good for you
> One sign that marathons (let alone ultramarathons) may not be particularly healthy is that the first guy to do one famously died, and then subsequently people die doing them every single year
I don't find this line of thinking terribly convincing
It's well known that (even young) elite athletes with unknown inborn heart defects sometimes die after extreme exertion. But it doesn't really follow that "extreme exertion is bad for you," the lurking variable is the heart defect.
Can't remember where I heard it-- some MD on a podcast recently-- but he mentioned distance running increases visceral fat in your muscles and around your organs when compared to HIIT and weight training, and visceral fat is generally a health risk indicator.
Visceral fat is fat around organs. It doesn't exist in muscles. I highly doubt that distance running increases visceral fat, that sounds made up. It may be that weight lifting is better for losing visceral fat, but that doesn't mean distance running is bad.
One of the healthiest things you can do is buy a vitamix or similarly powerful blender and make kale, spinach, broccoli, and mixed berry smoothies with olive oil. They don't have to taste GOOD, just good enough to be chugged as fast as possible.
There's a difference between informed speculation and uninformed speculation and most of the opinions so far fall into uninformed speculation where the writer implicitly blames those suffering for poor diet and lifestyle choices.
In addition a lot of the speculation assumes something specific to the US where this is a trend in multiple countries, predominantly high income ones[0][1], but this speculation that it might be 'chemicals' is fairly dull to read and adds nothing. Why this cohort specifically? What commonalities are there between countries with an observed increase? If it's diet why would it only impact the younger cohort?
Most people don't eat enough fiber, eat way too much processed junk, and have vitamin and mineral deficiencies. Yet still the overall risk for colon cancer is surprisingly low and takes a long time to develop for everyone but the unluckiest.
Earlier screenings are just compensating for poor education. It's not a solution to anything but the question of how to raise insurance costs for young people.
"Fiber from food" seems good enough. It's hard not to fibermax without incidentally improving your diet substantially. For example, beans are one of the best and easiest sources of it.
Splitting hairs beyond that, like insoluble and soluble, is the kind of thing that just confuses and intimidates people about nutrition advice.
It's a bridge you can cross once everyone is eating 50g+ of fiber per day, has chiseled physiques, and are looking to min/max.
>I'm guessing the colon cancer thing is probably due to pollutants
> You don't actually need fiber
Hey, you know what fiber is good for? Speeding up gut motility! You know what a faster gut motility is good for! Getting toxins out of our body quicker!
In that case, wouldn't you want to include things like sorbitol?
I want to emphasize I'm not making any grand claims of advice. I'm more being skeptical of traditional advice as someone who had/has a colon issue and tried everything under the sun.
Of the three people I personally knew who died of colon cancer in their 30s, all were athletes or vegans. I'm not saying that caused it, but I do think it is potentially more complex than just fiber.
the 1 reason for colon cancer is
milk.
it's not natural anymore and casein makes it's problems because the fat is altered by homogenization.
second is whey and monsanto.
third is canola oils.
fourth is cirtric acid, it's not from citrus. and it's everywhere, in every beverage, juice and preserved food, even in beers.
I think part of this can be attributed to prolonged gut inflammation caused by toxins and parasites. There’s something like 60% of the population has some form of parasite and have no idea, which causes a lot of inflammation and problems. Problems that don’t necessarily point to the gut being the culprit on the surface. So it’s misdiagnosed a lot.
I recommend everyone do a gut cleanse once a year.
CDC estimates about 60 million are effected by parasites in USA. which is about 17 or 18%.
Gut cleanse, colon cleanse, detoxing. None of this is supported by science. Nor would any of these things cure, prevent or in anyway help a parasitic infection.
Gut cleanses are probably stupid but I wonder if people would benefit from taking antiparasitics prophylactically. It's not something I've ever done, but I eat sashimi pretty regularly and wonder if I should take something like praziquantel because I'm probably at risk for Japanese broad tapeworm, and the symptoms are mild enough I can't really tell without testing, but the price of actually testing is much higher than just taking a drug with a great safety profile.
For similar reasons, I also wonder about people who consume raw milk. These people are more likely to endorse ivermectin for e.g. covid, because it made them feel much better. Maybe it's possible these people aren't lying about that, but not because it cured their covid.
If parasites was the concern then countries like Bangladesh would have incredibly higher rates given that people there tend to have orders of magnitudes more parasites than anywhere in the developed world.
And I’m not sure what toxins is supposed to mean and how Americans are more exposed to toxins than developing world children scouring through our electronic garbage on a daily basis
These sacrificial two-days-on-the-toilet offerings are like giving confessions to the priest to get back on the good side so you don't have to change your behavior.
Yes I can eat this 4200cal Costco pizza, I did my cleanse last month.
As a Multiple Sclerosis patient since I was a teenager, let me just say: all you “healthy diet” zealots aren’t helping. Your advice on which blended kale and gogi berry smoothie I should try is cringe and annoying. Normally, the person is right in front of me, and well-intentioned, so I typically smile and politely thank them with a non-committal gesture towards trying it someday.
But since this is all one-party and relatively anonymous, I’d like to take the opportunity to tell everyone that unless you have a PhD or MD in a relevant field, your thoughts about fiber are irrelevant and unwelcome to anyone actually suffering from the disease(s) in question.
I think this is probably due to people suffering from the just-world fallacy. Most folks like to believe that if you do the right things and consume the right stuff you'll have a long and healthy life when the fact of the matter is that luck/randomness plays a much larger role in your health than most people would like to admit.
One hundred percent. I work in film, and recently had an argument with a friend around this point. He's incredibly healthy, and frequently works a large number of unsociable hours. I was pointing out that filmmaking hours make no concession for family or age. He'd convinced himself that he'll have no more difficulty doing 80 hour weeks in his forties and fifties than he does in his mid thirties, because he 'takes care of himself'. The implication being that everyone could work those hours if they just ate better and held multiple martial arts belts as he does. It was no use pointing out that he'd confused cause and effect.
Certainly people work their way up and fade into a less strenuous role. Surely they don't just kick people to the curb. That would suck.
You can control your luck a bit though. Granted you could be in perfect health but roll a 1 five times in a row and get a heart attack when you are 40. Or you could be crushing junk food and alcohol but you just keep rolling 6s and make it to 80.
If you look at the sequence of events that happen to trigger a heart attack, it becomes really clear how big a role luck is, but still you can mitigate each step. Studying this stuff also makes your body seem like a walking time bomb.
I dont think this is right... most people I know care more about not doing the "wrong" thing than feeling entitled for doing the "right" thing.
The issue often manifests in victim blaming. They assume that because something bad has happened to someone then the someone must be guilty of some transgression. Its often done on an unconscious level and we have to check ourselves that we're not doing it.
You’re probably right but it’s also true that that is a very (probably unintended) cruel worldview that thought to the end claims all those suffering had it coming, and as such deserves to be called out and those having it should reconsider.
One should acknowledge the role genes/luck play in disease, while also admitting that there are a few foods about which there is more or less consensus they are very bad for your health. So you can roll your eyes if someone suggests eating kale sprouts will cure all your problems but don't just keep eating junk food as if the opposite of their take must be good.
This. I'm as exhausted as anyone about the latest macro/micro nutrient diet. But also, when I binge on a bag of potato chips, I assume (correctly) that I'll feel like shit later. Calorie dense food that's easily procured and eaten to excess was not part of our evolutionary path up to now. Every individual person is a cornucopia of variables though too, and one persons perfect diet would kill someone else. So advice is hard to give out, but there are clearly some broad guidelines to eating and health that help you mitigate bad dice rolls.
> one persons perfect diet would kill someone else Besides allergies, that's not literally true, is it? Or would you say that allergies or severe intolerances are common enough that such dramatic diet fitness differences exist?
You're on a discussion forum where the topic is colon cancer. Surely you understand that people are going to discuss it?
It's a bit hard to tell from your post what you're saying. Certainly I can imagine being annoyed by constantly being given health advice from layman. But this is... a forum.
There's a bazillion ways to discuss a topic that don't involve giving advice with unearned confidence. Even just saying "My experience is that doing X helped" instead of "You should do X" is a massive massive difference.
That's fine. It's just unclear to me if the parent poster is being critical exclusively of people "irl" giving unsolicited advice or if they're speaking to the forum of users who come here explicitly to discuss topics like these.
If it's the former, I'm ambivalent. I don't give advice as a general rule. If it's the latter, I find that totally silly.
One thing I've noticed is that Americans typically use the latter while conversing.
(Nearly) everybody does, it's not an American thing. It takes a bit of personal discipline to avoid it.
As someone who has worked in three different countries in a variety of positions, Americans conversed in that way in proportions far larger than other countries.
Now this may be due to sampling on my end, but I did find the difference extraordinary when asking the same questions to different people.
> As a Multiple Sclerosis patient since I was a teenager, let me just say: all you “healthy diet” zealots aren’t helping.
I don't understand the relevance to the article. Does Multiple Sclerosis come with a higher risk of colon cancer?
I'll echo this by saying that, as someone who has their MD, there is much we simply do not know. We're always updating our priors and have much to base our decisions off of, but we simply do not understand many things. Medicine is out here winging it with the best of intentions, but there are no "experts" in the grand scheme of things.
But have you tried Kaleidoscopic Perennial Kale?? Not saying it will help at all but it sure looks cool! https://cicadaseeds.ca/products/perennial-kale-seeds-homeste...
Lol your PhD got you this far, keep appealing to your PhD gods
They need to lower the screening to 40. I just had mine at 40, turned out fine luckily. Did it without sedation which my doctor said was rare in US, but common outside of US. I found surprising, wasn't that big of a deal. Pain was probably at a 7/10 during the turns (like 3 times) but ok the rest of the time. A little uncomfortable. Some new sensations, some familiar (feeling like you are crapping your pants).
I walked in and walked out no issue and went on about my day. Prep was fine but would be hard if I didn't work at home.
With old school sedation I think it might be worth avoiding it. But with propofol you are out like a light, and then wake back up just as fast when they turn it off -- and it feels like you just had a nice nap. Aside from feeling a bit groggy for a few minutes, you just get up and walk out the door and go about your day. Personally, I do not think I'd volunteer for 7/10 pain just to avoid that.
My first colonoscopy was without anesthesia, and it was as described above. A little uncomfortable on the one bend, but I don't even think I would put it at 7/10 (perhaps a 4 or 5—but not a sharp pain, mind you).
Definitely enjoyed the following times with anesthesia because, of course 0/10 as far as I know. Also, anesthesia just trips my mind—how seemingly time travel (going forward in time) seems to be involved.
Sounds a bit like the transnasal esophagoscopy I opted for recently in lieu of an upper endoscopy. Thin tube through nose, then down into the esophagus. Uncomfortable while threading it through (chest pain, like swallowing a sharp tortilla chip), but ultimately not a big deal, and done in-office in about 15 minutes.
Which state did you have it done in if I may ask? I'm in Oregon and haven't been able to find a doc that does it without sedation. I can't be put under sedation for medical reasons, but I definitely need this procedure done sooner than later due to new GI problems.
I had a colonoscopy and esophagogastroduodenoscopy (thankfully not in that order) without sedation. Had it done in D.C.
My doc looked at me like I was crazy when I asked if it could be done without sedation, and reminded me that it would be uncomfortable, but otherwise didn't have any problem with it. I've endured 50k runs, brutal workouts, and traumatizing childhood neglect - I really can't see what the fuss is with mild discomfort that, by comparison, barely registers, and for such a short amount of time at that.
I too had esophagogastroduodenoscopy and the "sedation" I received as a barely noticeable dose of fentanyl. It was unpleasant to feel like I was drowning in saliva but it was quite bearable.
If I ever receive that procedure again, I will ask to skip the fentanyl microdose. The anesthesia and the buzz were not only underwhelming but for some reasons I started to feel the typical opioid warmth when the procedure was almost completed. Had they waited a few minutes after the IM injection I might have had another opinion on the usefulness on fentanyl during endoscopie because the last 30s were almost pleasant!
FYI, there is an alternative, depending on what you need it for: https://jamiekoufman.com/tne-transnasal-esophagoscopy-is-the...
However, doctors who do it are a bit hard to come by.
With a esophagogastroduodenoscopy, I think the main issue is the gag reflex, not necessarily the pain.
Yea most of the time it was discomfort but the turns were pretty high up there in pain. But that was only 3 times.
I don't really mind the pain itself, but I could see myself thinking the worst in that situation and imagining the strong pain meant the probe had punctured my colon.
I assume that's not actually a realistic risk, right?
North Carolina. And I wasn't actually aware that some doctors wouldn't do until after I had it done (reading about it online). I just called before my appointment to say I didn't need sedation. They said ok and wrote it down. They weren't really pushy during the appointment other than asking me why I didn't want sedation.
I thought it was going to be awkward but wasn't at all. We just chatted. It was him and an assistant. I was able to watch the TV of my colon while he was doing it.
For people who might be interested in following your advice, the conventional wisdom is that you should definitely look around when choosing the doctor. I.e. do not use a regular gastroenterologist who primarily does sedated colonoscopies, you want one who has experience with non-sedated ones. They have a better idea of what hurts and how to mitigate that.
"They weren't really pushy during the appointment" (:
Do you have specific risk factors that caused your doctor to recommend getting it at 40, or did you have to convince them? My understanding is that if the doctor doesn't order it, many insurance companies won't cover it.
The prep is by far the worst of it. I wish they could do it differently.
There's an option which doesn't involve drinking any yucky fluids, just water. SuTab. You have two rounds of twelve pills that you drink with three cups of water at various intervals.
I've done it enough times that I'm totally fine with it: the electrolyte drink tastes like slightly bad-tasting Gatorade, which is hardly worth caring about.
And you get diarrhea-like bathroom runs half a dozen times maybe.
Yes it was annoying to get the runs and gross to drink the stuff the first few times, but people eat things like cow tongue or live octopus or whatever... I can handle some bad-tasting Gatorade and some diarrhea just fine, especially given the 5 years of peace-of-mind it buys me afterward.
I had a colonoscopy + upper endocoscopy a few months ago, age 29.
The prep was horrible, particularly the electrolyte drink they make you take the night before. I almost puked several times trying to get that stuff down.
Actual procedure was a breeze. I was sedated, and then I woke up and it was over.
There is going to be some big AHA moment tied so couple food practices. Like washing chicken in chlorine or something. I wonder how are the stats in other developed countries. The title says US.
My money is on massive overexposure to high fructose corn syrup in the Western diet.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9170474/
> high fructose corn syrup in the Western diet
US diet? Is corn syrup common elsewhere?
Sugar is 50:50 fructose:sugar and "high"-fructose sugar is 55:45. The slight difference in fructose:sugar between the two is not significant in terms of health outcomes, unless you mean sugar in general.
I can't make sense of your comment, but whatever you're trying to get at is wrong: Table sugar is sucrose. Corn syrup is mostly glucose and contains no fructose. HFCS is commonly produced at 42% and 55% fructose formulations. I don't think HFCS is meaningfully more or less harmful than any other sugar, but chemically there's a significant difference.
Sucrose is a disaccharide composed of 1 glucose and 1 fructose molecule, so the GP comment is correct, sugar is 50:50 glucose and fructose.
It's partly the pervasiveness of that product because it's in fking everything in the US at least. Why is it in BREAD? https://www.thedailymeal.com/1306301/unhealthiest-store-boug...
It's also the crazy amounts: we're accustomed to high levels of sweetness. Like 40g sugar in a can of soda.
It’s a humectant. And it subconsciously tastes good (yay capitalism).
Western means the US in your context. Western europe does not have that or whatever we consider not "easter diet".
Not Easter diet is also known as a low-cacoa diet.
lack of fiber is a biggie too. Foods too highly processed. too many oils.
Maybe instead of processing food to add more protein into it — even Starbucks sells "protein drinks" now — they should process food to have more fiber instead.
I usually stay out of health convos because it's just not my wheelhouse, but I think most people would benefit from extra fiber. It has an obvious direct benefit to your life the very next time you use the bathroom. I don't know if it is the answer to the rise of colon cancer; this is well studied and seems really easy to work with? We would surely know already. But I do know it's worth doing irrespective of that.
This is my personal bet. It's just low fiber diets.
It can't just be low fiber diets - there has to be some other exposures involved.
I mean, there's a well-documented link between colon cancer and inadequate fiber intake.
And it's also well-documented that the average Western diet is highly deficient in fiber and that this is a thing which has gotten much worse in the last 75 years.
There also seems to be at least some light evidence that there may be generational effects - that the starting point of your gut is already bad if your mother's was.
Why?
Apt username from a person suggesting that non edible fiber is the nutrient causing illness and thats the presupposition we should argue against.
Why would more fiber help?
The mechanism behind why more fiber helps is pretty straightforward:
Insoluble fiber speeds up gut motility. Faster gut motility means less time for toxins to sit and absorb in your gut.
Also, fermentable fibers serve as substrate for gut microbes, producing short-chain fatty acids (butyrate is one - a primary fuel source for colonocytes - the cells that line your colon).
It also lowers colonic pH, inhibiting pathogenic bacteria.
Lastly, (although there are tons more benefits I'm not listing), soluble fiber is incredible for people trying to lose weight, as highly fibrous foods increase satiety, keeping you fuller for longer.
Uh, what? I have not made a presuppositional argument (I made no argument at all...). I made a statement about my epistemic state - ie: that I would "bet" on low fiber being the major contributor to colon cancer rates. Someone then asserted that it can't be that, and I asked "why?".
> Why would more fiber help?
Because there is an incredible amount of research into high fiber diets being good for your gut, including reduced colon cancer rates. This is the consensus of various organizations such as WHO - high fiber diets have lower risks of colon cancer.
My comment is that it is not ONLY low fiber diets. There are a lot of other risk factors involved. Will high fiber help - absolutely. Is it the be all end all - no I doubt it.
Western diet collapsed its fiber intake well over 80 years ago - it would have shown up already.
> My comment is that it is not ONLY low fiber diets.
Well, you said "can't" and I asked "why", which feels very reasonable to me. Your argument seems to be that it wouldn't account properly for the data - specifically, you're saying we would have seen colon cancer rates rise earlier.
> Western diet collapsed its fiber intake well over 80 years ago - it would have shown up already.
I don't really buy this for a lot of reasons. Probably the two most important are (a) ability to screen historically and (b) the timing isn't particularly "off" for the fiber argument. We did see it already, we've been seeing increases in color cancer risks for decades.
Now, I'm not married to it "just" being fiber whatsoever, but if I were to "bet" on the major contributing factor, naively, that's where my money would go. I think it's very reasonable to not place your bet there.
Should be a betting service for this kind of thing instead of sports betting. Maybe all the men betting sports might read and change their habits based on the betting outcomes (and improve their health).
I would also bet top reason is fiber but it isn't the only reason - multiple factors at play.
I think that's all very fair.
That seems like wishful thinking, IMO. Seems more likely we will find it’s due a complex constellation of genetics, diet, lifestyle factors like exercise, environmental exposure, etc associated eith a modern sedentary lifestyle with no clear smoking gun or single preventative intervention.
It sort of reminds me of when Lesswrong was fixated on a hypothesis that lithium levels in the water supply was the cause of the obesity epidemic. There was a lot of enthusiasm for the idea at the time, and somewhat understandably as it would have been a single variable that could be tweaked for massive societal benefits.
But there wasn’t really any credible evidence to support it. Trying to reduce the complexity of human biology and lifestyle to single cause/effect relationship is an easy and tempting trap to fall into to explain unknowns in medicine.
The trend has been down, even for this cancer. Such that I agree there were probably some big AHA moments. But I assert they almost certainly happened 50 years ago.
My expectation is that it is less that there has been a growing trend of this cancer getting worse, and far more that we have gotten better at many other cancers. That is, overall, this is good news on progress. Not a scare headline.
I grew up in a fairly industrial area with lots of trades people around me. From my anecdata, I'd suspect you're right. We know more about some cancers and the causes and they are easier to prevent.
The choices, personal or otherwise, I have seen can't be good for your body, and some you're simply not allowed to make anymore.
Ironically, sitting on this laptop typing this might be as bad, but win some/lose some.
But some obvious examples?
Ever dip a shirt in benzene because it cools you down? Apparently it feels like Vicks, but doesn't leave that sticky feeling behind.
A good portion drank 6+ beers a day. I know they must have eaten, but some I never saw consume food. At all.
Some smoked a pack or two of cigarettes a day. Asbestos was in everything.
There was no ventilation/filtration for welders, painters, woodworkers, etc. If you could open the shop door it was a good day.
The trend has been upwards for invasive colorectal cancer among US residents under 50:
https://seer.cancer.gov/statistics-network/explorer/applicat...
It has ticked up 1-2 per 100k over the past few decades for that group. Zoom the chart out, and you would probably be excused for assuming it is flat with some noise.
By all means, we should study this more. But the way folks are talking about this is a touch nuts.
It went up by 4 per 100k. And, since it was at 6 in 2000, that's a large increase.
>Zoom the chart out, and you would probably be excused for assuming it is flat with some noise.
That's true of all cancers, if not all statistics.
The concern here is two-fold:
(1) The people under 50 now will be over 50 in a decade or so. We can already see that the trend of colorectal cancer among those aged 50 to 64 was decreasing until 2012, but had since gone up. This will likely get worse. Early onset colorectal cancer is a canary in the coalmine.
(2) Unless this trend is caused by a specific chemical exposure or a purely dietary reason, the behavior/lifestyle/health conditions behind it are likely to lead to other types of cancers. Obesity and lack of exercise have been linked to a lot of cancers. I'm worried about losing progress across the board when these young people reach their 60s.
It was not true of all cancers two decades ago. Which is largely my point. Things are better than they were 50 years ago. Including this. Should we try and make sure we don't reverse that progress? Absolutely.
And it is notable that this research largely pointed to genetics as being ~20% of the cases of early onset results. That combined with how it presents in a very different way from older patients seems to point to us also getting better at spotting it.
All of which is good! It is progress. And I hope we get even better at it.
If you are merely noting it as a concern for "things to continue to watch," I'm fully with you. Read the rest of the comments on this post, though. Tons of people pointing at things that just don't present in the evidence. Fear that we will find that one killer ingredient/process to explain the uptick here; all while failing to acknowledge that we did find many such problems in the past and have made quite astounding progress on it.
I had no clue this was a thing. Thanks for sharing your thought...
I think it's a combination of our pesticide usage and general food processing but like a sibling said these are educated guesses.
My bet is on low-fiber diet and people spending half hour playing with phone instead of getting up from toilet.
Why would me sitting down cause colon cancer?
Not saying it’s actually linked to cancer but it definitely does increase the risk of hemorrhoids, rectal prolapse and bleeding from straining. Which could mean chronic stress at a cellular level repairing damage over the long term.
Because anything that allows another person to look down on you and feel superior must therefore be true and moral.
> An estimated 95% of American adults and children fail to meet daily fiber recommendations, with intake often falling below 10 grams per 1,000 calories consumed
It's tempting to focus on some magic bad ingredient/practice to explain our bad health (like seed oils), but we don't exercise, we eat directly against dietary guidelines, and we eat foods that we know are bad for us.
Now add on to that the social media grifters and industry advocates who tell you that eating poorly is good for you.
I don't blame individuals just trying to live their life though. This is how we've let our whole food environment set up shop.
Focusing on fiber while leaving out glyphosate, sugar etc... is myopic.
I don't think I need to enumerate every way our diets are bad in an HN comment, do I? You didn't even want to do it and you're the one gunning for it.
But processed meat consumption would be another good example of where we happily eat against dietary guidelines despite its link with colorectal cancer.
So many folks that have it say things like "I was super healthy! Did exercise, young, don't drink, etc." Then you dig deeper and realize the last vegetable meal they ate was a soggy brussel sprout their mom made them when they were 17 years old, and also eat cold cut turkey sandwiches every lunch because they're "healthy", and maybe have a tiny shred of lettuce in the sandwich. For breakfast, they eat pancakes or sugary foods, and dinner is just a piece of steak
You can quickly find historical availability & consumption data and I don't think it supports any trivially obvious hypotheses like these. You'll find headlines saying things like that we're at a low point in vegetable consumption going back to 1988, but I'm reading an NIH paper charting '70-'2010 and the patterns look stable, except for increases in total calories, in dairy, and in added dairy fats and oils.
Whatever's going on, it's probably going to end up being complicated and multifactorial.
(I do love me a crucifer, though).
To add to your point, not only will you find that the patterns of consumption look somewhat stable, but that this cancer did like all other cancers in the last 50 years and plummeted in incidence.
The correlation to any of that stuff and cancer is basically meaningless in the scale of one persons life
https://realfood.gov/
Let's keep in mind that this is the recommendation from the same government that recently declined to regulate dangerous pesticides [1] and relaxed regulations on additives [2].
The current US administration is not at all interesting in addressing America's unhealthy food.
[1] https://cen.acs.org/environment/pesticides/glyphosate-roundu...
[2] https://www.fda.gov/news-events/press-announcements/fda-take...
It's better than the "Food Pyramid" and "MyPlate" which were the gov standards when I was growing up.
Those standards put processed carbs like bread/pasta as the largest part of a "healthy diet". Whoops.
Humans have relied on bread, pasta, rice, and tubers for most of their calories since time immemorial. Japanese people eat plenty of rice even today and they are very healthy.
"Food pyramid dumb, eat meat" is a very reductive take.
Folks had to do the harvest and milling work themselves until recently, it’s not the same. Nor are the quantities.
That's what I mean by reductive. Lifestyle changes, processed food filled with sugar and marketed by corporations...they all played a part.
Only the last hundred to twenty thousand years or so. Evolutionarily speaking, that's not our typical diet. Maybe excepting tubers.
Explain Japan.
I love when the Food Pyramid and MyPlate are brought up as arguments on why Americans are unhealthy these days.
National estimates suggest only 8%-14% of Americans ever followed MyPlate. https://pubmed.ncbi.nlm.nih.gov/40752889/
Also, MyPlate only used "grains" as a category, with a note to make half from whole grains...not just processed carbs. Big difference. And, vegetables are the biggest category.
Adding on to that, if you workout in ANY capacity, you need simple carbs.
> It's better than the "Food Pyramid" and "MyPlate" which were the gov standards when I was growing up.
Correct. The root of the problem is that corporate interests influence government regulation. [1] That hasn't changed. What has changed is which industry is offering the largest bribes.
[1] https://en.wikipedia.org/wiki/Regulatory_capture
Real Food, Truth Social.
"Guys, it's not the chemicals present in every packaged food you ever set your eyes on, or the pesticides every vegetable is grown in, it's just that you don't eat vegetables."
I can’t take hyperbolic appeals to the authority of chemical names = bad seriously. Let’s at least get specific and name a molecule with a known mechanism of action.
I think the people that dismiss this concern are just as bad and unscientific. It's a pretty decent Bayesian prior to assume that regular exposure to synthetic organic compounds in quantities or concentrations that hominids didn't receive exposure to in our evolution are likely to be potentially problematic. This is especially true when they don't occur naturally in any organisms biochemical processes and yet are active enough to interact with many of these things. This is OBVIOUSLY true for things used as pesticides / herbicides. We have evolved a natural aversion to areas where all the plants and animals are dead and rotting. There are good reasons for this to be a really good heuristic.
I'll go so far as to say that almost any pesticide or herbicide is likely to be bad for vertebrates and invertebrates alike. This is really likely the case for perservatives as well, for what should be obvious reasons.
It's really not that crazy to assume they're probably not good as a default assumption.
Go into a hardware store and almost every chemical, solvent, paint, etc. that you encounter is not good for you. Eat a salmon and enjoy billions of plastic particles. Open almost any prepackaged food and you'll be ingesting all manner of dyes, perservatives, anti-caking agents, etc. etc. etc. that simply weren't around in your food environment during our evolution. It's a surprisingly good baseline assumption that these things aren't likely to be good for you.
If you think about the study design and epidemiologic studies, it should be clear that it's going to be very difficult to prove harm in a lot of cases for things that are only a little harmful, or only harmful in combination, or harmful only after 20 years have passed since exposure, etc. ...except that the science is VERY clear: something (or lots of things) associated with "processed food" is really bad for you.
Sometimes I don't even want to reply to the crazy 'science or it didn't happen' people, but I do it just in case someone less terrible is reading and is on the fence. It's amazing that we even have to write what you just did..
You don't have to take it seriously. If you think "mold inhibiting agent" on shredded cheese is good for you, keep eating it. It's probably been tested as safe and your body can't tell the difference.
This just in, chemicals = bad
Are you serious? Do you really think thats the reason that this is happening -- that people don't just eat their veggies? Fiber is important but, um, that's a pretty hot take.
I suspect there are other factors at play.
The diet of most people in the US is pretty horrific. Absurd amounts of sugar, little to no vegetables, little fiber, lots of heavily processed foods.
That certainly does not help the situation. Whether it's correlational or causal I'd leave up to people more knowledgeable in the subject.
Right but as I understand the problem of colon cancer its impacting people across the board in good health - not strictly this "core" US consistuency of high fat, high sugar, low fiber, high processed food.
It is also across normal BMI, "healthy" diet and regular exercising population. Thats what's concerning about the uptick.
No health issue is so easily reducible, but the impact of eating a diet of "actual food" and moving around even a little bit daily cannot be overstated.
The odds ratios for nearly all diseases and all-cause mortality shift so far from those two interventions it's almost unbelievable.
We really don't know the reasons well. Food... some kind of bacteria or virus... 5 random things stuck together... it's silly to guess.
Victim blaming cancer patients as cope so you can convince yourself "it won't happen to me" is a disgusting trend
Recent discussion on this topic:
Overall, the colorectal cancer story is encouraging https://news.ycombinator.com/item?id=47078840
Quite scary since we don't know what causes it. I know there are some intelligent guesses, but my understanding is that we don't have any hard proof.
Yep, there is something going on here (some environment toxin that most/all of us are exposed to), but we don't know what it is
Hah, I've counted 10+ different intelligent(?) guesses in the replies.
I lean toward "people got better at not dying from everything else." It's plausible to me that it just enabled existing factors to unfold on the time scales they unfold on for more people.
My handy heuristic for headlines like this: Is it a scary new trend that means something or did other factors suppressing its natural emergence decline? Or is it a matter of observation?
A recent real-world example was the detection of two different objects entering the solar system. The naive speculation was "they came on the same plane, so they must be alien!" But the reality is more mundane: the new detection method that found them, while flexible, started by looking at that plane. So of course both objects it detected were on that plane.
>I lean toward "people got better at not dying from everything else."
Unfortunately, that doesn't seem the be the case here, and the article goes into this. Deaths due to colorectal cancer under 50 simply used to be incredibly uncommon. Younger people were simply not screened for it. The rise is not solely relative to other forms of death, but in absolute terms has increased.
There could still be another factor other than lifestyle or chemicals in the food, the dominant opinions as of posting. Point (which I realize I forgot to make) is we don't know and latching on to pet theories, even really smart ones, has never done anyone any good in general, but especially when it comes to health.
>as we don't know and latching on to pet theories, even really smart ones, has never done anyone any good in general
I'd agree that really smart and plausible theories can turn out to be incorrect. But, I'm not sure I'd necessarily agree that plausible guesses aren't doing anyone any good. So long as theory is otherwise healthy (eg: eat vegetables and exercise regularly) then they might be doing some accidental good, and if they turn out to be correct, give people a bit of a head start.
The decline in mortality for so many other types of cancer has caused colon cancer to become the leading cause of cancer deaths under 50 in US. Eat more fiber.
If you have the symptoms, go get yourself checked out. I delayed my colonoscopy for YEARS, hell - I even delayed my doctors visit for years, and I had pretty much every symptom there is. My anxiety was through the roof when taking the blood test, and getting the colonoscopy - as I simply assumed they'd find something.
But, no. They didn't find a single thing. Blood and stool tests came back fine. Not even a polyp was found during the colonoscopy.
The only thing that kind of sucked, was the prep - there's no way around that. But the colonoscopy itself, no problem. I get some mild sedatives, but was completely awake during the procedure - even watched it on the screen.
Hank Green's visualization[0] a few weeks ago cite several statistically significant risk increases to CRC incidence (omitting ultra endurance athletes):
- Sugary drinks (≥2/day as teen) - 2x
- Sedentary lifestyle (>2hr TV/day) - 1.7x
- Childhood antibiotics (recurrent) - 1.5x
Have any studies tracked the growth of these behaviors in recent decades, potentially lining up with the increase in early onset CRC?
[0] https://www.hankgreen.com/risk-factors
Interesting but link is dead? Would love to see this.
Found it: https://www.hankgreen.com/crc
My step-brother had this around 40. He's okay now, but it was a terrible process involving surgery, carrying around a bag, and chemo which aged him significantly during treatment (from no gray hair to all gray in a couple years).
You would have never guessed he was an unhealthy guy by looking at him, but I do assume it has something to do with foods we consider normal in the US. I've taken a page out of Bryan Johnson's book and started eating well over 100% of recommended daily fiber intake (easy and enjoyable if you make some chia seed porridge every morning), and I will say my digestion has never been better. Keeping the system clear seems like a sane first line of defense to preventing this kind of thing.
Scary. I had whole-genome sequencing done and the results came back with dozens of "Increased risk for colo-rectal cancer" results.
I'm likely going to die of either a heart attack (already had one, at age 28), or cancer, and it seems genetic.
EDIT: Specific genes and alleles below, if anyone is curious
https://i.imgur.com/szplWSj.png
Probably nothing to worry about. Unless it is lynch syndrome.
I have two SNP's for Lynch syndrome, is that enough to warrant concern?
https://i.imgur.com/DZiJhGJ.png
https://i.imgur.com/PKF2QDr.png
This almost certainly speaks more to how much we have advanced on other cancers? The chart for total incidence shows it peaked in the 80s at about 70 per 100k and is down to about 40 per the same amount, now.
Such that, yes, we can still get better. But people here are reacting as if there is some damning evidence that just doesn't track with the data. Even with an uptick in younger people getting this, we still don't have a smoking gun on anything that is directly causal to this.
Also, holy crap, if you have rectal bleeding, don't ignore it! That that is listed as an early warning sign that people ignore is terrifying.
https://archive.ph/UUKZ1
Here take your pick:
Antibiotics, Potassium bromate, aspartame, Red 40, rBGH/rBST, Chlorpyrifos, Atrazine and many more
Ultra-marathoners have a 7x chance of getting colon cancer under 50. This is where it needs to be studied, maybe it's a common food or common supplement they are taking?
That's such a big disparity I'm very suspicious of that data, but there seems to be plenty of evidence that grossly excessive cardiovascular exercise is bad for you in various ways.
If people enjoy it and really get a lot out of it then I wouldn't judge them for doing it, but let's not pretend it's healthy, because all the evidence is that it isn't.
In terms of cardio being able to run a half decent 5k a couple of times a week is probably a good idea, any more volume than that is really not necessary and at some point becomes harmful
Claiming that distance running is unhealthy is wild. It can lead to injury, and there's such thing as overtraining. But to claim that it's broadly unhealthy is just wrong
Why wouldn't it be, you think the body was made to run all day? Most animals lay around all day with some bursts of activity. The exercise fad is just a peculiar neuroticism modern Westerners have.
Risk of stroke is the most obvious (and fairly concerning) one where there's solid data.
Also there's "distance running" as in running maybe 50k a week, that's probably okay, although as you get older it will increase your risk of stroke. But ultramarathons are a whole different ball game and almost certainly bad for you
Can you link the data? I don't buy it.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11720530/ says there's a higher rate of AF in older, male althetes but a lower risk of stroke compared to similar aged, non-athletes.
At any rate, the data doesn't seem clear enough to claim that "distance running bad for you" or "any distance over 50K is bad for you".
I'm struggling to find it but I definitely remember reading a paper that claimed that aerobic exercise in over 60s decreased heart attack risk (which is good, obviously) but increased stroke risk.
I think the biggest risk though is acutely doing high intensity exercise (e.g. a marathon) whereas doing low intensity regular exercise (e.g. a 5k jogged at moderate pace 4x a week) is probably good.
So it's not "running is bad", it's more "running insane distances and/or running at insanely high intensity is bad", but the issue is a lot of people who get really into running end up doing one or both of those things.
One sign that marathons (let alone ultramarathons) may not be particularly healthy is that the first guy to do one famously died, and then subsequently people die doing them every single year. Yes the risk is low overall, but that doesn't mean it's actually good for you
> One sign that marathons (let alone ultramarathons) may not be particularly healthy is that the first guy to do one famously died, and then subsequently people die doing them every single year
I don't find this line of thinking terribly convincing
It's well known that (even young) elite athletes with unknown inborn heart defects sometimes die after extreme exertion. But it doesn't really follow that "extreme exertion is bad for you," the lurking variable is the heart defect.
Can't remember where I heard it-- some MD on a podcast recently-- but he mentioned distance running increases visceral fat in your muscles and around your organs when compared to HIIT and weight training, and visceral fat is generally a health risk indicator.
Visceral fat is fat around organs. It doesn't exist in muscles. I highly doubt that distance running increases visceral fat, that sounds made up. It may be that weight lifting is better for losing visceral fat, but that doesn't mean distance running is bad.
I can find only a single paper making this claim about marathoners. And that study has attracted a lot of criticism.
Can you provide a link? I looked and all I found was one study that looked for pre-cancerous adenomas.
I remember when that paper hit HN the thinking was actually to do with reduced bloodflow to the colon while running for long periods of time.
Dehydration? Overconsumption of carbohydrates?
Hmm - but has its incidence increased or just other causes have fallen down faster?
One of the healthiest things you can do is buy a vitamix or similarly powerful blender and make kale, spinach, broccoli, and mixed berry smoothies with olive oil. They don't have to taste GOOD, just good enough to be chugged as fast as possible.
Amazing how everybody in this thread has posted their pet theories as to cause:
- insufficient fibre
- too much high fructose corn syrup
- too much milk
- too much citric acid
- toxins and parasites (gut cleanse!)
- washing chicken in chlorine (voiced as hypothetical)
- ultra-marathoners - maybe their supplements and too much carbs or dehydration?
- too much processed junk
- vitamin and mineral deficiencies
- radiation
- insufficient veggies
Throw return to office in there. You know it's coming eventually.
Call it: RTO causes colon cancer, or WFH causes colon cancer?
Can we add microplastics to the list?
Yeah. Amazing how people on a forum are offering their opinions on something. Let’s point and laugh at them. /s
I’m more amazed at the toxic (no pun intended) comments in this post. It seems HN isn’t a place to voice health theories.
There's a difference between informed speculation and uninformed speculation and most of the opinions so far fall into uninformed speculation where the writer implicitly blames those suffering for poor diet and lifestyle choices.
In addition a lot of the speculation assumes something specific to the US where this is a trend in multiple countries, predominantly high income ones[0][1], but this speculation that it might be 'chemicals' is fairly dull to read and adds nothing. Why this cohort specifically? What commonalities are there between countries with an observed increase? If it's diet why would it only impact the younger cohort?
[0]: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2... [1]: https://www.gastrojournal.org/article/S0016-5085(21)00010-X/...
Most people don't eat enough fiber, eat way too much processed junk, and have vitamin and mineral deficiencies. Yet still the overall risk for colon cancer is surprisingly low and takes a long time to develop for everyone but the unluckiest.
Earlier screenings are just compensating for poor education. It's not a solution to anything but the question of how to raise insurance costs for young people.
Just eat your damn vegetables!
After a ton of research, I think the generic suggestion 'Fiber' is not helpful.
Some things to consider:
>There are classifications of fiber, insoluable vs soluable
>Even those classifications are overly generalized, and can/should be broken down into basically individual foods.
>Fiber and the various types have impact on your gut bacteria. If your gut bacteria is bad, you might be fueling growth of bad bacteria.
>You don't actually need fiber
>You don't actually need a colon
>I think gut bacteria management will probably be the next big thing. A combination of more scientific probiotics + fiber/prebiotics.
>I'm guessing the colon cancer thing is probably due to pollutants. Not necessarily air, but could be from food.
"Fiber from food" seems good enough. It's hard not to fibermax without incidentally improving your diet substantially. For example, beans are one of the best and easiest sources of it.
Splitting hairs beyond that, like insoluble and soluble, is the kind of thing that just confuses and intimidates people about nutrition advice.
It's a bridge you can cross once everyone is eating 50g+ of fiber per day, has chiseled physiques, and are looking to min/max.
This is hubris. I actually think I got my first colon issue because I ate too many beans.
>I'm guessing the colon cancer thing is probably due to pollutants
> You don't actually need fiber
Hey, you know what fiber is good for? Speeding up gut motility! You know what a faster gut motility is good for! Getting toxins out of our body quicker!
In that case, wouldn't you want to include things like sorbitol?
I want to emphasize I'm not making any grand claims of advice. I'm more being skeptical of traditional advice as someone who had/has a colon issue and tried everything under the sun.
Of the three people I personally knew who died of colon cancer in their 30s, all were athletes or vegans. I'm not saying that caused it, but I do think it is potentially more complex than just fiber.
> Just eat your damn vegetables!
At least if you can find some not previously doused in poison.
the 1 reason for colon cancer is milk. it's not natural anymore and casein makes it's problems because the fat is altered by homogenization. second is whey and monsanto. third is canola oils. fourth is cirtric acid, it's not from citrus. and it's everywhere, in every beverage, juice and preserved food, even in beers.
eat healthy my lads. trust not the media
could you provide some further information on this? it seems to contradict other studies, such as: - https://pmc.ncbi.nlm.nih.gov/articles/PMC11239739/
Those are some big claims, which without any references at all smell a lot like bro science.
Parroting the health "influencer" (grifter) talking points here ^
I think part of this can be attributed to prolonged gut inflammation caused by toxins and parasites. There’s something like 60% of the population has some form of parasite and have no idea, which causes a lot of inflammation and problems. Problems that don’t necessarily point to the gut being the culprit on the surface. So it’s misdiagnosed a lot.
I recommend everyone do a gut cleanse once a year.
CDC estimates about 60 million are effected by parasites in USA. which is about 17 or 18%.
Gut cleanse, colon cleanse, detoxing. None of this is supported by science. Nor would any of these things cure, prevent or in anyway help a parasitic infection.
Here are some common parasitic infections and how they're treated. None of these treatments recommend gut cleanse. https://en.wikipedia.org/wiki/Giardia#Infection https://en.wikipedia.org/wiki/Toxoplasma_gondii#Treatment https://en.wikipedia.org/wiki/Ascariasis#Treatment https://en.wikipedia.org/wiki/Hookworm_infection#Treatment https://en.wikipedia.org/wiki/Pinworm_infection#Treatment
Gut inflammation can be a problem, but I would not recommend treating it or even diagnosing it without evidence.
Gut cleanses are probably stupid but I wonder if people would benefit from taking antiparasitics prophylactically. It's not something I've ever done, but I eat sashimi pretty regularly and wonder if I should take something like praziquantel because I'm probably at risk for Japanese broad tapeworm, and the symptoms are mild enough I can't really tell without testing, but the price of actually testing is much higher than just taking a drug with a great safety profile.
For similar reasons, I also wonder about people who consume raw milk. These people are more likely to endorse ivermectin for e.g. covid, because it made them feel much better. Maybe it's possible these people aren't lying about that, but not because it cured their covid.
Gut cleanses are just marketing. Occasionally eating healthy and then going back to regular unhealthy diet skews the middle point of gut health.
Well for me it killed the parasites I had plaguing me and cured a lot of sickness I was experiencing. To each his own.
If parasites was the concern then countries like Bangladesh would have incredibly higher rates given that people there tend to have orders of magnitudes more parasites than anywhere in the developed world.
And I’m not sure what toxins is supposed to mean and how Americans are more exposed to toxins than developing world children scouring through our electronic garbage on a daily basis
What is a gut cleanse? That sounds destructive.
Doing an ambiguous preventive activity on 1 out of 365 days doesn't sound effective.
These sacrificial two-days-on-the-toilet offerings are like giving confessions to the priest to get back on the good side so you don't have to change your behavior.
Yes I can eat this 4200cal Costco pizza, I did my cleanse last month.
What do you mean when you say “do a gut cleanse”?
From the company that brought you the Lung Brush.
fenben, ivermect. herbs like blackseed oil, blac walnut, even organic cloves
I sacrifice a houseplant to baphomet as an alternative