Does the Mediterranean diet stop colon cancer?

Politicians love cancer ‘victims’. They can coo around us and make soothing noises about how everything will be better if only they were in power. Like babies and old ladies, we provide endless photo opportunities for the power hungry.

But don’t be blinded by their words. They use them to conjure up an impression that they’re somehow more caring or more worthy than their opponents. If they really cared they wouldn’t throw us under the bus to score lazy political points.

A good example is how politicians like to repeat that cancer is ’caused’ by diet. This creates a victim-blaming culture whereby those unlucky enough to get cancer have to start justifying their behaviour. Did they eat enough vegetables? Did they smoke or drink? Are they fat? This is one of the most unhelpful and cruel aspects of the current narrative. (see Stop playing politics with cancer and Cancer is not a moral issue). One of the sticks they use to beat us with is the Mediterranean diet – which has achieved mythical proportions even though no-one is really sure what a Mediterranean diet is.

Well I eat a Mediterranean diet because my family are of Italian extraction and because I like it. I still got colon cancer. I’m also yet to meet a researcher that claims diet is the cause of colon cancer. Scientists use phrases such as ‘may reduce the risk of’ and not ’causes’. They do this because they simply haven’t proven a causal relationship between colon cancer and diet. It’s not a case of eat a salad and you’re good; eat a sausage and you’re dead. This is nonsense. Mediterranean people also eat sausages and cured meats remember?

But does the Mediterranean diet hypothesis stand up to scrutiny? If they’re right, then there’s going to be a much lower incidence of colon cancer in Italy than in fat, beer-swilling, chip-eating England. Right?

Except I can’t find any evidence of that. According to World Cancer Research Fund stats (see here) Italy has the 15th highest rate of colorectal cancer in the world; Spain has the 17th. Where’s the UK? Apparently not in the top 20. So I looked for more stats. See these from International Cancer Screening. These also show the UK has a lower incidence and lower deaths than Italy.

I’m not gloating here, I’m just pointing out the fact that if the people most associated with the Mediterranean diet still have a high incidence of colon cancer then surely that means our thinking is wrong somewhere?

This benefits of this diet have started to reach almost cult-like status. I’ve seen outrageous statements reported that claim if you eat the mythical Mediterranean diet you won’t get colorectal cancer. But the link between this diet and preventing colon cancer is weak – there’s some evidence for reduction of incidence in rectal cancers. A far more reasonable assertion would be that there’s evidence that a better diet reduces inflammation and improves the microbiome (the bacterial balance in the gut). Both of these appear to be important in predicting the incidence of colorectal cancer, along with genetics. Watch this space because more work needs to be done… (see The role of bacteria in colon cancer)

Rather than lecturing people about the importance of eating olive oil and tomatoes, it’d be far better if politicians concentrated on making concrete commitments. This should be above party politics. I’d like to see both sides of the House of Commons commit to a strategy to reduce deaths from colon cancer. Remember, it’s the second biggest cancer killer in the UK. The best thing they can do in the short term is reduce testing to 45. That will have a massive impact, because caught early colorectal cancer is eminently treatable and a lot cheaper and less distressing to treat.

Next, put some money into education – get people to understand the risk, the signs and what they can do to lower their risk. Give more money to research both causes and treatments for colorectal cancer patients.

Cancer is not a moral issue. People need to stop playing the expert and stop judging others who they know nothing about. They need to stop jumping to conclusions that the science doesn’t support.

 

A statistical correlation may be interesting and give us some clues but it doesn’t prove the cause of something. For example, if researchers decreed that drinking tea made you more likely to get cancer (it doesn’t by the way), then a non-scientific assumption is that drinking tea causes the cancer. In fact, it might be some other behaviour or environmental factor and the tea drinking is only the clue. What if the cancer is caused by eating biscuits with your drink? Or by the sugar you added to your tea? Or by the washing up liquid used to clean the cup? Or by something in the paper that is used to make the tea bag? The list of possibilities is endless. The researchers have found a clue, but they haven’t found the cause.

As humans we want a simple, single answer and a simple, single piece of advice but there’s inherent danger that we end up over-simplifying things. It means we risk ignoring the fact that our cancer is most likely to be multi-factorial (have several causes) and some of its causes may be outside our control.

What is in our control today though is to test earlier and to encourage people to go for the tests when they’re offered. Stop being bored, too busy, too lazy or too embarrassed. Look after your health and take your colon cancer test. Nag everyone you know to do it. Nag the politicians to reduce the age of testing. Let’s start by concentrating on that.

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