What test did he take to get that CRE score?
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Sorry, it was a typo. It is CEA. It is a blood test.
Normal ranges for the colon cancer marker CEA (carcinoembryonic antigen) are typically 0-3 ng/mL for non-smokers and up to 5 ng/mL for smokers. Higher levels can indicate a greater likelihood of cancer, with levels above 10 ng/mL suggesting more extensive disease or metastasis, though a definitive diagnosis always requires further tests.
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Most people think of Colonoscopies like this guy.
GLP-1 drugs linked to dramatically lower death rates in colon cancer patients
A new University of California San Diego study offers compelling evidence that glucagon-like peptide-1 (GLP-1) receptor agonists â the class of drugs behind Ozempic, Wegovy and Mounjaro, for example â may do more than regulate blood sugar and weight. In an analysis of more than 6,800 colon cancer patients across all University of California Health sites, researchers found that those taking GLP-1 medications were less than half as likely to die within five years compared to those who werenât on the drugs (15.5% versus 37.1%).
The study, led by Raphael Cuomo, Ph.D., associate professor in the Department of Anesthesiology at UC San Diego School of Medicine and member of UC San Diego Moores Cancer Center, used real-world clinical data from the University of California Health Data Warehouse to assess outcomes across the stateâs academic medical centers. After adjusting for age, body mass index (BMI), disease severity and other health factors, GLP-1 users still showed significantly lower odds of death, suggesting a strong and independent protective effect.
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New Attia AMA focused on fibre, and he talks about the links to colon cancer. Here are some relevant sections of the show notes:
- Fiberâs protective effects appear to stem from two primary mechanisms:
- Supporting the integrity of the colonic barrier
- Reducing exposure to carcinogenic compounds
Colon barrier:
- Butyrate, a short-chain fatty acid (SCFA) produced from the fermentation of fiber, is the primary energy source for colon cells.
- Butyrate strengthens tight junctions between colonic cells, maintaining the physical barrier that prevents harmful substances from penetrating tissue.
- It reduces inflammation and induces apoptosis (cell death) of damaged cellsâan essential process in cancer prevention.
Reducing carcinogen exposure:
- Viscous soluble fibers (e.g., psyllium husk) can bind carcinogenic molecules such as secondary bile acids, preventing prolonged contact with the colon lining.
- Insoluble fibers (e.g., cellulose, vegetable peels, nuts, seeds) increase stool bulk and accelerate transit time, reducing how long potential carcinogens remain in contact with the colon wall.
Actual evidence:
- In a mouse model, fiber supplementation reduced the average number of colon tumors from 3â4 per mouse to about 1 per mouse after 5 months.
Human pilot data suggest resistant starch supplementation (which increases butyrate production) reduced new polyp formation by ~13% in individuals with familial adenomatous polyposis (FAP)âa high-risk genetic condition for colon cancer.
So there is some mechanistic plausibility, but the real-world clinical data is not that strong. Note, the study above with the 13% reduction was in an extreme risk population, and did not actually reach statistical significance.
Looking at epidemiology:
- A large of prospective studies suggests and 8% reduction in colorectal cancer risk per additional 8 grams of daily fiber, up to about 40 grams per day. At ~40 grams/day, the estimated total risk reduction may reach 20â25%, though the relationship is nonlinear.
- Despite these promising data, healthy-user bias remains a major limitation. People who eat high-fiber diets tend to also engage in other healthy behaviors that lower cancer risk.
So overall, I can absolutely believe that having a poor diet, low in fibre, increases colon cancer risk. Adding/supplementing fibre may be helpful, but probably isnât a game-changer in colon cancer risk. The biggest benefit probably comes from the well-rounded diet. And none of that reduces the necessity of colonoscopies.
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I always feel a little discouraged when I read these posts because no matter what I do to try to reduce colon polyps, nothing seems to work - Metformin, supplements, cutting out red meat and ultra-processed foods, and adding more fiber. Nothing works.
I think these approaches may work for the old form of colon cancer. I believe that there is something else driving the new form of colon cancer afflicting younger people, and the old strategies donât apply.
The only solution to preventing colon cancer I have seen is testing and polyp removal - a colonoscopy. To put your faith in fiber or anything else preventing colon cancer is akin to wishing on a star.
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Yes, and to be clear I did say that in my post.
But of course the best thing would be to not develop polyps in the first place, and fibre does seem to play some part in that. Clearly, a crappy diet (processed meat, low fibre, alcohol, certain fats) definitely increases risk of colon cancer and accelerates its growth. I wouldnât say that supplementing psyllium husk is âpreventingâ colon cancer, but if your intake is low and you add 5-10g then itâs almost certainly helpful and almost certainly not harmful.
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Ultra-processed food?
Iâve been paying more attention to ultra-processed foods lately, those products with long ingredient lists, additives, sweeteners, thickeners, flavourings, etc. What really hits me is that even food marketed as âhealthyâ, âfitâ, âlightâ, âhigh proteinâ, âveganâ, âorganicâ or whatever is so often ultra-processed once you actually read the label.
I recently tried to buy plain yogurt. Out of 30+ options, only about three were just milk and bacterial cultures. The rest had sugar or sweeteners, flavourings, starches, gumsâŚ
At the same time, more young adults are being diagnosed with colorectal cancer compared to a few decades ago. Research links high intake of ultra-processed foods with a higher risk of several health issues, including cancer, although other factors (weight, exercise, alcohol, etc.) matter too.
When I was a kid, our fridge was mostly basic foods, not this constant wall of ultra-processed stuff. Now you practically have to be a detective just to buy real yogurt.
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Yogurt is ultra processed, yet it probably wonât cause cancer. You can say the same about cheese. This is an ill defined term, which probably means discussions about it wonât be as productive as they can be.
Yes - I typically only buy the non-fat, plain greek yogurt.
But you have to be a detective if you buy any packaged food⌠they add sugar/HFCS to everything these days. Its no wonder kids are living shorter lives these days.
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Agree that the definition needs some work.
Iâm looking at a Costco Kirkland Signature greek yoghurt in front of me right now. Per 100g it has 9.4g protein, 0g fat and 5.3g carbs (2.9g sugar). The ingredients are âcultured pasteruized nonfat milkâ and a bunch of live bacterial cultures. [Incorrect part:] Itâs definitely âultra-processedâ based on NOVA and the amount of steps to get it from the cow into a pot in my fridge. However, I wouldnât think this yoghurt is detrimental to my health. [/Incorrect part]
I usually put a bunch of blueberries, almonds and walnuts on it. Sometimes I mix it with high protein soy milk if itâs a bit thick.
But youâre right. Someone from my kids school gave me a Muller Light Strawberry Corner and it has 12.0g of sugar, 4.3g protein, 3.9g fat, and the packaging proudly says âno artificial colourings, flavours or preservativesâ but the ingredient list has âModified Maize Starch, Pectins, Guar Gum, Flavourings, Citric Acidâ, so I would consider that as a fairly bad UPF.
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No, by NOVA plain yogurt is unprocessed / minimally processed food.
Ultra-processed foods are industrial formulations made mostly from refined ingredients + additives , with little or no intact whole food. Formulated to be hyper-palatable (very tasty, easy to overeat), convenient (ready-to-eat, ready-to-heat) and shelf-stable⌠yogurt with lots of additives fits this.
Processed food is what humans eat for milenia. Processing includes cooking, baking, adding salt, spices, fermenting, etc. Ultra-processing is industrial process that adds many industrial ingredients (protein isolates, modified starches, HFCS, hydrogenated oils, stabilizers, emulsifiers, thickeners, artificial sweeteners, colors, flavorings, flavor enhancers etc.)
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Just read this in NYT:
The scientists found that the nurses who consumed the most ultraprocessed foods (about 10 servings per day) were 45 percent more likely to have the most common type of precancerous polyp, called a conventional adenoma, than those who consumed the least (about three servings per day). The main types of ultraprocessed products they consumed were sliced breads and breakfast cereals; packaged sauces, spreads and condiments; and sugary or artificially-sweetened drinks.
Gifted link to the full article:
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I think itâs more about the additives than âprocessingâ per se.
"In most research and public-health discussions, âultra-processed foodâ is defined using the NOVA food classification system.
Core definition (NOVA Group 4)
Under NOVA, ultra-processed foods are:
Industrial formulations of food and food substances, typically with many ingredients, including:
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Added sugars, oils, fats and salt (often in higher amounts than in regular processed foods), plus
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Ingredients not used in home cooking (e.g., high-fructose corn syrup, maltodextrin, hydrogenated oils, modified starches, protein isolates),
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And cosmetic additives such as colors, flavors, flavor enhancers, emulsifiers, sweeteners, thickeners, etc.,
designed to make products hyper-palatable, convenient, cheap, and long-shelf-life. Wikipedia+1
Key points that usually signal a food is âultra-processedâ:
-
Made mostly from refined ingredients and industrial formulations, not whole foods.
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Contains additives with no real culinary function at home (emulsifiers, stabilizers, artificial sweeteners, ânatural flavors,â etc.). Wikipedia+1
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Often ready-to-eat or ready-to-heat (soft drinks, packaged snacks, instant noodles, reconstituted meat products, many breakfast cereals, etc.). Office of Research+1
Different organizations and new laws (like Californiaâs recent school-meal legislation) are now writing their own legal versions, but almost all of them are based on this NOVA concept: highly industrial products built from refined ingredients + cosmetic additives, rather than recognisable foods.
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Oh, thanks for the correction. Iâll edit my post