Low-Fat Equals Low-Risk

The possible connection between a high-fat, low-fiber diet and increased risk of colon cancer has been debated for decades. Some studies clearly show a connection: People eating the most fat and the least fiber appear to have the highest risk of colon cancer. Yet other studies show no connection at all between fat, fiber, and colon cancer risk.

Taking on the Controversy

To resolve the confusion, researchers have conducted studies in which they assign some people to eat a low-fat, high-fiber diet, while others in the study continue to eat their regular diet. Typically, this regular diet is low in fiber and high in fat - the eating pattern favored by many in the United States. This type of study, a randomized, controlled trial, is one of the best ways to learn more about the causes of disease, including colon cancer.

With much disappointment, when results became available from this research in the late 1990s and early 2000s, most of the randomized trials did not seem to find any connection between dietary fat and fiber and risk of colon cancer or colon polyps, a type of growth that if left untreated, can develop into cancer. But the key word here is "seem". On closer inspection, what many health experts have suspected all along appears to be true: Eating a low-fat, high-fiber diet decreases colon cancer risk.

It's Tough to Eat Well

In a recently published report, researchers analyzed data from the US Polyp Prevention Trial in a different way. Rather than comparing people assigned to the high-fiber, low-fat diet (intervention) group with people in the control (no diet) group, the researchers separated out those in the intervention group who actually followed the diet!

At several points throughout the study, the researchers interviewed the study participants to find out how they were eating. This is an important step to take, because as we all know, eating a healthy diet is not always easy. Simply because someone is assigned to eat a high-fiber, low-fat diet for a research study doesn't mean they actually will do it. With overweight and obesity rates in the U.S. hovering around 70%, we have all the proof we need to know that most people are not able to follow advice on healthy eating.

The Proof is in the (low-fat, high-fiber) Pudding

When the researchers analyzed the study data, they found that "super-compliers" - people in the intervention group who followed the healthy diet advice very closely - had 30% lower risk of developing an adenoma (polyp) compared with those in the control (regular diet) group. The super-compliers in the intervention group had a 50% lower risk of developing multiple polyps as well. By contrast, those people in the intervention group who did not follow the low-fat, high-fiber diet as instructed did not have a reduced risk of colon polyps.

One Bite at a Time

The evidence from this study clarifies that a healthy diet does indeed lower colon cancer risk. And the evidence is compelling: A healthy, high-fiber, low fat diet can help people who've had pre-cancerous growths (adenoma) removed from their colon reduce their risk of developing more of these growths by up to half. Knowing that a large number of these growths, called polyps or adenomas, can develop into cancer, reducing your risk of developing them is a smart way to reduce colon cancer risk.

While it can be challenging to change eating habits, many people find that taking it one step at a time is an effective way to improve their diet. Focusing on one positive change at a time can build a foundation upon which you add more of these healthy changes to your eating habits. Pick a place to start and stick with it until it's a habit. Once you've established that habit, add another. For example:

• Maybe you eat a sugary, low-fiber cereal every day for breakfast. Start by replacing 1/2 of your regular cereal with a healthier, high-fiber cereal that provides at least 8 grams of fiber per serving. Keep at this for one week, two weeks, even two months, if that's how long it takes to make it a habit. A habit is something you don't even have to think about; you just do it.
• After this, pick another habit to tackle. Maybe you hit the vending machine every afternoon at 3pm for a snack. Bring a healthier option from home. Try an apple and a handful of walnuts or almonds. Try a baggie of cut up vegetables. Maybe you like grapes. Whatever you choose as your replacement food, stick with it. Again, do this so often that it becomes a habit and move on to your third healthy eating change.

• Next you might try adding a high-fiber addition to your dinner plate. Instead of 8 ounces of meat and 2 ounces of vegetables, try 5 ounces of meat and 5 ounces of vegetables. Shift your plate a bit so that the healthier, high-fiber, low-fat foods, such as vegetables, fruit, and whole grains take up a slightly bigger portion, and the meat takes up a little less room. This may take some getting used to, but remember, "Rome wasn't built in a day..." Small, steady changes will add up to a much-improved diet and a healthier you over the course of months to years.
• Next you might revisit your breakfast bowl again. Try adding a bit more of the high-fiber cereal and a bit less of the sugary cereal, which will further increase your fiber intake.

These are just examples and they may or may not work for you. The point isn't to follow any particular "diet" (which don't work anyway). The point is to make measurable, sustainable changes to your eating habits. Over time, you can become a "super-complier" yourself!