Aug 16, 2018
Everyday choices affect our colorectal cancer risk – even what we eat and drink. Dr. Brian Bello discusses how eating a high-fiber diet and cutting down on certain beverages can help reduce your risk of developing colorectal cancer.
Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine.
Host: Thank you for joining us today. We’re talking with Dr. Brian Bello, a colorectal surgeon at MedStar Washington Hospital Center. Welcome, Dr. Bello.
Dr. Bello: Thank you very much for having me.
Host: Nutrition and dietary factors have been tied to a wide range of diseases in the past decade, including colorectal cancer. The choices we make every day about what we eat and drink can have a dramatic effect on our current and future health. Dr. Bello, what food and beverage options are most alarming to you as a colorectal surgeon?
Dr. Bello: Well, as a colorectal surgeon, we tell them to try to avoid processed meats, like bacon, sausage, ham and jerky, beef jerky. Unfortunately, the bacon and ham and sausage are the things that people love and like to eat, especially and also red meat, so we just try to tell them to substitute leaner meats or skinless poultry or fish, and that usually can help them.
Host: What is it about the red meat, specifically, is it more harmful as compared to leaner meats?
Dr. Bello: Yeah, scientists don’t know for sure. It’s probably the way that the meat is processed and preserved - maybe some chemicals there, it’s unclear.
Host: So I know we talked about food, are there any drinks that may contribute to a person’s risk?
Dr. Bello: We know that obesity and diabetes are risk factors for colon cancer. So, we know that people that drink a lot of these high sugar beverages may get diabetes. So, we usually tell people when we’re counseling them about their diet, to try to avoid those high sugar drinks, those energy drinks, those fruit drinks, and tell them to drink water, low dairy.
Host: And what about alcohol?
Dr. Bello: Alcohol, if consumed in a mild or moderate fashion’s okay, but we tell people not to drink excessive amounts of alcohol.
Host: Are your patients ever surprised when you mention diet and nutrition as a factor in colorectal cancer risk?
Dr. Bello: Yeah, people seem to be surprised, and many people don’t even realize that their diet is not a healthy one. So, usually we go over their usual daily intake and figure out what they can do better. We try to give them a lot of education about this. We try to give them menus and lists of things that they can do and eat so that they can have a better diet. We also find it helpful that, if they come with a family member, specifically the person that cooks for them, that they’re involved in that discussion.
Host: Now you mentioned some of the things that you recommend that your patients avoid. What would you consider an ideal nutrition plan, say for a lunch or a dinner, for someone at average risk of colon cancer?
Dr. Bello: We always recommend our patients be on a high fiber diet. So, when people come in and they tell me they’re eating a lot of red meats and processed meat, I immediately try to give them some education. I tell them what foods are rich in fiber which include raw fruits, like apples and bananas; vegetables, especially raw vegetables, like lettuce and spinach; legumes, like beans, all have a lot of good dietary fiber which has been associated with less colon cancer risk. So, it’s always good to have a variety of food, specifically a variety of fruits and vegetables, whole grains. I mentioned a high fiber diet - usually about 25 to 30 grams a day. Skinless poultry and fish are good. Nuts and beans. And we try to tell them to limit these things that aren’t good for you, so fatty food, fried food, sweets, foods that are high in sodium - those are the key things to limit.
Host: Should patients who admittedly make poor nutrition choices, or just really enjoy junk food, be screened more often for colon cancer than say an individual with a healthier diet?
Dr. Bello: That’s a good question. I’d say we haven’t had enough data to make that choice yet. I think we still take in account the other risk factors where the patient symptoms, are they having symptoms like bleeding or abdominal pain, change in their bowel movements. I think poor nutrition alone, we don’t recommend that they get screened more often than other people. That would probably lead to unnecessary tests. But I think we take the whole picture and see what their other issues are and what their other risk factors are.
Host: Could you discuss your team approach to care when it comes to balancing nutrition with colon cancer screening and awareness?
Dr. Bello: Yeah, so here at MedStar Washington Hospital Center, we have different experts in different fields. So, not only do we have surgeons and oncologists, we have nutritionists that can help patients find a good balance of what’s healthy and what tastes good. That’s an advantage that we have at Washington Hospital Center.
Host: So, why is MedStar Washington Hospital Center the best place to seek that colon cancer screening and guidance?
Dr. Bello: Yeah, I think we see a lot of colon cancer - we’re a high-volume center. So, a lot of us do primarily colon cancer and rectal cancer - those are our primary patients, such as myself and my colleagues. We do present any new colon cancer at a multidisciplinary tumor board, where there’s a lot of experts from different fields weighing in. With that, we come up with the very individualized treatment plan for each patient. So, because of that, we’ve shown that those patients have better outcomes.
Host: Could you share any success stories from your patient population, perhaps an individual with a very poor diet or a cancer risk that maybe turned their diet around?
Dr. Bello: Yeah, I think I get the most satisfaction when I’m seeing patients for a long time. For example, if I do a colon surgery on them, I usually follow them for several years, up to five years after surgery. And then I see that they’re following my recommendations of leading a good, healthy lifestyle. They’ve stopped smoking. They’re eating better. They’re eating more fiber in their diet. And they’re exercising. Those are the patients I feel that we’ve helped.
Host: Thank you for joining us today, Dr. Bello.
Dr. Bello: Thank you very much. My pleasure.
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