Skip to main content
SpringerLink
Log in

Effect of Resistant Starch on Potential Biomarkers for Colonic Cancer Risk in Patients with Colonic Adenomas

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Resistant starch decreases the concentration of secondary bile acids in the feces and the proliferation rate of colonic mucosal cells in healthy volunteers. This may reduce the risk of colon cancer. We investigated 23 patients with recently removed colonic adenoma(s) in a controlled parallel trial. They consumed 45 g of maltodextrin per day as placebo for four weeks and were randomly assigned to either 45 g of native amylomaize starch, containing 28 g of resistant starch type II or 45 g of maltodextrin for another four weeks. No effect on colorectal cell proliferation, fecal wet and dry weights, pH, and short-chain fatty acid excretion was seen. The bile acid concentration in fecal water decreased by 15% (P = 0.048) and the percentage secondary bile acids decreased by 14% (P = 0.002) on resistant starch relative to placebo. Whether this has a substantial role in colon cancer prevention in these patients remains to be established.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Potter JD: Nutrition and colorectal cancer. Cancer Causes Control 7:127–146, 1996

    Google Scholar 

  2. Steinmetz KA, Potter JD: Vegetables, fruit, and cancer prevention: A review. J Am Diet Assoc 96:1027–1039, 1996

    Google Scholar 

  3. Hill MJ: Cereals, cereal fibre and colorectal cancer risk: A review of the epidemiological literature. Eur J Cancer Prev 6:219–225, 1997

    Google Scholar 

  4. Asp NG: Dietary fibre-definition, chemistry and analytical determination. Mol Aspects Med 9:17–29, 1987

    Google Scholar 

  5. Kim YI: AGA technical review: Impact of dietary fiber on colon cancer occurrence. Gastroenterology 118:1235–1257, 2000

    Google Scholar 

  6. Fleming SE, Marthinsen D, Kuhnlein H: Colonic function and fermentation in men consuming high fiber diets. J Nutr 113:2535–2544, 1983

    Google Scholar 

  7. Pomare EW, Branch WJ, Cummings JH: Carbohydrate fermentation in the human colon and its relation to acetate concentrations in venous blood. J Clin Invest 75:1448–1454, 1985

    Google Scholar 

  8. Flourie B, Florent C, Jouany JP, Thivend P, Etanchaud F, Rambaud JC: Colonic metabolism of wheat starch in healthy humans. Effects on fecal outputs and clinical symptoms. Gastroenterology 90:111–119, 1986

    Google Scholar 

  9. Reddy B, Engle A, Katsifis S, Simi B, Bartram HP, Perrino P, Mahan C: Biochemical epidemiology of colon cancer: Effect of types of dietary fiber on fecal mutagens, acid, and neutral sterols in healthy subjects. Cancer Res 49:4629–4635, 1989

    Google Scholar 

  10. Cummings JH, Hill MJ, Jenkins DJ, Pearson JR, Wiggins HS: Changes in fecal composition and colonic function due to cereal fiber. Am J Clin Nutr 29:1468–1473, 1976

    Google Scholar 

  11. Cummings JH, Branch W, Jenkins DJ, Southgate DA, Houston H, James WP: Colonic response to dietary fibre from carrot, cabbage, apple, bran. Lancet 1:5–9, 1978

    Google Scholar 

  12. Fleming SE, O'Donnell AU, Perman JA: Influence of frequent and long-term bean consumption on colonic function and fermentation. Am J Clin Nutr 41:909–918, 1985

    Google Scholar 

  13. Haack VS, Chesters JG, Vollendorf NW, Story JA, Marlett JA: Increasing amounts of dietary fiber provided by foods normalizes physiologic response of the large bowel without altering calcium balance or fecal steroid excretion. Am J Clin Nutr 68:615–622, 1998

    Google Scholar 

  14. Chen HL, Haack VS, Janecky CW, Vollendorf NW, Marlett JA: Mechanisms by which wheat bran and oat bran increase stool weight in humans. Am J Clin Nutr 68:711–719, 1998

    Google Scholar 

  15. Englyst HN, Kingman SM, Cummings JH: Classification and measurement of nutritionally important starch fractions. Eur J Clin Nutr 46Suppl 2:S33–S50, 1992

    Google Scholar 

  16. Ranganathan S, Champ M, Pechard C, Blanchard P, Nguyen M, Colonna P, Krempf M: Comparative study of the acute effects of resistant starch and dietary fibers on metabolic indexes in men. Am J Clin Nutr 59:879–883, 1994

    Google Scholar 

  17. van Munster IP, de Boer HM, Jansen MC, de Haan AF, Katan MB, van Amelsvoort JM, Nagengast FM: Effect of resistant starch on breath-hydrogen and methane excretion in healthy volunteers. Am J Clin Nutr 59:626–630, 1994

    Google Scholar 

  18. Nordgaard I, Mortensen PB, Langkilde AM: Small intestinal malabsorption and colonic fermentation of resistant starch and resistant peptides to short-chain fatty acids. Nutrition 11:129–137, 1995

    Google Scholar 

  19. Muir JG, Lu ZX, Young GP, Cameron SD, Collier GR, O'Dea K: Resistant starch in the diet increases breath hydrogen and serum acetate in human subjects. Am J Clin Nutr 61:792–799, 1995

    Google Scholar 

  20. Hylla S, Gostner A, Dusel G, Anger H, Bartram HP, Christl SU, Kasper H, Scheppach W: Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention. Am J Clin Nutr 67:136–142, 1998

    Google Scholar 

  21. Van Munster IP, Tangerman A, Nagengast FM: Effect of resistant starch on colonic fermentation, bile acid metabolism, and mucosal proliferation. Dig Dis Sci 39:834–842, 1994

    Google Scholar 

  22. Phillips J, Muir JG, Birkett A, Lu ZX, Jones GP, O'Dea K, Young GP: Effect of resistant starch on fecal bulk and fermen-tation-dependent events in humans. Am J Clin Nutr 62:121–130, 1995

    Google Scholar 

  23. Cummings JH, Beatty ER, Kingman SM, Bingham SA, Englyst HN: Digestion and physiological properties of resistant starch in the human large bowel. Br J Nutr 75:733–747, 1996

    Google Scholar 

  24. Alberts DS, Martinez ME, Roe DJ, Guillen RJ, Marshall JR, van-Leeuwen JB, Reid ME, Ritenbaugh C, Vargas PA, Bhattacharyya AB, Earnest DL, Sampliner RE: Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas. N Engl J Med 342:1156–1162, 2000

    Google Scholar 

  25. Thornton JR, Dryden A, Kelleher J, Losowsky MS: Superefficient starch absorption. A risk factor for colonic neoplasia? Dig Dis Sci 32:1088–1091, 1987

    Google Scholar 

  26. Clausen MR, Bonnen H, Mortensen PB: Colonic fermentation of dietary fibre to short chain fatty acids in patients with adenomatous polyps and colonic cancer. Gut 32:923–928, 1991

    Google Scholar 

  27. Velazquez OC, Lederer HM, Rombeau JL: Butyrate and the colonocyte. Implications for neoplasia. Dig Dis Sci 41:727–739, 1996

    Google Scholar 

  28. Vogelstein B, Kinzler KW: The multistep nature of cancer. Trends Genet 9:138–141, 1993

    Google Scholar 

  29. Lipkin M: Biomarkers of increased susceptibility to gastrointestinal cancer. Their development and application to studies of cancer prevention. Gastroenterology 92:1083–1086, 1987

    Google Scholar 

  30. Ponz dL, Roncucci L, Di Donato P, Tassi L, Smerieri O, Amorico MG, Malagoli G, De Maria D, Antonioli A, Chahin NJ: Pattern of epithelial cell proliferation in colorectal mucosa of normal subjects and of patients with adenomatous polyps or cancer of the large bowel. Cancer Res 48:4121–4126, 1988

    Google Scholar 

  31. Scalmati A, Roncucci L, Ghidini G, Biasco G, Ponz dL: Epithelial cell kinetics in the remaining colorectal mucosa after surgery for cancer of the large bowel. Cancer Res 50:7937–7941, 1990

    Google Scholar 

  32. Terpstra OT, van Blankenstein M, Dees J, Eilers GA: Abnormal pattern of cell proliferation in the entire colonic mucosa of patients with colon adenoma or cancer. Gastroenterology 92:704–708, 1987

    Google Scholar 

  33. Cats A, de Vries EG, Kleibeuker JH: Proliferation rate in hereditary nonpolyposis colon cancer. J Natl Cancer Inst 83:1687–1689, 1991

    Google Scholar 

  34. Einspahr JG, Alberts DS, Gapstur SM, Bostick RM, Emerson SS, Gerner EW: Surrogate end-point biomarkers as measures of colon cancer risk and their use in cancer chemoprevention trials. Cancer Epidemiol Biomarkers Prev 6:37–48, 1997

    Google Scholar 

  35. Wargovich MJ, Isbell G, Shabot M, Winn R, Lanza F, Hochman L, Larson E, Lynch P, Roubein L, Levin B: Calcium supplementation decreases rectal epithelial cell proliferation in subjects with sporadic adenoma. Gastroenterology 103:92–97, 1992

    Google Scholar 

  36. Stadler J, Stern HS, Yeung KS, McGuire V, Furrer R, Marcon N, Bruce WR: Effect of high fat consumption on cell proliferation activity of colorectal mucosa and on soluble faecal bile acids. Gut 29:1326–1331, 1988

    Google Scholar 

  37. van Gorkum BAP, Karrenbeld A, van der Meer R, de Vries EGE, Kleibeuker JH: Colonic epithelial cell proliferation throughout the colon is not affected by supplementary calcium or resistant starch in adenoma patients: results of a controlled study. Eur J Gastroenterol Hepatol 11:A24, 1999

    Google Scholar 

  38. Anonymous. NEVO tabe. Nederlands Voedingstoffenbestand (NEVO table. Dutch nutrient database). Den Haag, Netherlands, Voorlichtingsbureau voor de Voeding, 1987 (in Dutch)

    Google Scholar 

  39. van Faassen A, Nagengast FM, Hectors M, van den Broek WJ, Huijbregts AW, Van der Werf SD, van Berge Henegouwen GP, van Tongeren JH: Determination of individual human faecal bile acids by gas-liquid chromatography after enzymatic deconjugation and simultaneous solvolysis and methylation using dimethoxypropane. Clin Chim Acta 152:231–239, 1985

    Google Scholar 

  40. Tangerman A, van-Schaik A, Meuwese AM, van-Tongeren JH: Quantitative determination of C2-C8 volatile fatty acids in human serum by vacuum distillation and gas chromatography. Clin Chim Acta 133:341–348, 1983

    Google Scholar 

  41. Narisawa T, Magadia NE, Weisburger JH, Wynder EL: Promoting effects of bile acids on colon carcinogenesis after intrarectal instillation of MNNG in rats. J Natl Cancer Inst 53:1093–1097, 1974

    Google Scholar 

  42. Chomsai C, Bhadrachari N, Nigro ND: The effect of bile on the induction of experimental intestinal tumours in rats. Dis Colon Rectum 17:310–312, 1974

    Google Scholar 

  43. Koga S, Kaibara N, Takeda R: Effect of bile acids on 1,2-dimethylhydrazine-induced colon cancer in rats. Cancer 50:543–547, 1982

    Google Scholar 

  44. Valhouny GV, Satchithanandram S, Lightfood F: Morphological disruption of colonic mucosa by free or cholestyraminebound bile acids. Dig Dis Sci 29:439–442, 1984

    Google Scholar 

  45. Hill MJ: Bile acids and colorectal cancer: hypothesis. Eur J Cancer Prev 1(suppl 2):69–72, 1991

    Google Scholar 

  46. van Munster IP, Tangerman A, de Haan AF, Nagengast FM: A new method for the determination of the cytotoxicity of bile acids and aqueous phase of stool: The effect of calcium. Eur J Clin Invest 23:773–777, 1993

    Google Scholar 

  47. Lapre JA, van der Meer R: Diet-induced increase of colonic bile acids stimulates lytic activity of fecal water and proliferation of colonic cells. Carcinogenesis 13:41–44, 1992

    Google Scholar 

  48. Rafter JJ, Eng VW, Furrer R, Medline A, Bruce WR: Effects of calcium and pH on the mucosal damage produced by deoxycholic acid in the rat colon. Gut 27:1320–1329, 1986

    Google Scholar 

  49. Walker AR, Walker BF, Walker AJ: Faecal pH, dietary fibre intake, and proneness to colon cancer in four South African populations. Br J Cancer 53:489–495, 1986

    Google Scholar 

  50. Thornton JR: High colonic pH promotes colorectal cancer. Lancet 1:1081–1083, 1981

    Google Scholar 

  51. Cummings JH: Short chain fatty acids in the human colon. Gut 22:763–779, 1981

    Google Scholar 

  52. Butler LM, Hewett PJ, Fitridge RA, Cowled PA: Deregulation of apoptosis in colorectal carcinoma: Theoretical and therapeutic implications. Aust N Z J Surg 69:88–94, 1999

    Google Scholar 

  53. Heerdt BG, Houston MA, Anthony GM, Augenlicht LH: Mitochondrial membrane potential (delta psi(mt)) in the coordination of p53-independent proliferation and apoptosis pathways in human colonic carcinoma cells. Cancer Res 58:2869–2875, 1998

    Google Scholar 

  54. Payne CM, Bernstein H, Bernstein C, Garewal H: Role of apoptosis in biology and pathology: Resistance to apoptosis in colon carcinogenesis. Ultrastruct Pathol 19:221–248, 1995

    Google Scholar 

  55. Dysseler P, Hoffem D: Estimation of resistant starch intake in Europe. In Proceedings of the Concluding Plenary Meeting of EURESTA. NG, Asp JM, van Amelsvoort JG Hautvast (eds). Den Haag, CIP-data Koninklijke Bibliotheek, 1995, pp 87–94

  56. Kashtan H, Stern HS, Jenkins DJ, Jenkins AL, Thompson LU, Hay K, Marcon N, Minkin S, Bruce WR: Colonic fermentation and markers of colorectal-cancer risk. Am J Clin Nutr 55:723–728, 1992

    Google Scholar 

Download references

Authors
  1. M.J.A.L. Grubben
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C.C.M. van den Braak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Essenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Olthof
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Tangerman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M.B. Katan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F.M. Nagengast
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grubben, M., Braak, C.v.d., Essenberg, M. et al. Effect of Resistant Starch on Potential Biomarkers for Colonic Cancer Risk in Patients with Colonic Adenomas. Dig Dis Sci 46, 750–756 (2001). https://doi.org/10.1023/A:1010787931002

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1010787931002

Search

Navigation