Dietary Fiber and Laryngeal Cancer

Dietary Fiber and Laryngeal Cancer

Review of Ann of Oncol 2003;14(1):162-67.

The two biggest risk factors for laryngeal cancer are tobacco (smoking and chewing) and alcohol (drinking). However, even for individuals who have a history of smoking, chewing tobacco, and/or alcohol use, certain types of diet may increase or decrease risk of laryngeal cancer. A study published in the Annals of Oncology examined diet and risk of laryngeal cancer.  This article review discusses the findings of this study. The study indicates that eating more fiber DECREASES laryngeal cancer risk. We provide PRACTICAL information on what these findings mean.  Most importantly, we provide ideas for using this information in a dietary plan to reduce laryngeal cancer risk. Factors such as past use of tobacco and alcohol, age, and genetics cannot be changed, but diet and nutrition can! This type of information will allow people to take concrete and practical steps to decrease their risk of laryngeal cancer.

Note: Numbers appearing at the end of sentences indicate research references. References are listed at the end of each article.

Background

Laryngeal cancer occurs in the larynx, which is in the throat. Laryngeal cancer is located either on the vocal cords or just above or below the vocal cords. In the 1980s, researchers began to notice that diet might affect risk of laryngeal cancer (1,2). Since that time, researchers have continued to study how diet might increase or decrease laryngeal cancer risk (3-9). The two biggest risk factors for laryngeal cancer are tobacco (smoking and chewing) and alcohol use (drinking). However, even for individuals who have a history of smoking, chewing tobacco and/or alcohol use, certain types of diet may increase or decrease risk of laryngeal cancer. A study published in the journal Annals of Onoclogy examined fiber in the diet and risk of laryngeal cancer (10). It is hoped that this type of study will identify what type of diet increases or decreases risk of laryngeal cancer. Factors such as past use of tobacco and alcohol, age, and genetics cannot be changed, but diet and nutrition can! This type of information will allow people to take concrete and practical steps to decrease their risk of laryngeal cancer.
 
What The Study Found

For this study (10),527 people with laryngeal cancer and 1297 people without cancer were asked about their diet. Information on other lifestyle factors, including tobacco and alcohol use was collected and accounted for in the study. Researchers classified people regarding the amounts and types of fiber they had eaten in the past. Researchers used this information to examine whether or not eating fiber was related to having a history of laryngeal cancer.  Several important results came out of this study.

First, the researchers found that people who ate 22 or more grams of fiber per day had only ONE-THIRD the risk of laryngeal cancer when compared to people who ate 12 or less grams of fiber per day. In other words, eating MORE fiber DECREASES laryngeal cancer risk.

The other important finding from this study is that MANY different types of fiber decreased laryngeal cancer risk. In this study, both soluble fiber and insoluble fiber protected against laryngeal cancer equally. Both vegetable fiber and fruit fiber protected against laryngeal cancer. Vegetable fiber appeared to lower risk more than fruit fiber, but even fruit fiber decreased risk of laryngeal cancer by HALF, when researchers compared those eating the most fruit fiber with those eating the least! 

Vegetable fiber was the MOST protective against laryngeal cancer. People who ate 8 or more grams of vegetable fiber per day had only ONE-FIFTH the risk of laryngeal cancer when compared to people who ate 4 or less grams of vegetable fiber per day.

This type of information is helpful for knowing how to change the diet to get the MOST benefit and protection against laryngeal cancer.

What do these results mean?

If we assume that the people studied are similar to most people, then this study suggests that eating at least 22 grams of total fiber per day will decrease risk of laryngeal cancer. Government recommendations suggest that eating at least 25 to 35 grams of fiber per day is needed for optimal good health. This means if you meet the minimum recommended fiber intake, this should reduce your risk of laryngeal cancer.

Clearly, the number 1 and 2 things that you can do to most reduce your risk of laryngeal cancer is to stop using tobacco (smoking & chewing) and to decrease use of alcohol (beer, wine, hard liquor), if you currently use these products. Tobacco, in particular, is a large risk factor for this type of cancer.  Studies tell us that smokers have as much as 35 TIMES the risk of laryngeal cancer as non-smokers. Alcohol is a moderate risk factor for laryngeal cancer, with heavy drinking increasing risk the most. Light to moderate alcohol use likely does not increase risk greatly.  However, using both tobacco and alcohol together is a VERY, VERY large risk factor for laryngeal cancer.  People who both smoke and drink alcohol have the highest risk of laryngeal cancer.

The bottom line is that diet can be protective against laryngeal cancer, but be sure to look at your other habits too.

How can I change my diet to try to reduce my laryngeal cancer risk?

What should you do to help reduce your risk of getting laryngeal cancer? Remember, most importantly, stop smoking and reduce drinking, if you currently have these habits. However, according to this study (10), greatly increasing your intake of fiber, in particular fiber from vegetables, may be helpful for protecting against laryngeal cancer. Amazingly, even for those who have a long history of smoking and drinking, eating more fiber still helps reduce risk of laryngeal cancer!

Use the tips below to accomplish the goal of eating more fiber. 

Quick Tips On How to Eat More Cancer Fighting Fiber

• Rely on frozen produce during the off season.
• Add a handful of frozen blueberries, strawberries, or blackberries to your cereal.
• Stuff your favorite omelet with low-fat shredded cheese, tomatoes, and frozen spinach (cook and drain spinach first); Garnish with strawberries or peaches for a fruit serving.
• Snack on baby carrots and humus; you get both vegetables and legumes (beans) with this snack.
• For a tasty salad, steam several cups of frozen or fresh vegetables (cauliflower, carrots, broccoli, Brussels sprouts), until tender and crisp; Add 1/4 to 1/2 cup of salad dressing; Mix well and refrigerate until chilled; Instead of store-bought salad dressings, try your own mix of balsamic or apple cider vinegar and olive oil; If you find it too difficult to mix your own salad dressing, chose a brand that does not contain the words 'hydrogenated' or 'partially hydrogenated' in the ingredient list; Examples of this type of dressing include Annie's Naturals, Chelton House, and Seeds of Change. These are just a few examples. There are many companies that offer similar products. READ the label. If you see the words 'hydrogenated' or 'partially hydrogenated', go with a different product.
• Improve the nutrition value of your family's favorite main dish casserole by adding one cup of frozen mixed vegetables. Be sure to look for the veggie blends that include cauliflower, broccoli, and carrots.
• Stuff your favorite potato with antioxidant-rich toppings such as stewed tomatoes, green and red peppers, onions, broccoli, and low-fat cheese. Try a sweet potato instead of a white potato and you get even more nutrition value. 
• Get acquainted with green leafies. Try adding a few leaves of kale, chard, mustard greens, collard greens, dandelion greens, or any other green leafy food to your regular salad. Try our recipe for Sweet Spicy Kaleto get green food into your diet.
• Replace snack foods (pretzels, chips, crackers, etc.) with vegetables & fruits. Purchase pre-chopped and pre-washed vegetables and fruit, if you are busy. These may cost more, but if you eat them, it is worth the investment in your health!
• Focus on variety; The more color you eat in your plant foods, the better.
• Try to eat all colors of plant foods including orange, red, green, yellow, blue, purple, and dark green; Think of carrots, sweet potatoes, peppers, mangoes, papaya, blueberries, eggplant, kale, collard greens, spinach, etc.; Most people do not get enough variety for maximum cancer-fighting effect!
• Start basing your diet around UNPROCESSED whole plant foods including vegetables, fruit, whole grains, and legumes. Do this instead of basing your food choices around fast food, microwave meals, or instant dinner trays. These items contain unhealthy fats and too many  calories. Plus, they DO NOT contain as much healthy, cancer fighting fiber as whole plant foods (fruits, vegetables, whole grains, legumes).
• Try to have three-quarters of your plate covered by fruit, vegetables, whole grains, and legumes. It is ok to have one-fourth of the plate covered by chicken, meat, or fish. Chose fish more often - it is a healthier choice than other meats.

Quick Tips On How to Eat Even More Fiber

• Eat a high-fiber, whole grain, cereal, such as All-Bran, Bran-Buds, or Raisin Bran; Chose a cereal with at least 6 grams of fiber per serving.
• Chose whole grain, high fiber breads. Chose bread with at least 3 grams of fiber per serving.
• To be sure your bread products are whole grain, read the ingredient list. If you see the word 'enriched', then the product is NOT whole grain. Instead look for words such as 'whole grain' , 'stone ground', 'whole ground', 'whole wheat flour', 'whole oat flour', and 'whole barley flour'. These words tell you that this food is a whole grain.
• Learn to love legumes (beans). Legumes are a terrific source of fiber and other healthy nutrients.
• Eat low-sodium bean or lentil soup for lunch; it's quick and convenient and counts as a serving of legumes. Legumes are loaded with fiber.
• Use canned beans; rinse well and sprinkle on salad to add protein and fiber to your meal.
• Use whole grain pasta instead of plain, white pasta. One brand to try is Hodgson Mills; this is found in most local grocery stores.

A Few High Fiber Foods:

Food	Serving Size	Fiber
Breads/Cereals
Bran Cereal	1/2 cup	4-12 grams
Brown Rice	1/2 cup	3-6 grams
Oatmeal	1/2 cup	4 grams
Popcorn (air popped)	2 cups	5 grams
Raw Wheat Bran	1/4 cup	6 grams
Rye Bread	1 slice	2 grams
Whole Oat Bread	1 slice	4 grams
Whole Wheat Bread	1 slice	2-5 grams
Whole Wheat Pasta	1 cup	3-7 grams
Nuts/Seeds
Almonds	1 ounce	4 grams
Peanuts	1 ounce	3 grams
Pecans	1 ounce	2 grams
Sunflower Seeds	1 ounce	4 grams
Walnuts	1 ounce	2 grams
Legumes (beans)
Chickpeas (garbanzo)	1/2 cup	7 grams
Kidney	1/2 cup	8 grams
Lentils	1/2 cup	8 grams
Navy	1/2 cup	9 grams
Peas (canned)	1/2 cup	4 grams
Peas (dried)	1/2 cup	8 grams
Soynuts	1 ounce	5 grams
Fruit
Apple with peel	1 medium	4 grams
Apricots (dried)	6 pieces	3 grams
Banana	1 medium	2 grams
Blackberries	1/2 cup	4 grams
Blueberries	1/2 cup	2 grams
Kiwi	1 medium	5 grams
Orange	1 medium	3 grams
Peach with skin	1 medium	2 grams
Pears with skin	1 medium	5 grams
Prunes	5 pieces	3 grams
Raisins	1/4 cup	3 grams
Raspberries	1/2 cup	4 grams
Strawberries	1/2 cup	1.5 grams
Vegetables
Broccoli	1/2 cup	4 grams
Brussels Sprouts	1/2 cup	3 grams
Carrots	1/2 cup	2 grams
Cauliflower	1/2 cup	2 grams
Collard Greens	1/2 cup	1 gram
Corn (loose kernels)	1/2 cup	4 grams
Corn on the Cob	1 ear	6 grams
Green Beans	1/2 cup	2 grams
Kale	1/2 cup	2 grams
Mustard Greens	1/2 cup	2 grams
Turnip Greens	1/2 cup	2 grams
Water Chestnuts	1/2 cup	2 grams

*1 ounce of most nuts is about a small handful

You may want to try some of our high fiber recipes for more ways to increase fiber in your diet.

Sweet Spicy Kale

Tasty Tempeh Stir Fry

Lentil Sweet Potato Soup

NOTE: If you are in cancer treatment, these diet changes may not be right for you.

References

1. Kolonel LN, Hankin JH, Lee J, Chu SY, Nomura AM, Hinds MW. Nutrient intakes in relation to cancer incidence in Hawaii. Br J Cancer. 1981 Sep;44(3):332-9.

2. Notani PN, Jayant K. Role of diet in upper aerodigestive tract cancers. Nutr Cancer. 1987;10(1-2):103-13.

3. Pisa FE, Barbone F. Diet and the risk of cancers of the lung, oral cavity and pharynx, and larynx: a population-based case-control study in north-east Italy. IARC Sci Publ. 2002;156:141-44.

4. Bosetti C, La Vecchia C, Talamini R, Negri E, Levi F, Dal Maso L, Franceschi S. Food groups and laryngeal cancer risk: a case-control study from Italy and Switzerland. Int J Cancer. 2002;100(3):355-60.

5. Kasum CM, Jacobs DR Jr, Nicodemus K, Folsom AR. Dietary risk factors for upper aerodigestive tract cancers. Int J Cancer. 2002;99(2):267-72.

6. Levi F, Pasche C, Lucchini F, Chatenoud L, Jacobs DR Jr, La Vecchia C. Refined and whole grain cereals and the risk of oral, oesophageal and laryngeal cancer. Eur J Clin Nutr. 2000;54(6):487-89.

7. De Stefani E, Boffetta P, Oreggia F, Brennan P, Ronco A, Deneo-Pellegrini H, Mendilaharsu M. Plant foods and risk of laryngeal cancer: A case-control study in Uruguay. Int J Cancer. 2000;87(1):129-32.

8. Chatenoud L, Tavani A, La Vecchia C, Jacobs DR Jr, Negri E, Levi F, Franceschi S. Chatenoud L, Tavani A, La Vecchia C, Jacobs DR Jr, Negri E, Levi F, Franceschi S. Whole grain food intake and cancer risk. Int J Cancer. 1998;77(1):24-28.

9. Riboli E, Kaaks R, Esteve J. Nutrition and laryngeal cancer. Cancer Causes Control. 1996;7(1):147-56.

10. Pelucchi C, Talamini R, Levi F, Bosetti C, La Vecchia C, Negri E, Parpinel M, Franceschi S. Fibre intake and laryngeal cancer risk. Ann Oncol. 2003;14(1):162-67.

Publish Date: 10/2003