Pancreatic Cancer and Diet

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The recent death of Kim Jong Il from complications likely caused by pancreatic cancer in N. Korea was unusual in his country even though pancreatic cancer has been increasing in most other countries. Why? Because Kim Jung Il enjoyed a typical Western diet and lifestyle while most N. Koreans have little or no access to such a lifestyle. The incidence of pancreatic cancer has been increasing dramatically in other Asian countries like South Korea, Japan and Taiwan as they adopt a more Western-style diet with more fatty meats and dairy products and more refined sugars and less fiber. As we’ve seen with Steve Jobs, Patrick Swayze, Luciano Pavarotti, and Count Basie having access to the best modern Western medicine has to offer does little to prevent death from pancreatic cancer. Very few diagnosed with pancreatic cancer live more than a year or two. Even when caught early before spreading the prognosis is not great with 77% dying within 5 years. Last year about 37,500 Americans died of pancreatic cancer, which is the most ever. If current trends continue pancreatic cancer may soon pass breast cancer as the third most common cancer killer of Americans.

High Insulin Levels May Promote Pancreatic Cancer

Obesity, insulin resistance, type 2 diabetes, and a diet high in fatty meats and dairy products have all been associated with an increased risk of developing pancreatic cancer.1 A study in Sweden, which followed over 75,000 people for 7.2 years, found that consuming more sugar significantly increased the risk of developing pancreatic cancer. People who added sugar to their foods and drinks at least 5 times per day had a 69% increased risk of pancreatic cancer com- pared to those who did not add sugar to their food.2 Consuming dietary sugar in beverages has been linked to weight gain and the development of type 2 diabetes in several studies. A recent case controlled study done in Italy examined the diets of 326 pancreatic cancer patients and that of 652 healthy controls and found that those consuming the most soluble fiber were 60% less likely to get pancreatic cancer. Those consuming more insoluble fiber were 50% less likely to get pancreatic cancer.3 This study and earlier studies have shown that fiber from fruits and vegetable appears to be more protective than fiber from grains.4

A study that followed men for 16.7 years found that those who had higher levels of insulin, blood glucose, and insulin resistance at the start of the study were more likely to develop pancreatic cancer.5 Both men and women with type 2 diabetes are known to have at least double the risk of developing pancreatic cancer as those without diabetes. However, the risk of developing pancreatic cancer is far higher for type 2 diabetics who inject insulin and/or use sulfonylurea drugs (which lower blood sugar by increasing blood insulin levels) to lower blood sugar levels than for those who rely largely on metformin (which lowers blood sugar levels and insulin levels). One study showed metformin users were 62% less likely to develop pan- creatic cancer than those using insulin and sulfonylureas.6 It appears higher insulin levels and perhaps the accompanying elevated insulin-like growth factor may play a major role in promoting pancreatic cancer.

A study that followed 190,045 people for 7 years found that those who ate the most pro- cessed meats as well as those who consumed the most beef, pork and lamb had a 50-68% increased risk for pancreatic cancer.7 Red meat and particularly processed meat intake is also linked to an increased risk of developing type 2 diabetes.8

Bottom Line: Since pancreatic cancer is nearly always fatal, an ounce of prevention is worth far more than expensive but largely ineffectual medical treatments. It is increasingly clear that a rich Western diet that leads to weight gain earlier in life and the development of insulin resistance and type 2 diabetes also likely promotes the development of pancreatic cancer. Exercise, weight loss and a diet high in whole grains, fruits, vegetables, beans with a little or no processed meats and red meats coupled with less refined carbohydrates appears best for those interested in avoiding pancreatic cancer - the most deadly of all the common cancers. Such a diet would also likely reduce the risk of colorectal cancer and other ills associated with a low-fiber modern diet.

By James J. Kenney, PhD, FACN

References:

1. J Nat Cancer Inst. 2009;101:1001:11

2. AmJClinNutr2006;84:1171-6

3. AnnOncology2012;23:264-8

4. InternatJCancer2005;114:817

5. JAMA2005:294;2872

6. Gastroenterology2009;137:482-8

7. JNatlCancerInst2005;97:1458

8. Pan, A. et al. Am J Clin Nutr. 2011;94:1088-96

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