Dr Maria Abreu is on the cutting edge of one of the biggest health tragedies in a generation.
Over the past decade, the Miami gastroenterologist has diagnosed an increasing number of young people with colon cancer – once considered an old person’s disease.
Obesity, sedentary lifestyles, and ultra-processed foods have long been blamed for the rise, but Dr Abreu said she’s seeing people in their 20s and 30s who eat healthy and stay fit developing the condition.
She’s convinced there’s more to the story.
Dr Abreu, who is also the president of the American Gastroenterological Association, told DailyMail.com she believes two additives that became common in the 1970s and are seldom talked about in relation to the colon cancer crisis could be behind the rise.
The first is high-fructose corn syrup, a liquid sweetener uniquely common to the United States and not used in other countries.
The above graph shows the rise of colorectal cancer in Americans under 50 in the last two decades
It’s usually associated with junk food like sodas and desserts but it has also sneaked into more ‘healthy’ foods such as salad dressings, oatmeal, fruit juices, cereals and bread.
High fructose corn syrup was introduced in the 1970s as a bid to stabilize food prices. At the time, President Richard Nixon authorized subsidizing corn crops to get farmers to grow more of them.
That excess led to the development of high-fructose corn syrup, which became cheaper to produce than sugar. Thus, it ended up everywhere.
Dr Maria Abreu, a gastroenterologist at the University of Miami, shared that preventing colon cancer needs to start at any early age
The other ingredient is emulsifiers, which is used to give foods a creamy texture and found in healthy foods such as low-fat yogurts, cottage cheese, and peanut butter.
Dr Abreu said these ingredients wreak havoc on the microbiome, a network of healthy bacteria in our guts.
When this delicate ecosystem becomes damaged, it reduces our ability to protect the digestive tract from pathogens that irritate our cells and create inflammation.
Over time, that inflammation can cause the formation of premalignant cells and lead them to multiply quickly, a process called proliferation.
Chronic inflammation can also lead to inflammatory bowel conditions like Crohn’s disease and ulcerative colitis, which Dr Abreu said ‘significantly’ raises the risk of colon cancer.
She notes the introduction of high-fructose corn syrup and emulsifiers in the 1970s and 80s could explain why so many adults in their 40s are getting colon cancer at record rates.
Data shows more than 50,000 Americans are expected to die from colorectal cancer this year. And for young people, figures are expected to double between 2010 and 2030.
Rates in people under 50 have also risen about two percent per year since the early 2000s.
The US has the sixth highest rate of early-onset cancers – disease in people under 50 – with 87 cases per 100,000 people younger than 50 years old – and colon cancer is among the fastest rising.
Researchers from the University of Missouri-Kansas City recently looked at rates of colorectal cancer in people 10 to 44 years old over the last two decades and found cases had risen in all age groups.
The rate of colorectal cancers grew 500 percent among children ages 10 to 14 and 333 percent among teenagers aged 15 to 19 years.
Rates rose by 71 percent among people 30 to 34 to seven cases per 100,000 people. Among people 35 to 39, rates rose by 58 percent to 12 cases per 100,000 people.
Dr Abreu said: ‘Chronic inflammation leads to colon cancer, and I suspect that’s transformative in this new rise of young people developing colon cancer.’
She noted similar effects have been seen with emulsifiers.
High fructose corn syrup is extremely common in popular foods because a small amount is incredibly sweet, making it cost-effective for food manufacturers
Joe Faratzis, 34, from Los Angeles, is pictured above in his twenties before his stage-four colon cancer was detected (left) and during treatment which began in 2020 (right)
Emulsifiers are common additives that help give dairy-free and low- and non-fat foods their combined and creamy texture. Ice cream and cream cheese are some of the most common foods containing these additives.
Common emulsifiers include soy lecithin, sucralose, xanthan gum, carrageenan, maltodextrin and polysorbate, all of which appear on ingredient labels.
Dr Abreu said: ‘One of the things that has changed very dramatically in our food supply is the addition of emulsifiers.’
A 2021 study published in the Journal of Physiology found six-week-old mice – the equivalent of a human teenager – who were given diets high in high-fructose corn syrup had ‘profound’ changes to their microbiome.
As for emulsifiers, one 2022 study found when mice consumed diets high in emulsifiers, their offspring experienced destruction of their intestinal barrier, leading to inflammation. The mice in the experiment were three weeks old, the equivalent of a human infant.
Dr Abreu noted this could be because children’s microbiomes are not as diverse and stable as an adult’s, so additives like emulsifiers and high-fructose corn syrup could have a larger impact on them than they would as adults.
To cut down on both additives, she recommends parents avoid pre-flavored or pre-sweetened foods and instead add sweeteners or flavors at home.
She uses Greek yogurt as an example.
While the breakfast staple is high in healthy bacteria called probiotics, which help regulate the microbiome, flavored varieties can be sweetened with high-fructose corn syrup.
Dr Abreu said: ‘I certainly don’t want to rat out yogurt as bad for you. Yogurt is one of the best things you can buy.
‘Greek yogurt, made naturally, can be a wonderful snack for people. But if you start eating stuff that’s really more sugar and milk than there is yogurt, that’s changing our gut bacteria.’
Instead, she suggests buying plain, unsweetened varieties and adding your own toppings like honey, granola, and fruit to make it taste better.
‘Even if you added table sugar to it, it would still have a whole lot less sugar than what they’ve added for you,’ she said.
‘Food made at home is still much better.’
However, other experts aren’t so sure these additives are all bad.
While high-fructose corn syrup has no known health benefits, some experts have claimed it’s not detrimental to health as long as the rest of your diet is balanced.
Daniel Feldman, a registered dietitian in New York, said in an interview with gynecologist Dr Jen Gunter: ‘If other aspects of your nutrition are on point (total calories, macronutrients, vitamins, minerals, fiber, and water) then there is no need to worry about HFCS.
Laurie Koshers, pictured above with two of her children, was diagnosed with stage 3 colon cancer at 44 years old. Mrs Koshers was a lifelong vegetarian and avid runner, so her cancer diagnosis came as a shock
‘That being said, since HFCS is a sweetener found in processed foods, and processed foods tend to be less nutrient dense and more calorically dense than unprocessed foods, foods with HFCS should generally constitute a small part of your diet (especially if your goal is weight loss).
‘But there is nothing inherently bad about HFCS.’
And when it comes to emulsifiers, Abbey Sharp, a myth-busting dietitian with more than 800,000 TikTok followers, said on TikTok these are typically only added to foods in small amounts and have not been well tested in humans.
Other experts also say the picture is more complex and have suggested the surge in young colorectal cancer cases could be due to a lack of fiber, which helps regulate digestion, and high amounts of processed and red meats.
Some recent research has even suggested that microplastics could be to blame, as they may damage protective intestinal lining.
The US also isn’t the only country experiencing a rise in young colorectal cancer cases. The UK, for example, is seeing a similar increase, with the disease rising 50 percent in people under 50 over the last 30 years.
However, the UK largely avoids high-fructose corn syrup in favor of cane sugar, so it’s unlikely the additive is responsible for those cases.
For both additives, Dr Abreu said: ‘I think it’s good to convey to parents that they should have their children minimally exposed to these things.
‘I’m a believer that colon cancer is preventable. Some of it has to start by transmitting this message to parents because we believe this is set in motion at a very early time.
‘It takes a lifetime of making good choices.’
THE CANCER-BUSTING, FIBER-LOADED DIET
An ideal lunch would include two slices of whole wheat bread, which provides six grams of fiber, one cup of tossed salad for three grams of fiber, two ounces of roast beef, a medium apple, which contains about three grams of fiber, and a glass of lemonade.
And for dinner, doctors recommend one baked potato with skin for three grams of fiber, three ounces of baked chicken, half a cup of broccoli for three grams of fiber, and a large glass of water.
The average American diet comprises processed foods, red meat, fats, simple carbohydrates, and just 15 grams of fiber a day.
In early 2023, the American Cancer Society (ACS) reported that 20 percent of diagnoses in 2019 were in patients under 55, roughly double the rate in 1995.
With the threat of excess deaths due to CRC in younger adults looming closer by the year, both the US Preventive Services Task Force (USPSTF) and the Multisociety Task Force on Colorectal Cancer, two organizations that offer preventive health guidelines, now advise that most Americans begin colorectal cancer screening at age 45—five years earlier than before—and continue to get screened regularly until age 75.
