In recent years, there’s been a significant growth in young adults being diagnosed with colorectal cancer before age 50, which is now defined as early-onset colorectal cancer (EOCRC). Several risk factors, such as diet, physical inactivity, obesity, and lifestyle habits, can contribute to the development of EOCRC in young adults.
A recent study suggests that a major contributor to EOCRC may be a diet high in ultraprocessed foods (UPFs). The implications are especially important for the Black community, particularly Black women, who may face unique dietary, lifestyle, and access-to-care challenges.
What the Study Found
In a cohort study published in JAMA Oncology, researchers examined 29,105 female nurses participating in the Nurses’ Health Study II in the United States between 1991 and 2015. They analyzed how much of the participants’ diet was made up of UPFs and then measured the incidence of EOCRC precursor lesions (conventional adenomas) that developed before age 50.
Researchers discovered that women whose diets placed them in the highest quintile of UPF intake had 45% higher odds of developing early-onset conventional adenomas compared to women in the lowest quintile.
Why the Results Matter
There’s been a significant rise in EOCRC diagnoses worldwide, especially in high-income countries. Because regular colorectal screening is often recommended starting at age 45, younger adults are not yet getting routine screening, so identifying modifiable risks—such as diet—is urgent.
As mentioned earlier, one of the primary risk factors for early-onset colorectal cancer is diet. Ultraprocessed foods, such as ready-to-eat meals, sugary sodas, and packaged snacks, are very prominent in the American diet. In fact, researchers estimate that up to 70% of the U.S. diet consists of ultraprocessed foods. These foods are significantly low in beneficial nutrients like fiber and high in added sugars, refined flour/starch, and saturated fats.
While the study participants were primarily white women, the findings raise important red flags for broader populations, including Black women. Given the disparities in diet, access to fresh foods, socioeconomic factors, and colorectal cancer outcomes for Black adults, this type of research should inform public health strategies in historically underserved communities.
What’s Considered “Ultraprocessed Food?”
In the study, researchers used the Nova classification system to categorize foods by level of industrial processing. Ultraprocessed foods are defined as commercially formulated, ready-to-eat or heat products that contain little to no whole foods and several additives (e.g., sweeteners, salt, Yellow 5, xanthan gum, etc.).
In this cohort, the average UPF intake contributed to ~34.8% of daily calories and ~5.7 servings per day. The largest contributors were ultraprocessed breads and breakfast foods; sauces, spreads, and condiments; and sugary or artificially sweetened beverages.
What Black Women Can Take Away From This Study
While the study’s population was predominantly white, here are the broader implications that matter:
- Black adults in the United States have the highest mortality and incidence rates of colorectal cancer, which is why early prevention is so critical.
- In many Black communities, access to affordable, healthy, whole foods (fresh produce, whole grains, minimally processed meals) may be limited, while food deserts and reliance on packaged, processed foods are more common. Racism, discrimination, low wages, and unemployment are also contributing factors that make it challenging for some Black people to access healthy foods.
- Cultural dietary patterns and marketing of UPFs can disproportionately affect Black communities. Recognizing the risks associated with UPFs can empower better food choices and advocacy for better access.
- Young Black women can advocate for themselves by discussing their diet history and EOCRC risk with their healthcare providers (even if formal screening may not yet be recommended, lifestyle modification is relevant).
How to reduce ultra-processed food intake
Here’s what you can do to limit your intake of ultraprocessed foods and reduce your risk of early-onset colorectal cancer:
- Read labels and check ingredients: If a food item includes a lot of ingredients you don’t recognize (emulsifiers, preservatives, or artificial flavors) or if it’s “ready to eat” or “heat to serve,” it may be ultraprocessed.
- Choose whole or minimally processed foods: Opt for a diet rich in fresh fruits and vegetables, legumes, nuts, and seeds, lean meats, poultry, and fish, and home-cooked meals.
- Switch sugary beverages for water or unsweetened drinks: Because sugar-sweetened or artificially sweetened beverages were a major UPF subgroup in the study, try to limit or eliminate them from your diet.
- Limit fast food, packaged baked goods, and processed snacks: While it’s okay to enjoy them on occasion, aim for most meals to feature primarily whole ingredients with little to no processed ingredients.
- Speak with your healthcare provider: If you have other risk factors for colorectal cancer (e.g., family history, obesity, type 2 diabetes, etc.), talk with your provider about diet and screening recommendations.
Final thoughts
If you’re a young Black woman—particularly if you have an elevated risk of colorectal cancer—pay attention to what kinds of foods you consume. This study suggests that a diet high in ultraprocessed foods could increase your risk of developing colorectal cancer before age 50.
You can prevent EOCRC by shifting your focus toward whole and minimally processed foods, staying physically active, maintaining a healthy body weight, and discussing your risk factors with your healthcare provider.