There has been a concerning increase in colon cancer rates among young adults over the past two decades. While more research is needed to fully explain the rise in early-onset colorectal cancer, experts have identified several risk factors that may be playing a role, including diets high in fats and ultra-processed foods, obesity, and other lifestyle and environmental factors.

Yale faculty members Michelle Hughes, MD, assistant professor of medicine (digestive diseases), and Anne Mongiu, MD, PhD, assistant professor of surgery (colon and rectal), are launching a new campaign, Loving Your Guts, to promote colon health. The campaign, which kicks off during Colon Cancer Awareness Month, includes research and community outreach efforts on food deserts and swamps in the state of Connecticut and their impact on early-onset colorectal cancer and other gastrointestinal conditions that are influenced by diet, such as inflammatory bowel disease (IBD).

“So much of the focus around colon cancer awareness has been on screening,” says Hughes. “While screening is essential, we also want to highlight ways to prevent and reduce the risk of these diseases.”

Educating the community on healthy eating for colon health

Hughes, a gastroenterologist who primarily takes care of patients in the hospital, says that there is a need for more education about healthy eating to promote colon health.

“In a busy health care setting, it’s easy to tell patients to adopt a high-fiber diet and then send them on their way,” Hughes says. “But it’s hard for most of us to know exactly what a high-fiber diet looks like or why avoiding red meat and ultra-processed foods is important. We can help people develop realistic ways to feed themselves and their families despite their busy lifestyles.”

As part of the new Loving Your Guts campaign, Hughes and Mongiu are collaborating with the Yale New Haven Health Irving and Alice Brown Teaching Kitchen to host a series of events to provide people with free, easily accessible information about foods to help improve colon health.

The first free, virtual event will take place on March 17, 2024, and will be presented by Yale faculty Max Goldstein, MS, RDN, and Nate Wood, MD, MHS, and with cookbook author Leanne Brown, MA. During the event, the presenters will demonstrate and discuss simple, easy-to-make meals for a healthy colon. The event will focus on portable, high-fiber, low-effort meals that can be made ahead of time using ingredients covered by SNAP-EBT for under $4 per meal.

“We hope to make this information accessible to everyone, including patients at Yale, our medical students, faculty, and staff, and families in the community who want to learn more about eating well for colon health,” says Mongiu. “In addition to the incredible work being done in research and drug discovery, we can impact people's lives today by teaching them how to prepare more healthy meals.”

Mapping food deserts and food swamps in Connecticut

Mongiu and Hughes are also conducting new research to identify hot spots for IBD and colon cancer within Connecticut so that they can focus future outreach and education in communities that are most affected.

To start, Mongiu and her team are mapping out food deserts and food swamps in New Haven and Fairfield counties. The map will include detailed, street-level data on fast food restaurants, sit-down dining options, grocery stores, convenience stores, and other locations that sell food.

“A person in a food desert may have healthy food nearby, but it is inaccessible because of a lack of transportation or financial resources. In a food swamp, the only food available is unhealthy,” says Mongiu. “Living in a food desert or food swamp may put people at higher risk of colon cancer, IBD, and other related diseases.”

The research team plans to correlate this map with Yale health outcomes data, such as rates of early-onset colon cancer and IBD.

“Using our comprehensive Yale dataset, we can drill down on the health of the populations and learn more about how access to healthy food influences health outcomes,” says Mongiu.

“Once we have these maps, we hope to be able to better understand which populations are most affected and where education and other resources are most needed so that we can more specifically target communities and community organizations,” Hughes adds. "We hope to collaborate with other amazing members of our medical community who are doing great work in and around Connecticut to address social drivers that impact the health of our community."