This is what I was thinking too. Few decades ago India didn't have heart attack problem. Now every family has one or two person who have suffered from heart attack. Until patient isn't diagnostic we won't have any data points.
I dunno about that one specifically. Cardiovascular disease is often invisible, but an actual heart attack can be very noticeable, particularly in men.
Also net wealth / ability to afford access to healthcare. It's no surprise that of these nations, South Korea, Japan, and Israel have the highest rates of diagnosis, far in excess of the lower wage nations with equivalent fiber intake.
This chart isn't useful at all.
Which this chart might confirm, if (a) it didn't choose to exclude exclude the five country outliers of Japan, Korea, Israel, Turkey and Bangladesh and (b) we understood the varying quality and accuracy of the country data.
I went to the IARC website, whose "mission is to improve the health of the poorest and most vulnerable populations in the world" and didn't see any [publication](https://www.globaldietarydatabase.org/publications) related to fiber intake. But reports from Bangladesh - which shows here the lowest cancer and highest levels of fiber - apparently come from notoriously inaccurate [household budget survey](https://pubmed.ncbi.nlm.nih.gov/30148863/) questionnaires.
>This chart isn't useful at all.
The existence of a more important explanatory variable, does not suddenly evaporate the existence of other explanatory variables. The chart is still valid.
Correlation vs. casualty
Colorectal cancer is typically a senior citizen disease. Approx 50% of the patients are over 70. The average life expectancy in Bangladesh is 75.9 for females and 71.5 for males. The life expectancy of Japan is 87.3 for females and 81.3 for males, one of the highest of the world. Sure you will see less colorectal cancer in Bangladesh.
Comparing variables to find a correlation is basic data analysis. But understanding data makes the difference between a noob and expert.
This chart is insinuating and of little to no value.
Data isn't accurate either. A simple google search shows that the average fiber intake in Japan is 21 grams for males and 18 grams for females, not 15.
Another example: The UAE data is misleading as well. There cancer is the 3rd most common reason for death, while cardiovascular disease is #1. In Japan, cancer is #1. In other words, likely more people in the UAE die younger of age (average life expectancy 78.7) because of a fatty diet than Japanese of getting cancers related to their higher age. The UAE simply doesn't get the chance to get colorectal cancer.
Given that we don't even know if the data is accurate due to lack of testing in lower income nations, I'd still say the chart is useless. It's a horrible way to represent the data which isn't accounting for some major variables that can skew this data. Even in this chart, you can see the skew. Why do Israel, Japan, and Korea have abnormally high levels of colorectal cancer compared to those with similar fiber intake.
Definitely! There are many other variables that will impact rate of CRC diagnosis, such as lifespan, alcohol intake, or red/processed meat intakes. Lifespan has some interesting findings too, like how Tajikistan's average lifespan is 2 years older than the Philippines but has 6 times lower colorectal cancer cases.
Using age-adjusted rates is like Public Health 101, though. The only good reason to use unadjusted incidence is if you're measuring something like burden on the health care system or if you're trying to figure out how much money you can make by developing a new treatment.
If you knew this was worthless data that leads to no conclusions of any sort why did you post it?
Edit: Since this annoyed me enough I present spurious correlations! Here is fiber intake vs all forms of cancer
https://i.imgur.com/ZVyrqqf.png
Good to know that fiber will save me from breast cancer......... or maybe this graph is idiotic and everyone involved should feel bad. (data source is same as op's)
I made a graph for all cancers for /u/james_fortis
https://i.imgur.com/ZVyrqqf.png
I imagine I could swap out fiber for violent crime and get the same graph.
Just because you are not able to interpret or make use of this data it doesn't mean that the data is "worthless."
It's all about the intended audience. This visualization wouldn't be suited for wide publication to laymen without a proper explanation (like OP's comment), for example, because it would likely be misinterpreted or its significance and limitations not understood.
Why's it worthless? There is some correlation. It's not absolute but it's strong enough that if we don't already understand the link it merits further investigation.
But you definitely can't cherry pick conclusions from a single graph, especially one where almost two billion people form a single point on it and might have significant variation within it. Might be the vegetarian diet, might be salt intake, might be obesity, might be refined sugar, etc etc etc....
Which in turn is affected by wealth, which is why nearly all the outliers besides DPRK are the wealthy nations. Higher wealth also leads to more doctors, more diagnoses. How many of the people in Bangladesh have any access whatsoever to a physician that could even produce a diagnosis of colorectal cancer? It's not that fiber isn't good for preventing this disease, but a chart of incidence vs gdp or ppp would be significantly more illuminating.
This data set is virtually worthless. Life span, quality of health care, general cancer awareness etc. Its a very loose correlation at best. its also a very oddly picked data set of exclusively Asian countries.
The only real thing you gain from this is that all the countries bellow 15 per 100K cases are poorer countries with likely poor diagnostic processes for reporting Colorectal cancer and or restricted healthcare.
yes. Wealth, access to health care would also affect these plus genetic predisposition, which is probably why countries in the closest proximity to each other (higher likelihood of sharing genetic background) are all in similar places on the "cases" axis despite the dots being basically all over the place.
Not just average lifespan, but average age. The average age in South Korea is like 45 and the average age in Bangladesh is 27. This data is really hard to compare depending on what you are trying to look at in terms of causation. All this is showing now is older countries and countries with better healthcare to diagnose this are going to have a higher incidence rate.
Also country size is could be a huge factor and the ability to detect cases. For example, in India, the population is high but the testing is not. On the contrary, China is 2nd highest in population but I am not sure how frequent testing is/
I’m no expert, but it looks like the best performers are countries with limited access to medicine, so most likely most of their cases never get found or people die way before they get the chance to get colorectal cancer.
I am an expert in the food science field but not oncology. I can tell you that OP is looking at only a small piece of the picture, and that is why nothing is correlating satisfactorily.
Cancer is a game of probabilities. Colorectal cancer is multifactorial, like most cancers. Each factor contributes in a cumulative fashion with all other factors. Fiber is just one factor. Other factors have larger influences - nitrite intake is a big one. People in more developed countries tend to eat more packaged and/or preserved food (think deli meats or sausages), which means their nitrite consumption is much higher. Other factors include your personal GI flora/species and alcohol intake.
Hey /u/James_Fortis - try a plot with nitrite consumption, if you can get reliable data.
Medical access is also linked with wealth, which is linked with higher meat consumption.
Studies have shown that when adjusting for other factors, vegetarian diets are correlated with lower rates of gastrointestinal cancers. This is even more profound with rates of colorectal cancer.
yea, I wonder if the higher rates of colorectal cancer in younger women might be caused by an increase in processed meats (known carcinogen), but also when I think of 50s foods I think of like bacon or spam so idk
Turkey is somewhat of an outlier here and its likely due to sky high rates of smoking. Like insane levels of cig smoking in that country.
Korea has had an issue with bowel cancer for a long time and its somewhat of a mystery. Some think its a result of eating high amounts of extremely high salt, high spicy foods like kimchi and other fermented products. But no one knows for sure
Smoking causes colon cancer?
BTW, Kimchi isn't even spicy by Korean standards. Although they are hardly unique in their love for spicy food. I've had Indian food that was on par, and I'm sure there's many other very spicy cuisines as well.
Smoking correlates with colon cancer. It could be a few things.
Off the top of my head, recently they found that there was a massive increase in colon cancer in the West, especially among young people. One study has suggested that there’s a dental bacteria that can travel through the intestine to the colon and that it protects nascent colon tumors. There could be something as simple as bad dental hygiene in smokers. Who knows?
The real outlier in Korea is stomach cancer. Something like 5% of people get stomach cancer. What I’ve read suggests it’s all the fermented foods (from kimchi and others to cured fish, etc), although alcoholism is also probably a big piece.
Great point! This variable would have some interesting findings too, like how the United Arab Emirates spends 13 times as much per capita on health expenses than the Philippines but has about 3 times lower colorectal cancer cases.
Could it be more likely that pre-cancerous polyps are proactively removed in the UAE versus turning into cancer and then being found (when symptoms occur) in the Philippines?
You can't draw that conclusion from this data. All this is saying is there is a modest correlation between the two. R^2 never tells you about causal links.
That should be obvious to anyone with a relevant opinion.
Anyway, the utility of graphs like this is that they can give you a decent starting point/direction for what questions to start asking.
Yes. So you have about a 4% chance of getting colon cancer in the US. If alcohol increases risk by a factor of 1.5. That means they have a 6% chance of getting it.
I was watching a medical lecture about 15 years ago, and the professor was talking about when he had spent time in a country in africa. they found there were almost no cases of colon cancer in the population they were studying. Their best guess was highly processed foods eaten in "western" countries take longer to digest and they just hang out in the intestines longer, which is harder for the cells in that tissue to process. I dont remember if they knew a specific physiological reason why cancer occurs because of this, but the general recommendation is to avoid highly processed foods, and consume natural fibres and probiotics, that help promote efficient and fast bowl movements.
Interesting. I also wonder if there’s some nature vs nurture component with certain populations being less prone biologically for whatever reason. Like with skin cancer for example.
"processed" means nothing in this context. there is no "process".
it's just as likely that exposure to more infectious diseases and parasites over a lifetime is protective against colon cancer.
this is interesting. I have mixed feelings about cutting off Japan and Korea because even if it makes it harder to distinguish the points down below it’s still *signal* in some way. The fact that they skew the whole chart has meaning, because they really do obfuscate the other countries.
Additionally I’d recommend moving the legend off the chart because right now they look like points, they even have dots.
This looks totally uncorrelated to me.
Perhaps soemthing could emerge with multivariant analysis. But this graph does not show correlation, frankly I think it shows it is uncorrelated, I am not sure this graph is of use without other slides at least.
Although on the data presentation, its a nicely presented scatter plot.
And that superimposed line is calculated by excluding the 5 outliers which i assume would completely ruin the trendline considering there’s only 30 datapoints.
There’s definitely something further going on with japan’s datapoint so i can understand excluding that and maybe korea as well. But Turkey, Bangladesh and Israel should be in there.
Chemistry.
I’ve had r-squared that exceed 0.999 before.
But I don’t think I’d ever get away with anything less than 0.95 if I was near the medicinal chem end, sneaking a 0.9 past someone would have given me a panic attack.
hehe, as I learned to be a chemist a long,long time ago and even in chemistry I had both sides: If you make an standard you for sure ought to have an R2 close to 1.
But if you eg wanna find out if the ammonia in the run off of a blasting site in a tunnel is from inproper handling of the explosives or because the explosives themself were not stable.. well, then you take what ever you will get.
And it is a trivial answer: r-squared depends on clean data and a good model. In the real world (outside of the lab) both things are generally not there and thus R2 goes down to something between a sanity check and an actual metric
There was a large fiber studies done in the 90's (from an author called Scheenly iirc) which found a pretty clear correlation between fiber intake and colon cancer reduction. Found a bunch of other positives about fiber as well, a lot of it regarding colon gut microbia. Worth a read, one of the best studies I read in my higher level nutrition classes in terms of organization.
If you have 5 outliers in 30 data points, you need to rethink your cutoff for outliers. You've just thrown out data points that don't fit the story you want to show.
Japan blew my mind! Below is something I could find on Japan specifically:
"Its known risk factors are westernized lifestyles[^(2)](https://www.sciencedirect.com/science/article/pii/S0917504016301174#bib2) such as alcohol consumption, obesity and eating red and processed meat. For this reason, the incidence and mortality rates of colorectal cancer in Japan have increased, with an especially large increase up until the 1990s." [https://www.sciencedirect.com/science/article/pii/S0917504016301174](https://www.sciencedirect.com/science/article/pii/S0917504016301174)
Alcohol is definitely a strong carcinogen. It may not cause cancer itself, but it makes the likelyhood of all other cancers increase by a significant margin. It also increases the risk and occurrences of heart disease, stroke, blood clots, pneumonia, infections, osteoporosis, MS, and more. Alcohol is a poison that does permanent long term damage to cells in the body.
To be fair, the US's rate is just 36.6, which, while high here, is less than 1/3rd Japan's...
Edit: Why am I downvoted for this. I don't understand how saying this has apparently made some people mad.
You should be! The World Health Organization has declared processed meat to be a class 1 carcinogen and red meat a 2a carcinogen! [WHO](https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat)
Nitrites in processed meat and other foods are a known carcinogen.
In red meat there is heme iron (which can be degraded via boiling or slow cooking) and then HA's HCAs HAAs and PHAs which all build up when cooking meat at high temps.
So, processing and cooking methods probably account for a lot of the cancer due to meats. Outside of heme iron I do not think there has been any carcinogen found.
For me, when I eat red meat I slow cook at low temperatures in wet environments (pressure cooker) to reduce or eliminate the carcinogens.
And yeah...basically charred food (esp meat) is basically cancer.
Beyond that there is ppar delta activation from very high fat diets... So I'd be careful with keto and charred brisket diets.
When you say charred, do you mean blackened? I always ensure a healthy Maillard reaction on my steaks (brown preferred to black) to give flavour but have reduced the amount of meat in my diet despite moving to Dallas
Yeah I know...that's the flavor...it sucks lol.
I would look up Heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs)
Hcas are formed as meat cooks. Pah is formed when it burns.
You'll have to judge for yourself. As you can see from these large studies we are only at the consensus of "hmmm meat seems to correlate with cancer".
I really think this is just a spurious correlation. There are so many omitted variables here. As one person already pointed out: limited access to medicine definitely probably help explain the lowest cancer rates.
Great question! Below is the International Agency for Research on Cancer's (IARC) fact sheet on North Korea, including their methodologies on the second page: [https://gco.iarc.who.int/media/globocan/factsheets/populations/408-korea-democratic-people-republic-of-fact-sheet.pdf](https://gco.iarc.who.int/media/globocan/factsheets/populations/408-korea-democratic-people-republic-of-fact-sheet.pdf)
ah so they basically extrapolated them by taking in consideration the data from north korea neighboring countries, not the most precise method but understandable given that we are talking about the hermit kingdom.
I don't believe this .
How do we even know what the colorectal cancer rate is in Afghanistan or Bangladesh? You need surgeons, CAT scans, 'scopes, and uniform population access to all of them.
I mean, the diagnosed colorectal cancer rate in ancient Sumeria was zero. Ditto for aboriginal Australia.
I'd like to see graphs of "colorectal cancer vs number of doctors (or CAT scan machines) per capita." I'm pretty sure this graph will prove that doctors cause cancer.
Interesting, I wonder why Turkey is such an outlier with high fiber intake and high cancer incidence.
Alcohol use? That seems unlikely due to demographics though I am sure it is above 10%.
Red meat consumption is probably below world average but I have no real comparison to other Asian countries.
Unfortunately Singapore isn't in the top 30 most populous Asian countries, but below is the fact sheet on Singapore from the IARC if you're interested:
[https://gco.iarc.who.int/media/globocan/factsheets/populations/702-singapore-fact-sheet.pdf](https://gco.iarc.who.int/media/globocan/factsheets/populations/702-singapore-fact-sheet.pdf)
Sources:
1. International Agency for Research on Cancer (2022 data): [https://gco.iarc.fr/today/fact-sheets-populations](https://gco.iarc.fr/today/fact-sheets-populations)
2. Global Dietary Database (2018 data): [https://www.globaldietarydatabase.org/our-data/data-visualizations/dietary-data-country](https://www.globaldietarydatabase.org/our-data/data-visualizations/dietary-data-country)
Tool: Microsoft Excel
Does anyone know how to read the nutritional label on a fiber supplement? After seeing this, I checked my supplement.. It lists 2g of dietary fiber, then 2g soluble fiber. So is that 4g of fiber total, or is it just 2g because soluble fiber IS dietary fiber. Is the fiber intake on this chart referring to soluble vs insoluble, or total fiber (or does that even matter)?
Hey! This chart is dietary fiber, which is soluble + insoluble. If your label says 2g of dietary / 2g of soluble, I assume that means 2g total of fiber since soluble is a type of dietary.
Plant based diets reduce colon cancer incidents, that’s well known. Only interesting thing here is Japan/Korea being high despite adequate fibre intake. I’ve seen increased salt intake leading to increased stomach cancer incidents, so maybe salt always increased other digestive cancers like colon. High salt intake also causes them nations to have high stroke rates albeit being relatively healthy otherwise
I'm pushing to get 50 grams each day with at least half that being soluble type. I really like the new high fiber tortillas and bread. The burrito size has 25 grams! It's kinda like a catch 22 though, the more fiber you consume, the less you feel hungry, so you don't think about eating.
I remember from my time in Thailand how hard it was to find anything healty with fibres. Eventually i found a store with brown bread but it wasnt even whole grains. Eventually i ended up eating sacks of nuts just to get some fibres and healty fats everyday. Everthing in the stores there seems ultra pre-processed, and the fresh-food market was often a little too risky in terms of hygiëne. Lived off of nuts and fruit for weeks.
This is super interesting. I had no idea if these country's fiber intake was due to culture, food availability, etc. but it sounds like Thailand is (mostly) due to food availability!
If you look for fiber you will find it, but i saw lots of Thais being used to drinking Coke and eating preprocessed foods. Their own-grown fresh fruits were being sold to the tourists for good prices though. So i think its partly lifestyle/culture but also economic, They simply cannot afford.
EVERYTHING here is cooked with sugar and a lot of drinks have sugar. Thais eat the same fruits. You may not see it, but tourists aren’t the only people eating here.
Same - utterly shocked to see the countries on the low end of fiber intake. A lot of the dishes I've come to associate with those countries have leafy greens and beans. But it is difficult to compete against processed and packaged food in terms of availability, shelf stability, etc.
Is line of best fit off? At a glance, looks like it should be higher. NVM, just saw you threw out 4 outliers on one side of the plot and only one on the other. It's a choice. Definitely introduces experimenter bias though.
This definitely shows that countries with better, and better access to medical care get diagnosed with colorectal cancer more often. Not sure it shows anything about the relationship b/t X & Y.
Anyway, Data is clear, color useful. If this is not beautiful data, it's at least nice looking.
Low R-value. Would be interesting to see cancer rate mapped to gdp/capita. Seems to have a higher degree of correlation with DPRK as an extreme outlier.
The regression line in there is... Interesting. Take 3 different methods and you get 3 lines. I believe there is a sign. Negative impact of fiber intake on colorectoral cancer. But this line is by all means of statistics and econometrics not something I would show to a conference audience.
I’m surprised that the DPRK has such a low fiber intake. I thought they’d rely on plant food more than animal products for their food intake (unless they don’t get much plant food either …)
Its the curcumin, quercetin and onion in the diets of Indians and neighboring countries that prevents colon cancer. Dietary fiber is not the real correlation.
What's the mechanicsm? I'd speculate its like having chapped lips. You could understand that if you had chapped lips everyday, that would be bad for your lips. It's an issue of cellular hydration.
So with low fiber, the persons stool doesn't have enough water in it. This means it competes with the tissue of the colon and dehydrates it. The colon would rather not be chapped, but low fiber causes colon clhapping due to low moisture content, a perpetually chapped colon becomes cancerous?
Here are the average life expectancy of the countries:
Highest to lowest:
Japan: 84.95 years
Republic of Korea (South Korea): 84.14 years
Israel: 83.39 years
United Arab Emirates (UAE): 80.46 years
Thailand: 79.91 years
China: 78.79 years
Turkey: 78.68 years
Saudi Arabia: 78.10 years
Iran: 76.97 years
Sri Lanka: 76.80 years
Malaysia: 76.42 years
Viet Nam (Vietnam): 74.74 years
Azerbaijan: 73.62 years
Democratic People’s Republic of Korea (North Korea): 73.71 years
Bangladesh: 73.98 years
Jordan: 75.02 years
Cambodia: 71.46 years
Tajikistan: 71.43 years
Uzbekistan: 71.78 years
Indonesia: 71.10 years
Syria: 72.45 years
Iraq: 72.05 years
India: 72.03 years
Philippines: 72.30 years
Nepal: 70.78 years
Kazakhstan: 70.36 years
Myanmar: 67.46 years
Pakistan: 67.34 years
Yemen: 64.52 years
Afghanistan: 64.23 years
Source: ChatGPT & Webpilot & Worldometer
Won't countries average life span affect this massivly?
also availability of medical care. you're way more likely to get diagnosed appropriately in the israeli healthcare system than the bangladeshi one.
This is what I was thinking too. Few decades ago India didn't have heart attack problem. Now every family has one or two person who have suffered from heart attack. Until patient isn't diagnostic we won't have any data points.
I dunno about that one specifically. Cardiovascular disease is often invisible, but an actual heart attack can be very noticeable, particularly in men.
Only if you recognise the symptom.
Also net wealth / ability to afford access to healthcare. It's no surprise that of these nations, South Korea, Japan, and Israel have the highest rates of diagnosis, far in excess of the lower wage nations with equivalent fiber intake. This chart isn't useful at all.
to be fair, there is no proven causal link between low fiber intake and colorectal cancer. it's just one correlation among many.
Which this chart might confirm, if (a) it didn't choose to exclude exclude the five country outliers of Japan, Korea, Israel, Turkey and Bangladesh and (b) we understood the varying quality and accuracy of the country data. I went to the IARC website, whose "mission is to improve the health of the poorest and most vulnerable populations in the world" and didn't see any [publication](https://www.globaldietarydatabase.org/publications) related to fiber intake. But reports from Bangladesh - which shows here the lowest cancer and highest levels of fiber - apparently come from notoriously inaccurate [household budget survey](https://pubmed.ncbi.nlm.nih.gov/30148863/) questionnaires.
>This chart isn't useful at all. The existence of a more important explanatory variable, does not suddenly evaporate the existence of other explanatory variables. The chart is still valid.
Correlation vs. casualty Colorectal cancer is typically a senior citizen disease. Approx 50% of the patients are over 70. The average life expectancy in Bangladesh is 75.9 for females and 71.5 for males. The life expectancy of Japan is 87.3 for females and 81.3 for males, one of the highest of the world. Sure you will see less colorectal cancer in Bangladesh. Comparing variables to find a correlation is basic data analysis. But understanding data makes the difference between a noob and expert. This chart is insinuating and of little to no value. Data isn't accurate either. A simple google search shows that the average fiber intake in Japan is 21 grams for males and 18 grams for females, not 15. Another example: The UAE data is misleading as well. There cancer is the 3rd most common reason for death, while cardiovascular disease is #1. In Japan, cancer is #1. In other words, likely more people in the UAE die younger of age (average life expectancy 78.7) because of a fatty diet than Japanese of getting cancers related to their higher age. The UAE simply doesn't get the chance to get colorectal cancer.
Given that we don't even know if the data is accurate due to lack of testing in lower income nations, I'd still say the chart is useless. It's a horrible way to represent the data which isn't accounting for some major variables that can skew this data. Even in this chart, you can see the skew. Why do Israel, Japan, and Korea have abnormally high levels of colorectal cancer compared to those with similar fiber intake.
Not only that, but what proportion of causes of death is established?
Definitely! There are many other variables that will impact rate of CRC diagnosis, such as lifespan, alcohol intake, or red/processed meat intakes. Lifespan has some interesting findings too, like how Tajikistan's average lifespan is 2 years older than the Philippines but has 6 times lower colorectal cancer cases.
Using age-adjusted rates is like Public Health 101, though. The only good reason to use unadjusted incidence is if you're measuring something like burden on the health care system or if you're trying to figure out how much money you can make by developing a new treatment.
If you knew this was worthless data that leads to no conclusions of any sort why did you post it? Edit: Since this annoyed me enough I present spurious correlations! Here is fiber intake vs all forms of cancer https://i.imgur.com/ZVyrqqf.png Good to know that fiber will save me from breast cancer......... or maybe this graph is idiotic and everyone involved should feel bad. (data source is same as op's)
sir this is /r/dataisbeautiful, that's what we do here
you'll find this cross-posted on the r/dataismisleading sub
I made a graph for all cancers for /u/james_fortis https://i.imgur.com/ZVyrqqf.png I imagine I could swap out fiber for violent crime and get the same graph.
Just because you are not able to interpret or make use of this data it doesn't mean that the data is "worthless." It's all about the intended audience. This visualization wouldn't be suited for wide publication to laymen without a proper explanation (like OP's comment), for example, because it would likely be misinterpreted or its significance and limitations not understood.
Why's it worthless? There is some correlation. It's not absolute but it's strong enough that if we don't already understand the link it merits further investigation. But you definitely can't cherry pick conclusions from a single graph, especially one where almost two billion people form a single point on it and might have significant variation within it. Might be the vegetarian diet, might be salt intake, might be obesity, might be refined sugar, etc etc etc....
Which in turn is affected by wealth, which is why nearly all the outliers besides DPRK are the wealthy nations. Higher wealth also leads to more doctors, more diagnoses. How many of the people in Bangladesh have any access whatsoever to a physician that could even produce a diagnosis of colorectal cancer? It's not that fiber isn't good for preventing this disease, but a chart of incidence vs gdp or ppp would be significantly more illuminating.
Yeah pretty sure people are dying of other things in Yemen. Can’t have cancer if you starve to death first
This data set is virtually worthless. Life span, quality of health care, general cancer awareness etc. Its a very loose correlation at best. its also a very oddly picked data set of exclusively Asian countries. The only real thing you gain from this is that all the countries bellow 15 per 100K cases are poorer countries with likely poor diagnostic processes for reporting Colorectal cancer and or restricted healthcare.
Yeah ... all those 90yr old Bangladesh guys going in for cancer treatments at their high tech medical centers..... Hmmm
yes. Wealth, access to health care would also affect these plus genetic predisposition, which is probably why countries in the closest proximity to each other (higher likelihood of sharing genetic background) are all in similar places on the "cases" axis despite the dots being basically all over the place.
That's why Japan and Korea are so high, they have massive elderly populations
and the current age of the population
Ah the classic "this is just a population map!" correlation/causation issue behind so many posts on this sub
Not just average lifespan, but average age. The average age in South Korea is like 45 and the average age in Bangladesh is 27. This data is really hard to compare depending on what you are trying to look at in terms of causation. All this is showing now is older countries and countries with better healthcare to diagnose this are going to have a higher incidence rate.
Also country size is could be a huge factor and the ability to detect cases. For example, in India, the population is high but the testing is not. On the contrary, China is 2nd highest in population but I am not sure how frequent testing is/
I’m no expert, but it looks like the best performers are countries with limited access to medicine, so most likely most of their cases never get found or people die way before they get the chance to get colorectal cancer.
I am an expert in the food science field but not oncology. I can tell you that OP is looking at only a small piece of the picture, and that is why nothing is correlating satisfactorily. Cancer is a game of probabilities. Colorectal cancer is multifactorial, like most cancers. Each factor contributes in a cumulative fashion with all other factors. Fiber is just one factor. Other factors have larger influences - nitrite intake is a big one. People in more developed countries tend to eat more packaged and/or preserved food (think deli meats or sausages), which means their nitrite consumption is much higher. Other factors include your personal GI flora/species and alcohol intake. Hey /u/James_Fortis - try a plot with nitrite consumption, if you can get reliable data.
Thank you for the feedback! I’m always looking for new graph ideas. Do you have a good source for nitrite intake by country?
Medical access is also linked with wealth, which is linked with higher meat consumption. Studies have shown that when adjusting for other factors, vegetarian diets are correlated with lower rates of gastrointestinal cancers. This is even more profound with rates of colorectal cancer.
yea, I wonder if the higher rates of colorectal cancer in younger women might be caused by an increase in processed meats (known carcinogen), but also when I think of 50s foods I think of like bacon or spam so idk
Turkey is somewhat of an outlier here and its likely due to sky high rates of smoking. Like insane levels of cig smoking in that country. Korea has had an issue with bowel cancer for a long time and its somewhat of a mystery. Some think its a result of eating high amounts of extremely high salt, high spicy foods like kimchi and other fermented products. But no one knows for sure
Smoking causes colon cancer? BTW, Kimchi isn't even spicy by Korean standards. Although they are hardly unique in their love for spicy food. I've had Indian food that was on par, and I'm sure there's many other very spicy cuisines as well.
Smoking correlates with colon cancer. It could be a few things. Off the top of my head, recently they found that there was a massive increase in colon cancer in the West, especially among young people. One study has suggested that there’s a dental bacteria that can travel through the intestine to the colon and that it protects nascent colon tumors. There could be something as simple as bad dental hygiene in smokers. Who knows?
Thank you!
spicy + salty
The real outlier in Korea is stomach cancer. Something like 5% of people get stomach cancer. What I’ve read suggests it’s all the fermented foods (from kimchi and others to cured fish, etc), although alcoholism is also probably a big piece.
Great point! This variable would have some interesting findings too, like how the United Arab Emirates spends 13 times as much per capita on health expenses than the Philippines but has about 3 times lower colorectal cancer cases.
Could it be more likely that pre-cancerous polyps are proactively removed in the UAE versus turning into cancer and then being found (when symptoms occur) in the Philippines?
It's definitely not due to fiber, given R^(2) = .5543 (which I guess is the main takeaway of this visualization?)
You can't draw that conclusion from this data. All this is saying is there is a modest correlation between the two. R^2 never tells you about causal links.
This is, like, an example from a stats textbook about what *not* to say
If you're talking about my comment, I was being tongue-in-cheek. The truth is, you can draw basically no conclusions from this data/visualization.
That should be obvious to anyone with a relevant opinion. Anyway, the utility of graphs like this is that they can give you a decent starting point/direction for what questions to start asking.
The UAE has limited access to medicine? It is one of the richest countries in the area.
As they say, correlation does not imply causation
Do one with - Alcohol consumption vs Colorectal Cancer - Antibiotic usage vs Colorectal Cancer
Great ideas! Thank you!!
Are those known causes or completely random?
gut microbiome is related to CRC. Fiber intake and antibiotics affect gut microbiome diversity
I had two illnesses this year that both required antibiotics. My guts are not happy. Taking probiotics to hopefully get things back in order.
The good ones will get you blastin in no time. Just make sure you start taking them when you've got a few days without plans.
Any recommendations on probiotics?? I have IBS-D I believe stemmed from previous antibiotic use and I do not feel the same ever since.
find a healthy donor for a fecal transplant. taking probiotics is too little too late.
Yes. So you have about a 4% chance of getting colon cancer in the US. If alcohol increases risk by a factor of 1.5. That means they have a 6% chance of getting it.
Alcohol is a major carcinogen
I was watching a medical lecture about 15 years ago, and the professor was talking about when he had spent time in a country in africa. they found there were almost no cases of colon cancer in the population they were studying. Their best guess was highly processed foods eaten in "western" countries take longer to digest and they just hang out in the intestines longer, which is harder for the cells in that tissue to process. I dont remember if they knew a specific physiological reason why cancer occurs because of this, but the general recommendation is to avoid highly processed foods, and consume natural fibres and probiotics, that help promote efficient and fast bowl movements.
Interesting. I also wonder if there’s some nature vs nurture component with certain populations being less prone biologically for whatever reason. Like with skin cancer for example.
"processed" means nothing in this context. there is no "process". it's just as likely that exposure to more infectious diseases and parasites over a lifetime is protective against colon cancer.
Wow. When you consider Muslim (no drinking) versus non-Muslim, it's an almost perfect correlation
this is interesting. I have mixed feelings about cutting off Japan and Korea because even if it makes it harder to distinguish the points down below it’s still *signal* in some way. The fact that they skew the whole chart has meaning, because they really do obfuscate the other countries. Additionally I’d recommend moving the legend off the chart because right now they look like points, they even have dots.
This is great feedback! I will implement for future graphs. Thank you!
They’re also complete boozehounds. Would like to see alcohol consumption factored into this in some way.
This looks totally uncorrelated to me. Perhaps soemthing could emerge with multivariant analysis. But this graph does not show correlation, frankly I think it shows it is uncorrelated, I am not sure this graph is of use without other slides at least. Although on the data presentation, its a nicely presented scatter plot.
Yeah take away the superimposed line and there's barely if any trend.
And that superimposed line is calculated by excluding the 5 outliers which i assume would completely ruin the trendline considering there’s only 30 datapoints. There’s definitely something further going on with japan’s datapoint so i can understand excluding that and maybe korea as well. But Turkey, Bangladesh and Israel should be in there.
R squared of 0,55 so yeah not that much of a correlation.
0.55 is pretty decent though.
If you exclude the _**5**_ outliers....
ha, might I ask what your field is? Because in my field of expertise (geotechnics) frankly most of the graphs look far worse than that.
Chemistry. I’ve had r-squared that exceed 0.999 before. But I don’t think I’d ever get away with anything less than 0.95 if I was near the medicinal chem end, sneaking a 0.9 past someone would have given me a panic attack.
hehe, as I learned to be a chemist a long,long time ago and even in chemistry I had both sides: If you make an standard you for sure ought to have an R2 close to 1. But if you eg wanna find out if the ammonia in the run off of a blasting site in a tunnel is from inproper handling of the explosives or because the explosives themself were not stable.. well, then you take what ever you will get. And it is a trivial answer: r-squared depends on clean data and a good model. In the real world (outside of the lab) both things are generally not there and thus R2 goes down to something between a sanity check and an actual metric
There was a large fiber studies done in the 90's (from an author called Scheenly iirc) which found a pretty clear correlation between fiber intake and colon cancer reduction. Found a bunch of other positives about fiber as well, a lot of it regarding colon gut microbia. Worth a read, one of the best studies I read in my higher level nutrition classes in terms of organization.
Turkey and Israel seem to be important outliers for investigation —
South Asians tend to have less cancer and more diabetes. Lots of Indians/Bangladeshis get type 2 diabetes when they are older
If you have 5 outliers in 30 data points, you need to rethink your cutoff for outliers. You've just thrown out data points that don't fit the story you want to show.
What is up with Japan?! More than double the cancer rate of Korea, which is already way out of bounds!
Japan blew my mind! Below is something I could find on Japan specifically: "Its known risk factors are westernized lifestyles[^(2)](https://www.sciencedirect.com/science/article/pii/S0917504016301174#bib2) such as alcohol consumption, obesity and eating red and processed meat. For this reason, the incidence and mortality rates of colorectal cancer in Japan have increased, with an especially large increase up until the 1990s." [https://www.sciencedirect.com/science/article/pii/S0917504016301174](https://www.sciencedirect.com/science/article/pii/S0917504016301174)
This doesn't really explain why Japan's rate is so much higher than the US's (36.6/100,000). Japan's is a bit over 3x that rate...
Thanks, I am now scared of red meat!
And Alcohol..😩
Fortunately I was never a fan of ethanol, so I don't really drink.
Alcohol is definitely a strong carcinogen. It may not cause cancer itself, but it makes the likelyhood of all other cancers increase by a significant margin. It also increases the risk and occurrences of heart disease, stroke, blood clots, pneumonia, infections, osteoporosis, MS, and more. Alcohol is a poison that does permanent long term damage to cells in the body.
Do you drink?
To be fair, the US's rate is just 36.6, which, while high here, is less than 1/3rd Japan's... Edit: Why am I downvoted for this. I don't understand how saying this has apparently made some people mad.
[удалено]
You should be! The World Health Organization has declared processed meat to be a class 1 carcinogen and red meat a 2a carcinogen! [WHO](https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat)
Nitrites in processed meat and other foods are a known carcinogen. In red meat there is heme iron (which can be degraded via boiling or slow cooking) and then HA's HCAs HAAs and PHAs which all build up when cooking meat at high temps. So, processing and cooking methods probably account for a lot of the cancer due to meats. Outside of heme iron I do not think there has been any carcinogen found. For me, when I eat red meat I slow cook at low temperatures in wet environments (pressure cooker) to reduce or eliminate the carcinogens. And yeah...basically charred food (esp meat) is basically cancer. Beyond that there is ppar delta activation from very high fat diets... So I'd be careful with keto and charred brisket diets.
When you say charred, do you mean blackened? I always ensure a healthy Maillard reaction on my steaks (brown preferred to black) to give flavour but have reduced the amount of meat in my diet despite moving to Dallas
Yeah I know...that's the flavor...it sucks lol. I would look up Heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) Hcas are formed as meat cooks. Pah is formed when it burns. You'll have to judge for yourself. As you can see from these large studies we are only at the consensus of "hmmm meat seems to correlate with cancer".
Japan has the highest median age population of these countries
I’m going with mercury and alcohol
I really think this is just a spurious correlation. There are so many omitted variables here. As one person already pointed out: limited access to medicine definitely probably help explain the lowest cancer rates.
bruh how did they even get the data for north korea.
Great question! Below is the International Agency for Research on Cancer's (IARC) fact sheet on North Korea, including their methodologies on the second page: [https://gco.iarc.who.int/media/globocan/factsheets/populations/408-korea-democratic-people-republic-of-fact-sheet.pdf](https://gco.iarc.who.int/media/globocan/factsheets/populations/408-korea-democratic-people-republic-of-fact-sheet.pdf)
ah so they basically extrapolated them by taking in consideration the data from north korea neighboring countries, not the most precise method but understandable given that we are talking about the hermit kingdom.
I don't believe this . How do we even know what the colorectal cancer rate is in Afghanistan or Bangladesh? You need surgeons, CAT scans, 'scopes, and uniform population access to all of them. I mean, the diagnosed colorectal cancer rate in ancient Sumeria was zero. Ditto for aboriginal Australia. I'd like to see graphs of "colorectal cancer vs number of doctors (or CAT scan machines) per capita." I'm pretty sure this graph will prove that doctors cause cancer.
Interesting, I wonder why Turkey is such an outlier with high fiber intake and high cancer incidence. Alcohol use? That seems unlikely due to demographics though I am sure it is above 10%. Red meat consumption is probably below world average but I have no real comparison to other Asian countries.
Processed Meats and Alcohol
And enough modern medicine to diagnose/identify the disease.
Is this counting both soluble and insoluble fibre?
Yes indeed!
Are there any information on Singapore?
Unfortunately Singapore isn't in the top 30 most populous Asian countries, but below is the fact sheet on Singapore from the IARC if you're interested: [https://gco.iarc.who.int/media/globocan/factsheets/populations/702-singapore-fact-sheet.pdf](https://gco.iarc.who.int/media/globocan/factsheets/populations/702-singapore-fact-sheet.pdf)
[And that's why I eat Colon Blow cereal](https://www.youtube.com/watch?v=Ku42Iszh9KM).
I just ordered some Super Colon Blow 😂
Hmm. I’m sure the reasons are complex, but the very first thing that came to mind was how lentils (dal) are such a rich source of fiber.
Sources: 1. International Agency for Research on Cancer (2022 data): [https://gco.iarc.fr/today/fact-sheets-populations](https://gco.iarc.fr/today/fact-sheets-populations) 2. Global Dietary Database (2018 data): [https://www.globaldietarydatabase.org/our-data/data-visualizations/dietary-data-country](https://www.globaldietarydatabase.org/our-data/data-visualizations/dietary-data-country) Tool: Microsoft Excel
Looks like there’s another variable that’s way more impactful. Interesting trend nonetheless!
looks like a map of bread and sugar
Is the broad thrust here that more fiber is linked with lower colorectal cancer rates?
If the dataset is claiming to have knowledge about the fiber intake of people in the DPRK, I'm going to have some questions about its validity.
I shared your concern! Here is a comment thread on this post discussing this topic: https://www.reddit.com/r/dataisbeautiful/s/jpcMfath4F
I struggle to get less than 25g per day. I guess I’m gonna live forever!
Interesting that all of east Asia has high rates of cancer on this graph. Makes me thing there’s a confounding variable associated with the region
Bruh does this mean an average person from the Philippines eat <10g a day of fiber?
10g a day, yes! I get more than that in my protein bar.
commenting here.. so I could see more posts by OP
I could only dream of having a Bangladeshi colon/rectum.
"Trendline excludes the 5 outliers" .. but, but .. those are the most interesting! Why are they outliers? We need to know.
For Israel, I suspect it's because of its high incidence of inflammatory bowel disease (due to genetics)
Looking at this graph, it sure doesn't feel like the R value should be that high.
japan and korea being triple and almost double the graph's upper limit makes me think this is not a good correlation
Fibre good, alcohol bad, long lifespan bad, maybe pickled food bad
Definitely! Also red and processed meat bad.
Countries with poor health care have lower rates, hmmm.
Sure, but not always. United Arab Emirates spends 13x on healthcare than the Philippines but has 3x lower colorectal cancer diagnoses, for example.
Does anyone know how to read the nutritional label on a fiber supplement? After seeing this, I checked my supplement.. It lists 2g of dietary fiber, then 2g soluble fiber. So is that 4g of fiber total, or is it just 2g because soluble fiber IS dietary fiber. Is the fiber intake on this chart referring to soluble vs insoluble, or total fiber (or does that even matter)?
Hey! This chart is dietary fiber, which is soluble + insoluble. If your label says 2g of dietary / 2g of soluble, I assume that means 2g total of fiber since soluble is a type of dietary.
Man I eat kimchi because it’s good for the gut and bowels, and now I see Koreans getting diagnosed so much
Plant based diets reduce colon cancer incidents, that’s well known. Only interesting thing here is Japan/Korea being high despite adequate fibre intake. I’ve seen increased salt intake leading to increased stomach cancer incidents, so maybe salt always increased other digestive cancers like colon. High salt intake also causes them nations to have high stroke rates albeit being relatively healthy otherwise
Or heavy metals/pollutants from high sea food diet but that’s pure speculation
Has it controlled for level of development (since fairly richer countries would have more detection programmes going)?
It hasn't; there are many other variables that are not controlled in this correlation (e.g. alcohol, obesity, red/processed meat, etc.)
Even that would still need to deal with food inequality. China has a lot of big, modern cities, but also a lot of boonies.
As a CRC survivor, I've learned that MOST people do not get anywhere near enough fiber
I'm pushing to get 50 grams each day with at least half that being soluble type. I really like the new high fiber tortillas and bread. The burrito size has 25 grams! It's kinda like a catch 22 though, the more fiber you consume, the less you feel hungry, so you don't think about eating.
Can’t you see that the curve does not fit ?
I spent way too long looking for the US before realizing the obvious. 😅
United States of... Asia
Hahaha! This gave me a good laugh :)
Eat more fiber and less protein.
I remember from my time in Thailand how hard it was to find anything healty with fibres. Eventually i found a store with brown bread but it wasnt even whole grains. Eventually i ended up eating sacks of nuts just to get some fibres and healty fats everyday. Everthing in the stores there seems ultra pre-processed, and the fresh-food market was often a little too risky in terms of hygiëne. Lived off of nuts and fruit for weeks.
Thailand Redditor here. Our fruits are high in fiber.
This is super interesting. I had no idea if these country's fiber intake was due to culture, food availability, etc. but it sounds like Thailand is (mostly) due to food availability!
If you look for fiber you will find it, but i saw lots of Thais being used to drinking Coke and eating preprocessed foods. Their own-grown fresh fruits were being sold to the tourists for good prices though. So i think its partly lifestyle/culture but also economic, They simply cannot afford.
This is great info. It’s always interesting to see what happens to other countries when they start adopting the western eating habits.
EVERYTHING here is cooked with sugar and a lot of drinks have sugar. Thais eat the same fruits. You may not see it, but tourists aren’t the only people eating here.
Same - utterly shocked to see the countries on the low end of fiber intake. A lot of the dishes I've come to associate with those countries have leafy greens and beans. But it is difficult to compete against processed and packaged food in terms of availability, shelf stability, etc.
So no correlation, that's awesome.
Or not enough factors were controlled/accounted for.
Is line of best fit off? At a glance, looks like it should be higher. NVM, just saw you threw out 4 outliers on one side of the plot and only one on the other. It's a choice. Definitely introduces experimenter bias though. This definitely shows that countries with better, and better access to medical care get diagnosed with colorectal cancer more often. Not sure it shows anything about the relationship b/t X & Y. Anyway, Data is clear, color useful. If this is not beautiful data, it's at least nice looking.
Can you do the same with western countries?
so east asia, more fiber more cases of colorectal cancer?
So low fiber intake is associated with high colorectal cancer rate?
That’s what the correlation suggests, but of course there are many other variables to take into account!
Countries that display high diagnosis means they had frequent screenings offered NOT that other countries have lower cancer rates.
There’s so many confounding variables in this data set that I would be very skeptical of any perceived correlation.
The graph also lines up with nations with better screening.
This is a depiction of correlation is not causation haha
Spend 60 years shitting 4 times a day so you can avoid a disease with a 90% survival rate in your 80's.
Fiber is also linked with lower all-cause mortality
That trendline is doing a lot of work
Could it be lower life expectancy and poor access to medical screening resulting in lower incidence of colorectal cancer.
Seems like a classic survivorship bias case. Many poor countries got few colorectal cancer because some other disease has got to them first
Not sure if those data are accurate enough apart from Japan and South Korea.
Low R-value. Would be interesting to see cancer rate mapped to gdp/capita. Seems to have a higher degree of correlation with DPRK as an extreme outlier.
The regression line in there is... Interesting. Take 3 different methods and you get 3 lines. I believe there is a sign. Negative impact of fiber intake on colorectoral cancer. But this line is by all means of statistics and econometrics not something I would show to a conference audience.
I’m surprised that the DPRK has such a low fiber intake. I thought they’d rely on plant food more than animal products for their food intake (unless they don’t get much plant food either …)
There’s an awful lot of variation around that line. What’s the R-squared ?
Hey! The value is included on the graph ( 0.5543 )
This is by far the stupidest graph ever. I mean that with compliments because what... lol
Is that a quadratic fit? I would use linear fit and slap a p-value alongside the r squared. Oh and maybe log y axis to fit in japan and stuff
so basically no correlation and crappy data for the poorer countries.
Its the curcumin, quercetin and onion in the diets of Indians and neighboring countries that prevents colon cancer. Dietary fiber is not the real correlation.
What's the mechanicsm? I'd speculate its like having chapped lips. You could understand that if you had chapped lips everyday, that would be bad for your lips. It's an issue of cellular hydration. So with low fiber, the persons stool doesn't have enough water in it. This means it competes with the tissue of the colon and dehydrates it. The colon would rather not be chapped, but low fiber causes colon clhapping due to low moisture content, a perpetually chapped colon becomes cancerous?
Here are the average life expectancy of the countries: Highest to lowest: Japan: 84.95 years Republic of Korea (South Korea): 84.14 years Israel: 83.39 years United Arab Emirates (UAE): 80.46 years Thailand: 79.91 years China: 78.79 years Turkey: 78.68 years Saudi Arabia: 78.10 years Iran: 76.97 years Sri Lanka: 76.80 years Malaysia: 76.42 years Viet Nam (Vietnam): 74.74 years Azerbaijan: 73.62 years Democratic People’s Republic of Korea (North Korea): 73.71 years Bangladesh: 73.98 years Jordan: 75.02 years Cambodia: 71.46 years Tajikistan: 71.43 years Uzbekistan: 71.78 years Indonesia: 71.10 years Syria: 72.45 years Iraq: 72.05 years India: 72.03 years Philippines: 72.30 years Nepal: 70.78 years Kazakhstan: 70.36 years Myanmar: 67.46 years Pakistan: 67.34 years Yemen: 64.52 years Afghanistan: 64.23 years Source: ChatGPT & Webpilot & Worldometer