It's not simply endurance athletes though. It was 2x ultra-marathons >26 miles, or at least 5 marathons completed.

owenversteeg an hour ago | parent | next [-]

>2x ultra-marathons >26 miles, or at least 5 marathons completed

Yes, and it seems like it's really a 7.5x risk increase. Still pretty spectacular, though!

I really wonder what could cause that. Randomly throwing out possible causes: 1) blood redirected away from gut, 2) overuse of NSAIDS, 3) ultraprocessed foods (gels etc), 4) strange microbiome issues (gels + stress in gut from extreme exertion = altered gut flora?)

The study that found the result is DOI: 10.1200/JCO.2025.43.16_suppl.3619

▲

inglor_cz 2 hours ago | parent | prev [-]

Which is way more than what original hunters and gatherers ever clock. They do move a lot, but not so much, and they alternate their activities a lot too (running, walking, resting, taking entire days off and just guarding their village).

We're not really optimized for this sort of extreme endurance and long-term development of serious pathologies is unsuprising.

▲

greygoo222 2 hours ago | parent [-]

You shouldn't so offhandedly assume a hunter-gatherer lifestyle couldn't lead to issues like increased risk of CRC, or that activities which lead to increased risk of CRC couldn't be what hunter-gatherers did. Evolution is neither fast nor perfectly precise. Plenty of animal populations have common health problems that simply weren't harmful enough to reproduction to be selected out, much less something rare and late-onset like CRC.

▲

inglor_cz 2 hours ago | parent [-]

I don't assume anything. From what we know about health of the last surviving hunter-gatherers, they suffer significantly less from "diseases of civilization" when taken in proportion to their settled neighbours. Some of those diseases (such as high blood pressure or diabetes 2nd type) seem to be totally absent in them. Cancers do happen, but not as often.

This pattern is quite old. Already ancient Egyptians suffered from civilizational diseases much more than hunter-gatherers, especially the richer ones (heart attacks, gout, cancer).

▲

greygoo222 an hour ago | parent [-]

I won't bother checking or disputing the accuracy of your factual claims, because it does not matter.

Colorectal cancer is not the same thing as high blood pressure, or type 2 diabetes, or any other cancer that isn't colorectal cancer. Diseases are not a monolith and you cannot assume low risk of some diseases means low risk of others. That is wild guesswork passed off as logic, like measuring the shadow your testicles cast on the wall and announcing it is 24.1 degrees Celsius. Ultra-marathon runners also have low risk of type 2 diabetes!

Do you have specific evidence that modern hunter-gatherers have low rates of colorectal cancer that cannot be explained by survivorship bias, screening, genetic differences, and all other confounders, and that they are representative of historical hunter-gatherers? No? Then you cannot confidently conclude that hunter-gatherers didn't experience elevated rates of CRC.

	▲	pfannkuchen an hour ago \| parent \| next [-]
		Absolutely, we may have a depressed rate of CRC where ultramarathoners just get back up to the historical baseline. Who knows, but we don’t know it isn’t that.
	▲	inglor_cz an hour ago \| parent \| prev [-]
		"Diseases are not a monolith and you cannot assume low risk of some diseases means low risk of others. That is wild guesswork passed off as logic..." Diseases are not a monolith, but they do tend to arise and fall in some specific clusters, and that is not "logic", good or bad (too many computer-minded people drag logic into the chaos that is biology), but rather a long-time empirical observation, albeit with some exceptions.