Cancer is a global health concern, claiming the lives of about 10 million people in 2020 alone. However, when we turn our attention to Arab countries in the Middle East, a fascinating observation emerges. Despite the growing incidence of cancer in the region, the figures remain significantly lower compared to Western countries. In this article, we delve into various factors that might contribute to this discrepancy, ranging from lifestyle choices to genetic predispositions.

Background:

In 2020, cancer was responsible for a staggering number of deaths worldwide, with breast, lung, colon, and rectum cancers leading the charts. Alarmingly, long-term projections for the Middle East indicate a 1.8-fold increase in cancer incidence by 2030. Yet, when we examine the reported figures, Arab countries exhibit considerably lower rates than Western counterparts.

Comparative Analysis:

Australia and New Zealand top the list of countries with the highest cancer rates, reporting 452.4 and 422.9 cases per 100,000 people, respectively. In contrast, Middle East countries, with Egypt and Lebanon leading the pack, report significantly lower figures, with Saudi Arabia and Sudan at the bottom of the list.

I. Fasting:

One intriguing aspect is the practice of fasting, particularly during Ramadan. This religious rite involves abstaining from food and drink from dawn to dusk for a month. Research suggests that intermittent fasting might play a role in cancer prevention and treatment. It is believed that healthy cells adapt better to nutrient scarcity, while cancer cells struggle to grow in such conditions. Some studies propose that fasting may enhance cancer cell sensitivity to chemotherapy, protecting normal cells and promoting stem cell production.

• Decreased Inflammation: Intermittent fasting has been associated with decreased inflammation, a factor linked to cancer development and progression. Studies indicate that short fasting periods can lead to a reduction in inflammatory markers in the blood.


• Enhancement of Immunity: Fasting induces changes that enhance cellular protection, initially guarding against weight loss and increasing protection from oxidative stress. The drop in insulin levels during fasting is significant, potentially impacting cancer risk. Studies in mice suggest that fasting can rejuvenate the immune system.


• Autophagy: Autophagy, a cellular process that degrades and recycles components, is another aspect linked to fasting. Its role in cancer is complex, but research explores its potential in preventing tumor formation or enabling adaptation, proliferation, survival, and metastasis of cancer cells.


• Slowing Cancer Growth and Promoting Cell Regeneration: Fasting may reduce glucose levels in the blood, making it harder for cancer cells to grow. Cancer cells rely heavily on glucose, and fasting may limit their access to it. Additionally, fasting could promote cell regeneration through a process called autophagy.

II. Spices:

The rich use of spices in Arab cuisine is another factor that may contribute to lower cancer rates.

• Turmeric: Turmeric, known for its anti-inflammatory properties, has shown promise in preventing cancer growth and killing certain cancer cells. Studies are ongoing to explore its potential when combined with conventional chemotherapy.


• Cinnamon: Cinnamon is believed to have an anti-cancer effect by affecting apoptosis-related pathways in cancer cells.


• Cardamom: Compounds in cardamom may enhance the activity of enzymes fighting cancer cells, potentially aiding in cancer prevention.


• Saffron: Saffron exhibits selective toxicity against cancer cells, inhibiting RNA and DNA synthesis and increasing apoptosis.


• Nutmeg, Black Seed, Dill, and Sesame Seed: Nutmeg compounds have shown the ability to inhibit some aspects of cancer cell metabolism, while black cumin (Nigella sativa) has demonstrated anti-inflammatory, antibacterial, antihistamine, and anticancer properties.

III. Alcohol and Cigarette Smoking:

The link between alcohol, cigarette smoking, and various cancers is well-documented. Interestingly, the Middle East shows significantly lower rates of female smoking compared to Western countries, and alcohol is prohibited in many Islamic nations.

IV. Genetic Predisposition:

Despite the changing incidence rates of breast cancer in the Middle East, genetic factors such as mutations in the BRCA1 and BRCA2 genes appear less prevalent among Arab populations compared to other ethnic groups.

Conclusion:

The Middle East experiences an accelerated incidence of some cancers, often attributed to adverse lifestyle choices and westernization. However, the overall cancer rates remain lower than those reported in Western countries. Clinical trials are crucial to understand the impact of caloric restriction, fasting, and dietary patterns in the Middle East on cancer incidence. Additionally, exploring hereditary cancer genes across the Arab world is essential for a comprehensive understanding of the observed patterns.