Exploring Non-Genetic Factors in Cancer Resistance among Ramsar Residents: From Medical Geology to the Role of Diet: A Review

Document Type : Review Article

Authors

1 Independent Health/Nutrition Researcher, Tehran, Iran

2 Petroleum Engineering, Institute of Petroleum Engineering, University of Tehran, Tehran, Iran

3 Ionizing and Non-Ionizing Radiation Protection Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

5 Caldecot Centre, King's College Hospital NHS Foundation Trust, London, UK

6 Nutrition Research Center, Shiraz University of Medical Science, Shiraz, Iran

7 Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Science, Shiraz, Iran

8 Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

10.30476/ijns.2025.105774.1404

Abstract

Ramsar in northern Iran provides a unique natural setting to investigate the biological effects of exposure to chronic radiation and the potential adaptive mechanisms. It is owing to its exceptional high concentrations of radium in sedimentary rocks, hot springs, and the elevated indoor radon levels. Despite prolonged exposure, available evidences did not demonstrate an increased incidence of cancer among local residents, which may indicate adaptive biological responses or protective lifestyle factors, although a causal relationship has not been established. Beyond potential genetic influences, it can be hypothesized that the predominantly vegetarian diet of Ramsar inhabitants, rich in raw vegetables, fruits, nuts, and garlic, may contribute to the reduced cancer risk through its antioxidant and
anti-inflammatory effects. To explore the relatively low cancer incidence observed in this population, this review assessed existing evidences in relation to the potential protective role of diet against cancer and compared these findings with populations consuming acidogenic diets high in processed foods and animal proteins. The evidences collectively suggested that lifestyle and dietary factors may influence the biological impact of environmental stressors such as chronic exposure to natural radiations.

Highlights

Seyed Mohammad Javad Mortazavi (Google Scholar)

Seyed Jalil Masoumi (Google Scholar)

Keywords

References

  1. Al-Khawlany AH, Khan A, Pathan J. Review on studies in natural background radiation. Radiation Protect Environ. 2018;41:215-22. DOI: 10.4103/rpe.RPE_55_18.
  2. Cowart J, Burnett W. The distribution of uranium and thorium decay‐series radionuclides in the environment—a review. J Environ Qual. 1994;23:651-62. DOI: 10.2134/jeq1994.00472425002300040005x.
  3. Gökmen A, Gökmen IG, Hung YT. Radon pollution control. Advanced Air and Noise Pollution Control: Springer; 2005.p.335-57.
  4. Abbasi S, Mortazavi S, Mortazavi S. Martian residents: mass media and Ramsar high background radiation areas. J Biomed Phys Eng. 2019;9:483-86. DOI: 10.31661/jbpe.v0i0.1138. PMID: 31531302.
  5. Restier-Verlet J, Devic C, Bellemou C, et al. High Natural Background Radiation Areas: A Literature Review that Reveals Systematic Adaptive Response but Controversial Data With Single Dose. Dose Response. 2025;23:15593258251330680. DOI: 10.1177/15593258251330680. PMID: 40904649.
  6. Ghosh A. Biological and cellular responses of humans to high-level natural radiation: a clarion call for a fresh perspective on the linear no-threshold paradigm. Mutat Res Genet Toxicol Environ Mutagen. 2022;878:503478. DOI: 10.1016/j.mrgentox.2022.503478. PMID: 35649671.
  7. Ghiassi-Nejad M, Mortazavi S, Cameron J, Niroomand-Rad A, Karam P. Very high background radiation areas of Ramsar, Iran: preliminary biological studies. Health Phys. 2002;82:87-93. DOI: 10.1097/00004032-200201000-00011. PMID: 11769138.
  8. Mortazavi S, Ikushima T. Open questions regarding implications of radioadaptive response in the estimation of the risks of low-level exposures in nuclear workers. Int J Low Radiation. 2006;2:88-96. DOI: 10.1504/IJLR.2006.007899.
  9. Mortazavi S, Ghiassi-Nejad M, Rezaiean M, editors. Cancer risk due to exposure to high levels of natural radon in the inhabitants of Ramsar, Iran. International Congress Series; 2005: Elsevier.
  10. Mowlavi AA, Shahbahrami A, Binesh A. Dose evaluation and measurement of radon concentration in some drinking water sources of the Ramsar region in Iran. Isotopes Environ Health Stud. 2009;45:269-72. DOI: 10.1080/10256010903084084. PMID: 20183237.
  11. Pourhabib Z, Binesh A, Mohammadi S. A study on heavy radioactive pollution: Radon and Radium in streams and drinking water of Ramsar region by measured Prassi system. Iran J Phys Res. 2019;11:397-403.
  12. Amirzadi M, Hosseini PMS, Taheri M, et al. Complementary measurements of radon concentration in water sources and natural exposure in dwellings in the vicinity of the Ramsar HLNRA, Iran. Nuclear Technol Radiation Protec. 2012;27:399-403. DOI: 10.2298/NTRP1204399A.
  13. Ghiassi-Nejad M, Beitollahi M, Asefi M, et al. Exposure to 226Ra from consumption of vegetables in the high level natural radiation area of Ramsar-Iran. J Environ Radioact. 2003;66:215-25. DOI: 10.1016/S0265-931X(02)00108-X. PMID: 12600755.
  14. Fathabadi N, Salehi AA, Naddafi K, et al. Radioactivity levels in the mostly local foodstuff consumed by residents of the high level natural radiation areas of Ramsar, Iran. J Environ Radioact. 2017;169:209-13. DOI: 10.1016/j.jenvrad.2016.12.011. PMID: 28157640.
  15. Mortazavi S, Nematollahi S, Toosi SR, et al, editors. Does Exposure of Astronauts' Brains to High-LET Radiation in Deep Space Threaten the Success of the Mission? 2020 IEEE Aerospace Conference; 2020: IEEE.
  16. Mortazavi SMJ, Rafiepour P, Mortazavi SAR, et al. Radium deposition in human brain tissue: A Geant4-DNA Monte Carlo toolkit study. Z Med Phys. 2024;34:166-74. DOI: 10.1016/j.zemedi.2023.09.004. PMID: 38420703.
  17. Akbari B, Baghaei‐Yazdi N, Bahmaie M, et al. The role of plant‐derived natural antioxidants in reduction of oxidative stress. Biofactors. 2022;48:611-33. DOI: 10.1002/biof.1831. PMID: 35229925.
  18. Hendry JH, Simon SL, Wojcik A, et al. Human exposure to high natural background radiation: what can it teach us aboutradiation risks? J Radiol Prot. 2009;29:A29-42. DOI: 10.1088/0952-4746/29/2A/S03. PMID: 19454802.
  19. Sohrabi M. Proceedings of the international conference on high levels of natural radiation. Radiation Measurements. 1994;23:261-2. DOI:10.1016/1350-4487(94)90048-5.
  20. Mortazavi S, Azarpira N, Arshadi M, et al. High Background Radiation, Lower Risks: Rethinking Radiation's Role in Cancer through a Novel Murine Study. 2024.
  21. Mortazavi S, Niroomand-Rad A, Roshan-Shomal P, et al. Does short-term exposure to elevated levels of natural gamma radiation in Ramsar cause oxidative stress? Int J Appl Basic Med Res. 2014;4:72-6. DOI: 10.4103/2229-516X.136778. PMID: 25143879.
  22. Bugała E, Fornalski KW. Radiation adaptive response for constant dose-rate irradiation in high background radiation areas. Radiat Environ Biophys. 2025;64:29-44. DOI: 10.1007/s00411-024-01093-0. PMID: 39470814.
  23. Abbasi Siar F, Abdolmaleki P, Haeri A, Hosseini Pooya M. Chronic exposure effect study on Ramsar high background natural radiation areas (HBNRAs) residents using micronucleus assay. J Nuclear Sci Eng Technol. 2023;44:103-10. DOI: 10.24200/nst.2023.1345.
  24. Welsh JS, Bevelacqua JJ, Mortazavi S. Ramsar, Iran, as a Natural Radiobiological Surrogate for Mars. Health Phys. 2022;122:508-12. DOI: 10.1097/HP.0000000000001521. PMID: 35244616.
  25. Mortazavi S, Rabiee S, Fallah A, et al. Adaptive Responses in High-Radiation Environments: Insights From Chernobyl Wildlife and Ramsar Residents. Dose Response. 2025;23:15593258251385632. DOI: 10.1177/15593258251385632. PMID: 41122297.
  26. Mortazavi SMJ, Shekoohi Shooli F, Kadivar F, et al. The Role of Adipose Tissue-Derived Stem Cells together with Vitamin C on Survival of Rats with Acute Radiation Syndrome. J Biomed Phys Eng. 2024;14:1-10. DOI: 10.31661/jbpe.v0i0.2311-1680.
  27. Bahrami H, Tafrihi M. Global trends of cancer: The role of diet, lifestyle, and environmental factors. Cancer Innov. 2023;2:290-301. DOI: 10.1002/cai2.76. PMID: 38089751.
  28. Aghamir SMR, Mehrabani D, Dehghanian AR, et al, Nematolahi S, Kohi O, Shekoohi-Shooli F, Mortazavi SMJ. The regenerative effect of bone marrow-derived stem cells on cell count and survival in acute radiation syndrome. World J Plast Surg. 2017;5:111-13. PMID: 28289623.
  29. Mortazavi SMJ, Shekoohi-Shooli F, Aghamir SMR, et al. The healing effect of bone marrowderived stem cells in acute radiation syndrome. Pak J Med Sci. 2016;32:646-51. DOI: 10.12669/pjms.323.9895. PMID: 27375707.
  30. Jin ZY, Wu M, Han RQ, et al. Raw garlic consumption as a protective factor for lung cancer, a population-based case–control study in a Chinese population. Cancer Prev Res (Phila). 2013;6:711-8. DOI: 10.1158/1940-6207.CAPR-13-0015. PMID: 23658367.
  31. Wang Y, Liu B, Han H, et al. Associations between plant-based dietary patterns and risks of type 2 diabetes, cardiovascular disease, cancer, and mortality–a systematic review and meta-analysis. Nutr J. 2023;22:46. PMID: 37789346. DOI: 10.1186/s12937-023-00877-2.
  32. Bahrami H, Tafrihi M. Improving Natural Resistance to Cancer: An Overview of Metabolic Pathways in Cancer Cells Integrated with Regional Cancer Incidence Statistics. Jentashapir Journal of Cellular and Molecular Biology. 2023;14:e136216. DOI:10.5812/jjcmb-136216.
  33. Kenessey I, Nagy P, Polgár C. The Hungarian situation of cancer epidemiology in the second decade of the 21st century. Magy Onkol. 2022;66:175-84. PMID: 36200497.
  34. Rodler I, Zajkas G. Hungarian cancer mortality and food availability data in the last four decades of the 20th century. Annal Nutr Metab. 2002;46:49-56. DOI: 10.1159/000057640. PMID: 12011572.
  35. Zakerinia M, Amirghofran S, Namdari M, et al. Relationship between exposure to pesticides and occurrence of acute leukemia in iran. Asian Pacific J Cancer Prev. 2015;16:239-44. DOI: 10.7314/apjcp.2015.16.1.239. PMID: 25640359.
  36. Zakerinia M, Pakrooh R, Amirghofran S, et al. The correlation between breast cancer and plastic bras in fars province, southern iran. World Appl Sci J. 2013;27:1275-77. DOI:10.5829/idosi.wasj.2013.27.10.8186.
  37. Bogos K, Kiss Z, Gálffy G, et al. Revising incidence and mortality of lung cancer in Central Europe: an epidemiology review from Hungary. Front Oncol. 2019;9:1051. DOI: 10.3389/fonc.2019.01051. PMID: 31709174.
  38. Kesteloot H. Regional differences in mortality: a comparison between Austria, Hungary and Switzerland. Acta Cardiol. 1999;54:299-309. PMID: 10672285.
  39. Bahrami H, Tafrihi M. Global trends of cancer: The role of diet, lifestyle, and environmental factors. Cancer Innov. 2023;2:290-301. DOI: 10.1002/cai2.76. PMID: 38089751.
  40. Kanani A, Krasowska J, Fornalski KW, et al. Adaptive Response: A Scoping Review of Its Implications in Medicine, Space Exploration, and Beyond. Dose Response. 2025;23:15593258251360051. DOI: 10.1177/15593258251360051. PMID: 40686626.
International Journal of Nutrition Sciences
Volume 10, Issue 4 - Serial Number 4
December 2025
Pages 540-545

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