Does Rye Bread Protect Against Cancer?

Sept 14 Rye Bread copy.jpeg

Previously, I've explored the beneficial effects of flaxseeds on prostate cancer (Flaxseeds vs. Prostate Cancer), as well as breast cancer prevention and survival (Flaxseeds & Breast Cancer Prevention and Breast Cancer Survival & Lignan Intake). The cancer-fighting effect of flaxseeds is thought to be because of the lignans, which are cancer-fighting plant compounds found in red wine, whole grains, greens (cruciferous vegetables), and especially sesame seeds and flaxseeds, the most concentrated source on Earth. But this is based on per unit weight. People eat a lot more grains than seeds. Of the grains people eat, the highest concentration of lignans is found in rye. So, can rye intake decrease the risk of cancer? Theoretically yes, but unlike flaxseeds, it's never been directly put to the test... until now.

In my video Does Rye Bread Protect Against Cancer?, I discuss the evidence that does exist. If you measure the levels of lignans in the bloodstream of women living in a region where they eat lots of rye, the odds of breast cancer in women with the highest levels do seem to be just half that of women with the lowest levels. But lignans are also found in tea and berries, so we couldn't be sure where the protection is coming from. To get around this, researchers decided to measure alkylresorcinol metabolites, a class of phytonutrients relatively unique to whole grains.

Researchers collected urine from women with breast cancer and women without, and the women with breast cancer had significantly lower levels compared to those without. This suggests that women at risk for breast cancer consume significantly lower amounts of whole grains like rye. But if we follow older women in their 50s through 60s, the intake of whole grain products was not associated with risk of breast cancer. A similar result was found in older men for prostate cancer. Is it just too late at that point?

We know from data on dairy that diet in our early life may be important in the development of prostate cancer, particularly around puberty when the prostate grows and matures. If you look at what men were drinking in adolescence, daily milk consumption appeared to triple their risk of advanced prostate cancer later in life. (Learn more about milk and prostate cancer in my video Prostate Cancer and Organic Milk vs. Almond Milk.) So, researchers looked at daily rye bread consumption during adolescence.

Those who consumed rye bread daily as kids did appear to only have half the odds of advanced prostate cancer. This is consistent with immigrant studies suggesting that the first two decades of life may be most important for setting the pattern for cancer development in later life. These findings are certainly important for how we should feed our kids, but if we're already middle-aged, is it too late to change course? To answer this question, researchers in Sweden put it to the test.

Researchers took men with prostate cancer and split them into two groups. One group got lots of rye bread, while the other got lots of high-fiber, but low-lignan, wheat bread. There's been some indirect evidence that rye may be active against prostate cancer--like lower cancer rates in regions with high rye consumption--but it had never been directly investigated... until this study. Biopsies were taken from the subjects' tumors before and after three weeks of bread eating, and the number of cancer cells that were dying off were counted. Though there was no change in the cancer cell clearance of the control bread group, there was a 180% increase in the number of cancer cells being killed off in the rye group. A follow-up study lasting 6 weeks found a 14% decrease in PSA levels, a cancer marker suggesting a shrinkage of the tumor.

The researchers note they used very high rye bread intakes, and it remains to be tested if more normal intake levels would have effects that are of clinical importance. As a sadly typical American, my lack of intimate familiarity of the metric system did not flag the "485 grams" of rye bread a day as far out of the ordinary, but that translates to 15 slices! Rather than eating a loaf a day, the same amount of lignans can be found in a single teaspoon of ground flaxseeds.


I've created several videos on flaxseeds for both breast cancer prevention and treatment, including Flaxseeds & Breast Cancer Prevention, Breast Cancer Survival and Lignan Intake, Flaxseeds & Breast Cancer Survival Epidemiological Evidence, and Flaxseeds & Breast Cancer Survival: Clinical Evidence.

What's more, flaxseeds may help with cyclical breast pain (Flaxseeds for Breast Pain), prostate cancer (Flaxseed vs. Prostate Cancer), diabetes (Flaxseeds vs. Diabetes), and hypertension (Flaxseeds for Hypertension).

And if you're wondering Which Are Better: Chia Seeds or Flaxseeds?, get the answer in the video!

The wonders of whole grains are also discussed in Whole Grains May Work as Well as Drugs, Can Oatmeal Reverse Heart Disease?, and Can Oatmeal Help Fatty Liver Disease?.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

Does Rye Bread Protect Against Cancer?

Sept 14 Rye Bread copy.jpeg

Previously, I've explored the beneficial effects of flaxseeds on prostate cancer (Flaxseeds vs. Prostate Cancer), as well as breast cancer prevention and survival (Flaxseeds & Breast Cancer Prevention and Breast Cancer Survival & Lignan Intake). The cancer-fighting effect of flaxseeds is thought to be because of the lignans, which are cancer-fighting plant compounds found in red wine, whole grains, greens (cruciferous vegetables), and especially sesame seeds and flaxseeds, the most concentrated source on Earth. But this is based on per unit weight. People eat a lot more grains than seeds. Of the grains people eat, the highest concentration of lignans is found in rye. So, can rye intake decrease the risk of cancer? Theoretically yes, but unlike flaxseeds, it's never been directly put to the test... until now.

In my video Does Rye Bread Protect Against Cancer?, I discuss the evidence that does exist. If you measure the levels of lignans in the bloodstream of women living in a region where they eat lots of rye, the odds of breast cancer in women with the highest levels do seem to be just half that of women with the lowest levels. But lignans are also found in tea and berries, so we couldn't be sure where the protection is coming from. To get around this, researchers decided to measure alkylresorcinol metabolites, a class of phytonutrients relatively unique to whole grains.

Researchers collected urine from women with breast cancer and women without, and the women with breast cancer had significantly lower levels compared to those without. This suggests that women at risk for breast cancer consume significantly lower amounts of whole grains like rye. But if we follow older women in their 50s through 60s, the intake of whole grain products was not associated with risk of breast cancer. A similar result was found in older men for prostate cancer. Is it just too late at that point?

We know from data on dairy that diet in our early life may be important in the development of prostate cancer, particularly around puberty when the prostate grows and matures. If you look at what men were drinking in adolescence, daily milk consumption appeared to triple their risk of advanced prostate cancer later in life. (Learn more about milk and prostate cancer in my video Prostate Cancer and Organic Milk vs. Almond Milk.) So, researchers looked at daily rye bread consumption during adolescence.

Those who consumed rye bread daily as kids did appear to only have half the odds of advanced prostate cancer. This is consistent with immigrant studies suggesting that the first two decades of life may be most important for setting the pattern for cancer development in later life. These findings are certainly important for how we should feed our kids, but if we're already middle-aged, is it too late to change course? To answer this question, researchers in Sweden put it to the test.

Researchers took men with prostate cancer and split them into two groups. One group got lots of rye bread, while the other got lots of high-fiber, but low-lignan, wheat bread. There's been some indirect evidence that rye may be active against prostate cancer--like lower cancer rates in regions with high rye consumption--but it had never been directly investigated... until this study. Biopsies were taken from the subjects' tumors before and after three weeks of bread eating, and the number of cancer cells that were dying off were counted. Though there was no change in the cancer cell clearance of the control bread group, there was a 180% increase in the number of cancer cells being killed off in the rye group. A follow-up study lasting 6 weeks found a 14% decrease in PSA levels, a cancer marker suggesting a shrinkage of the tumor.

The researchers note they used very high rye bread intakes, and it remains to be tested if more normal intake levels would have effects that are of clinical importance. As a sadly typical American, my lack of intimate familiarity of the metric system did not flag the "485 grams" of rye bread a day as far out of the ordinary, but that translates to 15 slices! Rather than eating a loaf a day, the same amount of lignans can be found in a single teaspoon of ground flaxseeds.


I've created several videos on flaxseeds for both breast cancer prevention and treatment, including Flaxseeds & Breast Cancer Prevention, Breast Cancer Survival and Lignan Intake, Flaxseeds & Breast Cancer Survival Epidemiological Evidence, and Flaxseeds & Breast Cancer Survival: Clinical Evidence.

What's more, flaxseeds may help with cyclical breast pain (Flaxseeds for Breast Pain), prostate cancer (Flaxseed vs. Prostate Cancer), diabetes (Flaxseeds vs. Diabetes), and hypertension (Flaxseeds for Hypertension).

And if you're wondering Which Are Better: Chia Seeds or Flaxseeds?, get the answer in the video!

The wonders of whole grains are also discussed in Whole Grains May Work as Well as Drugs, Can Oatmeal Reverse Heart Disease?, and Can Oatmeal Help Fatty Liver Disease?.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

Which Dietary Factors Affect Breast Cancer Most?

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One of my favorite cancer-specific charities, the American Institute for Cancer Research, lauds the China Study and the documentary Forks Over Knives, with which they share the same bottom-line message: The healthiest diets are those that revolve around whole plant foods.

They then translate that advice into their Ten Recommendations for Cancer Prevention, featured in my video Which Dietary Factors Affect Breast Cancer Most? We now have evidence that those who follow such advice are actually protected against cancer. Breast cancer risk was reduced by 60% in women who met at least five recommendations compared with those who met none. The most important dietary advice was to be as lean as possible within the normal range of body weight, eat mostly foods of plant origin, and limit alcoholic drinks.

What about other cancers? Greater adherence to the AICR dietary guidelines was also associated with significantly less endometrial, colorectal, lung, kidney, stomach, oral, liver, and esophageal cancer. In other words, adherence to dietary recommendations for cancer prevention may lower the risk of developing most types of cancer. The drop in bladder cancer did not reach statistical significance, but a larger follow-up study following 469,000 people for 11 years (the largest to date) found that just a 3% increase in the consumption of animal protein calories was associated with a 15% higher risk of bladder cancer, whereas just a 2% increase in plant protein was associated with a 23% lower risk.

AICR recommendation number ten is that cancer survivors should follow the recommendations for cancer prevention. The same diet that can help prevent cancer in the first place can be used to help save our life after diagnosis. Adherence to the guidelines for cancer prevention was found to be associated with lower mortality among older female cancer survivors, or breast cancer and other cancers in general.

A cancer diagnosis is considered a teachable moment to get people eating and living healthier. Oncologists revel at the growth in the number of cancer survivors in this country, now ten million strong and growing. It's great that those with cancer are living longer, but even better to prevent it in the first place so we can all live longer. Not only does adherence to the guidelines lower cancer risk, but extends our lifespan because the guidelines are also significantly associated with a lower hazard of dying from heart disease and respiratory disease, suggesting that following the recommendations could "significantly increase longevity."

Just like eating to prevent cancer helps to prevent heart disease, eating to protect our heart helps prevent cancer. It sounds self-evident, but adherence to a healthy lifestyle is therefore associated with a lower risk of mortality overall. And the more healthy behaviors we have, the longer we get to live. Such factors included not smoking, walking every day, or eating green leafy vegetables almost daily.

To help differentiate the effects of diet from other lifestyle behaviors like smoking and drinking on cancer incidence, Adventists were recently compared to Baptists. Both discourage alcohol and tobacco, but the Adventists go further, encouraging a reduction of meat. In general, the Adventists had lower cancer hazard rates than the Baptists, and within Adventist populations, the vegetarians did even better, and those eating the most plants, did the best.

Why do plant-based diets appear to lower the risk of cancer? A number of fascinating mechanisms:

Specific to breast cancer:

Though plant-based beverages may be harmful: Breast Cancer and Alcohol: How Much Is Safe?

In terms of foods associated with breast cancer survival, see:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: MesserWoland

Image Credit: [Lev Kropotov] © 123RF.com

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Why Deep Fried Foods May Cause Cancer

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In the latest study on dietary patterns and breast cancer risk among women, healthier eating was associated with eliminating three-quarters of the odds of breast cancer, whereas less healthy eating was associated with up to nearly eight times the odds. Included in the unhealthy eating pattern was the consumption of deep-fried foods, which have previously been linked to breast cancer, pancreatic cancer, lung cancer, oral and throat cancers, esophageal cancer, and cancer of the voicebox. No deep fried foods? What's a Southern belle to do? Instead of deep fried foods, how about the traditional Southern diet, characterized by high intakes of cooked greens, beans, legumes, cabbage, sweet potatoes and cornbread, which may reduce the risk of invasive breast cancer significantly.

What about the consumption of deep-fried foods and risk of prostate cancer? Researchers at the Fred Hutchinson Cancer Research Center and the University of Washington found that eating French fries, fried chicken, fried fish, and doughnuts was associated with about a third greater odds of prostate cancer. After stratifying for tumor aggressiveness, they found slightly stronger associations with more aggressive disease, suggesting that regular intake of deep-fried foods may contribute to the progression of prostate cancer as well.

What in deep fried foods is so bad for us? Just heating oil that hot can generate potentially carcinogenic compounds, and then known carcinogens such as heterocyclic amines and polycyclic aromatic hydrocarbons form when the muscles of chickens and fish are cooked at that temperature. Deep-fried plants, on the other hand, can form acrylamide.

I did a video about acrylamide back in 2008, suggesting it's a probable human carcinogen (See Acrylamide in French Fries). Since then, studies have suggested pregnant women may want to cut back on French fries to protect the growth of their baby's body and brain. Based on a study (highlighted in my video, Cancer Risk from French Fries) feeding people a little bag of potato chips every day for a month, it now seems acrylamide may also cause inflammation as well, which could explain its purported role in cancer progression.

Acrylamide intake has been associated with endometrial cancer, ovarian cancer, lung cancer, kidney cancer, and esophageal cancer. How much cancer risk are we talking about? Taiwanese researchers examined lifetime cancer risk and French fry consumption. The researchers picked on French fries because they comprise by far the greatest percentage contribution of acrylamide to the diets of children. They estimated that, at most, one or two boys and girls out of every ten thousand would develop cancer eating French fries that they would otherwise not have developed if they hadn't eaten French fries. So it's not as bad as eating something like fried fish, or fried chicken, but how much is that saying?

The level of cancer risk in both boys and girls associated with French fries depends on how long and hot they're fried. In Europe, the food industry swore that they'd self-regulate and control fry times to decrease acrylamide levels, but we've yet to see any subsequent change in acrylamide levels in French fries.

Researchers continue to urge that the cooking temperature should be as low as possible and the cooking time should be as short as possible, "while still maintaining a tasty quality" of course. We wouldn't want to reduce cancer risk too much--they might not taste as good!

Blanching the potatoes first reduces acrylamide formation, but potato chip companies complain that, not only would it muck with the flavor, but it would reduce the nutritional properties by leaching away some of the vitamin C. But if we're relying on potato chips to get our vitamin C, acrylamide is probably the least of our worries.

More on heterocyclic amines:

There are some things we can do to counteract the effects of these carcinogens, though:

I touch on polycyclic aromatic hydrocarbons in Meat Fumes: Dietary Secondhand Smoke and Is Liquid Smoke Flavoring Carcinogenic?
Certain fats may play a role in breast cancer survival as well: Breast Cancer Survival, Butterfat, and Chicken and Breast Cancer Survival and Trans Fat.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Kim Love / Flickr

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Do Cholesterol Statin Drugs Cause Breast Cancer?

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What does breast cancer have to do with cholesterol? There are many potential mechanisms by which cholesterol boosts breast cancer growth. For example, our bodies make estrogen, which is correlated with an increased risk of breast cancer, out of cholesterol. We also package cholesterol into LDL, which, as you can see in my video Cholesterol Feeds Breast Cancer Cells, appeared to increase cancer proliferation and decrease patient survival.

Cholesterol is a major component of "lipid rafts." Compared to their normal counterparts, cancer cells have higher levels of these cholesterol-rich lipid rafts in their plasma membrane, which may be important for cancer cell survival and may serve in human cancer development in terms of tumor migration and invasion. Elevated levels of cholesterol-rich lipid rafts have been found in breast cancer cells, and the hypothesis is that reducing blood cholesterol levels "may disrupt lipid raft formation and thereby inhibit breast cancer development." This suggests cholesterol targeting may be used as a cancer therapy.

Controlled laboratory experiments have shown that phytosterols in seeds and nuts at dietary relevant levels appear to inhibit the growth of several types of tumor cells including breast cancer cells, including both estrogen-receptor negative and estrogen-receptor positive cancer. The therapeutic implications are that "plant-based diets rich in phytosterols may offer protection against the development of breast cancer." Of course, you can't make a lot of money on pumpkin seeds, so researchers looked to cholesterol-lowering statin drugs (this study is highlighted in my video, Statin Cholesterol Drugs and Invasive Breast Cancer).

Some petri dish work looked promising, but population studies have shown mixed results. Some studies showed that women on statins had decreased breast cancer risk, some showed increased risk, and most showed no association. These were all relatively short-term studies, though. "Long-term" statin use was defined as mostly just three to five years, but breast cancer can take decades to grow. The one study that looked at ten or more years of statin use only included 62 cases.

Given the increase in statin use over the past few decades, and the fact that they're commonly prescribed to be taken every day for the rest of women's lives, the studies published to date only had limited ability to evaluate the impact of long durations of use. We better figure this out: about one in four women over 45 in this country are on these drugs.

But that all changed with the publication of a study in 2013 including thousands of breast cancer cases. Long term statin users--women taking statins for ten years or more--had more than double the risk of both major types of breast cancer: invasive ductal carcinoma and invasive lobular carcinoma. Once women do get breast cancer, though, recent studies in Finland and the UK suggest statin use may improve survival.

The number one killer of women is heart disease, not breast cancer, so we still do need to bring down cholesterol levels. Might there be a way to get the benefits of cholesterol reduction without the risks? Plant-based diets have been shown to lower LDL-cholesterol by over 30%, within just a couple weeks, equivalent to most of the standard cholesterol lowering statin drugs and without any breast cancer risk.

As drugs go, statins are remarkably safe, but they can still present rare but serious side effects in both men and women (Statin Muscle Toxicity).

How can we lower cholesterol without drugs? It's Purely a Question of Diet. We can lower our cholesterol by lowering our intake of three things: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero. Where are trans fats found? Trans Fat In Meat And Dairy. Where is cholesterol found? Predominantly eggs: Eggs and Cholesterol: Patently False and Misleading Claims. There are also some foods particularly adept at lowering cholesterol levels:

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Ana C. / Flickr

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Breast Cancer Cells Feed on Cholesterol

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One in eight American women will be diagnosed with breast cancer in her lifetime. There are a number of compounds in plant foods that may protect against breast cancer by a variety of mechanisms. I've talked about the benefits of broccoli, flaxseeds, and soy foods before (See Breast Cancer Survival Vegetable, Flaxseeds & Breast Cancer Prevention, and Breast Cancer Survival and Soy) but a recent German study reported something new. The researchers found that sunflower and pumpkin seeds were associated with reduced breast cancer risk. They initially chalked the association up to the lignans in the seeds (See Breast Cancer Survival and Lignan Intake), but their lignan lead didn't pan out. Maybe it's the phytosterols found concentrated in seeds? (See Optimal Phytosterol Source).

There is evidence that phytosterols may be anticancer nutrients and play a role in reducing breast cancer risk. I thought phytosterols just lowered cholesterol? (See How Phytosterols Lower Cholesterol) What does cancer have to do with cholesterol?

Increasing evidence demonstrates the role that cholesterol may play in the development and progression of breast cancer. Cancer feeds on cholesterol. Transformed cells take up LDL, so-called "bad" cholesterol, and it's capable of stimulating the growth of human breast cancer cells in a petri dish.

The ability to accumulate fat and cholesterol may enable cancer cells to take advantage of people eating high fat and high cholesterol diets and at least partially explain the benefit of a low-fat diet on lowering human breast cancer recurrence. Although the data has been mixed, the largest study to date (highlighted in my video, Cholesterol Feeds Breast Cancer Cells) found a 17% increased breast cancer risk in women who had a total cholesterol over 240 compared to women whose cholesterol was under 160. However, the researchers could not rule out that there may be something else in cholesterol-raising foods that's increasing breast cancer risk.

Tumors suck up so much cholesterol that LDL has been considered a vehicle for delivering antitumor drugs to cancer cells. Since cancer feeds on cholesterol, maybe we could stuff some chemo into it like a Trojan horse poison pill?

The uptake of LDL into tumors may be why people's cholesterol levels drop low after they get cancer--the tumor is eating it up. In fact, patient survival may be lowest when cholesterol uptake is highest. "High LDL receptor content in breast cancer tissue seems to indicate a poor prognosis, [suggesting] that breast tumors rich in LDL receptors may grow rapidly [in the body]." We've known about this for decades. You can tell that wass an old study because, when it was published in the '80s, only 1 in 11 American women got breast cancer.

If cholesterol increases breast cancer risk, what about the use of cholesterol-lowering drugs? See Statin Cholesterol Drugs and Invasive Breast Cancer.

More videos on broccoli and soy's protective effects against breast cancer:

Some I didn't mention include:

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Andrew Bennett / Flickr

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Phytates in Beans: Anti-Nutrient or Anti-Cancer?

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In my videos, Phytates in the Prevention of Cancer and Phytates for Rehabilitating Cancer Cells, I described how phytates in beans may be the reason why legumes are so successful in preventing cancer and re-educating cancer cells. What about phytates for the treatment of cancer?

Colorectal cancer is the second leading cause of cancer death in the United States. It arises from "adenomatous polyps," meaning that colon cancer starts out as a benign little bump called a polyp and then grows into cancer that can eventually spread to other organs and kill. So the National Cancer Institute funded the Polyp Prevention Trial, highlighted in my video, Phytates for the Treatment of Cancer, to determine the effects of a high-fiber, high fruit and vegetable, low-fat diet.

Researchers found no significant associations between polyp formation and overall change in fruit and vegetable consumption. However, those with the greatest increase in bean intake only had about a third of the odds of advanced polyps popping up. It could have been the fiber in the beans, but there's lots of fiber in fruits and vegetables, too. So it may have been the phytate.

If the tumors develop from polyps, they still need to spread. Tumor growth, invasion, and metastasis are multistep processes that include cell proliferation, digestion through the surrounding tissue, and migration through barrier membranes to reach the bloodstream so the tumor can establish new proliferating colonies of cancer cells. A critical event in tumor cell invasion is the first step: the tunneling through the surrounding matrix. To do this, the cancer cells use a set of enzymes called matrix metalloproteinases. This is where phytates might come in. We've known that phytates inhibit cancer cell migration in vitro, and now perhaps we know why. Phytates help block the ability of cancer cells to produce the tumor invasion enzyme in the first place (at least for human colon and breast cancer cells).

So what happens if you give phytates to breast cancer patients? Although a few case studies where phytates were given in combination with chemotherapy clearly showed encouraging data, organized, controlled, randomized clinical studies were never done--until now. Fourteen women with invasive breast cancer were divided randomly into two groups. One group got extra phytates; the other got placebo. At the end of six months, the phytate group had a better quality of life, significantly more functionality, fewer symptoms from the chemo, and did not get the drop in immune cells and platelets chemo patients normally experience.

What are the potential side effects of phytates? Less heart disease, less diabetes, and fewer kidney stones.

Because cancer development is such an extended process--it can take decades to grow--we need cancer preventive agents that we can take long-term. Phytates, which naturally occur in beans, grains, nuts, and seeds, seem to fit the bill.

In the past, there were concerns that the intake of foods high in phytates might reduce the bioavailability of dietary minerals, but recent studies demonstrate that this co-called "anti-nutrient" effect can be manifested only when large quantities of phytates are consumed in combination with a nutrient poor diet. For example, there used to be a concern that phytate consumption might lead to calcium deficiency, which then led to weakened bones, but researchers discovered that the opposite was true, that phytates actually protect against osteoporosis (See Phytates for the Prevention of Osteoporosis). In essence, phytates have many characteristics of a vitamin, contrary to the established and, unfortunately, still existing dogma among nutritionists regarding its 'anti-nutrient' role.

As one paper in the International Journal of Food Science & Technology suggests:

"Given the numerous health benefits, phytates participation in important intracellular biochemical pathways, normal physiological presence in our cells, tissues, plasma, urine, etc., the levels of which fluctuate with intake, epidemiological correlates of phytate deficiency with disease and reversal of those conditions by adequate intake, and safety - all strongly suggest for phytates inclusion as an essential nutrient, perhaps a vitamin."

The paper concludes that inclusion of phytates in our diet for prevention and therapy of various ailments, cancer in particular, is warranted.

More on preventing tumor invasion and metastasis in:

Other foods that can help stop the progression of precancerous lesions (like the adenomatous polyps) are profiled in Strawberries versus Esophageal Cancer and Black Raspberries versus Oral Cancer.

There's a substance in mushrooms that's also another "essential" nutrient candidate. See Ergothioneine: A New Vitamin?

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: The Ewan / Flickr

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Why are Cancer Rates so Low in India?

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It is estimated that many tumors start around the age of 20. However, detection of cancer is normally around the age of 50 or later. Thus, it takes cancer decades to incubate. Why does it take so long? Recent studies indicate that in any given type of cancer, hundreds of different genes must be modified to change a normal cell into a cancer cell. Although cancers are characterized by the dysregulation of cell signaling pathways at multiple steps, most current anticancer therapies involve the modulation of a single target. Chemotherapy has gotten incredibly specific, but the ineffectiveness, lack of safety, and high cost of these monotargeted therapies has led to real disappointment, and drug companies are now trying to develop chemo drugs that take a multitargeted approach.

Many plant-based products, however, accomplish multitargeting naturally and are inexpensive and safe compared to drugs. However, because drug companies are not usually able to secure intellectual property rights to plants, the development of plant-based anticancer therapies has not been prioritized. They may work (and work better for all we know), and they may be safer, or even fully risk free.

If we were going to choose one plant-based product to start testing, we might choose curcumin, the pigment in the spice turmeric (the reason curry powder looks yellow). Before we start throwing money at research, we might want to ask some basic questions, like "Do populations that eat a lot of turmeric have lower cancer rates?" The incidence of cancer does appear to be significantly lower in regions where turmeric is heavily consumed. Population-based data indicate that some extremely common cancers in the Western world are much less prevalent in regions where turmeric is widely consumed in the diet.

For example, "overall cancer rates are much lower in India than in western countries." U.S. men get 23 times more prostate cancer than men in India. Americans get between 8 and 14 times the rate of melanoma, 10 to 11 times more colorectal cancer, 9 times more endometrial cancer, 7 to 17 times more lung cancer, 7 to 8 times more bladder cancer, 5 times more breast cancer, and 9 to 12 times more kidney cancer. This is not mere 5, 10, or 20 percent more, but 5, 10, or 20 times more. Hundreds of percent more breast cancer, thousands of percent more prostate cancer--differences even greater than some of those found in the China Study.

The researchers in this study, highlighted in my video Back to Our Roots: Curry and Cancer, conclude: "Because Indians account for one-sixth of the world's population, and have some of the highest spice consumption in the world, epidemiological studies in this country have great potential for improving our understanding of the relationship between diet and cancer. The lower rates of cancer may, of course, not be due to higher spice intake. Several dietary factors may contribute to the low overall rate of cancer in India. Among them are a "relatively low intake of meat and a mostly plant-based diet, in addition to the high intake of spices." Forty percent of Indians are vegetarians, and even the ones that do eat meat don't eat a lot. And it's not only what they don't eat, but what they do. India is one of the largest producers and consumers of fresh fruits and vegetables, and Indians eat a lot of pulses (legumes), such as beans, chickpeas, and lentils. They also eat a wide variety of spices in addition to turmeric that constitute, by weight, the most antioxidant-packed class of foods in the world.

Population studies can't prove a correlation between dietary turmeric and decreased cancer risk, but they can certainly inspire a bunch of research. So far, curcumin has been tested against a variety of human cancers, including colorectal cancer, pancreatic cancer, breast, prostate, multiple myeloma, lung cancer, and head and neck cancer, for both prevention and treatment. For more information on turmeric and curcumin, check out Carcinogen Blocking Effects of Turmeric Curcumin and Turmeric Curcumin Reprogramming Cancer Cell Death.

I'm working on another dozen or so videos on this amazing spice. This is what I have so far:

Amla, dried Indian gooseberry powder, is another promising dietary addition:

I add amla to my Pink Juice with Green Foam recipe. Not all natural products from India are safe, though. See, for example, my video Some Ayurvedic Medicine Worse than Lead Paint Exposure.

More on the antioxidant concentration in spices in general in Antioxidants in a Pinch. Why do antioxidants matter? See Food Antioxidants and Cancer and Food Antioxidants, Stroke, and Heart Disease.

Which fruits and vegetables might be best? See #1 Anticancer Vegetable and Best Fruits for Cancer Prevention.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: peddhapati / Flickr

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Does Antioxidant Intake Matter for Cancer?

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The USDA removed their online antioxidant database of foods, "concerned that ORAC values were routinely misused by food and dietary supplement manufacturing companies to promote their products." Indeed, supplement manufacturers got into my-ORAC-is-bigger-than-your-ORAC contests, comparing their pills to the antioxidant superfood du jour, like blueberries. We know there are lots of bioactive compounds in whole plant foods that may help prevent and ameliorate chronic disease in ways that have nothing to do with their antioxidant power, so I understand the USDA's decision. So should we just eat lots of whole healthy plant foods and not worry about which one necessarily has more antioxidants than the other, or does one's dietary antioxidant intake matter?

We have some new data to help answer that question. Researchers recently analyzed total dietary antioxidant capacity and the risk of stomach cancer, the world's second leading cancer killer. A half million people were studied, and dietary antioxidant capacity intake from different sources of plant foods was indeed associated with a reduction in risk. Note that they say dietary intake; they're not talking about supplements.

Not only do antioxidant pills not seem to help, they seem to increase overall mortality--that's like paying to live a shorter life. Just giving high doses of isolated vitamins may cause disturbances in our body's own natural antioxidant network. There are hundreds of different antioxidants in plant foods. They don't act in isolation; they work synergistically. Mother Nature cannot be trapped in a bottle.

Similar results were reported with non-Hodgkin's lymphoma: the more ORAC units we eat per day, the lower our cancer risk drops (though antioxidants or not, green leafy vegetables were particularly protective. Going from eating one serving of green leafy vegetables per week to a serving a day may cut our odds of lymphoma in half).

Should we be worried about antioxidant intake during cancer treatment, since most chemo drugs work by creating free radicals? According to some of the latest reviews, highlighted in my video Food Antioxidants and Cancer, there is no evidence of antioxidant interference with chemotherapy, and antioxidants may actually improve treatment and patient survival.

But should we take a multivitamin? See Should We Take a Multivitamin?

What about fish oil supplements? Is Fish Oil Just Snake Oil?

I recently covered how and why we should strive to eat antioxidants with every meal in an important three-part series:

  1. Minimum "Recommended Daily Allowance" of Antioxidants
  2. How to Reach the Antioxidant "RDA"
  3. Antioxidant Rich Foods With Every Meal

Preferentially getting one's nutrients from produce not pills is a common theme in the nutrition literature. See, for example:

Antioxidants may also slow aging (See Mitochondrial Theory of Aging), reduce inflammation (See Anti-Inflammatory Antioxidants), improve digestion (See Bulking Up on Antioxidants), and help prevent COPD (See Preventing COPD with Diet). So where are antioxidants found? See my series that starts with Antioxidant Content of 3139 Foods and Antioxidant Power of Plant Foods Versus Animal Foods.

What about the role of antioxidants in other leading causes of death? That's the subject of my video, Food Antioxidants, Stroke, and Heart Disease.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Arya Ziai / Flickr

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Are Multivitamins Just a Waste of Money?

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About one in three Americans take a multivitamin. Is that helpful, harmful, or just a harmless waste of money? In 2011, the Iowa Women's Health Study reported that multivitamin use was associated with a higher risk of total mortality, meaning that women who took a multivitamin appeared to be paying to live shorter lives. But this was just an observational study--researchers didn't split women up into two groups and put half on multivitamins to see who lived longer. All they did was follow a large population of women over time, and found that those that happened to be taking multivitamins were more likely to die. But maybe they were taking multivitamins because they were sick. The researchers didn't find any evidence of that, but ideally we'd have a randomized, double-blind, placebo controlled trial, where thousands were followed for over a decade, with half given a multivitamin and half a placebo. That's what we got the following year in 2012 with the Harvard Physicians' Study II. And after a decade, the researchers found no effect on heart attack, stroke, or mortality.

The accompanying editorial concluded that multivitamins are a distraction from effective cardiovascular disease prevention. The message needs to remain simple and focused: heart disease can be largely prevented by healthy lifestyle changes.

The researchers did, however, find that for men with a history of cancer, the multivitamin appeared to be protective against getting cancer again, though there was no significant difference in cancer mortality or cancer protection in those who've never had cancer before. Still, that's pretty exciting. It is just one study, though. Ideally we'd have maybe 20 of these placebo-controlled trials and then compile all the results together. That's what we got in 2013--a meta-analysis of randomized controlled trials that analyzed twenty-one trials and more than 90,000 individuals. The analysis found no influence on mortality either way. Some found more cancer mortality, some found less cancer mortality, but all in all it was a wash.

And that was heralded as good news. After the Iowa Women's Health Study came out we were worried multivitamins could be harming millions of people, but instead they don't appear to have much effect either way. The accompanying editorial asked whether meta-analyses trump observational studies. The Iowa Women's Health Study followed tens of thousands of women for nearly 20 years. What if we put all the studies together, the big observational studies along with the experimental trials? And that's what we got in December 2013. The review for the U.S. Preventive Services Task Force, highlighted in my video, Should We Take a Multivitamin? found that multivitamins appear to offer no consistent evidence of benefit for heart disease, cancer, or living longer.

But aren't vitamins and minerals good for us? One explanation for this result could be that our bodies are so complex that the effects of supplementing with only one or two components is generally ineffective or actually does harm. Maybe we should get our nutrients in the way nature intended, in food.

The accompanying editorial to the December 2013 review concluded that enough is enough. We should stop wasting our money on vitamin and mineral supplements. Americans spend billions on vitamin and mineral supplements. A better investment in health would be eating more fruits and vegetables. Imagine if instead we spent those billions on broccoli?

I've previously addressed multivitamins in my videos Are Multivitamins Good For You? and Multivitamin Supplements and Breast Cancer (with a follow-up in my Q&A Is multivitamin use really associated to an increased risk of breast cancer?). I also touched on potential risks in Dietary Theory of Alzheimer's.

With the exception of vitamins D and B12 (Vitamin Supplements Worth Taking), we should strive to get our nutrients from produce, not pills.

What about fish oil supplements? Check out Is Fish Oil Just Snake Oil?

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Tom Magliery / Flickr

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