What to Eat to Protect Against Kidney Cancer

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58,000 Americans are diagnosed with kidney cancer every year, and 13,000 die. And the numbers have been going up. Approximately 4 percent of cases are hereditary, but what about the other 96 percent? The only accepted risk factor has been tobacco use, but cigarette smoking has been declining.

Nitrosamines are one of the most potent carcinogens in cigarette smoke. One hot dog has as many nitrosamines and nitrosamides as five cigarettes. And these carcinogens are also found in fresh meat as well: beef, chicken and pork. So even though smoking rates have dropped, perhaps the rise in kidney cancer over the last few decades may have something to do with meat consumption. But would kidney cancer just be related to the processed meats like bacon, sausage, hot dogs and cold cuts that have nitrate and nitrite additives, or fresh meat as well?

The NIH-AARP study featured in my video Can Diet Protect Against Kidney Cancer? is the largest prospective study on diet and health ever performed--about 500,000 followed for nine years. In addition to examining nitrate and nitrite intake from processed meat, they also looked at intake from other sources such as fresh meat, eggs and dairy. Nitrite from animal sources, not just processed meats, was associated with an increased risk of kidney cancer, and total intake of nitrate and nitrite from processed meat sources was also associated with kidney cancer risk. The researchers found no associations with nitrate or nitrite intake from plant sources, but nitrates from processed meat was associated with cancer.

When meat producers advertise their bacon or lunch meat as "uncured," this means no nitrites or nitrates added. But if you look at the small print you'll see something like, "except for celery juice." That's just a sneaky way to add nitrites. Processed meat producers ferment the nitrates in celery to create nitrites, then add it to the meat; a practice even the industry admits "may be viewed as incorrect at best or deceptive at worst."

But that same fermentation of nitrates to nitrites can happen thanks to bacteria on our tongue when we eat vegetables. So why are nitrates and nitrites from vegetables on our tongue harmless, but nitrates and nitrites from vegetables in meat linked to cancer? The actual carcinogens are not nitrites, but nitrosamines and nitrosamides. In our stomach, to turn nitrites into nitros-amines, and nitros-amides we need amines and amides, which are concentrated in animal products. And vitamin C and other antioxidants in plant foods block the formation of these carcinogens in our stomach. That's why we can safely benefit from the nitrates in vegetables without the cancer risk. In fact some of the highest nitrate vegetables like arugula, kale, and collards are associated with decreased risk of kidney cancer. The more plants, it appears, the better.

Plant-based diets and fiber-rich diets are recommended to prevent cancer directly, as well as chronic conditions associated with kidney cancer, such as obesity, high blood pressure and diabetes. It's similar to sodium intake and kidney cancer. Sodium intake increases kidney disease risk, but that's not just because sodium intake increases blood pressure. It appears the salt is associated with increased cancer risk even independently of hypertension. What about plant-based diets? Turns out the protective association remains even in people who are not obese and have normal blood pressure. So overall, plant-based and fiber-rich diets appear to do both: decrease cancer risk directly and indirectly.

I briefly address kidney health in Preventing Kidney Failure Through Diet and Treating Kidney Failure Through Diet, but have a whole series of more in-depth videos dealing with various kidney issues.

More on the fascinating nitrate/nitrite story in my 17-part series about improving athletic performance with nitrate-rich vegetables such as beets and arugula. Here are a few short highlights:

More on carcinogens caused by cooking meat in videos like:

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.

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How to Cook Broccoli

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When I used to teach medical students at Tufts, I gave a lecture about this amazing new therapeutic called "iloccor-B." I'd talk about all the new science, all the things it could do, its excellent safety profile. Just as they were all scrambling to buy stock in the company and prescribe it to all their patients, I'd do the big reveal. Apologizing for my "dyslexia," I would admit that I'd got it backwards. All this time I had been talking about broccoli.

The main active ingredient in broccoli is thought to be sulforaphane, which may protect our brains, protect our eyesight, protect our bodies against free radicals, boost our detoxification enzymes, and help prevent and treat cancer.

In my videos The Best Detox and Sometimes the Enzyme Myth is the Truth, I talked about how the formation of sulforaphane is like a chemical flare reaction, requiring the mixing of a precursor compound with an enzyme, which is destroyed by cooking. This may explain why we get dramatic suppression of cancer cell growth from raw broccoli, cauliflower and Brussels sprouts, but hardly anything from boiled, microwaved or steamed (except for microwaved broccoli, which actually retains some cancer fighting abilities). But who wants to eat raw Brussels sprouts?

There is a strategy to get the benefits of raw in cooked form. In raw broccoli, the sulforaphane precursor, called glucoraphanin, mixes with the enzyme (myrosinase) when you chew or chop it. If given enough time--such as when sitting in your upper stomach waiting to get digested--sulforaphane is born. The precursor and sulforaphane are resistant to heat and therefore cooking, but the enzyme is destroyed. No enzyme = no sulforaphane.

That's why I described the "hack and hold" technique--if we chop the broccoli, Brussels sprouts, kale, collards, or cauliflower first and then wait 40 minutes, we can cook them all we want. The sulforaphane is already made; the enzyme has already done its job, so we don't need it anymore.

When most people make broccoli soup, for example, they're doing it wrong. Most people cook the broccoli first, then blend it. We now know it should be done the exact opposite way. Blend it first, wait, and then cook it.

What if we're using frozen broccoli, though? In my video, Second Strategy to Cooking Broccoli, you can see the amount of sulforaphane in someone's body after they eat broccoli soup made from fresh broccoli versus from frozen broccoli. The difference is dramatic. Commercially produced frozen broccoli lacks the ability to form sulforaphane because vegetables are blanched (flash-cooked) before they're frozen for the very purpose of deactivating enzymes. This prolongs shelf life in the frozen foods section, but the myrosinase is dead by the time you take it out of your freezer. It doesn't matter how much you chop it, or how long you wait, no sulforaphane is going to be made. This may be why fresh kale suppresses cancer cell growth up to ten times more than frozen.

The frozen broccoli is still packed with the precursor--remember that's heat resistant--and we could get lots of sulforaphane out of the frozen broccoli by adding some outside enzyme. Where do we get myrosinase enzyme from? Researchers just buy theirs from a chemical company. But we can just walk into any grocery store.

All cruciferous vegetables have this myrosinase. Mustard greens, a cruciferous vegetable, grow out of little mustard seeds, which we can buy ground up in the spice aisle as mustard powder. If we sprinkled some mustard powder on our cooked frozen broccoli, would it start churning out sulforaphane? We didn't know...until now.

Boiling broccoli prevents the formation of any significant levels of sulforaphane due to inactivation of the enzyme. However, researchers from the University of Reading found that the addition of powdered mustard seeds to the heat processed broccoli significantly increased the formation of sulforaphane. In the video I mentioned earlier, Second Strategy to Cooking Broccoli, you can see the amount of sulforaphane in boiled broccoli versus the amount after half a teaspoon or a teaspoon of mustard powder is added. Both a half teaspoon and a full teaspoon increase sulforaphane by the same amount, suggesting that we could use even use less mustard powder for the same effect. Therefore, although domestic cooking leads to the deactivation of myrosinase and stops sulforaphane formation, the addition of powdered mustard seeds to cooked cabbage-family vegetables provides a natural source of the enzyme such that it's practically like eating them raw.

So, if we forget to chop our greens in the morning for the day, or are using frozen, we can just sprinkle some mustard powder on top at the dinner table and we're all set. Daikon radish, horseradish, or wasabi--all cruciferous vegetables packed with the enzyme--work as well. Just a quarter teaspoon of Daikon radish root for seven cups of broccoli worked--just a tiny pinch can do it. Or you can add a small amount of fresh greens to your cooked greens, because the fresh greens have myrosinase enzyme that can go to work on the cooked greens.

I love kitchen chemistry--it totally revolutionized my daily greens prep. One of the first things I used to do in the morning is chop my greens for the day, so when lunch and supper rolls around they'd be good to go. But now with the mustard powder plan, I don't have to pre-chop.

This helps explain the results I presented in Raw Broccoli and Bladder Cancer Survival.

OK, but what's so great about this sulforaphane stuff? For a taste, 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 Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

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Bile Binding Beets

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In my video Breast Cancer and Constipation, I discussed how fruits and veggies bind carcinogenic bile acids in our gut. Since bile acids are absorbed back into our systems, they may increase our risk of not only colon cancer but also other cancers as well. In light of this, researchers publishing in the journal, Nutrition Research, concluded that to "lower the risk of diet and lifestyle-related premature degenerative diseases and to advance human nutrition research, relative bile acid-binding potential of foods and fractions need to be evaluated."

They found that some vegetables bind bile acids better than others. We know that those eating more plant-based diets are at a lower risk of heart disease and cancer. This could partly be because of phytonutrients in plants that act as antioxidants and potent stimulators of natural detoxifying enzymes in our bodies. Veggies can also lower cholesterol and detoxify harmful metabolites, functions that can be predicted by their ability to bind bile acids.

A group of USDA researchers studying this topic discovered three important things. First, they found an over five-fold variability in bile acid binding among various vegetables that had similar fiber content, suggesting that bile acid binding is not just related to total dietary fiber content (as previously thought), but instead some combination of unique phytonutrients yet to be determined.

Second, they discovered that steaming significantly improves the bile acid binding of collards, kale, mustard greens, broccoli, peppers, cabbage, beets, eggplant, asparagus, carrots, green beans, and cauliflower, suggesting that in this way steaming vegetables may be more healthful than those consumed raw.

Finally, they ranked multiple vegetables for bile binding ability. Which vegetables kicked the most bile butt? (in my video, Which Vegetable Binds Bile Best?, you can see a visual comparison of bile binding ability.) Turnips turned up last. Then came cabbage, cauliflower, bell peppers, spinach, asparagus and green beans. Mustard greens and broccoli were better. Eggplant, carrots and Brussels sprouts basically tie for the #5 slot. Then collards at #4. Kale got the bronze, okra the silver, and beets the gold. Kale, surprisingly, got beet.

The researchers concluded that inclusion of all these vegetables in our daily diets should be encouraged. When consumed regularly, they concluded, these vegetables may lower the risk of premature degenerative diseases and improve public health.

More raw versus cooked comparisons in

Beets also have a number of other remarkable properties. Check out my video series on Doping with Beet Juice as well as Hearts Shouldn't Skip a Beet, and Whole Beets vs. Juice for Improving Athletic Performance.

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 Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

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Foods for Glaucoma

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Glaucoma is the second leading cause of legal blindness in white women, and the number one cause of blindness in African-American women. In a study I profile in the video Greens vs. Glaucoma, researchers chose a population of African-American women to study the effects of fruit and vegetable consumption on glaucoma risk because they were specifically interested in studying the effect of foods with the highest concentration of those eye-protecting phytonutrients like zeaxanthin. Zeaxanthin is found primarily in plants such as kale and collard greens. (It is also found in eggs--find out how much in Egg Industry Blind Spot). However, we'd be lucky if we could find one in ten white people eating even a single serving of these dark green leafy vegetables a month, whereas nearly nine out of ten African-American women in the study consumed this amount.

What did the researchers find? Well, as I've stressed over the years, all fruits and vegetables are not the same (see for example, How to Reach the Antioxidant "RDA"). Whether the participants hardly ever ate bananas or had one or more every day didn't seem to matter much in terms of the risk of glaucoma. However, eating only a couple oranges every week was associated with dramatically lower risk. Orange juice was not associated with a lower risk, though, even if drunk every day. A similar finding was found for peaches: fresh peaches seemed to help, but canned peaches didn't.

Similarly the intake of vegetables in general as a catch-all term didn't seem to matter. For example, whether subjects ate a green salad twice a week, once a week, or zero times a week didn't seem to matter when it came to reducing glaucoma risk, but most people's salads are pretty pitiful. It was a different story for kale and collard greens: just two or three servings a month was associated with half the risk of glaucoma compared to once a month or less.

It may be especially important for white people to consume kale and collard greens. The lighter our eye color, the more greens we need to eat. Blue eyes let 100 times more light through, so people with blue or gray eyes appear significantly more vulnerable to damage compared to brown or black. Green and hazel fall somewhere in the middle.

This is interesting: carrots appeared to be less protective in black women compared to white women. They suggest it could be a difference in food preparation methods. Perhaps the African-American subjects tended to eat carrots raw, limiting the absorption of certain nutrients, while they chopped and prepared their collard greens with oil, making the nutrients more bioavailable because the absorption of carotenoid phytonutrients depends on the presence of fat. This is why I encourage people to eat nuts or seeds with the greens--such as a little tahini sauce or something.

Why not just take a zeaxanthin pill? We don't know what exactly it is in these wonderful foods that's working their wonders, so it's probably better to just eat our greens rather than supplements. In fact, people that take calcium or iron supplements may even be doubling, quadrupling, or septupling their odds of glaucoma. It's better to get most of our nutrients from produce, not pills.

I wish there were more studies on under-represented populations. I've covered a few, such as Preventing Breast Cancer By Any Greens Necessary, but I am constantly on the lookout for more.

My other videos on glaucoma include Prevent Glaucoma and See 27 Miles Farther and Dietary Treatment of Glaucoma. For more on eye health check out my video, Dietary Prevention of Age-Related Macular Degeneration.

-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.

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Quadrupling Breast Cancer Survival

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Half a million Americans are expected to die this year from cancer, equal to five jumbo jets crashing every day. The number of Americans who die from cancer each year is more than all those who have died in all U.S. wars combined. And this happens every single year.

After a cancer diagnosis people tend to clean up their diets. About a third to a half of breast cancer patients, for example, make healthy dietary changes following diagnosis, such as increasing fruit and vegetable consumption and decreasing meat, fat, and sugar intakes. Does it actually help that late in the game? Well, the Women's Healthy Eating and Living Study was undertaken in a few thousand breast cancer survivors to determine if a plant-based, low-fat, high-fiber diet could influence breast cancer recurrence rates and survival.

Previously they famously reported that simple changes -- five or more servings of fruits and veggies a day and just walking 30 minutes a day six days a week -- were associated with a significant survival advantage, cutting the risk of death nearly in half. Note: it was fruits and veggies and exercise. In the video, Breast Cancer Survival Vegetable, you can see the proportion of women with breast cancer surviving nine years in the study if they had low fruit and vegetable consumption and low physical activity, compared to those high in one and low in the other, compared to the survival curve of those high in both. And it worked just as well in women with estrogen receptor negative tumors, which normally have twice the mortality -- unless women eat those few fruits and veggies and take a few strolls.

Imagine, for a second, you or a loved one has just been diagnosed with breast cancer. Imagine sitting in that chair, in the doctor's office, as your doctor gives you the news. But, she says, there's a new experimental treatment that can cut your chances of dying in the next few years from 16 percent down to just 4 percent. To quadruple their survival rate, many women would re-mortgage their homes to fly to some quack clinic in Mexico and would lose all their hair to chemo, but most, apparently, couldn't stand the thought of eating broccoli.

The Women's Healthy Eating and Living Study found that while fruits and vegetables in general may be good, cruciferous vegetables may be better. For women on tamoxifen, for example, women who consumed one of their five daily servings of fruits and veggies as broccoli, cauliflower, collards, cabbage, or kale had their risk of cancer recurrence cut in half.

I recommend that all women with breast cancer eat broccoli sprouts. See my 8-part video series:

1. DNA Protection from Broccoli
2. Sulforaphane: From Broccoli to Breast
3. Broccoli Versus Breast Cancer Stem Cells
4. Liver Toxicity Due to Broccoli Juice?
5. How Much Broccoli Is Too Much?
6. The Best Detox
7. Sometimes the Enzyme Myth Is True
8. Biggest Nutrition Bang for Your Buck

They may also help out with other cancers (Lung Cancer Metastases and Broccoli and Raw Broccoli and Bladder Cancer Survival).

For more on breast cancer survival, see:

What's even better is preventing breast cancer in the first place. Here are the 10 latest videos, but there are 81 other videos on breast cancer:

Some of this video may sound familiar -- I included it in my 2013 live presentation, which you can watch here.

-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 presentation Uprooting the Leading Causes of Death.

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