Heart of Gold: Turmeric vs. Exercise

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The endothelium is the inner lining of our blood vessels. Laid end-to-end, endothelial cells from a single human would wrap more than four times around the world. And it's not just an inert layer; it's highly metabolically active. I've talked before about how sensitive our endothelium is to oxidation (The Power of NO) and inflammation (The Leaky Gut Theory). If we don't take care of it, endothelial dysfunction may set us up for heart disease or a stroke. Are we ready to heed our endothelium's early warning signal?

If it's all about oxidation and inflammation, then fruits and vegetables should help. And indeed it appears they do. Each daily serving of fruits or vegetables was associated with a 6% improvement in endothelial function. These fruit- and vegetable-associated improvements in endothelial function are in contrast to several negative vitamin C pill studies that failed to show a benefit. It can be concluded that the positive findings of the fruit and vegetable study are not just because of any one nutrient in fruits and veggies. Rather than searching for the single magic bullet micronutrient, a more practical approach is likely to consider whole foods. Increasing fruit and vegetable consumption is likely to have numerous benefits due to synergistic effects of the plethora of wonderful nutrients in plants.

Exercise helps our endothelial cells, too, but what type of exercise helps best? Patients were randomized into four groups: aerobic exercise (cycling for an hour a day), resistance training (using weights and elastic bands), both, or neither. The aerobic group kicked butt. The resistance group kicked butt. The aerobic and resistance group kicked butt, too. The only group who didn't kick butt was the group who sat on their butts. Our endothelium doesn't care if we're on a bike or lifting weights, as long as we're getting physical activity regularly. If we stop exercising, our endothelial function plummets.

Antioxidant pills don't help, but drug companies aren't going to give up that easy. They're currently looking into anti-inflammatory pills. After all, there's only so much you can make selling salad. For those who prefer plants to pills, one of the most anti-inflammatory foods is the spice turmeric. Researchers in Japan recently compared the endothelial benefits of exercise to that of curcumin, the yellow pigment in turmeric and curry powder. About a teaspoon a day's worth of turmeric for eight weeks was compared to 30 to 60 minutes of aerobic exercise a day.

Which group improved their endothelial function more? The group who did neither experienced no benefit, but both the exercise and the curcumin groups significantly boosted endothelial function. The researchers reported: "The magnitude of the improvement achieved by curcumin treatment was comparable to that obtained with exercise. Therefore, regular ingestion of curcumin could be a preventive measure against cardiovascular disease" at least in postmenopausal women, who were the subjects of this study. "Furthermore, [their] results suggest that curcumin may be a potential alternative treatment for patients who are unable to exercise."

Ideally, we'd both eat curcumin and exercise. One study looked at central arterial hemodynamics. Basically, if our endothelium is impaired, our arteries stiffen, making it harder for our heart to pump. Compared to placebo, we can drop down the pressure with turmeric curcumin or exercise. However, if we combine both, then we really start rocking and rolling, as you can see in the chart about 4 minutes into my video Heart of Gold: Turmeric vs. Exercise. The researchers conclude that these findings suggest that regular endurance exercise combined with daily curcumin ingestion may reduce the pressure against which our hearts have to figh. We want both healthy eating and exertion for our endothelium.


This entry is a follow-up to Turmeric Curcumin vs. Exercise for Artery Function.

Endothelial dysfunction is at the heart (pun intended) of many of our deadliest diseases. Pledge to save your endothelial cells and check out some of these other videos about the effects of food on our endothelial function:

For more on the concept of nutrient synergy, see Garden Variety Anti-Inflammation and Cranberries vs. Cancer.

Regardless what you do or don't eat, exercise is critical:

I must have dozens of turmeric videos by now, but here are a few to get you started:

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

Heart of Gold: Turmeric vs. Exercise

Sept 5 Heart of Gold copy.jpeg

The endothelium is the inner lining of our blood vessels. Laid end-to-end, endothelial cells from a single human would wrap more than four times around the world. And it's not just an inert layer; it's highly metabolically active. I've talked before about how sensitive our endothelium is to oxidation (The Power of NO) and inflammation (The Leaky Gut Theory). If we don't take care of it, endothelial dysfunction may set us up for heart disease or a stroke. Are we ready to heed our endothelium's early warning signal?

If it's all about oxidation and inflammation, then fruits and vegetables should help. And indeed it appears they do. Each daily serving of fruits or vegetables was associated with a 6% improvement in endothelial function. These fruit- and vegetable-associated improvements in endothelial function are in contrast to several negative vitamin C pill studies that failed to show a benefit. It can be concluded that the positive findings of the fruit and vegetable study are not just because of any one nutrient in fruits and veggies. Rather than searching for the single magic bullet micronutrient, a more practical approach is likely to consider whole foods. Increasing fruit and vegetable consumption is likely to have numerous benefits due to synergistic effects of the plethora of wonderful nutrients in plants.

Exercise helps our endothelial cells, too, but what type of exercise helps best? Patients were randomized into four groups: aerobic exercise (cycling for an hour a day), resistance training (using weights and elastic bands), both, or neither. The aerobic group kicked butt. The resistance group kicked butt. The aerobic and resistance group kicked butt, too. The only group who didn't kick butt was the group who sat on their butts. Our endothelium doesn't care if we're on a bike or lifting weights, as long as we're getting physical activity regularly. If we stop exercising, our endothelial function plummets.

Antioxidant pills don't help, but drug companies aren't going to give up that easy. They're currently looking into anti-inflammatory pills. After all, there's only so much you can make selling salad. For those who prefer plants to pills, one of the most anti-inflammatory foods is the spice turmeric. Researchers in Japan recently compared the endothelial benefits of exercise to that of curcumin, the yellow pigment in turmeric and curry powder. About a teaspoon a day's worth of turmeric for eight weeks was compared to 30 to 60 minutes of aerobic exercise a day.

Which group improved their endothelial function more? The group who did neither experienced no benefit, but both the exercise and the curcumin groups significantly boosted endothelial function. The researchers reported: "The magnitude of the improvement achieved by curcumin treatment was comparable to that obtained with exercise. Therefore, regular ingestion of curcumin could be a preventive measure against cardiovascular disease" at least in postmenopausal women, who were the subjects of this study. "Furthermore, [their] results suggest that curcumin may be a potential alternative treatment for patients who are unable to exercise."

Ideally, we'd both eat curcumin and exercise. One study looked at central arterial hemodynamics. Basically, if our endothelium is impaired, our arteries stiffen, making it harder for our heart to pump. Compared to placebo, we can drop down the pressure with turmeric curcumin or exercise. However, if we combine both, then we really start rocking and rolling, as you can see in the chart about 4 minutes into my video Heart of Gold: Turmeric vs. Exercise. The researchers conclude that these findings suggest that regular endurance exercise combined with daily curcumin ingestion may reduce the pressure against which our hearts have to figh. We want both healthy eating and exertion for our endothelium.


This entry is a follow-up to Turmeric Curcumin vs. Exercise for Artery Function.

Endothelial dysfunction is at the heart (pun intended) of many of our deadliest diseases. Pledge to save your endothelial cells and check out some of these other videos about the effects of food on our endothelial function:

For more on the concept of nutrient synergy, see Garden Variety Anti-Inflammation and Cranberries vs. Cancer.

Regardless what you do or don't eat, exercise is critical:

I must have dozens of turmeric videos by now, but here are a few to get you started:

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

Might Turmeric Help Prevent Alzheimer’s?

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There are plenty of anti-inflammatory drugs out there that may reduce the risk of Alzheimer's disease, but stomach, liver, and kidney toxicity precludes their widespread use. So maybe using an anti-inflammatory food like the spice, turmeric, found in curry powder, could offer the benefits without the risks? Before even considering putting it to the test, though, one might ask, "Well, do populations that eat a lot of turmeric have a lower prevalence of dementia?" And indeed, those living in rural India who do just that may actually have the lowest reported prevalence of dementia and Alzheimer's.

In rural Pennsylvania, the incidence rate of Alzheimer's disease among seniors is 19/1000. Nineteen people in a thousand over age 65 develop Alzheimer's every year in rural Pennsylvania. In rural India, using the same diagnostic criteria, that same rate is three, confirming they have among the lowest reported Alzheimer's rates in the world.

Although the lower prevalence of Alzheimer's in India is generally attributed to the turmeric consumption as a part of curry, and it is assumed that people who use turmeric regularly have a lower incidence of the disease, but let's not just assume. As highlighted in my video, Preventing Alzheimer's with Turmeric, a thousand people were tested, and those who consumed curry at least occasionally did better on simple cognitive tests than those who didn't. Those that ate curry often also had only about half the odds of showing cognitive impairment, after adjusting for a wide variety of potential confounding factors. This suggests that curry consumption may indeed be associated with better cognitive performance.

Of course it probably matters what's being curried--are we talking chicken masala, or chana masala, with chickpeas instead of chicks? It may be no coincidence that the country with among the lowest rates of Alzheimer's also has among the lowest rates of meat consumption, with a significant percentage of Indians eating meat-free and egg-free diets.

Studies have suggested for nearly 20 years now that those who eat meat--red meat or white meat--appear between two to three times more likely to become demented compared to vegetarians. And the longer one eats meat-free, the lower the associated risk of dementia, whether or not you like curry.

There's another spice that may be useful for brain health. See my video Saffron for the Treatment of Alzheimer's. What about coconut oil? See Does Coconut Oil Cure Alzheimer's? In terms of preventing cognitive decline in the first place, check out my video How to Slow Brain Aging By Two Years.

I've raised the issue of plant-based diets and dementia in Alzheimer's Disease: Grain Brain or Meathead?

For more on spices and inflammation, see Which Spices Fight Inflammation? and the follow-up, Spicing Up DNA Protection.

What about treating Alzheimer's disease with the spice turmeric? That's the topic of my video, Treating Alzheimer's with Turmeric.

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.

Image Credit: Marcel Oosterwijk / Flickr

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Topical Application of Turmeric Curcumin for Cancer

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In my video, Turmeric Curcumin and Colon Cancer, I talked about a study where researchers showed that, by taking curcumin, the yellow pigment in the spices turmeric and curry powder, those at high risk for colon cancer could cut down on precancerous and even pre-precancerous lesions, in effect reversing cancer progression. Are there other high risk lesions we can try spicing up?

How about giving turmeric extracts to people who just had bladder cancer taken out? Or to those who have an early stage of squamous cell carcinoma skin cancer caused by arsenic exposure, or early stage cervical cancer, or precancerous lesions in the mouth or stomach? Researchers did this, and in about a quarter of the patients, the lesions started to get better. One out of the two bladder cancer survivors, two out of seven patients with precancerous mouth lesions, one out of six patients with precancerous stomach lesions, one out of four early stage cervical cancer cases, and two out of six patients with early stage skin cancer, all without any noticeable side-effects.

One of the reasons turmeric curcumin may work in some cancers better than others, or in some people better than others, is differences in bioavailability. Megadoses were given, yet just a tiny amount ended up in the bloodstream. If we're treating skin cancer, though, why not just put the curcumin directly on the skin?

I've talked about what turmeric compounds can do to cancer cells in a petri dish. In the video, Topical Application of Turmeric Curcumin for Cancer, you can see some before and after pics. Cervical cancer cells are laid to waste as more and more curcumin is added, and normal cells are unharmed. But to make it to the cervix, curcumin must be absorbed (though a vaginal cream has been invented).

A variety of delivery methods have been devised, including oral, intra-abdominal, intramuscular, under-the-skin injections, straight into the veins or the arteries, on the skin, up the bladder, in the nose, breathed like an inhaler, up where the sun don't shine, or straight into the spinal column, bone marrow, the tumor itself, or implanted somehow. Taken orally, some curcumin does actually get into the tissues. We can measure the amount of curcumin absorbed into the wall of the intestine by examining biopsies and surgical specimens taken after a curcumin regimen. It makes sense to take turmeric orally to try to fight colon cancer, but if we have cancer erupting on our skin why not just rub it on directly?

That's what one group of researchers did. They took some turmeric from the store, made a tincture out of it, dried it, put it in Vaseline, and then had cancer patients rub it on their cancer three times a day. What kind of cancer can you get at with a finger? These were folks with cancers of the mouth, breast, skin, vulva, and elsewhere. Isn't breast cancer under the surface? Not always. Advanced breast cancer can ulcerate right through the skin. The subjects were all people with recurrent ulcerating tumors that had failed to respond to surgery, radiation, and chemo. These open cancers can stink, itch, and ooze, and there was nothing else medicine had to offer. So they rubbed some turmeric ointment to see what happened. It produced remarkable relief. A reduction in smell was noted in 90% of the cases, even in extensively ulcerated cases of breast cancer, and a reduction in itching in almost all cases as well. For example, treatment relieved severe itching in two of the vulva cancer patients. Most of the lesions dried up, and in many cases this relief lasted for months, all from just rubbing on the harmless spice turmeric, which the researchers describe as "an indigenous drug ... highly effective in reducing smell, itching and exudate." The effect of this so-called drug is remarkable. And that "drug" is just some edible spice used in curries for centuries.

More on what this golden spice can do in:

There are ways of Boosting the Bioavailability of Curcumin to get it into our blood stream.

Some should be cautious about turmeric use, though. See Who Shouldn't Consume Curcumin or Turmeric?

-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.

Image Credit: Andrea Kirkby / Flickr

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Preventing and Treating Colon Cancer with Turmeric Curcumin

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The low incidence of bowel cancer in India is often attributed to natural antioxidants such as curcumin, the yellow pigment in the spice turmeric, used in curry powder. However, it is important to remember that the benefits of a diet are seldom produced by a single ingredient in that diet. For example, diets rich in beta-carotene lower the risk of tobacco-related cancers, but beta-carotene pills do not. That doesn't stop researchers from trying, though.

Back in 2001, in a last ditch attempt to save the lives of 15 patients with advanced colorectal cancer that didn't respond to any of the standard chemotherapy agents or radiation, researchers started them on a turmeric extract. The extract appeared to help stall the disease in a third (5 out of 15) of the patients, suggesting that turmeric extract may clinically benefit at least some patients with advanced refractory colorectal cancer.

If we were talking about some new kind of chemotherapy, and it only helped one in three, we'd have to weigh the benefits against chemo side effects, such as losing our hair, the sloughing of our guts, intractable vomiting, maybe being bed-ridden. Therefore, a drug scenario, a one in three benefit may not sound particularly appealing. But when we're talking about plant extract proven to be remarkably safe, it would be worth considering even if it just helped 1 in a 100. With no serious downsides, a one in three benefit for end-stage cancer is pretty exciting.

To see if colon cancer could be prevented, five years later, researchers at Cleveland Clinic and John Hopkins School of Medicine tested two phytochemicals, curcumin (from turmeric) and quercitin, (found in fruits and vegetables such as red onions and grapes) in people with familial adenomatous polyposis, an inherited form of colon cancer in which individuals develop hundreds of polyps that may become cancerous unless prophylactically removed. (See Turmeric Curcumin and Colon Cancer). Researchers gave supplements of curcumin and quercetin to five such patients who already had their colons removed, but still had either polyps in their rectum or in a little intestinal pouch. Each patient had between 5 and 45 polyps each, but after six months on the supplement they ended up with on average fewer than half the polyps, and the ones that were left had shrunk in half. One patient got rid of all polyps by month three, but then they seemed to come back. The researchers asked the patient what's what, and it turned out that the patient stopped taking the supplements. So researchers put the patient back on the phytonutrient supplements for another three months, and the polyps came back down with virtually no adverse events and no blood test abnormalities.

By studying people at high risk for colon cancer, the researchers were able to show noticeable effects within just months. But polyposis is a rare disease; they were only able to recruit five people for the study. Thankfully, smokers are a dime a dozen. After another five years, researchers put 44 smokers on turmeric curcumin supplements alone for a month and measured changes in their colorectal aberrant crypt foci, which may act like the precursors to polyps, which are the precursors to cancer. After just one month there was a significant drop in the number of these abnormal crypt foci in the high dose supplement group but no change in the low dose group. There were also no dose-limiting side effects (although the stools in the participants did turn yellow).

The low cancer rates in India may also be related to phytate consumption (Phytates for the Prevention of Cancer) and plant-centered diets (Back to Our Roots: Curry and Cancer).

More on turmeric and Cancer in Carcinogenic Blocking Effects of Turmeric and Turmeric Curcumin Reprogramming Cancer Cell Death.

Given the poor systemic absorption of turmeric compounds, what cancers other than that of the digestive tract may be directly affected? See my follow-up video Topical Application of Turmeric Curcumin for Cancer.

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.

Image Credit: sea turtle / Flickr

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How Curry Can Kill Cancer Cells

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It is estimated that the human body consists of ten or so trillion cells. Almost all of these cells get turned over within approximately 100 days. That means we're like a new person every three months. We reinvent ourselves physically. And since we're physically made of air, water, and food--those are essentially the only inputs--we are what we eat, literally and physically. In a sense our body has to rebuild itself every three months with the building materials we deliver to it through our stomach. Our mouths are like the access road to the continual construction site of our body. Trucks roll in three times a day. What do we want them to deliver? Some shoddy cheap stuff we scrounged around for or bought at the discount outlets that's just going to fall apart? Or do we want to build our foundation solid? We are each walking inside the greatest known architectural structures in the universe. Let's not ruin such grand blueprints by consuming junk.

We only own the biological real estate we're born with, so if we need to rebuild every three months, we also need a wrecking crew. If we're replacing ten trillion cells every hundred days, that means we have to kill off about 100 billion cells every day. Out with the old, in with the new. We do that primarily through "apoptosis," pre-programmed cell death (from the Greek ptosis, meaning "falling", and apo, "away from"). For example, we all used to have webbed fingers and toes. Literally. Each one of us did in the womb until about four months, when apoptosis kicked in, and the cells in the webbing kill themselves off to separate our fingers.

However, some cells overstay their welcome: cancer cells. They don't die when they're supposed to by somehow turning off their suicide genes. What can we do about that? Well, one of the ways the yellow pigment in curry powder kills cancer cells is by reprogramming the self-destruct mechanism back into cancer cells. Let me just run through one of these pathways.

FAS is a so-called death receptor that activates the FAS associated death domain, death receptor five, and death receptor four. The FADD associated death domain then activates caspase-8, which "ignites the death machine," and kills the cell. (To see the diagram of the pathway, go to my video Turmeric Curcumin Reprogramming Cancer Cell Death). Where does curry powder fit into all this? In cancer cells, curcumin, the pigment in the spice turmeric that makes curry powder yellow, upregulates and activates death receptors (as shown in human kidney cancer cells, skin cancer cells, and nose and throat cancer cells).

Curcumin can also activate the death machine directly (as shown in lung cancer and colon cancer). Caspases are so-called "executioner enzymes," that when activated, destroy the cancer cell from within by chopping up proteins left and right--kind of like death by a thousand cuts.

And that's just one pathway. Curcumin can also affect apoptosis in a myriad other ways, affecting a multitude of different types of cancer cells. It also tends to leave normal cells alone for reasons that are not fully understood. Overall, researchers "showed that curcumin can kill a wide variety of tumor cell types through diverse mechanisms. And because curcumin can affect numerous mechanisms of cell death at the same time, it's possible that cancer cells may not easily develop resistance to curcumin-induced cell death like they do to most chemotherapy."

For more on turmeric and cancer, check out Back to Our Roots: Curry and Cancer and Carcinogen Blocking Effects of Turmeric.

Other herbs and spices such as garlic and amla have similar selective effects against cancer cell (See #1 Anticancer Vegetable and Some Ayurvedic Medicine Worse than Lead Paint Exposure).

I talk more about this concept of "apoptosis," programmed cell death in:

What else can turmeric do? Here's the videos I have so far (with more on the way!):

-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: Steven Jackson / Flickr

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Testing Turmeric on Smokers

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Researchers are becoming increasingly aware of "plant-derived substances that act as chemopreventive agents." Chemopreventatives are substances that help prevent cancer, as opposed to chemotherapy agents aimed at treating cancer. These plant-derived substances are not only inexpensive, they are also easily available and may have no or limited toxicity.

Since 1987, the "National Cancer Institute has tested more than a thousand different potential agents for chemopreventive activity, of which only a few dozen were moved to clinical trials. Curcumin, present in the Indian spice, turmeric, which is used in curry powder, is one such agent that is currently under clinical investigation for cancer chemoprevention."

According to their mode of action, chemopreventive agents are classified into different subgroups: antiproliferatives, antioxidants, or carcinogen-blockers. Curcumin belongs to all three, given its multiple mechanisms of action. Curcumin appears to play a role helping to block every stage of cancer transformation, proliferation, and invasion, and may even help before carcinogens even get to our cells.

A study back in 1987, highlighted in my video, Carcinogen Blocking Effects of Turmeric, investigated the effects of curcumin on the mutagenicity (DNA mutating ability) of several toxins and found that curcumin was an effective antimutagen against several environmental and standard mutagenic and cancer-causing substances. However, this was in vitro (from the Latin meaning "in glass," as in a test tube or petri dish). What about in people? We can't just take a group of people and expose them to some nasty carcinogen so we can give half of them turmeric and see what happens. We could wait until some toxic waste spill happens or nuclear accident, but 0therwise, how could researchers find people who would voluntarily expose themselves to carcinogens--unless, they smoke! That's why researchers test antimutagenic agents on smokers, who have carcinogens coursing through their veins every day.

If smokers pee on some bacteria, the number of DNA mutations shoot up dramatically. Remember, all life is encoded by DNA, whether bacteria, banana, or bunny rabbit. (When measuring urinary mutagens, it's easier to just pee on some bacteria.)

The urine of nonsmokers caused far fewer DNA mutations. It makes sense: nonsmokers have fewer chemicals running through their system. If we have nonsmokers eat some turmeric for a month, nothing really happens. But what if we do the same for smokers, in just fifteen days the mutagenic potential of their urine noticeably decreases, and it drops even more by day 30. The turmeric the researchers used was not some concentrated curcumin supplement, but just plain turmeric you might buy at the store. They also used less than a teaspoon of turmeric a day, indicating that dietary turmeric is an effective anti-mutagen.

However, in the same study the researchers found an even more effective anti-mutagen: not smoking. Even after eating turmeric for a month, the DNA-damaging power of smoker pee exceeded that of nonsmokers.

To find out more, check out Back to Our Roots: Curry and Cancer and Turmeric Curcumin Reprogramming Cancer Cell Death.

Other foods that may protect DNA include kiwifruit (Kiwifruit and DNA Repair), cruciferous vegetables (DNA Protection from Broccoli), leafy vegetables (Eating Green to Prevent Cancer), garlic (Cancer, Interrupted: Garlic & Flavonoids), green tea (Cancer, Interrupted: Green Tea (but which is better? Antimutagenic Activity of Green Versus White Tea), and plants in general (Repairing DNA Damage).

Smokers are common research subjects for carcinogen studies. But other groups of people following similar lifestyles are used. For example, see what happens to carcinogen levels when those eating processed meat start eating vegetarian in my video Heterocyclic Amines in Eggs, Cheese, and Creatine?

More information on cancer prevention, treatment, and reversal can be found in my latest annual presentations Uprooting the Leading Causes of Death, More Than an Apple a Day: Combating Common Diseases, and From Table to Able.

-Michael Greger, M.D.

Image Credit: Ed Schipul / Flickr

Original Link

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

Original Link

Why Pepper Boosts Turmeric Blood Levels

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"Historians from all around the world have produced evidence to show that apparently all primitive peoples used herbs-often in a sophisticated way. Quinine from Cinchona bark was used to treat the symptoms of malaria long before the disease was identified, and the raw ingredients of a common aspirin tablet have been a popular painkiller for far longer than we have had access to tablet-making machinery. Indeed, today many pharmacological classes of drugs include a natural product prototype that we originally discovered through the study of traditional cures and folk knowledge of indigenous people."

There's a plant in South Asia called Adhatoda (from adu meaning "goat," and thoda meaning "not touch" because it's so bitter even the goats won't eat it). It has compounds that help open one's airways and as such, Adhatoda tea has been used traditionally to treat asthma, where the leaves are steeped with black peppercorns. Leaves steeped with black peppercorns? That sounds gross to me--why would they do that? Because they're smart. Back in 1928, scientists discovered what the people evidently already knew, that adding pepper increased the anti-asthmatic properties of the leaves. Black pepper alone didn't work: it was the combination. And now we know why.

Just like approximately 5% of the spice turmeric is composed of an active compound called curcumin, about 5% of black pepper by weight is comprised of this compound called piperine. Curcumin is responsible for the yellow color of turmeric and piperine for the pungent flavor of pepper. Piperine is a potent inhibitor of drug metabolism. One of the ways our liver gets rid of foreign substances is making them water soluble so they can be more easily excreted. But this black pepper molecule inhibits that process.

And it doesn't take much. If people are given a bunch of turmeric curcumin, within an hour there's a little bump in the level in their blood stream. We don't see a large increase because our liver is actively trying to get rid of it. But what if the process is suppressed by taking just a quarter teaspoon's worth of black pepper? Then you see curcumin levels skyrocket (See Boosting the Bioavailability of Curcumin). The same amount of curcumin consumed, but the bioavailability shoots up 2000%. Even just a little pinch of pepper--1/20th of a teaspoon--can significantly boost levels. And guess what a common ingredient in curry powder is besides turmeric? Black pepper.

Another way to boost the absorption of curcumin is to consume it in the whole food, turmeric root (fresh or dried as a powder) because natural oils found in turmeric root and turmeric powder can enhance the bioavailability of curcumin seven to eight fold. When eaten with fat, curcumin can be directly absorbed into the bloodstream through the lymphatic system thereby in part bypassing the liver.

How is it prepared in India? With fat and black pepper. Amazing how they could figure that out without double blind trials. (Though maybe it just tastes good, and it's merely coincidence?) Their traditional knowledge certainly failed them with ghee, however, which is practically pure butter fat, which may explain India's relatively high rates of heart disease despite all their turmeric.

Why would we care about boosting curcumin levels? Learn why in my videos Which Spices Fight Inflammation? and Spicing Up DNA Protection, Turmeric Curcumin and Rheumatoid Arthritis, and Turmeric Curcumin and Osteoarthritis. It's also good to know Who Shouldn't Consume Curcumin or Turmeric.

I've previously covered this topic of food synergy in videos such as Apples and Oranges: Dietary Diversity and Garden Variety Anti-Inflammation that emphasize the importance of eating a variety of plant foods to take advantage of some of these interactions.

The black pepper mechanism reminds me of the grapefruit (Tell Your Doctor If You Eat Grapefruit) and broccoli (The Best Detox) stories. A testament to the power of plants.

The painkilling properties of aspirin mentioned in the video are actually found throughout the plant kingdom: Aspirin Levels in Plant Foods.

In some circumstances, traditional medicine wisdom seems incredible (Tomato Effect); in others, dangerous (Get the Lead Out). But that's what we now have science for!

-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: John Loo / Flickr

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The Spice That Helps Ease Rheumatoid Arthritis Pain

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Accordingto the World Health Organization, "80% of the Earth's inhabitants rely upon the traditional medicine for their primary health-care needs, in part due to high cost of Western pharmaceuticals. Medicines derived from plants have played a pivotal role in the health care of both ancient and modern cultures." One of the prime sources of plant-derived medicines is spices. Turmeric, for example, has been consumed over the centuries around the world. Turmeric is known by different names in different societies--my favorite of which is probably "zard-choobag."

Turmeric is the dried powdered root stalks of the turmeric plant--a member of the ginger family--from which the orangey-yellow pigment curcumin can be extracted. The spice turmeric is what makes curry powder yellow, and curcumin is what makes turmeric yellow. In the video, Turmeric Curcumin and Rheumatoid Arthritis, you can see the molecular structure of curcumin. I always thought it kind of looked like a crab.

In recent years, more than 5,000 articles have been published in the medical literature about curcumin. Many sport impressive looking diagrams suggesting curcumin can benefit a multitude of conditions via a dizzying array of mechanisms. Curcumin was first isolated more than a century ago, but out of the thousands of experiments, just a handful in the 20th century were clinical studies, involving actual human participants. Most of the 5,000 were just in vitro lab studies, which I've resisted covering until the studies moved out of the petri dish and into the person. But since the turn-of-the-century, more than 50 clinical trials have been done, testing curcumin against a variety of human diseases, with 84 more on the way. One such study got my attention.

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that causes progressive destruction of the cartilage and bone of joints. The long-term prognosis of RA is poor, with as much as 80% of patients affected becoming disabled with a reduced life expectancy. There are lots of drugs one can take, but unfortunately they're often associated with severe side effects including blood loss, bone loss and bone marrow suppression, and toxicity to the liver and eyes.

The efficacy of curcumin was first demonstrated over 30 years ago in a double-blind crossover study: curcumin versus phenylbutazone, a powerful anti-inflammatory that is used in race horses. Both groups showed significant improvement in morning stiffness, walking time, and joint swelling, with the complete absence of any side effects from curcumin (which is more than can be said for phenylbutazone, which was pulled from the market three years later after wiping out people's immune systems and their lives).

In the new study, 45 patients diagnosed with rheumatoid arthritis were randomized into three groups: curcumin, the standard of care drug, or both. The primary endpoint was a reduction in disease activity as well as a reduction in joint tenderness and swelling. All three groups got better, but interestingly the curcumin groups showed the highest percentage of improvement, significantly better than those in the drug group. The findings are significant and demonstrate that curcumin alone was not only safe and effective, but surprisingly more effective in alleviating pain compared to the leading drug of choice, all without any adverse side effects. In fact, curcumin appeared protective against drug side effects, given that there were more adverse reactions in the drug group than in the combined drug and curcumin group. In contrast to non-steroidal anti-inflammatory drugs (NSAIDs), curcumin has no gastrointestinal side effects, and may even protect the lining of the stomach.

Hard to appreciate the gorgeous color of fresh turmeric root unless you see it for yourself. You should be able to find it at any large Asian store. I incorporate it into my Natural Nausea Remedy Recipe. The inner color is almost fluorescent!

I'm afraid followers of NutritionFacts.org are going to get sick of turmeric, but there's a load of important new research I felt I needed to cover. So far there's Turmeric Curcumin and Osteoarthritis, Boosting the Bioavailability of Curcumin and Who Shouldn't Consume Curcumin or Turmeric?

I've previously talked about treating autoimmune joint inflammation with diets full of plants in Diet & Rheumatoid Arthritis and Potassium and Autoimmune Disease.

If phenylbutazone sounds vaguely familiar, maybe you read my Q&A Is horse meat safe to eat?

-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: David van Horn / Flickr

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