Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

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:

Image Credit: Sally Plank

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

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:

Image Credit: Sally Plank

Original Link

How Do Broccoli Supplements Compare to Sprouts?

NF-Nov3 broccoli sprouts vs supplements.jpg

Your parents would have been smart to tell you to to "eat your broccoli." But what about broccoli sprouts? Or broccoli supplements?

There have been a number of randomized, double-blind, placebo-controlled clinical trials on the use of broccoli sprouts as a complementary treatment in diabetes to reduce oxidative stress, inflammation, and insulin resistance and fasting blood sugars.

In my video, Biggest Nutrition Bang for Your Buck, I describe how to grow our own sprouts simply and quickly in five days. New science suggests, though, that it's even simpler and quicker than I described. If we look at other sprouts, their antioxidant phytonutrients appear to peak around sprouting day five (up to 10-fold higher than day two), but the sulforaphane content in broccoli sprouts appears to peak at around 48 hours, so 2-day-old sprouts may be even better (See Sulforaphane: From Broccoli to Breast).

What if we don't enjoy eating broccoli or broccoli sprouts but still want the benefits of the broccoli phytonutrients? Do the broccoli supplements on the market work? One group of researchers tested BroccoMax, which boasts a half pound of broccoli's worth in every capsule. Researchers compared six capsules a day to a cup of broccoli sprouts. In the video, Broccoli: Sprouts vs. Supplements, you can see the spike in broccoli phytonutrients in the bloodstream of those eating sprouts. The cup of broccoli sprouts dramatically outperforms the six capsules at a small fraction of the cost. The researchers conclude that the bioavailability of broccoli phytonutrients is dramatically lower when subjects consume broccoli supplements compared to the whole food.

What's so great about broccoli sprouts? See: The Best Detox and Sulfurophane: From Broccoli to Breast.

They can be overdone, though. See: How Much Broccoli is Too Much?

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

Image Credit: whologwhy / Flickr

Original Link

How Beans Help Our Bones

NF-Nov20 How Beans Help Our Bones.jpg

Health authorities from all over the world universally recommend increasing the consumption of whole grains and legumes--beans, split peas, chickpeas, and lentils--for health promotion. But what about the phytates?

Phytate is a naturally occurring compound found in all plant seeds (like beans, grains, and nuts) that over the decades has been maligned as mineral absorption inhibitors. That's why, for example, one hears advice to roast, sprout, or soak your nuts to get rid of the phytates so we can absorb more minerals, like calcium.

The concern about phytates and bone health arose from a series of laboratory experiments performed on puppies published in 1949, which suggested that high phytate diets have a bone softening and anti-calcifying effect. Subsequent studies on rats, in which they fed them the equivalent of ten loaves of bread a day, "confirmed" phytate's status as a so-called anti-nutrient. But more recently, in the light of actual human data, phytate's image has undergone a makeover.

A recent study published in the Journal of Medicinal Food asked a simple question: Do people who avoid high phytate foods--legumes, nuts, and whole grains--have better bone mineral density? No. Those that consumed more high-phytate foods actually had stronger bones, as measured in the heel, spine and hip. The researchers conclude that dietary phytate consumption had protective effects against osteoporosis and that low phytate consumption should actually be what's considered an osteoporosis risk factor.

A follow-up study, measuring phytate levels flowing through women's bodies and following bone mass over time, found the same thing: women with the highest phytate levels had the lowest levels of bone loss in the spine and hip. Those who ate the most phytates were also estimated to have a significantly lower risk of major fracture, and a lower risk of hip fracture specifically.

This is consistent with reports that phytate can inhibit the dissolution of bone similar to anti-osteoporosis drugs like Fosamax. Phytates don't have the side effects, though, such as osteonecrosis (bone death) associated with that class of drugs. People take these drugs to protect their bones, but by doing so may also risk rotting them away (See Phytates for the Prevention of Osteoporosis).

Eating healthy can help us avoid other drugs as well. See, for example:

Beans might not just help our skeleton last longer, but the rest of us as well. See Increased Lifespan From Beans.

How might one boost mineral absorption? See New Mineral Absorption Enhancers Found.

Alkaline Diets, Animal Protein, & Calcium Loss is another surprising video on bone health.

And more on the benefits of phytates can be found in my videos:

-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: Asja Boros / Flickr

Original Link

Chronic Headaches and Pork Parasites

NF-Aug26 Chronic Headaches and Pork Parasite.jpg

Neurocysticercosis is the sciencey name for an infection of the human central nervous system by pork tapeworm larvae. The invasion of baby pork tapeworms in the brain "has become an increasingly important emerging infection in the United States," and is the #1 cause of epilepsy in the world. It is the most common parasitic disease of the human brain and used to be found throughout only the developing world (with the exception of Muslim countries, since less pork is consumed there). That all changed about 30 years ago, and now it's increasingly found throughout North America.

Besides seizures, the pork parasites may actually trigger brain tumors or cause an aneurism or psychiatric manifestation like depression. It can also result in dementia, but with deworming drugs this is often reversible. Only rarely do surgeons have to surgically remove the larvae.

I've talked about pork tapeworms before (see my videos Pork Tapeworms on the Brain, Avoiding Epilepsy Through Diet, and Not So Delusional Parasitosis). What's new is that we now know that they may present as chronic headaches--either migraines or so-called "tension-headaches"--even when the worms in our head are dead. What researchers think is happening is that as our body tries to chip away at the worms' calcified bodies, bits of them may be released into the rest of our brain causing inflammation that could be contributing to headaches.

This condition is rare even in endemic areas, but we can avoid getting infested with an adult tapeworm in the first place by cooking pork thoroughly. It's found in some parts of pig carcasses more than others (see the meat chart here), and the worms can be frozen to death no matter how infested the muscles are by storing pork (cut up into small pieces) for a month at subzero temperatures. Then to ensure the larvae are dead the meat is recommended to be cooked for more than two hours. That's one well-done pork chop!

The New England Journal of Medicine recently featured a case of some guy who must have had thousands of pork tapeworm larvae wriggling through his muscles. In my video, Chronic Headaches and Pork Tapeworms, you can see an x-ray, showing the thousands of little white streaks in this man's body. Each white streak is a baby tapeworm. That's why you can get infected by pork, it gets in the muscles. So cannibals might want to cook for two hours too.

Not all parasites are associated with meat, though. An anxious but healthy 32-year-old male physician presented to the family medicine clinic with a sample of suspected parasites from his stools, which had been retrieved from the toilet that same day. They looked to be about an inch long. He had previously traveled to India, had Chinese food the night before--who knows what he had. Maybe it was hookworms? The sample was sent to the microbiology laboratory for analysis. Later that day, the microbiology physician called to report positive identification of Vigna radiata (previously known as Phaseolus aureus) in the stool sample. Or in common parlance, a bean sprout. They were bean sprouts!

"The patient was called and gently but firmly informed of the diagnosis. Given the nature of the identified specimen, the information was presented in a non-judgmental, respectful manner so as not to offend the sensibilities or sensitivities of the patient."

Their parting advice to fellow physicians in cases of this nature was as follows: "as comical as the findings might seem--try not to laugh!"

Other parasites in meat include toxoplasma (Brain Parasites in Meat), sarcosystis (USDA Parasite Game), and Anisakis (Allergenic Fish Worms). There can even be critters in some dairy products (Cheese Mites and Maggots). Eating Outside Our Kingdom describes a brain malady caused not by meat parasites, but by meat proteins themselves.

One of the nice things about eating plant-based is that plant parasites, like aphids, don't affect people. When is the last time you heard of someone coming down with a bad case of Dutch elm disease?

If you haven't yet, you can subscribe to my videos for free by clicking 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 presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: ML Cohen / Flickr

Original Link