Foods fighting cancer

“Autopsy studies from people who died in car accidents have shown that about 40% of women between the ages of 40 and 50 actually have microscopic cancers in their breasts. About 50% of men in their 50s and 60s have microscopic prostate cancers. And virtually 100% of us, by the time we reach our 70’s will have microscopic cancers growing in our thyroid. Yet without a blood supply, most of these cancers will never become dangerous.”~Dr. William Li, MD

All of us have tumor cells in our bodies. The problem is when they grow blood vessels and develop a blood supply: this is termed “Angiogenesis.”

In this Ted Talk by Dr. William Li, he talks about how our focus on cancer prevention should be on preventing the growth of blood vessels to tumors. Preventing this angiogenesis is one of the most important defenses against cancer, and he argues that this is something we can actually do with our diet.

Focusing on our diet might be the key to preventing the growth of cancers.

He explains: “Mother nature has laced a large number of foods and beverages and herbs with naturally occurring inhibitors of angiogenesis.”

Some of these naturally occurring anti-angiogenic foods include the following:

• Red wine/red grapes (Reservatrol) 
• Strawberries (Ellagic acid) 
• Soybeans (Genistein)

Here are some others: 

He ends by making the point that many local and sustainable foods are naturally anti-angiogenic. This is important because, as he says:

“For many people around the world, dietary cancer prevention may be the only practical solution, because not everyone can afford expensive end-stage cancer treatments, but everyone could benefit from a healthy diet based on local, sustainable, anti-angiogenic crops.” 

Getting enough omega-3's (without fish)

One of my concerns with being a non-fish eating vegetarian is the question of whether I get enough omega-3 fatty acids (“good fats”): Should I eat fish sometimes? Should I be taking fish-oil supplements? My body might need me to put those lox on my bagel and cream cheese?

We’ve heard why omega-3’s are good for us: they help reduce inflammation, reduce risk of heart disease, reduce risk of dementia… not to mention they may help keep protect your telomeres.

The other day my younger sister forwarded me a news alert from the Physicians Committee for Responsible Medicine, highlighting a recent study of 14,422 people showing that women on vegan diets do have an expected lower intake of omega-3’s, but they also have greater conversion of plant-based precursors to omega-3’s, and thus they have higher than expected blood levels of omega-3 fatty acids.

That’s reassuring! That means that our bodies will probably make adequate amounts of omega 3’s from a plant-based diet (which includes walnuts, flaxseeds, plant-based oils).

I was especially glad to see a medical peer-reviewed paper addressing the bigger problem of our diminishing fish supply:

“Current dietary recommendations for maintenance of [adequate omega-3 levels]… are to consume one or more portions of oily fish per week; however, the supply of wild fish is dwindling and efforts to conserve the fish supply are needed.”

(If you haven't yet seen the documentary End of the Line, check it out!):

Redesigning cafeterias

I was so excited to see this article in the New York Times today: how to redesign school lunchrooms to promote healthier eating. It's not about taking away the junk foods. Rather, it's about how simply redesigning cafeterias leads to healthier food choices. 

For example:

• Make healthy foods (like broccoli) the first thing you see
• Give food attractive names: Instead of “corn" call it “creamy corn”!
• Provide choices: Offer students a choice of carrots OR celery (not only carrots)
• Keep ice cream and desserts in closed containers so they're not easily visible
• Encourage tray use: This increases veggie and decreases ice cream consumption
• Decrease the size of bowls
• Move chocolate milk behind regular milk 
• Put apples and oranges in fruit bowl rather than a stainless steel pan (this makes it more appealing)
• Verbally offer students a salad (and more will say yes)
• Move the salad bar in front of the checkout (instead of off against a wall)
• Have student pay cash for desserts (instead of using lunch tickets to buy them)
• Make a “healthy express” check-out line for students not buying desserts or chips 

This is pretty much what my school lunches used to look like... yikes.

Revolution Foods

“Let’s look at the school lunch program…We are essentially feeding them fast food and teaching them how to eat it quickly… lunch should be educational. Right now the school lunch program is a disposal scheme for surplus agricultural commodities. When they have too much meat, when they have too much cheese, they send it to the schools, and they dispose it through our kids’ digestive systems. Let’s look at it in a different way. This should be about improving the health of our children.”

~ Michael Pollan (in an interview with Bill Moyers, November 28, 2008)

Check out this short video about a company called Revolution Foods, serving a new kind of school lunch:

The founders, Kristin Richmond and Kirsten Tobey, came up with the idea while in business school at Berkeley, motivated "by the idea of creating a healthier generation.”

Their company now serves almost 60,000 meals to mostly low-income students in 350 schools across the country!

The criteria for the food they serve:

• No high fructose corn syrup
• No trans fats 
• Antibiotic and hormone free meat and dairy 
• Local and organic foods preferred 
• No fried foods 

The challenge: healthy food is more expensive. These meals are $3-4/meal, while the government currently only reimburses schools up to $2.75 per meal. This is certainly worth the investment though, especially considering how much money this will save in medical bills down the road. 

How about also bringing this idea to hospital cafeterias?

For all the coffee lovers...

You are not alone… this survey shows that doctors and nurses “depend on coffee to get through the workday” much more than other professionals (I think I could’ve predicted that one!).

Sure we might be addicted, but the recent good news is that we also might be helping our inflammation and cholesterol levels.

This study followed healthy subjects for 3 months:

• The first month: subjects had 0 cups of coffee/day
• The second month: subjects had 4 cups of coffee/day
• The third month: subjects had 8 cups of coffee/day 

I like the design of this study because individual subjects serve as their own controls, helping control for confounders (like diet, exercise, or smoking which may be associated with coffee consumption), and making it easier to see the effects of coffee alone.

They compared markers of inflammation, oxidative stress, cholesterol, glucose, and insulin resistance. They found increased coffee consumption to be associated with:

• A decrease in markers of inflammation IL-18 and 8-isoprostane (no change in C-reactive protein or IL-6)
• An increase in adiponectin, a hormone involved in regulating metabolism and glucose levels (no change in fasting glucose or insulin)
• An increase in HDL cholesterol (the good kind of cholesterol) 

Their conclusion: “Coffee consumption appears to have beneficial effects on subclinical inflammation and HDL cholesterol.”

I’d love to see a similar study design looking at these markers after a month of a daily yoga practice!

And how much do you love these mugs?! I want one!!

Medical miseducation

If there was ever a time when doctors need to be as handy with a peeling knife as they are with a scalpel, this may be it. The draft version of the federal government’s 2010 Dietary Guidelines, which will be formally released in December, identifies obesity as the nation’s greatest public-health threat. It also notes the relationship of fast food (and physical inactivity) to unhealthy weight gain and emphasizes the importance of plant-based foods in the diet….

“For many doctors, an uneasy relationship with nutrition starts as early as medical school. Long hours and ready access to fast food, often on the hospital grounds, tends to undermine students’ best dietary intentions,” said Dr. Robert F. Kushner, a professor at Northwestern University Feinberg School of Medicine, where he directs the Center for Lifestyle Medicine. “Even the ones who come in excited about eating well and exercise find that good habits are harder and harder to maintain as time goes on,” Dr. Kushner said.

~From this great article in the New York Times, Doctor's Orders: Eat Well to Be Well

I could not agree more. It is incredibly difficult to develop and maintain healthy eating habits in medical school and residency (long hours in the hospital, sleep deprivation, high stress levels, free unhealthy food all around us, and lack of healthy choices in the cafeteria). 

When doctors don’t eat healthily themselves (and are given little to no education in what this means), then how can they be expected to counsel patients effectively?

Bill Clinton's new diet

Last night, Bill Clinton talked with CNN’s Wolf Blitzer about his new plant-based (basically vegan) diet:

"I went on essentially a plant-based diet. I live on beans, legumes, vegetables, fruit, I drink a protein supplemement every morning. No dairy. I drink amond milk mixed in with fruit and protein powder, so I get my protein in when I start the day out. It changed my whole metabolism, and I lost 24 pounds. I got back to basically what I weighed in high school."

After having heart surgery and having his stents re-clog because of his high cholesterol levels, he started doing his own research (including work done by Dr. Cladwell Esselstyn at the Cleveland Clinic, Dr. Dean Ornish at the Preventive Medicine Research Institute, and Dr. Colin Campbell author of The China Study). 

Clinton learned that 82% of people who go on a plant-based diet (no dairy or meat of any kind) can heal themselves and clear up their arterial blockage.

“We now have 25 years of evidence, and so I thought, well, since I need to lose a little weight for Chelsea’s wedding, I’ll become part of this experiment. I’ll see if I can be one of those who can have a self-clearing mechanism. We’ll see.” 

This is huge to have someone like Bill Clinton being an advocate for a plant-based diet! (I'm wondering if he’s tried yoga yet?!)

Is this too much?

Check out this commercial by the Physicians Committee for Responsible Medicine (PCRM) on the consequences of fast food:




Too much?

Negative ions

I spent the weekend at the Jersey shore. As we were lying around relaxing, someone suggested that this relaxed feeling might be because of the high concentration of negative ions at the beach.

What are negative ions?!

Negative ions are molecules with a negative charge (i.e. gain of an electron). This happens when molecules run into each other and break apart. They're present in higher concentrations in places like beaches, waterfalls, and showers. 

Could the presence of these invisible particles help explain why the beach is so relaxing?

This study at Columbia University looked at people with seasonal affective and bipolar disorder and found that high density negative ion generators actually improved symptoms of depression.

Columbia University researcher Michael Terman, PhD, explains in this article:

"The action of the pounding surf creates negative air ions and we also see it immediately after spring thunderstorms when people report lightened moods.”

According to researchers, negative ions may increase oxygen flow to the brain and lead to improved alertness and energy.

Where can we find negative ions? 

• By turning off the air conditioning and opening the windows
• In the shower 
• At beaches, mountains, waterfalls 
• After rainstorms
• By buying a negative ion generator

Low-carb diets: What happens in 20 years?

Are you on a low-carb diet or know someone who is? I've dabbled with this myself and hear friends and patients talking about it all the time.

But I've always wondered: can this really be good for our bodies? We lose weight in the short-term, but what about 20+ years down the road?

A recent study in the latest Annals of Internal Medicine starts to answer these questions. They find that where your proteins/fats come from (i.e. animals versus plants) matters very much for long-term health. 

They compared low-carb diets made up of animal sources versus low-carb diets made up of vegetable sources (in over 100,000 people for over 20 years), and found an important difference in mortality rates.

Low-carb diets high in animal-protein diets were associated with higher mortality (both cardiovascular and cancer mortality), while low-carb diets high in vegetable protein diets were associated with lower mortality overall (especially cardiovascular mortality rates). The authors’ conclusion:

“A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.”

Low-carb diets can be helpful or harmful. What really matters is everything else you are putting into your body. It seems best to stick to simple and intuitive food rules. Here are my 5 for the day: 

1. Avoid refined sugars (but do not avoid nutritious whole grains!)
2. Minimize animal products
3. Build meals around fresh colorful vegetables (the more color the better)
4. Avoid overeating
5. Chew thoroughly (this helps with #4)

The 7 Conditions of Health?

I went to another free lecture at Essene the other night. This time it was by Macrobiotic expert Denny Waxman, whose book I have just finished: The Great Life Diet.

He talked about the 7 conditions of health as defined by the Macrobiotic founders George Ohsawa and Michio Kushi. They are divided into 3 categories: Physical, Mental/Emotional, and Spiritual. Here they are:

Physical:

1. No tiredness

2. Good sleep

3. Good appetite

Mental/emotional:

4. Good memory

5. Never be angry

6. Joyous and alert

Spiritual:

7. Endless appreciation/gratitude

I thought this was a pretty good list, but there were some things missing for me (friendship, love, community, laughter, learning).

I'm also not sure about #5: Never be angry. Never? I don’t get angry often, but when I do it’s usually for a good reason (in my opinion, at least)!

Does anything else seem to be missing for you on that list?

Being ANTI-cancer

I recently came across this article by Dr. David Servan-Schreiber. I remember seeing his book in Barnes and Noble a couple years ago. I picked it up and read the whole thing sitting in the café - I could not put it down.

He is both a doctor and scientist (PhD in Neuroscience). At age 31, he discovered he had a brain tumor, which was picked up by chance when one of his patients didn’t show up and he ended up getting into the scanner instead.

After his diagnosis, he began furiously studying cancer. He wanted to learn as much as possible, especially why we get cancer and what we can do to prevent it.

The first thing I learned is that we all carry cancer cells in us. But I also learned we all have natural defenses that generally prevent these cells from turning into an aggressive disease. These include our immune system, the part of our biology that controls and reduces inflammation, and the foods that reduce the growth of new blood vessels needed by developing tumors.

In the West, one out of three people will develop cancer. But two-thirds will not. For these people, their natural defenses will have kept cancer at bay. I understood it would be essential for me to learn how to strengthen these defenses. 

Servan-Schrieber talks about the circumstances under which cancer grows:

1. A weakened immune system that cannot identify and control the growth of cancerous cells.
2. Chronic inflammation that supports cell growth and expansion.
3. Tumors develop their own blood vessels that allows them to grow to much larger sizes. 

He says, 

When we strengthen our immune system, reduce inflammation and reduce the growth of new blood vessels, we help create an anticancer ‘terrain.’

Here's how we can actively create anticancer terrain:

1. Eliminate sugar. According to Servan-Schreiber, this is the #1 cancer promoter in the US. Sugar feeds cancer cells and promotes low-grade chronic inflammation. 
2. Add cancer-fighting foods. Most simply, this means a colorful diet full of whole grains, fresh fruits, and vegetables.
3. Exercise. Simply walking daily for 30 minutes can reduce your cancer risk and cancer recurrence.
4. Reduce stress. Stress increases susceptibility to disease, so find ways to reduce stress in your life (yoga, meditate, time for friends).
5. Reduce pollutants. Do what you can to minimize exposure to chemicals and pesticides.

Prescribing veggies

Doctors are now prescribing fruits and veggies at local farmers’ markets. Check out this article in the NY Times last week if you haven't seen it yet.

Doctors at three health centers in Massachusetts have begun advising patients to eat “prescription produce” from local farmers’ markets, in an effort to fight obesity in children of low-income families. Now they will give coupons amounting to $1 a day for each member of a patient’s family to promote healthy meals.

Farmers’ markets can be a “hub of preventive health.”

“Can we help people in low-income areas, who shop in the center of supermarkets for low-cost empty-calorie food, to shop at farmers’ markets by making fruit and vegetables more affordable?” said Gus Schumacher, the chairman of Wholesome Wave, a nonprofit group in Bridgeport, Conn., that supports family farmers and community access to locally grown produce.

If the pilot project is successful, Mr. Schumacher said, “farmers’ markets would become like a fruit and vegetable pharmacy for at-risk families.”

The key will be to make it easy for people by bringing farmers' markets into hospital cafeterias, doctors' offices, schools, and churches. Speaking of which, I was so happy to walk into our hospital cafeteria the other day and see this: A table dedicated to produce from local farms!

Perhaps one day doctors will even be able to prescribe farm shares, so that fresh fruits and vegetables can be directly delivered to people each week. 

Good news in the medical world

The Dean Ornish lifestyle change program will now be covered by Medicare (article here, CMS decision memo here). This hopefully means we'll be seeing more diet and exercise programs pop up around the nation, and people will be able to afford them.

Below (or link here) is a 3-minute Ted Talk where Dean Ornish talks about the pandemic of cardiovascular disease, diabetes, high blood pressure, and obesity, and how these diseases are reversible through diet and lifestyle in 95% of people. He also talks about how prostate cancer can be reserved or stopped through diet and lifestyle. 

How acidic is your diet?

I've heard people (especially yogis) talk about wanting to eat a low-acid diet but never really paid much attention until recently. Then this article piqued my interest, about how a low-acid diet might help prevent osteoporosis.

How could a low-acid diet prevent osteoporosis? Our blood needs to stay within a neutral pH of 7.35-7.45. When the blood gets too acidic, calcium is leached from the bones in order to neutralize it. Too much calcium loss from the bones leads to osteoporosis. Different foods produce different amounts of alkalinity or acidity in the body.

Acid-producing foods include meats, beans, fish, cheeses, and grains. Foods with a high protein content leads to more acid production (especially animal proteins because of sulfurous amino acids). Coffee, tea, beer, wine, sugary foods (things we crave and become addicted to) all acid producing.

Alkali producing foods include fruits and vegetables. Even though lemons and other citrus fruits have acidic juice, when they are ingested they actually have an alkaline effect (result of the potassium and magnesium present).

The typical American diet is highly acidic: meat, dairy, sugar, alcohol, and coffee, while low in fruits and vegetables. A low-acid diet is high in fruits and vegetables, and low in animal protein.

Some are beginning to suggest that it may actually be the consumption of too much meat and animal protein (including dairy) that explains the high rates of osteoporosis in America. Even though dairy products contain calcium, they may actually end up weakening our bones because of their acid-producing effect. Research like this is surfacing, showing that there is insufficient evidence to recommend dairy to children for bone health.

My own doctors have always recommended dairy products to make sure I get enough calcium, but have never talked about the effects of a low or high acid diet on my bones. Have yours? I'm wondering if/how this might start to change over the next few decades.

Are we feeding our own cancer cells?

If you eat a lot of fructose (which most of us do), the scary answer might be yes.

There is a lot of fructose in the American diet, as high fructose corn syrup (HFCS) has infiltrated our grocery stores. The consumption of high-fructose corn syrup has actually risen 1,000% from 1970-1990.

This study just came out showing that fructose actually stimulates the growth of pancreatic cancer cells (CBS news overview here).

Fructose is taken up by cancer cells and used to make new nucleic acids, which are the building blocks of cell growth and proliferation.

The authors of this study write:

“Fructose is a particularly significant dietary sugar component with important implications for patients with cancer, particularly given the significant dietary change that has occurred in human fructose consumption since the mid- 20th century. Our findings provide important insights into recent epidemiologic studies that have identified refined fructose as an independent risk factor for pancreatic cancer, and identify fructose-mediated actions as a novel therapeutic cancer target.”

When I checked the ingredient list on my packaged foods at home, I was shocked at how much had high fructose corn syrup (HFCS) in it... even my "healthy" whole-wheat bagels and my seemingly innocent ketchup and BBQ sauce.

Can decreasing the amount of fructose in our diet inhibit cancer growth? This is the question we need to research now. 

Eliminating HFCS is essentially what the Ornish diet does when they recommend a whole foods, plant based diet. Some preliminary studies show that this diet, along with exercise and stress reduction, may have some effect on the progression of prostate cancer (in addition to reversing atherosclerotic disease).

How much HFCS are hospitals serving patients? I wish we could say zero. I’ve been thinking a lot about Ben’s post and could not agree more that hospitals should provide nutrition labels on their food.

If you’re interested in learning more about this fructose issue, here’s a post and “mini-med school lecture” about it. I’m sure this is something we’ll be hearing more and more about. 

Easy weight control: Keep meat off your plate

Eating meat may lead to weight gain, and this recent study provides the data (check out the NPR story here).

They looked at the association between meat consumption and weight gain, following 103,455 men and 270,348 women for 5 years.

3 important findings from this study:

1. There is a strong link between weight gain and meat consumption, even after controlling for variables such as total calories, weight, age, sex, and physical activity.
2. A diet that contains 250 grams of meat per day leads to 4 pounds of weight gain after 5 years.
3. Red meat is not the only culprit: weight gain is most strongly correlated with poultry consumption (which people tend to think of as the lower fat/ healthier meat option).  

Conclusion:

• Decreasing meat consumption (all types of meat) may help with weight management. High animal-protein diets will most likely not lead to long-term weight loss.

All I can think about is the massive amount of meat that we serve sick people in our hospitals and children in our schools. How much evidence will it take for us to actually start changing this?

Cannot wait to see this

Cannot wait to see this documentary: FORKS OVER KNIVES.

From the website:

“FORKS OVER KNIVES examines the profound claim that most, if not all, of the so-called “diseases of affluence” that afflict us can be controlled, or even reversed, by rejecting our present menu of animal-based and processed foods."

The documentary tells the stories of these two important and influential researchers:

• Dr. T. Colin Campbell. Nutrition researcher who focuses on the role of nutrition in cancer, and author of the well-known book, The China Study.
• Dr. Caldwell Esselstyn, Jr. Surgeon at the Cleveland Clinic and author of long-term nutrition research on reversing coronary artery disease (check out this study on how a plant based diet reversed coronary artery disease, and this paper on how moderation may actually kill when it comes to heart disease).

Hospital food matters

Hospitals are meant to be places of healing, but it seems that the food we serve our there may have the opposite effect. I have a feeling that we will look back in 50 years and be shocked at the things we’ve been feeding people.

This NPR story talks about a pilot study done by the Johns Hopkins Center for a Livable Future: What happens when hospitals serve less meat on their menus? (And the meat that they do serve is bought from local, organic, and sustainable sources.)

They looked at 3 hospitals and found the following:

• A 28% decrease in meat and poultry purchases (translated to save $400,000/year)
• Reduction in meat-related greenhouse gases by 1,648 tons/year
• Reduction in CO2 emissions equivalent to burning 102,454 gallons of gasoline or sequestering carbon by growing 23,354 tree seedlings over 10 years 

Wow… how can hospitals not do this?! It would mean both healthier patients and a healthier planet.

3 simple things health providers/hospitals can do right now:

1. Buy & sell less meat
2. Buy food from local, organic, sustainable food sources
3. Participate in Meatless Mondays (also started by Johns Hopkins – go them!) 

Even Einstein agrees...

"Nothing will benefit human health, and increase the chances for survival of life on Earth, as much as the evolution to a Vegetarian Diet" ~Albert Einstein

A little exercise: Good for your telomeres

We know that stress shortens telomeres. This new study indicates that this may happen only in inactive people.

The study at UCSF looked at 62 postmenopausal women suffering long-term stress (caregivers of chronically ill loved ones). They divided the group into inactive and active people (active = at least 75 minutes of weekly physical activity). It turned out that only the inactive group had shortened telomeres.

Wow! Another reason to make time for exercise… especially if we lead stressful lives. Seems that even just a little physical activity can protect these important pieces of our chromosome.

One of the lead telomere researchers, Elissa Epel, said:

"Telomere length is increasingly considered a biological marker of the accumulated wear and tear of living, integrating genetic influences, lifestyle behaviors, and stress… Even a moderate amount of vigorous exercise appears to provide a critical amount of protection for the telomeres."

To me, one of the most exciting things in the article was the last paragraph about how they are now telling people the length of their telomeres to see if this impacts people’s lifestyle choices (to reduce stress, eat less meat, exercise, drink less alcohol, etc) in order to keep their telomeres long and healthy. Can’t wait to hear results of that study...