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.” 

Is your mind wandering?

I don’t know about yours, but my mind loves to wander. I'm usually jumping between my to-do list, worries, plans, memories... anywhere but where I am.

What do exercise, good conversation, and sex have in common? According to this study recently published in Science, these are the times when our minds wander the least -- the times when we are most in the present moment.

From the opening paragraph of the paper:

Unlike other animals, human beings spend a lot of time thinking about what is not going on around them, contemplating events that happened in the past, might happen in the future, or will never happen at all. Indeed, “stimulus-independent thought” or “mind wandering” appears to be the brain’s default mode of operation. Although this ability is a remarkable evolutionary achievement that allows people to learn, reason, and plan, it may have an emotional cost. Many philosophical and religious traditions teach that happiness is to be found by living in the moment, and practitioners are trained to resist mind wandering and “to be here now.” These traditions suggest that a wandering mind is an unhappy mind. Are they right?

I like the way the authors went about answering this question: they used an iphone app to randomly contact people throughout the day and collect information on their daily thoughts, feelings, and actions. They were then able to create "an unusually large database of real-time reports of thoughts, feelings, and actions of a broad range of people as they went about their daily activities." 

They recorded people’s answers in this database www.trackyourhappiness.org. Check out that website if interested -- you can sign up to start tracking your own happiness levels (I just did!).

3 interesting findings from the study:

1. People’s minds wander frequently.
2. People were less happy when their minds were wandering than when they were not.
3. What people were thinking was a better predictor of their happiness than was what they were doing. 

They found that people are happiest when making love, exercising, and in conversation. Our minds tend to wander unpleasantly when we are working, sleeping, and at home on our computers. 

It seems that the ancient traditions were right: our wandering minds lead us to unhappiness. So maybe the key to happiness is figuring out how to control our minds.

That’s really the whole point of yoga: to train and discipline our minds, to keep coming back to the present moment, to practice being here now.

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.

How much have you laughed today?

I spent a wonderful weekend at home with my family and baby niece:

She is the cutest little button and I could not believe how much she laughs! This is something our adult-selves could do better! 

In book club a couple weeks ago, we talked about this New Yorker article about laughter yoga and the "Laughing Guru." Here are some cool little factoids that we learned: 

• Laughter reduces levels of stress hormones. This study looked at blood markers for stress in healthy males before and after watching a 60-minute humor video. When compared with controls, subjects who watched the humor video had lower cortisol, epinephrine, and growth hormone levels.
• Laughter modulates the immune system. This study looked at blood markers related to immune function before and after a 1-hour humor video. They found subjects to have increased natural killer cell activity and immunoglobulin levels (IgG and IgM).

The best part of that book club meeting might have been our 1-minute laughing exercise where we made ourselves laugh for 60 seconds (we actually timed it). Seriously, try it next time you’re bored! The initial forced fake laughter turns to real contagious laughter... and hey, it might even lower your stress levels and boost your immune function!

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!!

Let's stop apologizing, ladies.

In the yoga studio, in the hospital, in the lab, in relationships…. I always seem to be apologizing for something!

I see my girlfriends doing it too. Why are we apologizing so much?! I loved reading this paper that just came out (thank you for sending, Lizzie!) that provides some evidence and explanation for this “sorry” gender imbalance.

Here is what they found:

• Women apologize more often than men, but importantly, women report committing more offenses than men
• Men rate offenses as less severe (and less often deserving of an apology)
• Once men and women identified a behavior as offensive, they were equally likely to apologize (it’s just that men see fewer things as offensive) 

The bottom line: 

Women have a lower threshold for what constitutes offensive behavior

I want to work on cutting down on my “Sorry’s.” 

Here’s how:

1. Count my apologies. How many times do I actually apologize in a day? Yesterday I counted 4 before 10am… that seems like too much (especially since none of them really deserved an apology).
2. Categorize my apologies. This will help me understand what I’m actually apologizing for all day long. Every time I say “sorry,” label it in one of these categories (as described in the article) 
• Relational (e.g., insulting someone) 
• Failed obligation (e.g., failing to complete chores) 
• Inconvenience (e.g., calling a wrong number) 
• Physical or material (e.g., bumping into someone, damaging someone’s belongings)
3. Raise my sorry threshold. Pause before saying “sorry” – does this warrant an apology? Try to adopt more of a male mentality about this.

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?!)

Sunday yoga and the science of love

I can’t think of a better way to start a Sunday than with mysore practice with yogi friends followed by a group coffee date at La Colombe… perfect!

I love seeing our little yoga family growing here: new students, new friends, and new babies! Two of our beautiful ladies are now pregnant, and it’s such a treat to get to practice with them every morning (and have one of them be our amazing teacher)!

This is one reason we chose our latest book club book to be The Scientification of Love, by Michel Odent.

It’s about the science behind love (i.e. falling love, life partnership, pregnancy, giving birth, raising a child). The author, Michel Odent, is a French obstetrician whose research focuses on the primal period (the time of life between birth and 1 year of age), and he correlates events during this time period with health and behaviors later in life.

It’s a fascinating book. Here are some highlights:

1. In some animals, pain during birth correlates with love for the newborn. Research in animals has shown that when painkillers/anesthesia are given during birth, some mothers will actually reject their newborns (they do not seem to recognize it as their own). For example, ewes given epidurals will not take care of their lambs!
2. Oxytocin is the “hormone of love.” You may have heard about this hormone because it’s released during breastfeeding (builds the mother-child bond). In addition, both men and women release it during sexual activity/orgasm. Well, we also release it when we share a meal with someone! (One question that came up: do our oxytocin levels rise when we practice yoga together  each morning?)
3. Love-sickness is a real thing. Anyone who has ever been in love knows this feeling: the physical illness you get when you lose or are separated from your loved one (knot in the stomach, loss of appetite, etc). This is an actual chemical withdrawal of neurotransmitters (i.e. phenylethylamine - PEA), and you are craving them. 
4. Falling in love has chemical similarities to obsessive-compulsive disorder (OCD). You know the feeling: you meet someone, you get crushy, you fall in love, and you develop OCD tendencies with this person (similarly with a new baby). When people fall in love they actually have lower levels of serotonin in the brain, just like people with clinically diagnosed OCD. 

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)

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).

Just a little meditation

Every morning after asana practice, Richard would have us do sitting meditation for at least 10 minutes. I'd like to continue that now that I'm back home (here’s why), but it's HARD to create new habits and I find myself falling back into my old routines.

It’s already known that long-term meditation improves concentration, attention, mood, and stress levels. But what about those of us who just do it for a few days here and there? Does that help us focus our attention, limit mental chatter, or improve functioning? Or is it something we would have to keep up for months/years before it would be of any help?

Good news! This study just came out showing that short-term meditation (4 days for 20 minutes/day) has measurable benefits.

They looked at 65 people with no prior meditation experience, splitting them into two groups: one group did mindfulness meditation for four day (20 minutes/day), while the control group listened to The Hobbit on audiotape.

The meditation group had the following benefits when compared with controls:

• Decreased fatigue
• Decreased anxiety
• Improved attention
• Improved working memory
• Improved executive functioning 

That’s after only 4 days! This makes me wonder about other changes might happen in the body after just four days of meditation: Blood flow in the brain? Cortisol? Inflammation? Oxidative stress levels? Telomeres/telomerase?

It's nice to know that even if I don't sit and meditate every day, at least a little is still helpful.

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...

Yoga for sleep

“Health is the first muse, and sleep is the condition to produce it.” 

~ Ralph Waldo Emerson

Not being able to sleep is one of the most frustrating things for me and it’s been happening a lot lately. Maybe it’s because I sense things changing. I leave for Boulder in a week and many things will be different when I return (friends moving away or busy in residency, the start of my residency application process, etc).

All I can say is thank goodness for yoga. My sleeping troubles almost always have something to do with underlying stress or anxiety or sadness, and I really think yoga helps me process those feelings while also energizing me mentally for the day ahead, quieting my mind from unsettling thoughts, and exhausting my body for sleep at night (except maybe when I overdo backbends).

Which is why I was happy to wake up this morning to results from this study of 410 cancer survivors finding that yoga can help improve sleep at night and decrease fatigue during the day. They looked at gentle Hatha/ restorative yoga twice a week for four weeks. I can’t help but wonder what they might have found with a more physically intense and daily Ashtanga yoga practice over the course of years rather than weeks. 

As Dr. Kathryn Schmitz from Penn commented, most physicians tell cancer patients to "take it easy," but that "What we conclude based on a really thorough review of [yoga programs] is that it is absolutely safe for cancer survivors during and post treatment to be physically active, and indeed there are tremendous benefits to doing so."

What makes us happy?

Check out this article Josh found on what makes people truly happy. It’s about a study that followed 268 men who entered college in the 1930’s… following them through war, careers, success, failure, love, relationships, marriage, divorce, parenthood, retirement, death.

For me, I don’t think any kind of research study could get it more right than Allan Chalmers when he says a person needs just three things to be truly happy:

Someone to love. Something to do. Something to hope for.