Study Suggests Mechanism of Vegetables' Anti-Cancer Activity

Georgetown University Medical Center issued this press release on February 9th claiming that consuming certain vegetables can enhance DNA repair in cells, promoting protection against cancer:

In a study published in the British Journal of Cancer (published by the research journal Nature) the researchers show that in laboratory tests, a compound called indole-3-carbinol (I3C), found in broccoli, cauliflower and cabbage, and a chemical called genistein, found in soy beans, can increase the levels of BRCA1 and BRCA2 proteins that repair damaged DNA.


Although the health benefits of eating your vegetables�especially cruciferous ones, such as broccoli�aren't particularly new, this study is one of the first to provide a molecular explanation as to how eating vegetables could cut a person's risk of developing cancer, an association that some population studies have found, says the study's senior author, Eliot M. Rosen, MD, PhD, professor of oncology, cell biology, and radiation medicine at Georgetown's Lombardi Comprehensive Cancer Center.

"It is now clear that the function of crucial cancer genes can be influenced by compounds in the things we eat," Rosen says. "Our findings suggest a clear molecular process that would explain the connection between diet and cancer prevention."

Research: Yes, Diet Has a Huge Role In Health

Last week The New York Times printed an article featuring a study claiming that a low-fat diet does little to prevent cancer and heart disease. Dr. Fuhrman responded with ten reasons to keep eating healthy food despite the headlines.

Today New York Times reporter Gina Kolata continues to further the notion that what you eat might not shape your medical fate:

It's one of the great principles � no, more than principles, canons � of American culture to suggest that what you eat affects your health.

It's this idea that you control your own destiny and that it's never too late to reinvent yourself. Vice gets punished and virtue gets rewarded. If you eat or drink or inhale the wrong things you get sick. If not, you get healthy. Says James Morone, a professor of political science at Brown University.

Her article cites the rise and fall of numerous fad diets. Dr. David Altshuler, an endocrinologist and geneticist at Massachusetts General Hospital is quoted urging caution when making dietary suggestions:
We should limit strong advice to where randomized trials have proven a benefit of lifestyle modification.
Of course, fad diets have never been the answer. And health care professionals should be exceedingly careful in what they recommend--because a lot of common assumptions about food are not supported by science. (T. Colin Campbell's revolutionary research showing the dangers of too much animal protein was born out of his conviction that getting more animal protein to the malnourished of the developing world was the key to good health--instead he found that reducing animal protein in his own diet was the biggest lesson.)

But if you look at the science, there is not a serious case to be made that diet is not tied to health. Just as there are studies showing smoking is not good for you, so are there studies showing certain foods are not good for you, while others can play a huge role in combating chronic disease.

Dr. Fuhrman's dietary recommendations are based on many thousands of studies. Click "continue reading" to see references and summaries to 19 of them that, together, should go a long way to convincing anyone that yes, it does matter what you eat.

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Reaction on This Week's Big Study on Low-Fat Diets

Lots of reaction to the big study on low-fat diets described in detail earlier in the week... Thanks to a Followhealthlife reader for providing a link to the letters in response to The New York Times' coverage. They are fascinating. Certainly some leapt to the conclusion that this research shows you can eat whatever you want. But many of the letters--especially those from experts--were singing the same tune as Dr. Fuhrman. For instance, this is from David L. Katz, M.D., the director of the Prevention Research Center at the Yale School of Medicine:

That there were any discernible differences in outcomes at all is more surprising than how modest those differences were, particularly given that cancer and heart disease develop over decades and that this intervention occurred relatively late in life, in women well past menopause.

My convictions in the fundamentals of a healthful diet are unshaken.

Larry Norton, M.D. and Clifford Hudis, M.D. are experts from the Memorial Sloan-Kettering Cancer Center. Here's what they had to say:
The study reports that over a short average period of observation (about eight years) a small reduction in fat calories results in a 9 percent reduction in the risk of getting breast cancer, which is very close to "statistical significance" (an arbitrary criterion).

Women eating more fat before entering the trial and those adhering to the diet showed an even better reduction in breast cancer risk.

It is too soon to dismiss these findings as negative, and further follow-up of women on this trial is needed.

David J. Goldstein, M.D., from Indiana, writes:
This study provides no new information except confirmation that maintaining a diet is difficult and a hint that reducing "extremely high" levels of fat intake to "high" levels may be beneficial.
Alice H. Lichtenstein is a professor of nutrition science and policy at Tufts University, she writes:
This study may have raised more questions than it answered, but it would be counterproductive, as the editorial suggested, "to drown our confusion in a big serving of extra-rich ice cream."

The default option to dampen our frustration should be to take a brisk walk around the block.

Of course, not everyone agreed. Read all of the letters for an interesting cross-section of opinion.

Ten Reasons to Keep Eating Healthy Foods Despite Today's Headlines

Today's newspapers are blaring with crazy headlines. The New York Times, for instance, says that a "Low-Fat Diet Does Not Cut Health Risks, Study Finds."

Dr. Fuhrman draws no such conclusions. "This study compared two groups that both ate unhealthy diets," he says. "Look closely and you will see that the researchers compared a typical, disease-causing American diet, with one that was just marginally better, but still terribly unhealthy."

According to the study's authors, the "low fat diet" they told the women in the study to eat is as follows:

...postmenopausal women in the intervention group were advised to reduce total fat intake to 20% of energy and to consume at least 5 servings of fruits and vegetables and 6 servings of grains daily; women in the control group continued their usual eating pattern.
As it turned out, the women in the low fat group actually ate just about one more serving of fruit or vegetable per day, fell far short of the even the modest 20%-of-energy-from-fat goal, and consumed the same number of calories as the women who did not modify their diets. As Gina Kolata reports in The New York Times:
In the first year, the women on the low-fat diets reduced the percentage of fat in their diet to 24 percent of daily calories, and by the end of the study their diets had 29 percent of their calories as fat. In the first year, the women in the control group were eating 35 percent of their calories as fat, and by the end of the study their dietary fat content was 37 percent. The two groups consumed about the same number of calories.
Preventing tough diseases like heart disease and cancer with diet requires an approach that is aggressive, multi-faceted, and nuanced. Dr. Fuhrman says research has already shown that simple interventions like those studied here are not effective:
The studies published this week in JAMA are nothing new. Those who conducted those studies should already be aware of hundreds of others studies that demonstrate "low fat" is not the key factor in disease causation. High phytochemical intake, including critical antioxidants in (high-fat) nuts, seeds and avocados contain heart disease and cancer fighting compounds. Eating more low-fat foods such as egg whites, chicken, and pasta does not expose us to the disease-fighting compounds in berries, seeds, nuts, cruciferous vegetables, tomatoes and carrots.
Here are ten reasons why it still makes sense to eat a diet rich in vegetables, fruits, beans, legumes, nuts, and seeds:
1. Fruits and vegetables are the right things to eat, and among the best things they could have studied. But an increase of roughly one serving of vegetables and fruits per day--which is what was found in the study--does little to ward off cancer or heart disease. As described on Followhealthlife yesterday, I advocate a diet in which vegetables are 30-70% of calories, and fruit is 20-50% of calories.

2. A fixation on fat content is misleading. I do advocate little to no animal fats or oils (including olive oil). The fat from nuts and avocados is healthy and necessary, and for most of my patients I do not restrict it.

3. In this study, participants were encouraged to eat more grains, when in my diet--largely to achieve the potent anti-cancer and anti-heart disease benefits--I advocate replacing grains with vegetables as the basis of the diet.

4. Children were not included in this study. As we have discussed in greater detail previously, the best way to see the effects of diet on cancer is to examine the diets of children.

5. Even with this non-optimal diet, this study did find a correlation between diet and breast cancer. As The New York Times reports: "The women on low-fat diets had a 9 percent lower rate of breast cancer; the incidence was 42 per thousand per year in women in the low-fat diet group, compared with 45 per thousand per year in women consuming their regular diet."

6. The most important factor in preventing heart disease is LDL cholesterol. In this study, minor dietary changes were studied--and were found to make minor reductions in this all-important statistic. Imagine if they had studied serious dietary improvements.

7. Eating a diet heavy in bread, pasta, white meat, and processed foods can be low in fat, but is a very poor source of the micronutrition, especially phytonutrients, that contribute mightily to overall health. Many of the most important dietary interventions that we recommend were simply not studied.

8. The study was of post-menopausal women. The later in life they are started, the smaller effects dietary interventions can have.

9. Every time very healthy diets have been studied, they yield tremendous results. Consider the references below, as well as this evidence about diet and cancer, and diet and heart disease. In addition, the anecdotal evidence of my 15-year medical practice shows that not one of my active patients has had a heart attack.

10. For you hardened skeptics: there is no downside whatsoever to eating healthy food like fruits, vegetables, beans, legumes, nuts, and seeds. Try it for six weeks. (The details are in Eat to Live.) You'll feel great.

Dr. Fuhrman has day-to-day experience helping people prevent cancer and heart disease with diet. He sees it working every day in his practice, and says this study fails to focus on some of the most important findings in nutrition research.

To win the war on cancer; these positive diet change must occur when we are young.

When our cells are growing they expose their DNA to the damaging effects of low nutrient and low phytochemical intake. The low consumption of fruits, vegetables, beans, and nuts (only 5 percent of calories consumed by children) results in our unstoppable and growing cancer epidemic. Research scientists have been forced to accept the idea that the causes of cancer are usually set into motion more than 50 years before diagnosis. Our big artillery in the war on cancer is truly our in our kitchen; but we must start feeding our kids right to unleash the big guns.

Even though the factors initiating cancer causation cannot be eliminated with late-life dietary changes, nutritional excellence even later in life can have dramatic effects at lowering cholesterol and preventing heart disease. But a much more aggressive change in diet is required to achieve that degree of protection than what was looked at in these recent studies. It has already been established that a diet-style which contains a much larger percent of calories from unrefined plant foods (ninety percent) has dramatic effects on the occurrence of heart disease.

My vegetable-based diet was studied in the medical journal Metabolism in 2001 and was found to lower LDL cholesterol 33 percent and have dramatic effects on cardiac disease markers. Similar plant-based dietary approaches, either vegetarian or near-vegetarian containing mostly vegetables, bean, fruits, and nuts, have also been shown to offer dramatic protection against heart disease, even when adopted later in life.

And finally, some relevant studies to consider:

Jenkins DJ, Kendall CW, Popovich DG, et al. Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism 2001 Apr;50(4):494-503.

Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA 2002 Nov 27;288(20):2569-2578.

Campbell TC, Parpia B, Chen J. Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study. Am J Cardiol 1998 Nov 26;82(10B):18T-21T

Esselstyn CB. Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition. 2001 Autumn;4(4):171-177

Low-Fat Vegan vs. Eat to Live

After a recent post, Stan asked how Dr. Fuhrman's diet is different from Dean Ornish's.

The difference is that Dr. Fuhrman's program is based on a mathematical formula that takes into account the nutrient density of food.

It uses foods in proportion to their phytochemical and micronutrient density, meaning vegetables replace grains at the base of the pyramid.

This diet-style enables people to eat more food, obtain a lower glycemic index and more natural anti-oxidant and disease reversal benefits. Dr. Fuhrman also does not restrict fat from avocado, nuts, and seeds as much as Ornish. Dr. Fuhrman says he sees that arbitrary reduction of fat intake to below 10 percent to be less than ideal. Here's a little chart showing some differences.

Low-Fat Vegan DietDr. Fuhrman's Eat to Live
grain or starchy vegetable-basedlow carb vegetable-based
rice, potatoes, bread, pastacolorful veggies, greens, beans, mushrooms, eggplant, peppers, tomatoes, squash
less fruit, less nuts, no animal products, some processed foods more fruit, more nuts, no or very little animal products, no processed foods
less fiber, less nutrients, more sodium, less omega-3 fatshigh fiber, nutrients levels, less sodium, more omega-3 fats


Dr. Fuhrman's Food Pyramid
Fuhrmid.jpg
Want to print out Dr. Fuhrman's food pyramid to stick on your fridge? Click here to download a PDF.

Study: Spanish Obesity Linked to Fast Food

Reuters reports that a new study published in the American Journal of Clinical Nutrition points to the increased popularity of fast food and soft drinks as culprits in Spanish obesity:

Investigators explored the effects of soft drinks and other fast foods on more than 7,000 middle-aged and well-educated Spanish men and women...

High consumption of sugar-sweetened drinks has been associated with weight gain and obesity in the United States.

This trend may also be affecting populations with different eating patterns who increasingly are adopting typical U.S. dietary patterns.

In discussing the diabetes epidemic in New York City last month, The New York Times examined similar trends in this country.

Wall Street Journal Addresses Low Calorie Diets

In his book Eat to Live Dr. Fuhrman cites studies that show fewer calories can mean an increased life span. Recently The Wall Street Journal printed an article supporting calorie-restricting diets. Health Journal writer Tara Parker-Pope reports:

New research shows that calorie-restriction diets -- which cut calories by as much as 40% of your normal intake -- may help you live a longer life. Earlier this month, one of the first human studies of calorie restriction showed that people on the strict diet had younger hearts than normal-weight people on a typical Western diet.

While calorie restriction may not be practical or possible for everyone, there are still lessons to be learned. What is so surprising is that people who follow calorie-restriction diets in hopes of living longer are still eating a lot of food. They indulge in huge breakfasts and big dinners, but eat few or no snacks in between. The main difference in their diets compared with most people typically is in the nutritional quality of food they eat -- whole grains, fruits and vegetables and less animal protein and saturated fat. They avoid refined foods, sugary desserts, soft drinks and other sources of "empty" calories.

Researcher Luigi Fontana makes the key point about reducing calories in your diet: it's not about less food, it's about which food:

"It's not eating half a hamburger, half a bag of french fries and half a sugared beverage," notes Dr. Fontana.

Eat to Live explains all about low-calorie, nutrient-rich food like fruits, vegetables, legumes, seeds, and nuts is the key. Here are some of Dr. Fuhrman's findings from the book:

Reduced caloric intake is the only experimental technique to consistently extend maximum life span. This has been shown in all species tested, from insects and fish to rats and cats. There are so many hundreds of studies.

Scientists have long known that mice that eat fewer calories live longer. Recent research has demonstrated the same effect in primates (i.e., you). A recent study published in the Proceedings of the National Academy of Sciences found that restricting calories by 30 percent significantly increased life span in monkeys. The experimental diet, while still providing adequate nourishment, slowed monkeys' metabolism and reduced their body temperatures, changes similar to those in the long-lived thin mice. Decreased levels of triglycerides and increased HDL (the good) cholesterol were also observed.1 Studies over the years, on many different species of animals, have confirmed that those animals that we fed less lived longest. In fact, allowing an animal to eat as much food as it desires can reduce its life span buy as much as half.

In the wide field of longevity of research there is only one finding that has held up over the years: eating less prolongs life, as long as nutrient intake is adequate. We all must recognize that if we are to reach the limit of human life span, we must not overeat high-calorie food. Eating empty-calorie food makes it impossible to achieve optimal health and maximize our genetic potential.

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