Marc Joseph Nutrition - Blog

In a study published in the Journal of Clinical Investigation, researchers found that mice missing a key prostate cancer tumor suppressor gene were much more likely to survive with a high omega-3 fat, low omega-6 fat diet.

Specifically, survival rates in the study were:

• 60% for the mice fed a high omega-3 fat diet (1-to-1 omega-6 to omega-3 fat ratio)
• 10% for the mice fed a low omega-3 fat diet (20-to-1 omega-6 to omega-3 fat ratio)
• 0% for the mice fed a high omega-6 fat diet (40-to-1 omega-6 to omega-3 fat ratio)

In addition to improving survival times, omega-3 fatty acids slowed both the progression of cancer cell formation and tumor growth.

As one of the study’s co-authors notes, the implications are significant:

“This suggests that if you have good genes, it may not matter too much what you eat,” said Chen, a professor of cancer biology. “But if you have a gene that makes you susceptible to prostate cancer, your diet can tip the balance. Our data demonstrate the importance of gene-diet interactions, and that genetic cancer risk can be modified favorable by omega-3 PUFA.”

The bad news: The tumor suppressor gene absent in the mice in this study is estimated to be missing in 60% to 70% of human metastatic cancers. So, counting on good genes may not be a good bet.

The good news: Since prostate cancer cells are typically slow-growing, improving the omega-3 / omega-6 fat intake balance is one factor that may play an important role in determining whether one ultimately develops the disease.

Possible Mechanism

As discussed in an earlier post, a higher omega-3 / omega-6 fat intake tends to promote the production of anti-inflammatory immune system modulators (e.g., prostaglandin PGE-3), while a high omega-6 / omega-3 fat intake tends to promote the production of pro-inflammatory substances (e.g., prostaglandin PGE-2 and cytokines IL-6 and TNF-alpha).

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In a market-basket survey published in Environmental Science & Technology, researchers found that arsenic levels in U.S. rice varied significantly by region.

Specifically, rice grown in the south central U.S. (Arkansas, Louisiana, Mississippi, Texas, & Missouri) was on average 41% higher in arsenic than rice grown in California (0.27 mcg/g verus 0.16 mcg/g).

The scientists hypothesized that the higher level of arsenic found in south central U.S. rice could be attributed to the arsenic-containing pesticides previously used on the cotton fields that are now used for growing rice. Industry is currently trying to develop strains of rice that take up less arsenic from the soil.

Assessing Risk

Presently the government sets no maximum contaminant level for arsenic in food. The EPA has set a 10 mcg per liter limit for inorganic arsenic in drinking water.

The average consumption of rice in the U.S. is 25 grams per day. However, some ethnic groups, as well as people pursuing a gluten-free diet (e.g., individuals with Celiac diesease or on the autistic spectrum), may eat much more, and thus may be at risk for higher arsenic exposure. Also, as the researchers note, young children tend to eat much larger portions of rice relative to their small size.

Previous studies suggest that the percentage of inorganic arsenic (the most toxic form) found in U.S. rice varies widely, from 10% to 70% of the total arsenic in the rice. A person eating an average rice portion size of 100 grams with an arsenic content of 0.3 mcg/g would ingest 30 mcg of arsenic. If 50% of that arsenic were inorganic, total dietary exposure from rice alone would be 15 mcg, exceeding the EPA limit for a liter of water.

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Last month, I wrote a post questioning the conclusions of a poorly designed National Cancer Institute study that suggested taking “excessive” multivitamins could increase your risk for prostate cancer.

More recently, the Life Extension Foundation (LEF) put together an even more damning and detailed critique of the study’s results that raises other excellent points worth considering:

1. Study participants may have been mis-classified.

As mentioned in my earlier post, the study used self-reported food frequency questionnaires (FFQs) to ask study participants about prior supplement usage. FFQs are subject to significant error, as participants may over- or under-report supplement use.

As LEF notes:

Questionnaire-based information collection is limited in accuracy to the memory recall of the study subjects. The majority of people cannot recall what they ate for breakfast one week ago, or which shirt they wore to work two weeks ago, or how many gallons of gas they purchased during their last trip to the gas station, never mind specific doses and frequency of use of a myriad of dietary supplements months or years ago.

But it gets better when we learn what the researchers actually did in this case:

In this government-funded study bashing multivitamins, the researchers had the audacity to place each subject who stated they did not know how much vitamin E they took into the 400 IU a day category. This means when the results where tabulated to see if multivitamin use was associated with prostate cancer risk, men who may or may not have taken any vitamin E were deemed to have taken 400 IU a day.

Men who reported taking even one multivitamin supplement a month were recorded as taking a multivitamin every single day. This meant that when the data was tabulated, those who may have taken as few as twelve multivitamin supplements a year where considered to have taken a multivitamin each day.

If one were designing a study to make it impossible to conclude anything meaningful from the results, this would be a good way to do it.

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A few weeks ago, I wrote about the cancer-vitamin D link and highlighted an excerpt from an article that hinted at the pending release of a study with extremely promising findings:

[P]erhaps the biggest bombshell about vitamin D’s effects is about to go off. In June, U.S. researchers will announce the first direct link between cancer prevention and the sunshine vitamin. Their results are nothing short of astounding.

A four-year clinical trial involving 1,200 women found those taking the vitamin had about a 60-percent reduction in cancer incidence, compared with those who didn’t take it, a drop so large — twice the impact on cancer attributed to smoking — it almost looks like a typographical error.

Well, the paper has just been published in the American Journal of Clinical Nutrition. And the results are nothing short of spectacular.

In the double-blind, placebo-controlled study, researchers randomly assigned postmenopausal women (age >55) to receive either 1400-1500 mg of calcium alone (Ca), the calcium plus 1100 IU vitamin D3 (Ca+D), or a placebo.

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And on it goes. The latest salvo against nutritional supplements is a new study published in the Journal of the National Cancer Institute that suggests men taking “excessive” multivitamins are at increased risk for advanced and fatal prostate cancers.

Specifically, researchers found that men who took multivitamins more than 7 times a week had a 32% and 98% greater risk of developing advanced and fatal prostate cancers, respectively.

Advanced prostate cancer is certainly serious condition, but let us count the ways why the results of this study should not be of significant concern:

- No association was observed between multivitamin use and overall prostate cancer risk.

- No association was observed between multivitamin use and localized prostate cancer risk. With regular screening (prostate specific antigen - PSA & digital rectal exam - DRE) now much more common, the vast majority of prostate cancers are caught at a localized, early stage. Many treatment options are available and prognoses are good in such cases. In fact, most older men, and many younger men, have cancerous cells in their prostates. Yet, since the cancer is often slow growing, those affected individuals identified through screening often go on to die years later from another condition.

(Just to be clear, I’m not trivializing prostate cancer and its potential effects. It is the most common form of cancer affecting men, and more aggressive forms of prostate cancer, although infrequent, can be deadly. Regular screening and accurate diagnosis are important.)

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Excellent article in last week’s Toronto Globe and Mail discussing vitamin D. Covers a lot of ground, including a preview of a forthcoming study with amazing findings:

[P]erhaps the biggest bombshell about vitamin D’s effects is about to go off. In June, U.S. researchers will announce the first direct link between cancer prevention and the sunshine vitamin. Their results are nothing short of astounding.

A four-year clinical trial involving 1,200 women found those taking the vitamin had about a 60-percent reduction in cancer incidence, compared with those who didn’t take it, a drop so large — twice the impact on cancer attributed to smoking — it almost looks like a typographical error.

There are some great segments in the article, e.g.:

Those studying the vitamin say the hide-from-sunlight advice has amounted to the health equivalent of a foolish poker trade. Anyone practising sun avoidance has traded the benefit of a reduced risk of skin cancer — which is easy to detect and treat and seldom fatal — for an increased risk of the scary, high-body-count cancers, such as breast, prostate and colon, that appear linked to vitamin D shortages.

The sun advice has been misguided information “of just breathtaking proportions,” said John Cannell, head of the Vitamin D Council, a non-profit, California-based organization.

“Fifteen hundred Americans die every year from [skin cancers]. Fifteen hundred Americans die every day from the serious cancers.”

The whole thing is really worth reading.

Not Just Cancer

Vitamin D has also been linked to many other conditions, including multiple sclerosis, type 1 diabetes, heart disease, stroke, autoimmune diseases, influenza (the flu), and, of course, osteoporosis. Not too surprising given that vitamin D is actually a hormone (i.e., a chemical produced in one area of the body with effects on cells and tissues elsewhere in the body).

The results of the study above could potentially have far-reaching implications:

One of the researchers who made the discovery, professor of medicine Robert Heaney of Creighton University in Nebraska, says vitamin D deficiency is showing up in so many illnesses besides cancer that nearly all disease figures in Canada and the U.S. will need to be re-evaluated. “We don’t really know what the status of chronic disease is in the North American population,” he said, “until we normalize vitamin D status.”

What You Can Do

The primary source for vitamin D is the sun hitting exposed skin. Foods contain little vitamin D. People who spend most of their time indoors (e.g., office-workers, elderly), always wear sunblock, and/or who live in northern latitudes where even mid-day sun is not strong enough to generate adequate vitamin D are at high risk for deficiency.

Best bets to ensure adequate vitamin D levels:

• Get your vitamin D level checked once per year, preferably at a time that it is likely to be low (e.g., winter). The correct test is 25-hydroxyvitamin D. Target a level of 45-50 ng/mL (110-125 nmol/mL). One day this test will be included as a standard part of annual checkups.
• If getting vitamin D through mid-day sun exposure, 10-15 minutes 3 to 4 days a week for fair skinned people is typically adequate. Darker skinned people may need twice as much time in the sun. The pigment in the skin acts as sun-screen. You do NOT want the skin to change color; that means you’ve gotten more exposure than you need.
• Supplement with 1000 IU vitamin D3 (cholecalciferol) per day as a baseline year-round. As noted above, vitamin D costs only pennies a day. Always take vitamin D supplements with a meal containing fat for best absorption.
• In the winter, or if you’re not getting regular mid-day sun 10-15 minutes 3 to 4 days a week, increase daily supplementation to 2000 IU per day.
• Note that even 2000 IU per day may not be sufficient to reach target levels. Some research suggests the body may use as much as 3000 to 5000 IU per day or more.

Again, your best first step is getting your vitamin D level tested to make sure the combination of sun exposure and supplementation that you’re getting/using is keeping your body’s level at the high-end of the normal range year-round. Don’t guess.

Related Links

Vitamin D Deficiency Common Among Pregnant Women, Newborns

Researchers Call for Increase in Vitamin D Levels

Higher Vitamin D Levels May Greatly Lower Breast, Colon Cancer Risk

Epidemic Influenza and Vitamin D

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Discover How Nutrition Can Make a Difference in Your Life …

Marc Joseph Nutrition

More insight into the story behind the HPV vaccine:

A lead researcher who spent 20 years developing the vaccine for humanpapilloma virus says the HPV vaccine is not for younger girls, and that it is “silly” for states to be mandating it for them.

Not only that, she says it’s not been tested for effectiveness in younger girls, and administering the vaccine to girls as young as 9 may not even protect them at all. And, in the worst-case scenario, instead of serving to reduce the numbers of cervical cancers within 25 years, such a vaccination crusade actually could cause the numbers to go up.

“Giving it to 11-year-olds is a great big public health experiment,” said Diane M. Harper, who is a scientist, physician, professor and the director of the Gynecologic Cancer Prevention Research Group at the Norris Cotton Cancer Center at Dartmouth Medical School in New Hampshire.

“It is silly to mandate vaccination of 11- to 12-year-old girls There also is not enough evidence gathered on side effects to know that safety is not an issue.”

Internationally recognized as a pioneer in the field, Harper has been studying HPV and a possible vaccine for several of the more than 100 strains of HPV for 20 years - most of her adult life.

Harper goes on to note that all of her tests have been with women ages 15 to 25. Her recommended approach would be test women ages 18 and up for the presence of HPV and then provide the vaccine to those for whom the test result is negative.

For those who test positive for HPV?

“Then we don’t know squat, because medically we don’t know how to respond to that,” Harper said.

The rest of the story

Check out the end of the article for a succinct and useful set of facts about the vaccine.

For months Harper has been trying to get the word out and convince media outlets to report the entire story, but no one would do so. Not too surprising.

Good thing she didn’t give up trying:

“I want to be able to sleep with myself when I go to bed at night,” Harper said. “My concern is still, let’s get women’s health better. It is still a good vaccine. But let’s be honest. Don’t over-promise.”

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Discover How Nutrition Can Make a Difference in Your Life …

Marc Joseph Nutrition

In a study published in the journal Diabetes, researchers found that increased belly fat led to the production by fat cells of higher levels of inflammatory molecules that may directly promote systemic (whole body) inflammation. This increase in systemic inflammation may, in turn, raise the risk for several diseases, such as heart disease, diabetes, cancer, and cognitive decline.

There are two types of abdominal fat:

1. Subcutaneous fat - found just beneath the surface of the skin (the fat you can “pinch”)
2. Visceral fat - found in the spaces between internal organs

(Image: LA Times)

Visceral fat appears to be the primary source of the problem:

[T]he research team says visceral fat likely contributes to increases in systemic inflammation and insulin resistance. They sampled blood from the portal vein [which routes blood to the liver from the gastrointestinal tract] in obese patients undergoing gastric bypass surgery and found that visceral fat in the abdomen was secreting high levels of an important inflammatory molecule called interleukin-6 (IL-6) into portal vein blood.

“The portal vein is filled with blood that drains visceral fat,” says first author Luigi Fontana, M.D., Ph.D., assistant professor of medicine at Washington University in St. Louis and an investigator at the Istituto Superiore di Sanita, Rome, Italy. “Portal vein blood had levels of IL-6 that were 50 percent higher than blood from the periphery.”

Increased IL-6 levels in the portal vein correlated with concentrations of an inflammatory substance called C-reactive protein (CRP) in the body. High CRP levels are related to inflammation, and chronic inflammation is associated with insulin resistance, hypertension, type 2 diabetes and atherosclerosis, among other things …

… “Many years ago, atherosclerosis was thought to be related to lipids and to the excessive deposit of cholesterol in the arteries,” Fontana says. “Nowadays, it’s clear that atherosclerosis is an inflammatory disease. There also is evidence that inflammation plays a role in cancer, and there is even evidence that it plays a role in aging. Someday we may learn that visceral fat is involved in those things, too.”

Evidence Building

This latest study is one of many to highlight the influence of excess fat on systemic inflammation and disease risk. Here are links to a few other studies:

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A quick update on the HPV (human papilloma virus) vaccine (GARDASIL), which some states, such as Texas, are now considering requiring for all adolescent girls.

The National Vaccine Information Center (NVIC), the nation’s leading vaccine safety and informed consent advocacy organization, has openly questioned both the risks and costs of the HPV vaccine:

“GARDASIL safety appears to have been studied in fewer than 2,000 girls aged 9 to 15 years pre-licensure clinical trials and it is unclear how long they were followed up. VAERS [Vaccine Adverse Event Reporting System] is now receiving reports of loss of consciousness, seizures, arthritis and other neurological problems in young girls who have received the shot,” said NVIC President Barbara Loe Fisher. “At the same time, parents who take their daughters to private pediatricians are going to be shocked to find that they will be paying two to three times the widely publicized $360 cost for the three-dose series.

NVIC also notes how the HPV vaccine is being given by some doctors at the same time as other vaccines, despite no research to suggest that this practice is safe:

VAERS reports also indicate the doctors are administering GARDASIL to girls and women at the same with Tdap, DT, meningococcal (Menactra), hepatitis A, and other vaccines, even though the Merck product insert states that, with the exception of hepatitis B vaccine, “Co-administration of GARDASIL with other vaccines has not been studied.”

Certainly, cervical cancer is a terrible disease, but, as discussed in an earlier post, shouldn’t more research go into potential interactions between the various vaccine antigens? Why rush into adding another required vaccine, especially since cervical cancer rates have fallen dramatically because of routine pap smears?

There has been a more than 70 percent drop in cervical cancer deaths in American women since the 1950’s due to routine pap smears and nearly all cervical cancers can be prevented with regular pap smear screening and treatment.

Merck, the manufacturer of GARDASIL, even acknowledges the effectiveness of screening and notes it should not be stopped after vaccination:

In its product manufacturer insert, Merck states that “Vaccination does not substitute for routine cervical cancer screening. Women who receive GARDASIL should continue to undergo cervical cancer screening per standard of care.” Merck also states that “The duration of immunity following a complete schedule of immunization with GARDASIL has not been established.”

Something doesn’t seem quite right …

In a recent study published in the American Journal of Clinical Nutrition, researchers found that higher levels of vitamin A intake were associated with lower rates of gastric cancer.

Specifically, researchers, in an observational cohort study, looked at vitamin A consumption through both food and supplements, and noted that:

[H]igh intakes of vitamin A and retinol from foods only (dietary intake) and from foods and supplements combined (total intake) and of dietary alpha-carotene and beta-carotene were associated with a lower risk of gastric cancer.

The reduction in gastric cancer risk ranged from 45 to 50 percent.

Vitamin A - Forms & Functions

There are three biologically active forms of vitamin A:

• retinal
• retinol
• retinoic acid

Retinal is primarily derived from beta-carotene, one of the plant pigments (carotenoids) found in foods such as carrots, spinach, yams, etc. It can be converted in the body into retinol in a reversible reaction and into retinoic acid in an irreversible reaction. Retinal plays an important role in vision.

Retinol is found only in animal products, such as liver, cod liver oil, and milk. It can also be created through conversion from retinal in a reversible reaction. Retinol plays important roles in reproduction and growth.

Retinoic acid is derived from retinal in an irreversible reaction and plays important roles in gene expression and growth.

Suspected Vitamin A Role in Gastric Cancer

Vitamin A (primarily retinoic acid and retinol) is key in controlling cell differentiation and proliferation, two activities that go awry in cancer. Vitamin A helps to:

• control protein synthesis and differentiation of epithelial cells that line the body’s surfaces, such as the skin and the linings of the mouth, stomach, and intestines.
• regulate differentiation of goblet cells that produce mucus that coats and protects the epithelial cells from both bacteria and potentially harmful substances, such as gastric juices.

Vitamin A also influences immune system function, and helps to ensure proper T-cell response and natural killer cell activity, both critical in helping to prevent cancer from developing.

Clearly, it’s important to ensure adequate intake of all vitamin A forms, from both food and potentially supplements, to help reduce gastric cancer risk.