cruciferousvegetables — this week at FFFL

Our bodies are our gardens - our wills are our gardeners.

The author of this statement - none other than William Shakespeare - was one of the world's greatest stewards of language and western culture. While certainly not known as a nutritionist, he has nonetheless created two powerful metaphors in a single sentence, linking us decisively to the Nature from which we were created at the same time as admonishing us that our health is determined by how well we honor that relationship.

When we think of 'greens', most of us think of listless leaves of a vague sickly hue that taste like cardboard and are as exciting as the slow-moving herbivores who eat them, like rabbits, cows, goats and manatees. By contrast, it is the carnivores that we find most potent: lions, crocodiles, wolves and sharks, to name a few. After all, these are the flesh-devouring animals who hunt, kill and dominate the animal kingdom - and to whose 'winningness' we aspire, whether tackling a spreadsheet, kicking a ball through posts or watching an actor avenge someone's honor, guns blazing.

In short, few of us aspire to the role of the quiet gardener, preferring instead the (d)elusive dream of the triumphant gladiator. Except that in the world of nutrition, this basic misconception about fortitude can be quite literally deadly. We have posted here week after week about ever-increasing rates of obesity, diabetes, heart disease and cancer, all of which are caused, improved or exacerbated - in large part - by our modern, industrial, western diet. In Week 2 we dipped our toe into the murky waters of the food industry, using the heavily misleading, industry-friendly food pyramid to help you separate business enterprise from truth. Week 3 provided an overview of our modern diet and its relationship to disease; Week 4 parsed food words, focusing on those which are actually healthy from those which are designed to sound healthy but in truth are not. In Week 5 we explained the dangers of dieting. In Week 7 we 'saw the enemy', and it was us, due to our ever-decreasing expenditure on food. In Week 8, we addressed diet's relationship to cancer directly. And we will continue to explore the relationship of diet to health until we have exhausted every angle of this extremely complex - and incredibly contentious - subject.

This week, we aim to get back to foundations. In the case of human diet, from our earliest days as foragers, that foundation was - and should ever be - that which blankets the Earth's surface more than any other substance: plants; and in particular, green, leafy plants.

Part of the problem is our narrow definition of the word. 'Greens' - which are not a food group, or even a color, so much as a visual categorization of leafy vegetables - are more varied than any other food group, in terms of composition, flavor and nutritional value. In fact, 'greens' - or leaf vegetables - are the single most varied and plentiful food source on Earth. This Wikipedia listing alone tabulates over 400 edible leaf vegetables, many of which are neither leafy nor green, like Brussels Sprouts (spheroid), Cauliflower (white) and Radicchio (red-purple), to name just three. And while you cannot find all 400 of them easily in the US, dozens of the healthiest among them are available at every supermarket, every farmer's market and every specialty store. You simply need to understand what to buy, and why. And once you've mastered the basics, you can branch out to more exotic flora, where things get really interesting, as we will discuss below.

The ABCs of Greens

Let's start with the (near) obvious. Green leafy vegetables are full of vitamins, which maintain healthy cell tissue and organs, and minerals, which fuel the bio-chemical processes of metabolism. Spinach, kale, Swiss chard and collard greens alone each provide the body with over 20 of these key nutrients, with spinach topping the list. Ounce for ounce, no foods are denser or broader than greens in terms of what the body needs to function properly. But you knew this already, which is why your wise parents always nagged you to eat them.
Less obvious, and worth an in-depth explanation, green leafy vegetables are full of antioxidants that - as put beautifully by Sophia Breene in this article - are not so much a substance as a behavior. Perhaps unbeknownst to you, our bodies' cells need an even numbers of electrons in order to be considered stable (inert). When they don't, they behave erratically and steal electrons from adjacent cells, which in turn become unstable and rob yet others, causing a chain reaction of 'free radicals' (cells with unpaired electrons) that quickly cause cellular damage called oxidative stress. Oxidative stress degrades and 'ages' your body's proteins, DNA and lipids, which have been shown in studies to catalyze or exacerbate most modern diseases, including cancer, Alzheimer's, heart disease, stroke, Parkinson's, fibromyalgia, diabetes, aging, cognitive decline, and macular degeneration. Vitamins C and E are the body's chief source of water-soluble and fat-soluble antioxidants, respectively. Antioxidants are self-stable molecules that roam the body, donating electrons to unstable molecules without impact to themselves, thereby ending the free radical chain reaction. Broccoli, Brussels sprouts, cauliflower, kale, cabbage, bok choy, parsley and turnip greens - in descending order - all provide between 135% and 50% of your DRI (daily recommended intake) of vitamin C, while beet- mustard- and collard greens follow close behind. Only bell peppers, papayas and guavas rank higher. In terms of vitamin E, spinach, Swiss chard, turnip- beet- and mustard greens all provide, in descending order, between 25% and 17% of your DRI - second only to almonds and sunflower seeds. In short, greens are important, commonly available antioxidants that are easy to incorporate into your daily intake.
Green leafy vegetables are anti-inflammatory. If antioxidants roam the body preventing cellular damage, then anti-inflammatories keep your body's own immune system from overtaxing itself, due to chronic inflammation. 'Regular' inflammation is the cornerstone of the body's own defense system, which targets infected sites and sends additional nourishment and immune activity to its rescue. Think of inflammation as a SWAT team. But chronic inflammation is different. All soldiers need rest. If you keep pushing them without down time, eventually they collapse, and things break down. In the case of your body, chronic inflammation is not a localized immune response: it is instead an environment of ill-health in which the body is denied its 'pause', and is therefore in a constant state of aroused defense. Stress and lack of exercise are part of the cause; but diet is a major contributor, as well. Chronic inflammation has been directly linked to many cancers, Alzheimer's and heart disease. As we reported in the second part of Week 3's post, our ancestral, pre-modern diet comprised a balance of anti-inflammatory omega-3 fatty acids and pro-inflammatory omega-6's - a 1:1 ratio. Today, the typical western diet is tremendously pro-inflammatory, skewing the ratio to a staggering 25:1 in favor of omega-6's. This difference is the primary cause of the spike in chronic inflammation over the past half-century and the ensuing raft of modern diseases. The food culprits that cause unchecked inflammation? In descending order, they are: sugars, common cooking oils (in commercially prepared foods), trans fats (same), dairy, red meat, feedlot-raised meat (red or otherwise), refined grains (anything flour-based) and artificial food additives (in nearly every processed food). You can read more detail about each one here. And green leafy vegetables? They are the base of the anti-inflammatory food pyramid, as beautifully illustrated by wellness guru Dr. Andrew Weil, here. While nuts (esp. walnuts) and cold water fish are omega-3 royalty, green leafy vegetables are no slouches, with Brussels sprouts, cauliflower, broccoli, collard greens, spinach and kale offering healthy omega-3's in addition to everything else they do.

What is in a name?

Unfortunately, our problems extend beyond the simple choice of plant foods over industrial products. Even those among us who want to eat healthy food, and who do their best to reach for a salad over a burger, have large knowledge gaps when it comes to the plant world, and so parsing what sounds good (like 'salad') vs. what is good (the actual ingredients behind the name 'salad') is a challenge.

Which brings us to the inexplicable, and unfortunate, story of Iceberg lettuce. Iceberg is the most common leafy green (white, really) consumed in the United States, with each of us eating on average 17 lbs. of it every year, according to Jill Nussinow, a California-based culinary educator and author. It's likely the root cause of many people's perception of salad as being as exhilarating as a manatee. The problem with Iceberg lettuce, which is the foundation of the nutritional disaster called a Caesar's salad, is that it is mostly water, and almost devoid of nutrition. (We'll leave aside the dressing, which is an effective delivery method for adding empty calories, fat, sodium and cholesterol to your diet; not to mention those croutons...) In fact, the difference in nutritional value is so varied among 'greens', that it's worth taking three commonly eaten leaves and comparing them here for you, in detail. The chart below shows the DRI (daily recommended intake) of each vitamin, mineral and other key nutrients present in all three. Percentages show the amount of the average person's DRI that a single 100g serving of leaves provides. The last column shows the number of times higher in each nutrient the spinach is over the iceberg (with common romaine consistently in between the two). The discrepancy between leaves is staggering:

At the root of it (no pun intended), and in every single measurable nutrient, spinach contains roughly 2-45 times the concentration of 21 different essential nutrients as iceberg lettuce. You can find a fully detailed comparison here - one you can also customize to compare foods against one another, beyond the greens we have contrasted.

It gets better. The nutrient profile of the plant world's 'it' girl - kale - reaches close (but not quite) to that of spinach; as does nearly unknown but omnipresent Swiss chard; ditto mustard greens, collard greens, bok choy and broccoli - all leafy greens and all among the healthiest foods on the planet. Individually, they deliver significant amounts of roughly 40 essential vitamins, minerals and amino acids. The best part? There's so much choice when it comes to vegetables in general, and leafy greens in particular (think thyme, sage, rosemary, mint, parsley, cilantro, basil and oregano, which are common flavor bombs in tiny doses; or perilla, sorrel, mustard greens, mizuna, radicchio and arugula, which are far less common, but widely available and pack strong and highly distinctive flavors as additions to - or substitutions for - other everyday salad leaves), that there's really no excuse to think of greens as rabbit food.

Salads - the way we should think of them

Leaves are simply a base for other ingredients - and should be thought of as such, much the way that the Italians consider pasta to be a vehicle for delivering what's on it. As I remember fondly from my year-plus spent living there, they eat pasta every day, and often in multiple meals each day, without getting sick of it. Why? It's what's on it that counts, and provides the flavor. Unlike pasta, the flavor variation in greens is infinitely broader, and so the richness of variety allows for less repetition, if you pay attention and vary your greens.

In the world of food, salad as a category has morphed as much as the the martini has in the drinking world - where the term now applies to a broad set of vaguely related concoctions as unlimited as the minds that think them up. Salads these days - to the benefit of your well-being - can include aspects from every food group, from vegetables, fruits, meats, dairy, grains and nuts. Thus you can dress the 'plate' (i.e.: greens) however you want, and feel extremely good about feeding your body well. Beyond the near-infinite choice of vegetables that can and should make up a large proportion of your meal - not to mention some fruits that pair well (think spinach and dried cranberries or arugula and pear) - there are rich, flavorful and healthy unsaturated fats like those in avocados, olives, and heart-healthy oils like olive, coconut and walnut; proteins like nuts, seeds, beans and eggs (all of which also deliver excellent doses of heart-healthy fats and minerals); and animal products such as cheese (though this should be used sparingly and in its raw state, if possible, as we detail in the second half of Week 4's post), cold water fish (like wild Alaskan salmon), and the occasional piece of lean, pasture-raised beef or chicken (Week 4 covers this at length). In the case of salad, leaves should always comprise the lion's share of the bulk, followed in descending order by other vegetables; fruits; plant proteins; plant fats; and finally animal products - as represented in illustrations like Dr. Weil's pyramid. If your 'salad' looks like a grass-fed steak with a few leaves underneath it, it's not a salad.

If you lack the creative impulse to figure out what works, just look to indigenous cultures who have been combining ingredients for health and for taste since before agri-businesses existed, like these examples, to name just a few: French salade niçoise (greens; tuna; olives; haricots; potato; egg; anchovy); classic Greek salad (greens; cucumber; tomato; feta); Lebanese tabouleh (tomato; parsley; mint; bulgur; onion); Italian caprese (tomato; basil; mozzarella); Vietnamese 'Thanksgiving' salad (fennel; cabbage; cashew); and Mexican black bean salad (beans; peppers; tomatoes; corn; cilantro; onion; lime). Just make sure greens are the literal base of everything you do - even if the traditional salads listed above don't call for them. They'll combine well with any classic recipe, and will add tons of heart-healthy nutrition to your diet.

To paraphrase the duc d'Uzès during the 14th C accession of Charles VII, 'Salad is dead! Long live salad!

Spices and herbs

It's not just fresh leafy greens that provide your antioxidant needs. Sometimes, it's as simple as sprinkling some dried oregano or marjoram on your pasta. One pinch of oregano doubles the antioxidant value of a bowl of whole wheat pasta with a marinara sauce, according to Dr. Michael Greger, physician, author and Stephen Colbert / Dr. Oz guest. In his eccentric video, he walks you through visual aids that show how you can add nutrition value with dried spices and herbs. Basil, parsley, oregano, thyme and rosemary are all 'leafy greens' that one can easily store dry, for months on end, and which you can simply sprinkle onto the foods you already eat to up their antioxidant value dramatically, which - as we've seen - has a material effect on modern diseases like cancer, diabetes and heart disease.

Let's review what we've learned so far:

All leafy greens are not created equal. Some of the healthiest foods on Earth include spinach, kale, Swiss chard, bok choy, tatsoi (chinese spinach), mustard greens, collard greens, arugula, cabbage, watercress and turnip greens. Iceberg and other red-or-green lettuces, while not devoid of nutrition, should be substituted where possible with those listed above, since the difference is substantial.
Some leafy greens are neither green nor leafy. They are, however, as (or nearly as) nutritious as their forebears, especially the cruciferous vegetable family, which includes broccoli, cauliflower, romanesco (a delightfully tasty 'fractal' vegetable), Brussels sprouts, cabbage, kohlrabi, radish and turnips. Bonus: crucifers, which also includes kale and bok choy, are the food world's champion cancer-fighters. See the second half of Week 8's post for more detail on glucosinates and indoles).
Leafy greens should be thought of as a base for your culinary creativity. Vary the ingredients. Add vegetables; fats; proteins; dairy; grains... these things are limited only by your imagination - or your ability to conduct Google searches on sites like Epicurious, Gourmet, Bon Appétit and AllRecipes.
Leafy greens are incredibly flavorful, and varied. Venture beyond the lettuce aisle and pick up one of the leaves listed above; or go to a specialty market in Chinatown, or where the ethnic minorities in your area shop: the Indians, Vietnamese or Japanese, to name three cuisines that heavily feature leafy greens that are as flavorful as they are exotic and unexpected.
Spice it up. Spices are dried leaves. They're used to make tea; add flavor to foods; and are nutritious ways of including nutrients in your diet. The Indians - who use spices of greater depth and breadth than any other culture - are not just predominantly vegetarian, but understand spices' healing properties, like turmeric, which is one of the most powerful anti-inflammatories in Nature. It has been used for centuries by the Chinese and Indians - and increasingly modern medicine - to treat everything from IBS, rheumatoid arthritis, alzheimer's and cystic fibrosis, and has been shown in numerous studies to inhibit the growth of cancer cells significantly - to name just one of countless spices with real, measurable medicinal value.

Now that we've mastered the basics, let's move on to some lesser-known fare.

Sprouts - a Master's degree in 'greens'

The young of every living creature carries within its tiny package the genetic material for it to grow into maturity, whether in animal or plant form. The sheer density of healing, growth-promoting elements they contain makes them dwarf their adult counterparts' healthfulness because they represent a life form in its most vital state. In humans, children heal more quickly than adults; their skin is more supple; their systems are more robust; and the number of synaptic connections in their brains - and the speed at which they learn - run circles around those of grown-ups. The same is true in the plant world. According to nutrition expert Dr. Mercola, young plant foods - called sprouts or shoots, and commonly referred to as 'raw' or 'living foods' - contain up to 100 times as many enzymes as adult plants, and up to 30 times the density of vitamins and essential fatty acids. Let's repeat that: up to 100 times the enzymes and 30 times the vitamins and fatty acids as the world's otherwise healthiest foods. This is why they are often referred to as miracle foods. In addition, according to Dr. Mercola, the nutrients in sprouts are often more bioavailable than those in adult plants, which means the body can more readily absorb them, instead of simply passing them through your system, unused.

Better still? A wide variety of them are easy to find in both farmer's markets and specialty markets, including sprouts from broccoli, sunflower, pea shoots, alfalfa, clover, radish, lentils, wheatgrass and mung beans. On a walk through New York's Union Square last Saturday, I counted over a dozen purveyors of sprouts, alongside their usual greenmarket fare.

Best of all? Though this requires a commitment, and/or if you have trouble finding them where you live, it's extremely easy to grow them yourself, and to therefore not just save tons of money (they're pennies on the dollar) but to eat them within minutes of harvesting, regularly, when nutrient levels are highest. Here are links to growing many of the sprouts listed above, complete with videos: sunflower; broccoli; wheatgrass; mung beans and lentils; radish; pea shoots.

Matcha - Doctorate-level 'greens'

We will leave the subject of green, leafy nutrition with the story of matcha - my own newest discovery. While I'm decidedly late to the party, Japanese Zen buddhist monks and Shogun warriors have been sipping this beverage since the 12th Century - when they perfected a process invented by the Chinese some 300 years earlier. The monk Eisai - the man responsible for bringing it to Japan - referred to matcha as 'The Elixir of the Immortals', and its drinkers swore by its sustained energy and mental clarity.

Under the lens of modern science, the traditional endorsement not only holds up but becomes even more interesting. As measured on the Oxygen Radical Absorbance Capacity (ORAC) scale - which was developed the the National Institute of Aging (NIA) and venerable National Institutes of Health (NIH) - on a per-gram basis, matcha is one of the greatest antioxidants on the planet, matched or exceeded only by turmeric, dried oregano, sorghum, cinnamon, sumac and cloves - the last being the world's reigning champion. Moreover, the form of matcha's antioxidants - EGCGs, a form of the phenol catechin - have been shown to aid in the management or risk and severity reduction of both HIV-1 and cancer - the latter because EGCGs are chemopreventive. None other than the National Center for Biotechnology Information (NCBI), one of the nation's decisive authorities on molecular biology, lists EGCGs present in green tea as playing a potent role in cancer cell death. You can read their study here. And keep in mind that matcha has 30% more catechins (EGCGs) than regular green tea, making them even more effective in managing cancer cells.

In addition to its antioxidant and anti-cancer properties - and the fact that it is a good source of vitamins A, B-complex, C, E and K - matcha's particular caffeine, called theophylline, has been shown to release more slowly into the body than that of coffee, thereby sustaining energy levels longer without the spikes. Better still, L-theanine, an amino acid unique to matcha, is known to boost alpha waves in the brain, creating a paradoxically calm alertness. It is this alertness that attracted the monks to it all those centuries ago. I can attest to a (very uncharacteristic) calm that follows my own morning cupful, while those who know me well understand just how remarkable an outcome that is. Let's just say I've been encouraged to keep it up...

So to revisit what we've discussed just one more time:

Greens are the most varied food source in the world, with over 400 types, many widely available
Greens are calorie for calorie the most nutritious foods, with a number of standouts, listed above
The flavor of greens is far more complex than most people realize; the key is to experiment
We must select our greens carefully, since nutritional profiles vary widely, and avoid 'empty' ones
We should think of greens as a 'base' for other foods, the way Italians use pasta
To wit: greens don't replace other foods; they complement them and are essential to optimal health
Dried greens - aka spices and herbs - are nutritional powerhouses that are easy to incorporate
Sprouts are the plant world's champions, delivering unmatched nutrition
Matcha is a great substitute for coffee, and offers many of the benefits of 'other greens'

I'll leave you with some of my own favorite greens, in no particular order, with hyperlinks given for informational purposes only (FFFL does not endorse or have any commercial relationships with anyone):

Breakaway matcha: the quality of matcha is key to its efficacy
Red-veined sorrel: a lemon-flavored herb-leaf that makes a fantastic addition to any salad
Shiso (aka perilla): a minty, pungent, grassy herb as an accent to fish (used in Korea, Japan, Vietnam)
Sunflower sprouts: one of the tastiest sprouts, with a decidedly nutty flavor; add it to salads
Radish (aka Daikon) sprouts: for a wonderful little 'tang' in your salad
Romanesco: the most beautiful - and tastiest - among its siblings broccoli and cauliflower (I simply steam it for 4-5 minutes and drizzle with a high-quality olive oil and sea salt (fleur de sel)
Mustard Greens: want proof that greens can knock you off your feet? Try these amazing decongestants in your salad. Just don't say I didn't warn you. Or try this recipe.
Spinach: okay, so it's obvious, but it's the #1 world's healthiest food, surprisingly tasty and neutral, and as such able to be blended, eaten raw or cooked and combined with nearly anything. But skip the supermarket greens and get them from the farmer's market. They will not only be far tastier and stiffer (meaning less decomposed), but as such will last twice as long before beginning to wilt
Pea shoots: Peas are one of the most nutritious foods on the planet. And the sprouts? 7x the vitamin C content of blueberries; 8x the folic acid of bean sprouts; and 4x the vitamin A of tomatoes
Brussels sprouts: when I make them, they always disappear like popcorn. Half-fill a gallon-sized Ziploc with halved sprouts; add 3 tbsp. olive oil and 1 pinch sea salt; inflate/close the bag and shake vigorously until mixed. Place in a single layer in a 425F oven on a baking sheet, and flip each one every ten minutes; repeat the flipping until they're charred - usually 3-4 total times. Your friends and body will thank you.

Let food be thy medicine and medicine be thy food.

Hippocrates, the author of that statement and the sentiments behind it, was not a hippie quack, a denier of scientific progress or a fearful skeptic of doctors. He is, more than any other, the person who established medicine as a profession separate from philosophy and theology, instituting clinical practice as its methodology. Our experiences with doctors today are largely built on the foundations he laid 2,500 years ago, and he is accordingly considered the father of Western Medicine. Upon licensure, all physicians are still required to take an Oath to uphold the standards contained in a text that he wrote. According to Wikipedia, 'Hippocrates is credited with being the first person to believe that diseases were caused naturally - not because of superstition and gods.'

But just what is it in nature that causes disease?

The answer is incredibly simple. But to uncover it, to believe in that discovery, and to learn how to foster its opposite - health - is an uphill battle. First, we have lost our intuitive connection with food. If you were not born into aristocracy, then 100 years ago you were most likely a farmer, and understood plants, seasons, soil and yield. Today we understand none of it, since as we saw in Week 7's post, fewer than 1% of us still farm. Second, since industrial food conglomerates largely supply the foods that we no longer grow ourselves, their executives are the people determining how healthfully we eat, via the decisions they make and the products that emerge from those decisions. And their chief - if not singular - goal is to make money. This distinction bears little resemblance to the goal of the small farmer insofar as feeding his/her own family, where nutrition comes first. The bigger the company, the greater the influence small decisions in cutting costs have on the 'bottom line', whether in profitability to them or health to you, which are usually at opposite ends of that equation. Besides, there is so much food choice in supermarkets, gas stations and pharmacies today - to say nothing of national restaurant chains - that these companies are engaged in sales warfare, and must compete for your dollars. Overwhelmingly, this is accomplished via sophisticated marketing, through which we are invariably sold a story to lure us into brand loyalty. And this rarely has anything to do with how good something is for you. Quite the opposite: the less healthy and more engineered a product is, the more companies profit and hence the more they invest in selling it. And the strategy succeeds in large part because it's nearly impossible for us to gauge the actual healthfulness of most food products, since the long list of engineered substances they comprise are things we've never seen, smelled or touched in Nature. And so we rely on others to tell us what's good for us, and must spend our mental energies trying to divine truth from market-speak. We covered this phenomenon at length in Week 4's post: Food Words - Science or Snake Oil? Third, the food industry that dominates the West has so successfully taken control of the business of food via advertisements, websites, games, characters, lobbying, national policy and even Law, which are aimed collectively at creating economic health, that it is near impossible to practice healthy eating without overcoming the tidal wave of temptations that are designed to prevent most of us from doing so. It's just not good business.

To come back to that 'incredibly simple answer' to what causes disease, it's the processing of our foods. But if you've been following us closely, you already know that. We could fill multiple posts simply tabulating the specific health risks associated with each engineered food-like substance. Instead, we try to include one example each week that illustrates the point. In week 6's post, we learned that the modern process of milling wheat into flour - in which it is stripped of its bran, germ, endosperm, fiber and bulk (coarseness) - results in a 50% content loss of vitamins B1, B2, B3, B9 (folate) and E, and an equal amount of calcium, phosphorus, zinc, copper, iron, and fiber. We learned that in addition to that loss, the resulting wheat flour converts immediately into sugar once it reaches your stomach, where your pancreas starts going haywire producing insulin and spiking blood sugar levels. This week we will take it a step further, and explore the relationship between wheat and cancer.

Wheat flour is just one of many high-glycemic foods, so named because as we just mentioned, it converts quickly into sugar once ingested. A food's glycemic index is a tool for understanding how quickly and how much foods raise your blood sugar level once ingested. High glycemic foods are known to seriously increase the risk of the now-familiar triumvirate of modern disease: type 2 diabetes, heart disease, and cancer. This article by Harvard's School of Public Health provides a good overview on carbohydrates and blood sugar. Another good resource for understanding the glycemic load on common foods, posted by Harvard Medical School's Publications division, is here. In the HMS link, you'll notice that the list is overwhelmingly comprised of highly processed foods that make up 90% of our diets, according to Eric Schlosser, author of Fast Food Nation, and also covered in Week 7's post.

Why focus on wheat? Because it's one of the most consumed foods in the United States, via sandwiches, pastas, snack foods, baked goods, desserts, cereals and even salads. And so unpacking what we consume and how we consume it is of great relevance to the discussion of cancer, as we'll see in a moment.

First, let's look at the difference in the glycemic loads of two ingredients that to the typical shopper are opposite in health promotion: those of 'white' flour and 'whole wheat' flour breads. Both rate an identical 71 on the glycemic scale's 100-point index, qualifying them as high-glycemic foods - i.e.: quick to convert into pure sugar. Yet we are ever seduced by marketing campaigns into thinking whole wheat is healthier than 'white' wheat. It is, but only if consumed in whole grain form - i.e.: not milled into flour. Once wheat of any kind is milled, as the majority of so-called whole wheat products are, there is precious little difference. They become sugar and are devoid of the key nutrients that unmilled wheat carries as a living plant. Thus we encourage you to read food labels carefully, and avoid flour-based products altogether. If it says 'flour', it's simply not good for you. This resource by the Whole Grains Council allows you to find whole grain breads in a searchable database, to find good products or see how the ones you use measure up. In general, we highly recommend replacing non-whole grains (i.e.: any flour product) with their less processed counterpart. Sprouted grains are especially valuable, since beyond comprising whole grains, the act of sprouting lowers their gluten and starch content while preserving valuable enzymes and amino acids. These are often referred to as 'live' foods, and can be found easily in national grocery chains, in addition to specialty food shops - sometimes in the freezer section. A good resource that lists and grades sprouted grain-type breads is here.

So what do high-glycemic foods have to do with cancer, anyway? Everything. The sugars promote insulin resistance. Insulin resistance creates and environment that is conducive to tumor growth in your body, according to the American Institute of Cancer Research. For example, the risk of colon cancer increases by 300% in a high-glycemic diet, according to Dr. Liu and his fellow researchers at Harvard Medical School.

Which brings me to a personal story.

In the Fall of 2003, I received a call from my brother Jordan, a 38-year old Harvard-trained physician and proponent of holistic healing. Holistic healing centers on the belief that psychological health and diet are partners with Western medical science in providing long-term health. I was living in Hong Kong at the time, and he in Western Massachusetts, in no small part because of its proximity to both the Kripalu Center for Yoga and Health, where he meditated regularly, and the Kushi Institute, the American epicenter of Macrobiotics where he took most of his meals and learned all of his dietary practices. This was for two reasons: first, because of the ulcerative colitis from which he had suffered since the age of seventeen and which had wreaked havoc on his large intestine for more than half of his life; and second, because as an undergraduate student, he had taken a sabbatical from Harvard to live among a specific group of Tibetan monks who had proven through meditation to be able to exert a high degree of physiological control over their bodies. And his interest in learning from them was related to his own health challenges.

On the phone in Hong Kong, Jordan told me that his cancer had returned - for the fifth time - and that it was stage IV. Our family had lived through his first - a pineal blastoma (brain cancer) diagnosed at the age of 22 - from which he later became the disease's first-ever recorded long-term survivor. I knew about his ulcerative colitis and that it increased his risk of colon cancer, if untreated surgically. What I didn't know was that in the years between that odyssey and our phone call, he had already twice fought colon cancer; that this was his third such diagnosis; and that he had chosen to keep this information from his entire family. The reason, in part, was because he had declined surgery both times, striking a recurring bargain with his frustrated doctors: that if the cancer hadn't completely disappeared in twelve months following the diagnosis, without surgery or other Western medical intervention, he would allow the operation on his colon to take place. His plan was to heal himself through meditation and diet - and nothing else. And he knew our family would have likely pressured him emphatically to operate.

Like Hippocrates, my brother was no quack. He was a member of Mensa since the age of 10. He enjoyed our century-old high school's highest-ever grades. He went to Harvard at 17, after 11th grade, where he was elected Phi Beta Kappa and graduated Magna Cum Laude. And he finished Harvard Medical School as its valedictorian in spite of tackling brain cancer during his first year - the cancer from which he had been given a 0% of surviving. Jordan was a remarkable human being by every possible measure. He also firmly believed - to the point of putting his own life literally on the line - that his and others' path to health was through connecting his mind with his body, and through diet.

Twelve months after the onset of both of his battles with stage II colorectal cancer, by adhering to nothing more than a self-prescribed regimen of daily meditation informed by his Tibetan experience and a strict macro-biotic diet that Michio Kushi himself had created for my brother at his institute, Jordan's tumors disappeared and were, upon each final medical examination, untraceable. Both times, his doctors' reaction was the same: 'It's impossible'. And both times, my brother felt vindicated in his beliefs.

Back in Hong Kong, Jordan told me on the phone that this latest colon cancer was Stage IV, having spread to his lymph nodes and through them to other organs. He had chosen to tell us - his family - only because of this. He had entered hospice so that he could free himself of daily responsibilities, to allow him to re-double his focus on healing himself. He insisted, emphatically, incessantly, that he had no intention of dying.

My brother lived another nine months, battling 25-plus tumors everywhere from his brain to his lungs to his stomach and beyond. The largest - in his stomach - was the size of a cantaloupe. The week before that - the last in which he was able to articulate his thoughts - he reiterated that he had no intention of dying, but instead was grappling for one final piece to the mental mystery of healing. To his last breath, he felt he could heal himself, as he had done so many times before.

_____________

I include this story not to suggest the mind's absolute control over the body, or that diet alone is a panacea. Jordan's is, however, one of countless examples - in this case a very personal one - that points to the equally irrefutable influence of both diet and our psychological state over our health. My brother would not have been able to make his tumors disappear had his diet, or mind, or both not supported it. In tribute to my brother, I offer a web link to the only online presence he has: 2 enlightening interviews at the 2000 Macrobiotic Summer Conference, in which he discusses his battles and his medical philosophy - here.

We at FFFL are not doctors, oncologists, or cancer researchers. Cancer may well not be 'curable', capable only of going into remission, whether temporarily or permanently. It is likely caused by factors that are equally genetic, environmental and chemical. That said, diet has been proven many times to slow, stop or reverse cancer's spread - often completely, in people across the globe. The same holds for other chronic diseases that are as varied as the stories and people associated with each. I include links to just five testimonials/videos below in which the only common thread is the adoption of a plant-based diet and a resulting remission of cancer. To reiterate: we are not in any way advocating refusal of conventional medical treatment in the case of a cancer diagnosis. Our interest lies in exploring and sharing what we have learned about the very real power of diet in influencing health, lowering risk and reversing disease. Some stories:

Ruth Heidrich, PhD - breast, lung, bone and liver cancer. Cancer-free since 1982
Kelly Binkoski - invasive ductal carcinoma, triple-negative. Cancer-free since 2014
Scott Gill - stage IV colon cancer. Cancer-free since 1990
Candace-Marie Fox - stage III thyroid cancer. Cancer-free since 2014
Kris Carr - stage IV liver and lung cancer. Cancer-stable since 2005

Moving onto to diet itself, let's look at three specific foods (or groups), their relevant key nutrients and the current science that links them to cancer prevention. A powerful paper prepared for the World Health Organization (WHO) jointly by the University of Oxford, the National Cancer Institute and Harvard University's School of Public Health - included in full here - proposes that dietary factors account for 30% of all cancers, making it second only to tobacco use in cancer promotion. In one section, they list diet as being responsible for 80% of the increase in colon cancer rates between developed and developing countries, where colorectal cancer rates are ten-fold higher in the former than they are in the latter.

The most studied group of cancer-fighting foods are crucifers - aka brassicas. These include broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale, kohlrabi, mustard, rutabaga, turnips, bok choy, and Chinese cabbage, as well as arugula, horse radish, radish, wasabi, and watercress. All crucifers contain sulfur-containing compounds called glucosinolates, which have been shown to reduce certain types of cancer, either by removing carcinogens from the body before they can alter DNA, or by preventing normal cells from being transformed into cancerous ones. They are of particular interest in the prevention of lung and colorectal cancers. It is advised to consume these foods raw, for two reasons: 1 - the act of chewing results in glucosinolate hydrolysis - which creates the indoles and isothiocyanates that do the protecting; and 2 - cooking inactivates the enzymes that catalyze the all-important hydrolosis that protects us. Nutritional scientists also recommend cruciferous vegetables for their ability to fortify your gut's lining. This lining is all that separates the contents of your gut from your bloodstream. The anti-inflammatory, immune-strengthening properties of crucifers' indoles strengthen the lining, allowing toxins to remain trapped inside and be purged without seeping into your bloodstream and causing inflammatory havoc. Table 1 midway through the linked article here from OSU's Linus Pauling Institute lists crucifers in order of their glucosinolate quantity.

Coffee is the most popular drink in the United States. 83% of us drink it - making us the world's largest consumer. Coffee has several compounds that are of interest with regard to cancer. Caffeine speeds carcinogens' (and other toxins') passage through the digestive tract, reducing the time our bodies are exposed to them and lowering our risk of colorectal cancers. It also contains the antioxidant cholorogenic acid, which reduces inflammation and promotes self-destruction of cancer cells. Lastly, coffee's lignans regulate cell growth and promote the self-destruction of abnormal cells, including cancer. More information on coffee's anti-cancer properties can be found at the American Institute of Cancer Research (AICR) here.

Beans are an area of great interest, and not just for their cancer-fighting properties. The plant kingdom's best source of protein, beans are also vitamin and mineral powerhouses. Beans are high in fiber, which creates the sensation of fullness and helps regulate digestion, pushing toxins and carcinogens through digestion more quickly, as with coffee. Further still, beans are low in sugar, which prevents over-production of insulin, helping to decrease hunger. Together, these properties significantly assist us in achieving weight loss and reducing body fat, lowering the risk of inflammatory diseases like type 2 diabetes, heart disease and cancer. Lastly, beans contain the plant world's highest levels of anti-oxidants, which helps us to eliminate free radicals that have been cited widely in cancer prevention studies. In one, the National Center for Biotechnology Information conducted an eight-year study in Uruguay - where legumes are a major part of the national diet - and found a those individuals in the top third of bean (and lentil) consumption had significant decreases in the risk of the following cancers: oral cavity, pharynx, esophagus, larynx, upper aero-digestive tract, stomach, colorectal and kidney. AICR concurs that regular legume consumption convincingly reduces the risk of colorectal cancers - citing both its fiber, which we've discussed, and its folate, which regulates DNA and cell growth - as key to their conclusion. AICR is a treasure trove of information on plant foods and their ability to reduce the risk of cancer. We encourage you to explore their links and data related to a number of food groups here.

On the flip side, certain foods and their effect on our physiognomy have been shown to greatly increase our risk of cancers. These include red meat (colorectal cancer), alcohol (mouth, pharynx, larynx, oesophagus, colon and breast cancers) and body fatness - primarily caused by a high-sugar, highly processed diet (cancer of the oesophagus, pancreas, colon, breast, endometrium and kidney). Minimizing intake of these foods and remaining lean are of central importance in reducing risk.

So what to conclude?

Plant-based foods are not a panacea. Eating crucifers will not guarantee you will live a cancer-free life, nor will a diet that includes adzuki beans guarantee a reversal in your colorectal cancer diagnosis. We do not encourage you to forego the (surgeon's) knife in favor of the (table) fork. Those are personal choices, and surgery is directly responsible for innumerable lives being saved across the world.

What we are saying is that there is abundant nutritional, biochemical and molecular evidence, researched and supported by world's most respected institutes, that a plant-based diet in general - and one that includes key nutrients and food groups in particular - directly lowers your risk of many cancers. The most comprehensive book ever published on the links between food, nutrition, physical activity and cancer prevention, a summary of which can be found here, includes a fantastic matrix on pages 8 and 9 that maps foods to their likely influence on cancer factors. Created by a global partnership of more than 200 scientists and experts in 2007 and funded by the World Cancer Research Fund (WCRF) and American Institute of Cancer Research (AICR), the full report - all 537 pages of it - can be found here.

Beyond food, we know that non food factors significantly contribute to your overall state of health: your genetics, lifestyle (e.g.: smoking), psychological well-being and stresses, as well as environmental factors (e.g.: air pollution), quality of sleep, level of fitness, etc. etc.

But food is our fuel. It feeds us on a molecular level and promotes or inhibits every one of the millions of bio-chemical and bio-mechanical processes that keep us alive and healthy, or make us sick. Food influences what genes express themselves, and which are suppressed. What you put in your body matters - more than anything else - and can influence the other factors we listed above significantly. Without a healthy diet, like so many others before him, my brother's life would have been considerably shorter that it was. And while death by cancer at the age of thirty-eight is a tragedy, his diet bought him the most precious of human commodities - one for which I will personally be forever grateful and which made the difference beyond all others.

Time.

Week 12: Greens - Everything you don't know

Week 8: Cancer and Diet - a relationship