foodandcancer — this week at FFFL

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.