Sep
21
2019

What Makes Us Sick And What Keeps Us Healthy

An article in Nature Communication essentially asks what makes us sick and what keeps us healthy? The publication is about eating enough flavonoids to protect you from heart attacks and cancer.

The publication appeared on Aug. 13, 2019. It is a prospective study involving 56,048 participants of the Danish Diet, Cancer, and Health cohort. The medium age of the participant in the beginning of the study was 56 (range 52 to 60). This was cross-linked with Danish nationwide registries. The observation time was 23 years during which 14,083 participants died. As this study had a high number of participants and had a long observation period, the data are quite robust.

The researchers found that when people consume 500 mg of flavonoids from vegetables and fruit per day, they are dying significantly less from heart attacks and cancers.

Details of the study on flavonoid intake

Flavonoids are polyphenolic compounds in plant-derived foods and beverages such as vegetables, fruit, dark chocolate, coffee, tea, and red wine. There are six major subcategories of flavonoids: flavonols, flavan-3-ols, flavanones, flavones, isoflavones and anthocyanins. But it does not matter, which ones we consume, just that we consume enough (more than 500 mg per day).

The results were obtained with much stratification. For instance, in one set of results they normalized for age and sex. They called this model1. In another set they adjusted for age, sex, BMI, smoking status, physical activity, alcohol intake, hypertension, hypercholesterolemia, social economic status (income), diabetes, and prevalent disease. They called this model 2.

Participants with 536 mg of daily flavonoid intake had a reduction of 39% of heart attacks according to model 1. Using model 2 this changed to a reduction of 18% of heart attacks.

Cancer mortality reduction

The investigators did a similar analysis for cancer mortality reductions. At 536 mg of daily flavonoid intake model 1 showed a 36% reduction of cancer mortality. Model 2 still calculated a 21% reduction of cancer mortality. In both cases, the cardiovascular mortality risk and the cancer risk showed that more than 500 mg of flavonoids per day were not necessary as no more lives were saved by increasing the flavonoid dose beyond that. Unfortunately the opposite is true: people eat too many processed foods devoid of flavonoids, and they die of heart attacks and cancer prematurely.

Reducing the risk of heart attacks and cancer is not new

Many studies have shown what researchers found in this study, namely that vegetables and fruit can prevent heart attacks and cancer. Here is a brief summary with links to show this.

We heard many times that small amounts of alcohol consumption will keep the arteries clear of fatty deposits. This prevents heart attacks and strokes, but as the following study shows even small amounts of alcohol can cause various cancers.

Small doses of alcohol are still cancer producing

Dr. Timothy S. Naimi from Boston University Medical Center was the main investigator of an international team of scientists. The study found that every year 18,200 to 21,300 cancer deaths in the US (that is 3.2% to 3.7% of all US cancer deaths) are due to alcohol consumption. The authors of the study determined that every person who dies from alcohol related causes lost on average approximately 18 years of his/her life (scientists call this “years of potential life lost”).  51% of women developed breast cancer from alcohol exposure, 62% of men came down with upper airway and esophageal cancers. Less than 1.5 drinks per day caused between 26% and 35% of alcohol-related cancer deaths. There was no safe lower margin. The authors concluded, “Reducing alcohol consumption is an important and underemphasized cancer prevention strategy”.

Lifestyle important for longer life expectancy

I am reminded of a talk that Dr. David Katz delivered in a keynote address. He said that lifestyle improvements create profound changes in our system. This talk took place at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014. One study that was mentioned showed that in men who adopted a healthy lifestyle 35% of heart attacks could be prevented. With healthy lifestyle the authors meant consuming a healthy diet, not exceeding moderate alcohol consumption, no smoking, regular physical activity and having a normal waist circumference (less than 95 cm).

The ingredients you need to make it to age 100

A Swedish longevity study that went on for 50 years gave me the idea to write a blog about the factors that can help you to turn 100 and still have your mental capacity and good health.Let me introduce you to this study. Researchers at the Sahlgrenska Academy in Göteborg, Sweden (which is located at the University of Gothenburg) decided back in 1963 to follow a group of 855 Gothenburg men born in 1913 until they would either die or turn 100. The idea was to find out what killer diseases are in the way to reach such a ripe old age and if they would survive, what was it that made them reach this age. Think of it as a race to turn 100.

What diseases killed at older age and what led to longevity?

The researchers had checkpoints along that journey: various surveys were conducted at the age of 54, 60, 65, 75, 80 and 100 to analyze the factors that lead to longevity. 27% (232) of the original group reached the age of 80, and 13% (111) made it to 90. Only 1.1% of the men made it to the age of 100. What were the causes of death for the other ones who did not make it? 42% of deaths after the age of 80 were due to heart attacks, 20% due to infectious diseases, 8% due to strokes, 8% due to cancer, 6% due to pneumonia and 16% due to other causes. 23% of the men over 80 were diagnosed with Alzheimer’s or dementia. Factors that made people survive were refraining from smoking, maintaining a healthy cholesterol level and limiting coffee consumption to not more than 4 cups per day.

Beneficial effects of green tea and black tea

meta-analysis involving 194,965 people and 4378 strokes found that there was a reduction of strokes with increasing tea consumption. Those who drank 3 or 4 cups of green tea or black tea per day were the experimental group. Researchers compared them to the control group that drank less than one cup of tea per day. The experimental group had a 21% lower risk of getting a stroke than the control group.

meta-analysis of 18 studies from China showed that green tea and black tea consumption was beneficial for prevention of cardiovascular disease and for cancer prevention. The highest consumption of green tea reduced cardiovascular mortality (heart attacks and strokes) by 33%. The highest black tea consumption lowered mortality by 12%. Cancer mortality turned out different. Green tea did not produce a reduction in mortality, but black tea lowered it by 21%. I suspect that the different subcomponents of the bioflavonoid content in green and black tea are key to those findings.

Plant-based diet versus animal protein based diet

2016 study that had gone on for 49 years was involving 131,342 participants. Animal protein intake showed an association with higher mortality from heart attacks and strokes. The investigators substituted 3% of energy from processed red meat by an equivalent amount of plant protein. This reduced the all-cause mortality by 34%. For unprocessed red meat the 3% substitution reduced the all-cause mortality by 12%. If 3% of egg consumption is reduced, all cause mortality drops by 19%.

British Medical Journal study

new study has shown that you can save lives when you replace red meat and processed red meat. The replacement was with fish, poultry or protein from vegetables. The study appeared in the British Medical Journal on June 12, 2019. It involved 53,553 women nurses and 27,916 male doctors in the United States and ran from 1986 to 2010. Here is my summary of the blog where I reviewed this study in detail. A new study in the British Medical Journal showed that an increase in red meat consumption of only ½ serving per day for 8 years caused an increased mortality of 9% over the following 8 years. With regard to processed red meat the mortality was even bigger, namely 13%. The researchers replaced some of the meat with white chicken meat or vegetables and the mortality normalized.

In contrast, a Japanese study showed that there was no increase in cardiovascular disease with the consumption of up to 100 grams of beef or other meat products per week. The study went on for 16 years.

Using antibiotics as growth promoters is illegal in Japan and Europe

I pointed out before that there is literature explaining why there is a discrepancy: the beef industry in the US feeds the animals antibiotics as growth promoters. This changes the bowel flora in humans who eat the beef. The changed bacterial strains in the gut use carnitine from beef and make trimethylamine N-oxide (TMAO). This is a toxin that causes both cardiovascular disease and cancer. This explains why in the US beef is one of the culprits that cause heart attacks and colorectal cancer. In Japan this is not the case. Both Japan and Europe do not use antibiotics as growth promoters in the cattle industry, as it is illegal.

In the US it is likely safe to eat organic meats (beef, chicken) as these meats will not contain antibiotics. Due to the numerous additives in processed red meat, it is a sensible idea to skip these products altogether, as they produce cancer.

What Makes Us Sick And What Keeps Us Healthy

What Makes Us Sick And What Keeps Us Healthy

Conclusion

Several studies have pointed out the importance of eating less animal protein and increasing vegetables and fruit in your diet. Heart attacks, strokes and cancers are still the major causes of death in all of the developed countries. The Danish study mentioned in the beginning showed that keeping the daily intake of bioflavonoids at 500 mg or more prevented 18% to 39% of heart attack mortality and 21% to 36% of cancer mortality.

In other studies we learnt that deaths between the ages of 80 and 100 were mainly due to heart attacks, strokes and cancer (these accounted for 58% of deaths). Only 1.1% of the men in that Swedish study made it to the age of 100.

More evidence that flavonoids and plant protein save lives

Another study measured the effect of green and black tea consumption: There was a 21% reduction of strokes with green or black tea consumption.

Another study found reduced cardiovascular mortality by 33%. Green tea reduced cancer mortality by 21%.

Another study showed that when plant protein replaced red meat there was an astounding drop of the all-cause mortality by 34%.

All of these studies show that you must eat enough flavonoids to protect yourself from heart attacks and cancer. Of course you also need to engage in a regular physical exercise program to stay fit and healthy.

Jun
18
2016

High Vitamin D3 Prevents Cancer

In the last few years we learnt a lot about vitamin D3, but the newest thing is that high vitamin D3 prevents cancer.

Researchers at the University of California, San Diego School of Medicine reported that with respect to several cancer types higher doses of vitamin D3 led to less cancer over a period of time.

The cancers investigated were colon cancer, breast cancer, and lung and bladder cancer. People absorb vitamin D3 differently.  The researchers found that the best way to measure vitamin D3 concentration in the body is to use serum 25-hydroxyvitamin D (25(OH)D). In the past people did not pay much attention to this matter. However, several studies including the present study showed that in patients who had a lower level of 20 ng/ml cancer rates were higher.

Comparison of two cohort studies

The researchers used data from two prior studies, a randomized clinical trial of 1,169 women and a prospective cohort study of 1,135 women. The researchers found that the age-adjusted cancer incidence was 1,020 cases per 100,000 person-years in the randomized clinical trial, called “Lappe cohort”. The other prospective cohort study was called the “GrassrootsHealth cohort” where cancer incidence was 722 per 100,000 person-years. The interesting fact was that the Lappe cohort median blood serum level of 25(OH)D was 30 nanograms per milliliter, while the GrassrootsHealth cohort had a higher level of 25(OH)D of 48 ng/ml.

Higher vitamin D levels correlate with lower cancer incidence

This likely explains the lower cancer rate in the GrassrootsHealth cohort. Researchers combined the two trials in order to increase the statistical significance . The striking finding was that above 40 ng/ml the overall cancer risk was more than 71% lower than for the group of people whose level of 25(OH)D was 20 ng/ml or lower. The above ScienceDaily article was based on this scientific study.

Other studies showing high vitamin D3 prevents cancer

AfroAmerican men had less prostate cancer, if vitamin D level was higher

In a 2015 study Afro American men were found to have 71% less prostate cancer, if their serum 25-hydroxyvitamin D level was at least 30 ng/ml or higher.

Prospective study showing high vitamin D levels cancer protective

This 2006 study reported a 14-year prospective follow-up in men where all cancers were counted and blood serum 25-hydroxyvitamin D levels were correlated to cancer incidence. An increase of 25 nmol/L (=10 ng/ml) in predicted serum 25(OH)D level showed an association of a 17% reduction in total cancer incidence, with a 29% reduction in total cancer mortality and a 45% reduction in digestive-system cancer mortality. These investigators stated that it takes about 1500 IU of vitamin D3 increase per day to achieve an increment of serum 25(OH)D increment of 25 nmol/L (=10 ng/ml).

University of Arizona Cancer Center study

A publication from the University of Arizona Cancer Center in Jan. 2016 is more critical of the evidence regarding vitamin D3 and the claim that it lowers cancer rates. The researchers reviewed the cancer literature and found that for colorectal cancer there is a clear inverse relationship between serum 25(OH)D levels on the one hand and rates and mortality of colorectal cancer on the other hand. However, with breast cancer the literature was more divided. Only higher vitamin D levels were related to a lower risk for progression of breast cancer and a lower mortality rate. Randomized, double-blind clinical trials with regard to breast cancer failed to show effectiveness on cancer prevention or reduction of mortality. For prostate cancer conditions were similar with the exception of a study using 4000 IU of vitamin D3 per day, which inhibited progression of prostate cancer.

Mouse model regarding ovarian cancer and vitamin D

In a mouse model using a carcinogen to induce ovarian cancer there was an inverse dose-relationship between vitamin D3 and ovarian tumor development both in tissue culture and in the animal.

How high vitamin D3 prevents cancer

Immune stimulating effect of vitamin D3

Several studies have attempted to speculate how vitamin D3 may prevent cancer. Chirumbolo summarized the literature and noted that vitamin D3 has been shown to function as an immune cytokine stimulating the immune system non-specifically.  Vitamin D3 is also anti-inflammatory and counters insulin resistance and inflammatory kinins in obesity. Flavonoids with their antioxidant activity are also cancer preventing. We know that low levels of vitamin D have an association with higher cancer frequency. This means,. it is important to use vitamin D3 as supplements in our diet.

Chinese study describing action of vitamin D3 in detail

This Chinese study examined the effects of vitamin D3 on cancer prevention. It found that vitamin D3 combines three specific actions in one. Vitamin D3 is anti-proliferative meaning that it stops uncontrolled cell division. Secondly, it has an apoptotic (cell death) effect, which means it supports the removal of cells that are dying. If they are dying, but not removed, cancer can occur from these cell remnants. The third effect of vitamin D3 is that it has differentiating effects in several malignant cell types. When cancer cells are non-differentiated (=more immature cells) cancer can multiply quickly. Mature cells find it more difficult to turn cancerous. This is an effect that controls the speed by which cancer cells divide and how quickly cancer metastasizes.

High Vitamin D3 Prevents Cancer

High Vitamin D3 Prevents Cancer

Conclusion

There still is some confusion about the effects of vitamin D3 regarding cancer prevention. In colorectal cancer the statistics are clear: vitamin D3 can significantly prevent colorectal cancer to a large extent. There are also preventative effects in breast cancer and prostate cancer. But individuals may have to take at least 4000 IU of vitamin D3 or more. This is particularly true in higher latitudes where sunlight exposure is lower in the wintertime. Also, people absorb vitamin D3 differently. For this reason it is important to at least check your serum 25-hydroxyvitamin D levels on a few occasions. This will tell you whether your vitamin D3 supplementation is sufficient. Aim for levels in the 50-80 ng/ml, which is health promoting.

Apart from cancer prevention vitamin D3 is also important for prevention of cardiovascular disease. This is particularly true for diabetes, osteoporosis and Alzheimer’s disease.