Cancer, Garlic, and Leafy Green Vegetables; or, “How my Italian Grandmothers were Right”

Left with a diagnosis of kidney cancer and awaiting a second opinion, the feeling of powerlessness is, at times, overwhelming.  My appointment for that second opinion at Sloan Kettering  is this coming Tuesday (thank you Cigna).

My research, along with conversations with people who have actually been through the process makes it fairly probable that very soon after my appointment, I’ll be under the knife. Simply put, the treatment of preference is either the full or partial removal of the affected kidney, with further removal of the adrenal glands and lymph nodes if necessary. And waiting doesn’t make much sense. The cancer could spread.

In the meantime, however, I wait.  And of course, I research and fret, but not necessarily in that order.  My most recent foray into the scholarly has turned up something worth considering: my Italian grandmothers were right. Garlic actually is the answer. And so is spinach– and brussel sprouts.

After being diagnosed, feeling utterly powerless, I began feeling the need to do something. And, having been raised by an Italian family, I instinctively began putting loads of garlic into everything I ate–something, because of early training,  I tend to do whenever I am sick. I know researchers over the years have shown garlic to be bio-beneficial, but when I mentioned that I had begun doing so to a lawyer/nun friend of mine, she said “Why?”

The research I found subsequent is actually rather extraordinary. In a petri dish, garlic concentrations and leafy green vegetables actually inhibited the growth of various types of cancer cells. Entitled “Antiproliferative and antioxidant activities of common vegetables: A comparative study,” the paper was authored by researchers  from the  Laboratoire de Médecine Moléculaire and the Service d’hématologie-oncologie, Centre de Cancérologie Charles-Bruneau, Hôpital Ste-Justine, Université du Québec à Montréal.

The results?  Garlic, leeks, spinach, kale, brussel sprouts and curly cabbage are all now an integral part of my diet.

The researchers

evaluated the inhibitory effects of extracts isolated from 34 vegetables on the proliferation of 8 different tumour cell lines. The extracts from cruciferous vegetables as well as those from vegetables of the genus Allium inhibited the proliferation of all tested cancer cell lines whereas extracts from vegetables most commonly consumed in Western countries were much less effective. The antiproliferative effect of vegetables was specific to cells of cancerous origin and was found to be largely independent of their antioxidant properties. These results thus indicate that vegetables have very different inhibitory activities towards cancer cells and that the inclusion of cruciferous and Allium vegetables in the diet is essential for effective dietary-based chemopreventive strategies.

The cancer cell lines tested were PC-3 (prostate), AGS (stomach), U-87 (glioblastoma, brain), DAOY (medulloblastoma, pediatric brain), MCF-7 (breast), A-549 (lung), Panc-1 (pancreas), Caki-2 (kidney).

The vegetables which showed the most antiproliferative effect? The results varied by type of cancer, the researchers write:

Tumour cells derived from prostate and stomach cancer were most sensitive to the extracts while cells from kidney, pancreatic and lung cancers were much less affected by the tested extracts. For example, 23 of the 34 the tested vegetable extracts inhibited the proliferation of prostate tumour cells by more than 50%, while only 7 extracts were active against kidney cancer cells.

There’s a chart for each kind of cancer which shows the impact of each kind of vegetable tested. It’s worth a look and a read or just check out the video linked below and go back to the document for more specific information on the type of cancer you’re most interested in. For kidney cancer, leek, garlic, curley cabbage, brussel sprouts, kale and spinach did well. With leek inhibiting growth completely and the garlic imbued tumor cells growing to only around 5% of the control tumor–which was merely left to its own devices. Iceberg lettuce? Bock Choy? Not so good.

As you might imagine, I now have a refrigerator filled with cruciferous vegetables, garlic pre-sliced in 1lb. jars, and leeks. I also have enough spinach in cans to keep Popeye square for a month.

I should be clear though: the law degree and the tumor I have do not in any way, shape or form entitle me to dispense medical advice. I am not doing so. And I am not saying that vegetables are a substitute for medical care; I fully intend to have this thing (the tumor, not the law degree)–along with whatever part of my kidney has been compromised–cut out of me as soon as my doctor says he wants to do so.

You make up your own mind as it regards your diet–but mine has just seriously changed. Garlic was first in  antiproliferation among every kind of cancer except one (mine), in which it was second. Dr. Michael Greger over at NutritionFacts.org called that discovery “one of the most important findings of the year.” My grandmothers would agree.

Oh, why canned spinach? Because it’s fast and amazingly easy. Saute a ton of garlic along with some cut leek in extra virgin olive oil and dump in two cans of spinach–I use a little salt and sometimes paprika. Heat. Maybe add some parmesan cheese. It works for pretty much any of the leafy greens and cancer antiproliferation never tasted so good.

The video below will take you through the research and the charts–showing what vegetables did best for what. Bon appetite.

http://nutritionfacts.org/videos/1-anticancer-vegetable/

A Pyramid No More: You Are A Plate of Quadrants and A Dairy Circle

Photo from ChooseMyPlate.gov

Step aside, food pyramid, there’s a new dietary guide in town: MyPlate.  During a press conference on Thursday, First Lady Michelle Obama and Department of Agriculture Secretary Tom Vilsack released MyPlate –whose color-coded quadrants of fruits, vegetables, grains, and protein — plus dairy circle — are intended to serve as “a quick, simple reminder for all of us to be more mindful of the foods that we’re eating.”  MyPlate replaces the 2005 MyPyramid and the 1992 “old school” USDA Food Pyramid, both of which have been criticized as misleading or difficult to understand (I dare say that the MyPyramid color scheme was a little reminiscent of a similarly confusing color-coded federal government alert system).  MyPlate complements the federal government’s 2010 Dietary Guidelines for Americans, released earlier this year, which reminds consumers about:

Balancing Calories

• Enjoy your food, but eat less.
• Avoid oversized portions.

Foods to Increase

• Make half your plate fruits and vegetables.
• Make at least half your grains whole grains.
• Switch to fat-free or low-fat (1%) milk.

Foods to Reduce

• Compare sodium in foods like soup, bread, and frozen meals — and choose the foods with lower numbers.
• Drink water instead of sugary drinks.

MyPlate is meant to be an “easy-to-understand visual cue.”  Among the noticeable changes to the food guide are the absence of the “fats, oils, & sweets” section which once sat atop the 1992 food pyramid and the relabeling of the 2005 MyPyramid sections of “milk” to “dairy” and “meat and beans” to “protein.”  The AP reports that

[t]he guidelines and the icon were subject of lobbying by food industries who want to see their products promoted and not discouraged. Fruit and vegetable growers were celebrating their victory over half of the plate Thursday, while dairy producers said they were also pleased with the cup beside it. The president of the beef industry group National Cattleman’s Beef Associaton, Bill Donald, said he is not concerned about the elimination of the word “meat” because beef is so associated with the word “protein.”

According to the New York Times, MyPlate is the brainchild of the Department of Agriculture, the First Lady’s Child Obesity Task Force, and other federal health officials.  During the press conference, First Lady Obama noted that

[w]hen mom or dad comes home from a long day of work, we’re already asked to be a chef, a referee, a cleaning crew. So it’s tough to be a nutritionist, too. But we do have time to take a look at our kids’ plates. As long as they’re half full of fruits and vegetables, and paired with lean proteins, whole grains and low-fat dairy, we’re golden. That’s how easy it is.

Nutritionists cautiously welcomed MyPlate.  For instance, Marion Nestle, a New York University professor, told the New York Times that

“[i]t’s better than the pyramid, but that’s not saying a lot”….

Dr. Nestle praised the plate for being generally easy to understand, but she said that labeling a large section of the plate “protein” was confusing and unnecessary, because grains and dairy products also are important sources of protein and most Americans get far more protein than they need.

But she said the emphasis on fruits and vegetables was a significant step.

Dawn Jackson Blatner, a registered dietician in Chicago, told The Wall Street Journal Health Blog that “we went from something that was complex and hard for people to remember to something that is very visual, clear and based in science. People don’t eat off a pyramid, they eat off a plate.”  Except maybe for the people who designed the original food pyramid.

It’s early days yet, folks, but I agree with Ms. Blatner.  At least the food guide finally looks more like my dinner plate and less like a jumble of colors and pyramidal fragments.  Be sure to click here for an article from the Los Angeles Times to learn how other countries have visualized their food guides.

Fast Food, Childhood Obesity & the Hidden Costs of that Free Toy

Photo by shimelle via Flickr

Late last month, a consumer advocate group called the Center for Science in the Public Interest (CSPI) announced its intention to sue McDonald’s for using toys to market Happy Meals to children.  In an open letter to McDonald’s, CSPI litigation director Stephen Gardner alleged the toys were part of an unfair and deceptive marketing tactic which gave children “pester power” and taught them unhealthy eating habits.  Mr. Gardner further alleged the company violated Massachusetts, New Jersey, Texas, and California consumer protection laws.  Apparently McDonald’s recent Shrek 3 toy promotion was the final straw (and, somehow, the risk of cadmium exposure isn’t a concern here).  In a follow-up press release, Mr. Gardner also compared McDonald’s to:

… the stranger in the playground handing out candy to children.  McDonald’s use of toys undercuts parental authority and exploits young children’s developmental immaturity — all this to induce children to prefer foods that may harm their health.  It’s a creepy and predatory practice that warrants an injunction.

McDonald’s must decide later this month whether it will continue its Happy Meal toys or succumb to pressure.  So far the company believes that “[g]etting a toy is just one part of a fun, family experience….”

Before you completely write-off this lawsuit and characterization as over-the-top theatrics, just remember that CSPI already has a proven track record.  In 2006, the group sued KFC for using partially hydrogenated oils to deep-fry its food.  KFC subsequently switched to a trans-fat-free frying oil.  That same year CSPI also negotiated a settlement agreement with the Kellogg Company which set certain nutrition standards for marketing to children.  Better not tell CSPI about Cracker Jack and removable tattoos or Topps baseball cards and chewing gum.

In all fairness, CSPI isn’t the only group focusing on marketing to children.  Earlier this year in California, the Santa Clara County Board of Supervisors banned the inclusion of toys with meals numbering 485 calories or more.  Granted, Supervisor Donald Gage voted against the ordinance because “[i]f you can’t control a 3-year-old child for a toy, God save you when they get to be teenagers.”  The Los Angeles Times has reported on the increasing number of fast food television advertisements directed at children, particularly non-white children.  Likewise, CNN has reported on successful junk food marketing campaigns through the use of cartoon characters.  Perhaps CSPI and its supporters should go after DreamWorks and other studios whose agents negotiate these marketing agreements.  Just a thought.

This concern over McDonald’s Happy Meals and developing good eating habits in children coincides with the Trust for America’s Health (TFAH) report “F as in Fat: How Obesity Threatens America’s Future 2010.”  The report found that 38 states have adult obesity rates above 25 percent, a sharp increase from 20 years ago when no state had an obesity rate above 20 percent.  (Click here to see how your state weighs in.)  According to TFAH executive director Jeffrey Levi:

[o]besity is one of the biggest public health challenges the country has ever faced, and troubling disparities exist based on race, ethnicity, region, and income….  Millions of Americans still face barriers — like the high cost of healthy foods and lack of access to safe places to be physically active — that can make healthy choices challenging.

The report suggested a connection between income disparities and adult obesity: “35.3 percent of adults earning less than $15,000 per year were obese compared with 24.5 percent of adults earning $50,000 or more per year.”  The report also showed that “more than 12 million children and adolescents are considered obese” and half of Americans believe this is an important issue to address.  However, rather than suggesting that consumers sue fast food and junk food companies, the report recommended investing in public health initiatives and prevention programs.

I’m not a parent, so I won’t preach about better parenting skills when it comes to “pester power” and how a child’s eating habits are determined as much by their parents as the cartoon characters selling the food.  I’ll just say that there was seldom any debate with my parents over the foods that I ate as a child.  Admittedly, there sometimes are no other alternatives.  Whether you’re a high school athlete on the road, a parent with no time to make dinner, or looking for an inexpensive meal, fast food is the cheap and easy way to go.  Perhaps the key is moderation?

Does this mean CSPI should hold the fast food (and junk food) companies responsible for the development of our eating habits, from childhood to adulthood?  The TFAH report also referred to obesity liability laws in 24 states protecting restaurants, manufacturers, and marketers from weight-related lawsuits.  Take note, CSPI.  (And you, dear reader, take note of Michael Ricciardelli’s post containing some staggering numbers relating to the healthcare costs of managing Type-2 diabetes, in which obesity plays a factor, and Professor Pasquale’s beverage tax utilitarian calculus.)

Soda & Diabetes, How Much Does That Can of Soda Really Cost? Part II

Photo by Michael Reeve

Diabetes. In a brief but interesting interview on NPR’s Marketplace, Kaiser Permanente CEO George Halvorson had this to say:

HALVORSEN: …. Right now, when you look at diabetes, 32 percent of the cost of Medicare is diabetes. It’s the number one cost of blindness, it’s the number one cause of amputations, it’s the number one cause of kidney failures. And when you look at the care delivery patterns in America, we only get care right for diabetics 8 percent of the time. If we got care right for diabetics 80 percent of the time, we’d cut the number of kidney failures in half.

A few days ago we began to ask, “How Much Does that Can of Soda Really Cost?” We considered cost in terms of external or social cost (not price for the actual can of soda, but that which results incidental to the primary transaction and may be borne by other than the buyer or seller), and noted that a recent study shows that obesity plays a prominent role in health care expenditures, and that many believe that soda and other sugary soft drinks play a prominent role in obesity. We noted that the Wall St. Journal reported that

Overall obesity-related health spending reaches $147 billion, double what it was nearly a decade ago, says the study published Monday by the journal Health Affairs.

Obesity-related conditions now account for 9.1% of all medical spending, up from 6.5% in 1998, the study concluded.

Obesity is a key factor in Type 2 diabetes. And  32% of Medicare costs are attributable to diabetes. It is no stretch to say that if we have a Medicare cost problem in this country (we do), what we really have is a diabetes problem (and, considering Halvorsen’s “we only get it right 8% of the time” figure, a diabetes treatment problem as well).

But first things first. 32% is a mere scooch (yes, that’s the technical term) away from ONE THIRD. That’s an enormous number. If one were to relate this portion of Medicare expense to houesehold expenditures, it occupies a place similar to a mortgage– but an expensive mortgage in a house that no one wants to live in.

In addition, according to the American Diabetes Association (ADA)

The total annual economic cost of diabetes in 2007 was estimated to be $174 billion.  Medical expenditures totaled $116 billion and were comprised of $27 billion for diabetes care, $58 billion for chronic diabetes-related complications, and $31 billion for excess general medical costs. Indirect costs resulting from increased absenteeism, reduced productivity, disease-related unemployment disability, and loss of productive capacity due to early mortality totaled $58 billion.  This is an increase of $42 billion since 2002. This 32% increase means the dollar amount has risen over $8 billion more each year.

Importantly, the ADA believes those numbers may be understated:

The actual national burden of diabetes likely exceeds the $174 billion estimate because it omits the social cost of intangibles such as pain and suffering, care provided by non-paid caregivers, excess medical costs associated with undiagnosed diabetes, and diabetes-attributed costs for health care expenditures categories not studied.

Read more