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Spices, Phytonutrients and Medical Treatment
Ernest H. Rosenbaum, MD
Turmeric is an Indian spice often used to treat cancer. Curcumin is the active ingredient that makes turmeric yellow.
Studies in laboratory animals have shown that those taking high doses of curcumin have fewer breast, skin, mouth, and colon tumors. It induces apoptosis (programmed cell death) in cancer cells and may slow down metastases or cancer spread. Researchers at M. D. Anderson gave 8 gm of curcumin a day to inoperable pancreatic cancer cases.
There is also animal evidence that in traumatic brain injury, whether a stroke or Alzheimer's, curcumin can be protective for brain cells. It is known to bind directly to beta-amyloid deposits in the brain and reduces their size. This is the protein that builds up between brain cells in Alzheimer's patients. In one animal study, the size of the plaques was reduced by 30%, and some plaques were disappearing. These studies are preliminary.
The dose was 2-4 gm a day of curcumin, and cognitive studies are in progress. Randomized studies against placebos are planned. These are experimental trials.
Only a small amount of curcumin in pills seems to be absorbed or retained in the body, and curcumin in food might not be better. Only 2% of turmeric is curcumin, and curry powders vary up to ten times in their turmeric content.
In a study at UCLA on Alzheimer's disease, it took anywhere from, 8 to 80 cups of curry powder to get the 4,000 mg (4 gm) of curcumin that's being tested. Cooking with curcumin may also be helpful. When cooking with curcumin, it is put into hot oils and cooked. We do not know what the safe level currently is, but up to 2 gm of curcumin a day appears to be safe. It is often used with pepper extract, which can interfere with metabolism of other drugs.
Supplements of 1 gm a day resulted in a 30% reduction of blood glucose concentration levels. This may be a good adjuvant treatment for diabetes. In one study, which was placebo-controlled, there was roughly a 25% reduction from 225 to 157 in those taking 1 gm of cinnamon, by 18% in those taking 3 gm, and 29% in those who got 6 gm. Fasting blood sugars dropped by 10% in those given the equivalent of 10 gm a day of cinnamon powder - a smaller drop than in the initial study by Anderson. The active ingredient appears to be polyphenol type-A polymer, which activates insulin receptors on cell membranes much like insulin does. Failures have been noted, especially in those who are overweight. Anderson used 1 gm (about a half teaspoon of ground cinnamon) to lower blood sugar in people with diabetes. If you are taking it long term, use a water extract of the spice. It is a purified form without coumarin which can thin the blood.
(Reference: J Ethnopharmacol, 104: 119, 2006.)
Ginger has been used for morning sickness and also for motion sickness. NASA tested ginger doses in men and women in their rotating chair program to simulate motion sickness, and with 1000 mg of powdered ginger versus a placebo, it was found to reduce vomiting and cold sweats but not relieve nausea or vertigo.
It has also been used along with chemotherapy at 1000-2000 mg a day of ground ginger and was better than a placebo. It has also been used for osteoarthritis. 1500 mg of ground ginger is about 1 teaspoon's worth divided into several doses over the course of the day. It is believed to be safe for pregnant women. Doses greater than 6,000 mg a day can cause GI ulcers.
A study was done, which was a randomized, double-blind placebo controlled trial on the use of isoflavone phytoestrogen genistein, to reduce bone loss. There were 389 postmenopausal women with a bone density of 0.795 g/cm2 at the femoral neck without other comorbid conditions.
The bone mineral density (BMD) was evaluated in the lumbar spine and femoral neck at 24 months, and serum levels of alkaline phosphatase, insulin growth factor 1, urinary excretion of pyridinoline and deoxypyridinoline, and endometrial thickness were evaluated. Results at 24 months showed that the BMD had increased in the genistein recipients and decreased in the placebo recipients at the lumbar spine and femoral neck. Genistein decreased the urinary excretion of pyridinoline and deoxypyridinoline, increased levels of bone-specific alkaline phosphatase and insulin growth factor 1, and did not change endometrial thickening when compared to the placebo. There were more gastrointestinal side effects in the genistein group, and some had to discontinue the study. Fractures were not measured, and the conclusion of the study was with 24 months of treatment with genistein, there was a positive effect on bone marrow density in osteopenic, postmenopausal women.
In postmenopausal osteoporosis, there's a marked decrease in estrogen level and increased rate of bone remodeling. Current treatments for postmenopausal osteoporosis include hormonal replacement, calciton, bisphosphonates, and selective estrogen receptor modulators, such as Raloxifene.
Hormonal replacement therapy in survivors who have had breast, endometrial or ovarian cancers, cardiovascular disease, venous thrombosis and strokes is contraindicated.
This study was to see if phytoestrogens, especially the isoflavones in soy products, could reduce the risk of osteoporosis in the typical Western diet.
Genistein is an isoflavone phytoestrogen abundant in soybean products with a chemical structure somewhat related to 17B-estradiol. It is a natural selective estrogen receptor modulator, and this study has shown that it has a positive regulatory bone cell metabolism without the harmful estrogenic effects in the breast and uterus.
Some studies have suggested that there may be a conflict in breast cancer women, who are estrogen-receptor positive, as there can be a weak estrogenic effect. It is believed that they somewhat up-regulate insulin-like growth factor 1, transform a growth factor B, and inhibit osteoclastogenesis in bone marrow cells of rats. Some phytochemicals display estrogenic properties and mimic estrogen by activating insulin-like growth factor 1 - signaling events through estrogen receptor binding. Of note is that it's time dependent and long-term intakes may be needed.
Article Review from the Annals Intern Med, 2007; 146: 839-847, "Effects of Phytoestrogen Genistein on Bone Metabolism in Osteopenic, Postmenopausal Women," Marini, H., Minutoli, L., Polito, F., et. al.
Lycopene has been touted as a protector against cancer, especially prostate cancer. One recent study did find that higher blood levels of lycopene were not linked with a reduction in the risk of prostate cancer. In general, this does not negate the recommendation of eating habits but does emphasize the need for a variety of fruits and vegetables in all of our meals, including tomatoes.
Lycopene appears to be a potent weapon against cancer as one of the carotenoid phytochemicals related to beta-carotene. Lycopene seems to have a protective role for our cells' DNA with its strong antioxidant power and its ability to stimulate enzymes that deactivate carcinogens before a cancer gets started.
Lycopene is found in several reddish fruits and vegetables, including red and pink grapefruit, guava, and watermelon. Tomatoes provide the majority of Americans' lycopene intake, and studies evaluating lycopene consumption were mainly in men using greater tomato consumption. This has been associated, in several studies, with a lower risk for prostate cancer. Twenty-one studies were analyzed, where men ate the highest amount of raw tomatoes, which showed an 11% lower risk for prostate cancer versus those eating the most cooked tomato products, which showed a 19% reduction in prostate cancer risk. Lycopene is more readily absorbed in the state of cooked tomatoes. There are also positive studies showing that tomato consumption slowed development of prostate cancer that had already been diagnosed.
Of note, in a large study in 2006, the Prostate, Lung, Colon, Ovarian Cancer Screening Study (PLCO), involving approximately 30,000 men, who ate more than twenty-five different tomato-based foods, were studied for eight years, and neither the top 20% of lycopene or tomato consumers showed any reduced risk of developing prostate cancer. It was noted that lycopene absorption did improve with cooked tomatoes, so blood levels of lycopene were evaluated, and there was a report in May 2007, that there was no significant link between lycopene blood levels and reduced cancer risk.
The men in the PLCO study averaged eight to nine servings of vegetables and fruit a day. The analysis showed that only 22% of men consumed the minimum recommendation of three servings of vegetables a day, and 29% ate the minimum fruit recommendation of two or more servings per day. It was wondered if patients ate the recommended levels, it could impact a different result or outcome through the phytochemicals in food.
Finally, it is still recommended to include tomatoes in our meals, as it makes sense, adds flavor, nutrients and phytochemicals. Lycopene nor any other single food or phytochemical is likely to protect us in an overall healthy diet to defeat cancer.
"The Role of Lycopene and Cancer", reviewed by Karen Collins of the American Institute of Cancer Research, July 30, 2007.
- Flaxseed is a valuable supplement, but many of the reports and concepts have added conflict to its acceptance, in part because of contradictory data. The belief is that it can help prevent breast and prostate cancers, for example; although, others claim it may increase the risk. Others have used flaxseed for menopausal symptoms or to help control cholesterol.
Flaxseed is rich in lignans (a type of plant estrogen) and phytoestrogen (similar to soy and human estrogen). Lignans are digested and converted into estrogen-like substances called enterodiol and enterolactone. They could have an anticancer effect, as well as having antioxidant properties that could deactivate free radicals, which can damage cells. Lignans are found in sesame and pumpkin seeds, cranberries, tea and coffee. There are no lignans in flaxseed oil; although, lignans are often added by manufacturers to flaxseed oil.
Flaxseed is a source of an essential acid called alpha-linolenic acid (ALA), which the body does not manufacture and is an omega-3 fatty acid like the fats in fish. It is believed to help prevent heart attacks and lower cholesterol. Fish are a better source of ALA. Of note is that the true role in lowering cholesterol and in heart disease is still under study.
Other sources of ALAs include walnuts, canola oil, and soybean oil. Most of the studies about heart disease have been done with canola oil and/or walnuts - not flaxseed. Thus, flaxseed is not a critical source for the diet for disease prevention, as there are many good alternatives. It is nutritious and is often cooked in breads, muffins, and other baked goods.
- 1. It must be ground before using, and it does not preserve well even when refrigerated.
2. It can be expensive and often quickly turns rancid.
3. It is not recommended for children, pregnant women, or lactating women.
4. It does have a laxative effect, and you have to check for a possible interaction with other medications you may be taking.
- Reference: The Wellness Letter, The Newsletter of Nutrition, Fitness and Self-Care, University of California, Berkeley, vol. 23, issue 11, August 2007, pg. 1.
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