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In the 19th century, many African-Americans brought in the New Year with Hoppin’ John — a dish made with black-eyed peas and collard greens, among other ingredients, and thought to bring prosperity and luck. Those folks were onto something, according to the authors of “Becoming Vegan: Express Edition,” an award-winning guide to plant-based diets. By eating beans and greens regularly, they say, people can improve their fortune — or at least their health — year-round.
Beans and greens are the meat and potatoes of our modern era, say dietitians Vesanto Melina and Brenda Davis, whose book “Becoming Vegan” won the 2014 Canada Book Awards. Beans — more specifically legumes, which include beans, peas and lentils, but “beans” will be used here as a catch-all term — along with dark leafy green vegetables provide the backbone for creating really healthy meals, they say.
Beans, greens: good for your heart, bones, blood sugar and more
“Beans are a fabulous source of protein,” Melina says. “And we all know that beans are good for the heart.”
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Their viscous fiber — the kind that forms a gel when combined with water — binds cholesterol and then helps move it through your stool and out the body. She says that collards are full of viscous fiber and really good at binding cholesterol, too.
All that gel-like fiber in Hoppin’ John also helps regulate your blood sugar. Once you’ve swallowed a bite, the stomach churns it up like a blender and then sends the liquids into your small intestine, where proteins, fats and carbohydrates get broken down for your body to use. Tiny blood vessels in the intestine’s lining allow nutrients — including glucose — to pass into the blood. The gummy fiber, however, slows down the release of sugars into your bloodstream.
Beans and greens, says Melina, are also both great sources of folate — a B vitamin that helps keep your DNA working properly.
And new research on beans shows that they appear to be good for the bones, too, Davis adds. Beans are rich sources of nutrients that promote healthy bones: protein and folate, magnesium and calcium. But another compound in beans — phytic acid — binds to many minerals, and until recently, authorities believed that would negatively impact bone health. Recent research, however, suggests that phytic acid may actually protect against bone loss.
Beans, beans: The more you eat, the more you …
The reason beans cause flatulence and greens don’t is yet another compelling incentive for embracing the powerful seeds. “That’s your gut at work fermenting carbohydrates in the beans’ fiber into compounds that fight disease,” Davis says.
Once fiber has passed through your small intestine, it reaches the large intestine and then either passes out the body through stool or gets eaten — or fermented — by healthy bacteria that live in your gut. The fermentable carbohydrates in beans go even further, Davis says. “They serve as prebiotics, stimulating the growth of those friendly bacteria in the colon.”
Fermentation transforms carbohydrates in the fiber into compounds that help regulate appetite and blood sugar, control inflammation and fight cancer. They also aid your immune system by nourishing your intestinal lining, the barrier that keeps pathogens from traveling between your gut and blood. (Greens from the cruciferous family — collards, kale, mustard greens, for example — help build and repair that lining, too.)
What happens in your gut, scientists are learning, is crucial for your health, says Davis, and in most people, flatulence is easily controlled. When it comes to eating beans, soak and cook them well and make sure your gut has lots of healthy microbes to digest them, she suggests.
Tips for fending off flatulence
In their book, “Becoming Vegan,” Davis and Melina offer several tips for handling beans, including these guidelines:
— Soak them for at least 6 to 8 hours or overnight in lots of water: 3 cups for every cup of beans. Then put them in a colander and rinse well.
— Place soaked beans and fresh water into a heavy pot, again using 3 cups of water per cup of beans.
— Add a 2-inch to 6-inch strip of kombu, a sea vegetable containing enzymes that help break down the gas-producing carbohydrates.
— Bring to a boil, then reduce heat and simmer until beans are very well cooked, usually 1 to 1 1/2 hours, less for very small beans, more for very large ones.
— Skim off and discard any white foam. That, too, contains gassy starches.
— Add spices. Many common seasonings help counteract the production of gas: garlic, ginger, cloves, cinnamon, cumin, turmeric and black pepper, for example.
— Go slowly: Your colon needs time to build up its reserves of good bacteria that digest those fermentable carbs. If you’re just beginning to embrace beans in your diet this new year, start with small portions.
By eating beans regularly, you’ll soon be hoppin’ with healthy microbes.
Main photo: Beans and greens. Credit: Harriet Sugar Miller
As you’re simmering your cranberries with sweetness this holiday season, you can thank Mother Nature for their astringent qualities.
The compounds that produce the cranberry’s bite — their proanthocyanins (PACs) — not only ward off enemies such as small animals and insects but provide possible health benefits for us human predators.
PACs in cranberries have extremely strong chemical bonds, says Amy Howell, Ph.D., a research scientist at Rutgers University. Instead of being broken down and absorbed into the blood, they appear to travel intact and take their benefits with them, to various parts of your body.
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While cranberry juice’s ability to efficiently fight infections has been called into question, Jeffrey Blumberg has done research to identify why there may be conflicting results, and Howell is among those who suggest potential health benefits in areas such as these:
- Stomach and bladder: You may already be familiar with how cranberries are reported to benefit these organs. PACs bind to harmful bacteria that cause ulcers and urinary tract infections and thus keep those bugs from adhering to the stomach lining and bladder walls. If the bacteria can’t stick, then they can’t multiply and cause damage, Howell says. “Thus, they harmlessly leave the body.”
- Mouth: The same action happens here. PACs can help bind bacteria that contribute to decay and gum disease.
- Intestines: But it’s new research on how cranberry’s PACs behave in the gut of model animals that’s getting berry scientists excited. PACs can improve the bacteria in the colon, Howell says, and compounds produced by those bacteria have far-reaching effects on your health.
“A top story on cranberry right now, just published in a very prestigious journal [Gut], is beautiful evidence for how compounds in cranberries — PACs in particular — act in the gut,” says Mary Ann Lila, director of the Plants for Human Health Institute at North Carolina State University.
Fermentable fiber and your health
When it comes to fiber, “fermentable” is the latest buzzword. Once foods have been digested in the small intestine, the parts that aren’t digestible — their fiber — then travel to the large intestine. There, healthy bacteria feed on certain plant fibers and ferment them into important fatty acids. In turn, those fatty acids get absorbed into the blood and help control blood sugar, appetite and inflammation. They also help enrich your gut lining, which acts as a barrier to keep harmful particles from leaking out or in.
And that’s where cranberries come in. “The fiber in cranberry skins serves as a prebiotic to help establish colonies of probiotic bacteria,” Howell says. In addition, she is researching the possibility that cranberry’s PACs may help keep harmful bacteria such as E coli from invading the gut.
“This is very, very, very exciting stuff,” Lila says. “The cranberry PACs were able to create a healthy population of gut bacteria in those animals and protect against obesity, insulin resistance and inflammation caused by a poor diet,” she says.
In addition to PACs, cranberries have about 150 healthy compounds, as identified in research led by Jonathan Bock and Howell on esophageal and pharyngeal cancer — vitamins C and E; anthocyanins, which act as antioxidants and give them their vivid color; quercetin and myricetin, which bind minerals (iron and copper) that promote oxidation. Howell suggests that many of the compounds in cranberries may protect DNA from damage caused by oxidation and help guard against inflammation in body tissues beyond the colon.
- Cardiovascular system: Research suggests that regularly consuming cranberry products “can reduce key risk factors for heart disease,” says Howell, by reducing inflammation and oxidation of harmful LDL cholesterol and by increasing good HDL cholesterol and the flexibility of arteries.
- Brain: Scientists think that some of these anti-inflammatory compounds may also protect the brain against damage caused by stroke or aging, Howell says.
- Cancer: Preliminary studies, all done in lab animals and cell cultures, suggest that cranberry’s compounds have the potential to inhibit tumor growth of some types of cancer, but much research remains to be done, suggests Howell.
If you’re still stirring those cranberries, you may be wondering whether all that cooking will destroy their healthy benefits. Howell suggests that “cranberry PACs are not seriously damaged by cooking or processing.” But other health-promoting compounds may be damaged by heat, and the effects of cooking on foods “is an area that needs considerably more research,” says Ron Prior, a research chemist at the University of Arkansas. In general, harsh cooking methods will result in degradation.
With all the scientists out there investigating berries, the dream is that there will be a verdict on cranberries by next season’s holidays. For this year, however, we’re sticking to a quick cooking method — in hopes of pleasing some hungry guts. Should we tell them about the microbes?
Quick Cranberry Sauce, with healthy bugs
Prep time: 5 minutes
Cook time: 5 minutes
Total time: 10 minutes
Yield: 8 servings, 1/2 cup each
4 cups fresh cranberries
1 cup water
1 teaspoon cinnamon
2 oranges, juice and zest
1 teaspoon grated ginger
4 to 6 tablespoons maple syrup
1. Put cranberries and water in a medium saucepan, cover and bring to a boil. Lower heat and simmer for 3 to 4 minutes.
2. Take off heat. Add cinnamon, orange juice and zest, ginger and maple syrup. Sprinkle pecans on top.
3. Cranberries have no sugar, so you do have to sweeten them. Start with 4 tablespoons, let the dish sit for a while, then decide whether you want more.
Main photo: Cranberry sauce. Credit: Harriet Sugar Miller
Garlic, broccoli, green tea and turmeric: Health experts keep telling us to consume these foods to fight cancer.
But articles from a New York Times science journalist are challenging the view that diet can prevent cancer. The evidence on the influence of specific foods is weak, George Johnson wrote in a series of recent columns and in a book just released in paperback. Johnson reported that the results of studies connecting diet and cancer were conflicting and the numbers of preventable cases, small.
Ergo, diet doesn’t matter?
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Diet certainly matters, says Stephanie Maxson, senior clinical dietitian at the University of Texas’ MD Anderson Cancer Center, the country’s leading cancer treatment hospital, according to U.S. News & World Report’s most recent rankings. Eating a plant-based diet, as opposed to a diet high in fat or animal protein, is important for preventing cancer as well as all chronic disease, she says.
Faced with this competing points of view, we must make many decisions each day about what to feed ourselves and our families. How do we evaluate the research when it’s not perfect? How do we make the best decisions for our health? Here are five starting points:
1. Why is the evidence is conflicting?
The evidence is often conflicting because the science is complicated, says Maxson.
“It’s true that the research findings regarding individual foods and nutrients are often inconclusive. But this is not because diet has no effect has cancer risk. It’s because the study of food and nutrients is very complex,” she says.
The nutrients contained in a head of broccoli, for example, will depend on the cultivar, where and how it was grown and how it’s prepared, she says. “How the nutrients in a food behave in the body depends on all the other foods it’s consumed with, the genetics of the person consuming it, and the microorganisms in the colon of the person consuming the food.”
Variables like these can explain why one study might find broccoli protective and another not, and as scientists unravel the nuances, they’re able to design better research. “We’re only beginning to understand the complexities of diet, nutrition and cancer relationships,” says Dr. Stephen Clinton, a researcher and physician who, along with a small group of scientists, is currently revising the U.S. government’s dietary guidelines.
2. Are there research-based guidelines on diet and cancer?
If you do a PubMed search, you’ll come up with more than 50,000 studies on diet and cancer. How are we to make sense of them?
The American Institute of Cancer Research and its partner, the World Cancer Research Fund (AICR/WCRF), can serve as guides. These two nonprofit organizations study the studies.
Since the 1990s, a panel of AICR/WCRF experts — researchers and physicians from around the world– have been reviewing the evidence and producing periodic reports as well as broad dietary guidelines, which are used by hundreds of cancer treatment centers, including MD Anderson. “AICR/WCRF is the world’s preeminent organization working to define evidence-based recommendations regarding how diet and nutrition impacts cancer risk and survivorship,” says Clinton.
While the recommendations are for preventing cancer because that’s where most of the research is focused, cancer survivors, they say, should also follow these guidelines once treatment is completed. The suggestions include:
- Be lean. As the columnist points out, obesity increases the risk of many common cancers; body fat produces hormones that drive cancer growth.
- Consume plant foods primarily.
- Eat a variety of them.
Despite the inherent flaws in scientific research, “the evidence that whole diets involving a wide variety of plant foods provides real protection remains as strong as ever,” said AICR’s director of research in response to the columns.
3. What about specific foods and nutrients?
As part of its review process, AICR/WCRF judges the strength of the evidence on various foods and nutrients.
AICR/WCRF reports that there’s “probable” evidence that foods containing lycopene (tomato sauce, for example) or selenium (Brazil nuts, broccoli, garlic) decrease risk of prostate cancer and that diets high in calcium increase risk.
There’s “convincing” evidence that foods with fiber decrease risk of colorectal cancer and that red and processed meat increase it, they say.
Most often, however, the organizations deem the evidence “limited” or “suggestive,” meaning that more study is needed.
“We know of many food constituents that have anti-cancer properties,” says Dr. Steven Zeisel, director of the University of North Carolina’s Nutrition Research Institute and a member of AICR/WCRF’s expert panel that reviews all the studies. Garlic, broccoli, green tea and turmeric, for example, have been shown to fight cancer through extensive good research, he says. “But we do not know precisely which mixture of these constituents works best.”
Guidelines thus focus on patterns that decrease risk, such as plant-based diets, rather than individual nutrients or foods, he says. “What you eat certainly matters.”
4. How much cancer may be preventable?
According to AICR/WRCF estimates, approximately one-third of the most common cancers in the U.S. are preventable by a healthy diet and weight along with physical activity. For some types, the estimates for preventability are particularly high: colorectal, 50%; endometrial and esophageal, almost 60% and 70%, respectively.
In the U.S. alone, that’s nearly 375,000 cases of preventable cancer each year, said AICR’s director of research in a letter to the New York Times.
You can’t just look at each food individually and calculate risk, says its director of communications. “You have to look at the total diet and how all the foods you choose to eat and avoid together impact your cancer risk. You owe it to yourself to play the odds.”
5. What might your plate look like?
Playing the odds according to AICR‘s New American Plate design is fairly straightforward:
Fill at least two-thirds of your plate with plant foods, at most one-third with animal foods. Control portion sizes. Limit red meat to no more than 18 ounces weekly. As for dairy products, however, the evidence is still uncertain.
Meanwhile, as we continue the inevitably long wait for sufficient research-based evidence to warrant public policy on cancer and diet, I’ll be sticking to healthy plant-heavy patterns, lunching on this Mediterranean salad and not worrying about an occasional dollop of tzatziki. A walloping portion? Now that’s another story.
The following recipe is courtesy of The Jittery Cook.
All times are estimates. Cooking time for the pita varies from 7 to 10 minutes.
- ½ small head romaine, torn
- 1 bunch flat leaf parsley, chopped
- 1 bunch mint, chopped
- 2 cups mâche (lamb's lettuce)
- 1 cup arugula
- 6 red radishes, cut into thin half moons
- 12 cherry tomatoes, cut into quarters
- 6 Lebanese cucumbers, cut into chunky half moons (not peeled)
- 1 red onion, cut into small strips
- 1 large whole wheat pita
- 3 teaspoons zataar
- olive oil to lightly coat pita
- 2 lemons, juice only
- ⅓ cup olive oil (or more, if lemons are large)
- 1 heaping tablespoon sumac
- 2 cloves garlic, minced
- salt to taste
- Attack alliums first! Peel onion very gently, then cut it into a few parts and let it sit for a half hour before cutting finely and adding to salad. Smash garlic, let it sit for at least 10 minutes, then mince just before adding it to dressing.
- Separate the pita through the center, into two circular halves. Coat the insides lightly with olive oil and sprinkle on zataar. Cut into long strips, then bake at 350 F for 7-10 minutes, until crisp.
- Combine salad ingredients, dressing ingredients, and toss salad with dressing. Add pita to dressed salad. Either break strips into chips and toss with dressed salad—or serve in long strips for dramatic flair.
Main photo: Garlic is one of the foods that the National Cancer Institute says can reduce the risk of several types of cancer. Credit: Harriet Sugar Miller
Fresh local berries in season are a fleeting pleasure in most regions, and until we can virtually reach through the computer screen and grab them off the bush, the choice will come down to frozen berries or imports from faraway. If they’re not kept cool enough, fresh berries shipped long distances can lose important phytonutrients. Unless you’re up for interrogating suppliers, frozen berries are likely your best option, depending on how they’re frozen and thawed.
How to select and use frozen berries
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1. Reject blobs. Have you ever noticed that some packages of frozen berries feel like one big blob while in others, the berries run freely, resembling a sackful of M&Ms? When berries are frozen en masse, they surrender some of their phytonutrients to the moisture that becomes the blob, says Lila.
What you want are IQF berries — individually quick frozen, meaning they’re laid out on a large tray, berry by berry, and then frozen, a process that retains their healthy compounds, keeps them in singular form and thus makes them easier to thaw. How you thaw is crucial.
2. Defrost only the amount you’re planning to eat, consume them the same day and don’t refreeze them, Lila says. “Minimal handling helps the berries retain their ‘ just picked’ flavor and health protective components.”
3. Thaw berries quickly. A long, slow thaw in the fridge or on the counter activates enzymes that start to degrade phytonutrients, she says.
Lila suggests popping a small amount of frozen berries into the microwave for 15 to 20 seconds max just to get the frost off. She then throws them into her hot morning oatmeal. “The microwave can be devastating if overdone,” she says, so keep the temperature moderate and cooking time short.
4. Gently warm frozen berries on the stovetop, using a double boiler or placing them directly into a pot or pan and stirring continuously so they don’t scorch. A little bit of heat actually breaks down some of the healthy components so they get into your bloodstream faster, Lila says. Again, keep the process short and avoid high heat.
5. Consume the colorful juices left behind. They contain important water-soluble phytonutrients — including anthocyanins, a type of polyphenol that gives berries their red, blue and purple to blackish hues. In nature, anthocyanins protect plants from enemies such as insects and ultraviolet radiation, Lila explained on “The Dr. Oz Show.” In your body, they go straight to your large intestine, where they work with berry fiber and good gut bacteria to fight inflammation.
Lila’s new research suggests that eating berries — any berries — before or after exercising will increase the ability of those anthocyanins to fight inflammation. Her new research also shows that berries have some healthy fat soluble compounds as well, so eat them with a few nuts.
6. How to select and use dried berries.
Dried berries range from the traditional shriveled fruits to the new berries on the block, berry powders and freeze-dried whole fruits.
The traditional dried fruits — the tiny versions dehydrated in the sun — are highly concentrated in natural sugars, and many companies add glucose or other sweeteners. Choose wisely and eat dried fruits in moderation. Wild gojis from the Gobi, for example, are a good option because they’re not sweet and are dense in phytonutrients. All wild berries, if picked when ripe, usually beat out domesticated ones when it comes to producing healthy compounds, says Lila, because wild berries have to struggle in nature on their own, without human help.
Berry powders vary in quality, says Lila, depending on how they’re made. Often they’re spray dried, a process that uses gas to break down the fruits and destroys many phytonutrients.
Whole berries, on the other hand, are freeze-dried, which simply removes the water and retains all the good properties. “It’s the best way to preserve polyphenols,” Lila says. But the sugars become very concentrated and the process is expensive, making them a risky option for anyone with a sweet tooth and an addiction gene.
That would be me. As far as I’m concerned, the best thing about picking frozen berries is that I’m forced to control an unwavering urge to nosh. Have you ever tried biting into an icy fruit?
Main photo: Mary Ann Lila, with colleague Sally Gustafson, at North Carolina State University’s Plants for Human Health Institute. Credit: Courtesy of Plants for Human Health Institute
Broccoli was in the spotlight at the American Institute for Cancer Research’s recent annual conference, where global scientists shared their findings on the connection between diet and cancer. Had the researchers been giving out awards, broccoli’s baby sprouts, not just broccoli, would have snatched gold.
How you prepare broccoli, though, is the key to its cancer-fighting ability, said Elizabeth Jeffery, co-chair of one of the conference’s sessions and a professor in the department of food science and human nutrition at the University of Illinois at Urbana-Champaign. Her latest research could dramatically change your culinary habits.
Queen of the crucifers
You know the stinky smell that fills your kitchen when you’re cooking broccoli? That’s because of healthy sulfur-filled compounds, which exist in all crucifers. An enzyme in crucifers — marked by that kick you get when you bite into a raw one — turns sulfurs into two cancer-fighting categories:
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— Indoles, which help break down hormones as well as target a group of genes that promote prostate cancer. (The latter finding was reported by Wayne State University scientist Fazlul Sarkar at the conference.)
— Isothiocyanates (pronounced eye-so-thigh-o-sigh-a-nates), which counteract carcinogens in general and speed up their removal from the body. (Of course, broccoli also has many more healthy compounds.)
Broccoli bears the crown of queen of the crucifers because compared with other crucifers, it contains more of a particularly important isothiocyanate called sulforaphane.
Because heat degrades the enzyme that produces sulforaphane, many food scientists, until now, have recommended we eat crucifers raw or very lightly cooked. In her recent broccoli research, however, Jeffery has developed a more sophisticated approach to maximizing sulforaphane. Her work shows that how you make the broccoli and what you pair it with are vital.
Tips on handling broccoli
To capitalize on sulforaphane, first cook broccoli lightly, Jeffery said. Steam it in a little liquid for 3 to 4 minutes until bright green, using a steamer so that it doesn’t touch the cooking liquid. Or blanch it for 20 to 30 seconds, no more. Those methods are surprisingly better than eating it raw, she said, because when the enzyme acts on broccoli’s sulfur-containing compounds, the compounds can swing either way — and get turned into sulforophanes, which fight cancer, or nitriles, which don’t. “Every molecule of nitriles formed is a sulforaphane not formed,” Jeffery said. And just a little heat will keep nitriles from forming.
To counteract the enzyme reduction caused by heating Jefferey has a second suggestion:
Eat steamed broccoli along with a little raw crucifer — arugula, watercress, a little wasabi or spicy mustard, or perhaps even better, raw red radish. (The stronger the kick, the more enzyme you’re getting.) Red radishes contain sulforaphane and don’t have the inherent ability to produce nitriles. You don’t need much, Jeffery said — just two to three radishes or a ½ teaspoon of mustard or wasabi. And you don’t have to eat them in the same bite as broccoli, just in the same meal.
Here’s the final and most liberating finding for those of us chained to our kitchens: As long as you eat raw crucifers in the same meal, you can go ahead and cook broccoli any way you want, Jeffery said. The enzymes in the raw crucifers will act on compounds in the cooked ones.
Why broccoli sprouts?
While President George H.W. Bush was banning broccoli on Air Force One back in 1990, Johns Hopkins researcher Paul Talalay was busy exploring the crucifer’s newborn sprouts. What, he wondered, was the ideal number of days needed to germinate seeds to get the best sulforaphane content as well as taste?
The answer: three days. He and his son went on to develop a side business selling young broccoli sprouts. (Talalay, now 91, still collaborates on research and goes to his lab almost every day.)
In contrast to mature broccoli, broccoli sprouts have, on average, 20 times the amount of compounds that develop into sulforaphane, said Yanyan Li, a professor of food science at Montclair State University who is studying sulforaphane. Since the 1990s, researchers have been identifying cancer stem cells in many types of cancer, and Li has recently found that sulforaphane targets breast cancer stem cells at relatively low concentrations.
How much is enough?
To obtain that level of sulforaphane, however, you’d need to eat several pounds of broccoli — or, Li suggested, just a heaping cup of raw sprouts, lightly steamed and consumed along with a few raw radishes. Sulforphane is eliminated from the body relatively quickly, she said, so “eating them three times a day would be ideal to maintain the level.”
For the average person, that’s not really feasible, she acknowledges, and scientists at the conference agreed that eating crucifers four to five times a week is a reasonable goal for most — as long as you chew the vegetables well. By breaking the cell walls, you’re releasing those pungent enzymes.
Jeffery’s lab is now comparing the sulforaphane content in common varieties of broccoli, but that research is not yet ready for prime time.
Broccoli Sprout Salad With Synergy
(Recipe courtesy of Holly Botner, the Jittery Cook)
For the dressing:
½ lemon, juiced
2 tablespoons olive oil
1 clove garlic, minced
½ teaspoon salt
freshly ground black pepper to taste
For the broccoli sprout salad:
2 containers broccoli sprouts
4 red radishes, ½ thinly sliced, ½ julienned
1 handful baby arugula
½ carrot, cut into slivers with a peeler
¼ yellow pepper, finely chopped
1 orange, cut into segments as garnish
1. Combine all ingredients for the dressing and mix well.
2. Steam the sprouts until bright green, then cut off their green tops to use in the salad.
3. Arrange salad ingredients on two small plates. Spoon dressing lightly over salad.
Top photo: Broccoli sprout salad. Credit: Holly Botner / jitterycook.com
Carbs will be out, fats will be in, if a ketogenic diet proves to be a tool in the battle to fight cancer.
A ketogenic diet starves cancer cells of glucose, thereby stunting the disease’s growth and compelling the body to burn fats, which trigger the production of compounds called ketones that, scientists hypothesize, cancer cells can’t use for fuel. The effectiveness of the diet, which should only be used in consultation with a doctor, is in the pilot-study phase of human research.
The diet may work for other reasons: Like a campfire burning wood, cells burning glucose for energy undergo incomplete combustion, thus creating free radicals of oxygen that can damage DNA. In addition, scientists are increasingly studying the insulin the pancreas produces in response to glucose. It appears to trigger a cascade of actions that may stimulate cancer’s growth. Close to a century ago, German scientist Otto Warburg first suggested that glucose may play a role and in 1931 won a Nobel Prize for identifying cancer as a sugar feeder.
Recently, two American scientists collected a smaller prize for their pilot study. Dr. Eugene Fine, a physician and professor at Yeshiva University’s Albert Einstein School of Medicine in the Bronx, N.Y., and his colleague, Richard Feinman, professor of cell biology at State University of New York’s Downstate Medical Center took 10 patients with advanced cancers who had failed or refused standard chemotherapy and put them on ketogenic diets for 28 days, then looked at tumors on PET scans. Patients with the least ketosis (which they defined as least insulin inhibition) showed progressive disease whereas higher levels of ketosis were accompanied by stable disease or partial remission, they reported.
“We think what’s important is that we may have opened a door, long overdue, to studying dietary change as a component of cancer therapy,” Fine said, cautioning against reading too much into a small study.
Ultimately these scientists hope to identify which cancers might best respond to carbohydrate restriction. “For sure, they all won’t,” Fine said. The common slow-growing form of prostate cancer, he said, feeds on fats as well as glucose and glutamate, a protein that’s been implicated in a few cancers. “Even within a single individual with a primary cancer and metastases, the cancer’s behavior … can vary from one cell to the next.”
Ketogenic diet research takes off
Ketogenic diets are actually ancient. That’s how cave dwellers ate, Fine explained, and today’s paleo movement and the similar Atkins approach are bringing them back.
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Johns Hopkins Medicine in Baltimore has been using forms of a ketogenic diet since the 1920s to control epileptic seizures.
But in the cancer field, clinical trials of ketogenic diets are just sprouting up. Among the scientists touting the “fat as fuel” approach is Dr. Craig Thompson, the president and CEO of Memorial Sloan-Kettering Cancer Center in New York City. Thompson founded a private company that’s helping develop drugs to lower glucose and glutamine.
In his recent book, Boston College biology professor Thomas Seyfried takes the ketogenic diet one big step further. He advocates that patients fast periodically. There’s nothing more powerful than calorie restriction in reducing a tumor’s ability to grow blood vessels and spread, he said.
The diet he proposes includes 70% of calories from fat, 12% to 15% from protein, and the rest from carbs. How low carb is that? According to Fine, you need to eat 50 grams of carbs or less a day to get your body into a state of ketosis, where it produces ketones as a result of utilizing fat as its main energy source. The typical U.S. diet provides 250 to 400 grams daily.
Do the types of fat matter? Like the answers to most questions, it depends on whom you ask. Many versions of the ketogenic diet may include bacon and butter, albeit not on toast, but why consume saturated animal fats that are known to promote inflammation and disease? Unsaturated fats, such as those found in avocado and nuts, are good for your heart and may help control insulin. Omega 3 fats, abundant in fatty fish and flaxseed, fight inflammation.
And coconut fats contain medium-chain triglycerides, a type of fat that promotes the production of ketones. How about low-calorie vegetables immersed in high-fat coconut milk? One day that might be just what the doctor orders.
Top photo: A ketogenic diet of fats such as avocados, nuts and seeds is the focus of cancer research. Credit: Harriet Sugar Miller