The Wisdom of Menopause
Page 63
On the other hand, a diet that is too high in refined carbohydrates causes higher insulin levels, which in turn raises levels of a substance known as insulin-like growth factor (IGF-1). This substance affects the growth of breast cells in utero, during puberty, and during adult life. Breast cancer is definitely associated with abnormal IGF-1 activity. High insulin levels also trigger a metabolic cascade that results in cellular inflammation, and inflammation is a precursor for cancer. (See chapter 7.) High insulin levels also suppress sex-hormone-binding globulin (SHBG), which ordinarily circulates through the body binding estrogen and lowering its activity. With less SHBG in the bloodstream, more biologically active estradiol reaches the breast tissue and stimulates its growth. Over the course of many years, this relative excess of estrogen may increase the risk of breast cancer.8 A 2005 study conducted in Italy found a direct association between breast cancer risk and consumption of sweet foods with high glycemic index and load (including biscuits, brioches, cakes, puffs, ice cream, sugar, honey, jam, marmalade, and chocolate), which increase insulin and insulin growth factors.9
I would also like to make it clear that I have a fundamental problem with any approach, dietary or otherwise, that promises to “prevent” anything. Although there is an extensive body of evidence supporting the hormone-balancing and health-enhancing effects of the nutrient-dense, insulin-balancing diet I’ve suggested, here’s the problem: even women who eat perfectly sometimes get breast cancer. If you make food choices only out of the desire to “prevent” something, then by the law of attraction, you’ll actually be carrying the energy of the disease you’re afraid of right into your body along with the healthy food!
In the study mentioned above, for example, the nurses who ate the lowest amount of fat (less than 20 percent of their daily calories) actually had the highest rate of breast cancer in the group. Though surprising at first glance, these data support a link between breast cancer and self-sacrifice, an association that has been scientifically documented. If you are afraid of breast cancer, it will not be helpful for you to become a dietary martyr, always depriving yourself of the foods you love and find nurturing. Imagine eating a small green salad, all the while craving something more substantial, and thinking, “Well, I’ll deprive myself because I’m preventing breast cancer.” Does this feel nurturing or healthy to you? It doesn’t to me. (Personally, I can’t imagine living well without some high-quality chocolate!)
Above all, I urge you to nurture yourself fully every day by eating food that is delicious as well as healthy. Eat well, because doing so is a way of reaching your full potential.10
~ EAT LOTS OF FRUITS, VEGETABLES, AND FLAXSEED, CHIA, OR HEMP SEEDS. Research has shown that women who excrete the highest amount of lignans—which are formed in the intestinal tract from plant materials—have the lowest risk for getting breast cancer.11 The food source with the highest known concentration of health-promoting lignans is flaxseed. I suggest that you consume ¼ cup of freshly ground flaxseed daily. Diets high in plant materials also tend to be higher in fiber, which has been shown to help the body excrete excess estrogen in the stool.12 Start with 1 tbsp per day and work up. (I have a small coffee grinder that I use only for flax seeds.) Chia seeds come already milled in a product called Mila that I also use. Hemp comes ground as well.
Numerous studies have also demonstrated that fruits, vegetables, and seasonings—such as broccoli, kale, collards, cabbage (the cruciferous vegetables), tomatoes, turmeric, garlic, and onions—contain antioxidants and other phytochemicals that protect against cell damage and mutation caused by free radicals. They may also block carcinogens from reaching or reacting with critical target sites throughout the body.13 Indole-3-carbinol, the active estrogen-modulatory ingredient in the cruciferous vegetables, is also available in supplement form.
~ EAT FOODS RICH IN PHYTOHORMONES. Foods such as soy, flaxseed, hemp, or chia often help women with breast tenderness and pain, and they may even offer protection for women with breast cancer, or with high risk for it, thanks to isoflavones, which protect estrogen-sensitive tissue against overstimulation by estrogen.14 It is best to get your isoflavones from whole foods, rather than from the purified extracts of soy found in isoflavone tablets or capsules.
Some women have expressed concern about the phytoestrogens (estrogens from plants) in soy and in some herbs recommended in menopause. None of the breast cancer risks associated with estrogen replacement apply to the consumption of these plant hormones. The plant hormones found in whole soy food, dong quai, Pueraria mirifica, chasteberry, and black cohosh have never been associated with the promotion of breast cancer in any study. In fact, many studies have shown that they are protective because of their adaptogenic qualities, meaning their ability to modulate the activity of estrogen in our bodies in a healthful, balanced way. The Shanghai Breast Cancer Survival Study, published in 2009, reported that the more dietary soy women eat—whether soy protein or soy isoflavones—the lower their risk of death and recurrence of breast cancer.15 (This held up whether or not the cancer was estrogen-receptor-positive or estrogen-receptor-negative and whether or not the women took tamoxifen.) A 2010 study on postmenopausal breast cancer patients receiving adjuvant endocrine therapy showed that those with estrogen-and progesterone-receptor-positive cancers who had a high dietary intake of soy had a lower risk of recurrence.16 The herb Pueraria mirifica has actually been found to stop the growth of breast cells in vitro.17
WHY SOY IS SAFE FOR BREAST TISSUE
A study in mice that showed increased mammary tumors when the mice were exposed to Prevastein, an isolated soy isoflavone, received a great deal of media attention in the fall of 2005.18 Obviously many women were concerned, particularly those who eat soy. Here’s what you need to know.
Prevastein is a chemically extracted form of purified isoflavones. Soy products made from whole soy do not contain this kind of ingredient. Purified extracts from broccoli, carrots, potatoes, Brussels sprouts, tomatoes, and so on have also been shown to be toxic, depending on how they are made.
Mouse models are considered by most experts to be irrelevant to human studies because mice metabolize soy differently from humans (just like dogs can’t eat chocolate). Mice and rats make thousands of times more soy metabolites than humans do. The strain of mice used in this study spontaneously develops breast cancer on any diet (they are bred for this very reason) and the amount of isoflavones administered (130 mg/kg of body weight) in this study would be impossible to consume for a human who is using a product made from whole soy (the average 140-pound woman would have to consume thirty Revival soy shakes every day). Mouse studies using soy germ (the whole soybean) have not shown any increase in breast cells—only the highly purified extracts do this in mice.19 Recent monkey and human studies have administered soy at 200 mg to 1,000 mg per day and have not found breast stimulation. In fact, these new studies note that soy decreases estrogen levels, improves estrogen metabolism to healthier metabolites, and decreases mammogram density.20
Researchers participating in a 2009 meeting sponsored by the Council for Responsible Nutrition concluded that the evidence strongly supported the idea that isoflavones are safe, even for women who have breast cancer or who are at high risk for developing breast cancer. In fact, isoflavone-rich soyfoods may actually improve breast cancer patients’ prognoses.21 And phytoestrogen molecules are different enough from molecules of estradiol, the most biologically active form of estrogen, that they don’t act the same way in the body.22 In fact, a year-long study from the University of Minnesota published in 1998 found that breast cancer patients who had one Revival soy shake per day actually decreased their tissue inflammation.23 These soy shakes, which are made from whole soybeans, are even being used in three new breast cancer studies at Johns Hopkins University, and samples are available in the lobby of the breast cancer center for breast cancer patients. In another three-year monkey study (using a model that is the standard for humans—not mice or rats), the monkeys were given 400 mg per day of so
y isoflavones from whole soy. At the end of three years, no breast or endometrial stimulation occurred and the hormone profile was favorably improved, reducing breast cancer risk.24
~ EAT OMEGA-3 FATS. Studies have shown that women whose diet is high in omega-3 fats have a lower risk for developing breast cancer. Research has also shown that supplementing the diet with omega-3 fats can create a healthier ratio of omega-3 to omega-6 fats in breast tissue within three months.25 I’ve had several patients who have had significant softening of firm scar tissue around their breast implants when they’ve supplemented their diets with omega-3 fats daily. A diet that contains adequate amounts of omega-3 fats also helps prevent inflammation and tumor growth throughout the body. The 2010 Vitamins and Lifestyle (VITAL) cohort study of more than 35,000 postmenopausal women showed that those who took fish oil supplements had a lower risk of ductal breast cancer.26 Omega-3s are so powerful that they are even helpful for those already diagnosed with breast cancer. A French study published in 2009 showed that breast cancer patients whose cancer had spread and who had an expected survival time of about fourteen months boosted their survival an average of eight additional months if they took daily 1.8-gram DHA supplements for two to six months. Half the women in the study were able to boost their survival time for an average of nearly three full years on this regimen.27
You can get enough omega-3 fats by eating salmon, sardines, or swordfish two or three times per week. Or you can take 100–400 mg per day of DHA or fish oil supplements (1,000–5,000 mg of omega-3s per day). Another convenient source of omega-3 fats is ground flaxseed, chia, or hemp seeds. These seeds are true perimenopausal superfoods, and I recommend ¼ cup per day to all women.
~ GET ENOUGH VITAMIN D. Clinicians are increasingly finding low serum levels of vitamin D in women with breast cancer (and other cancers as well). Those with the lowest levels (less than 25 mg/dl in blood) have the highest risk. Studies by Cedric Garland, Dr. P.H., of the University of California, San Diego, School of Medicine and other prominent vitamin D researchers show that if women in the United States could keep their blood levels of vitamin D at 40–60 ng/ml year-round, it would prevent 58,000 new cases of breast cancer (and 49,000 new cases of colorectal cancer) each year.28 Dr. Garland’s research also shows that women with vitamin D levels above 52 ng/ml can cut breast cancer risk in half.29 A 2010 study from Canada further shows that women who took vitamin D supplements reduced their risk for breast cancer.30
Women already diagnosed with breast cancer can benefit from optimal levels of vitamin D as well. Breast cancer patients with very low levels of vitamin D are more likely to have aggressive tumors and are 73 percent more likely to die, according to research presented at the 2008 annual meeting of the American Society of Clinical Oncology.31 A study published the following year showed breast cancer patients with low levels of vitamin D were almost twice as likely to have their cancer spread and were also 1.7 times as likely to die.32
We’ve been brainwashed into avoiding the sun, and women don’t get nearly enough vitamin D in food or supplements. There are vitamin D receptors on all the immune system cells and optimal amounts of this hormone/vitamin are essential for proper immunity. In addition to moderate sunlight exposure (about ten minutes or so per day), I recommend taking at least 2,000–5,000 IU of vitamin D 3 per day. This will also help to increase bone density. (See chapter 12.)
~ INCREASE YOUR IODINE INTAKE. Iodine is vital for breast health because it reduces breast pain when taken in adequate amounts—and at high enough levels, it may even prevent breast cancer. But most American women consume only a fraction of what they really need of this nutrient. The RDA for iodine in adult women is 150 mcg, but current research shows that for optimal health of the breasts, ovaries, and uterus, women need significantly higher amounts. I recommend a dose of 3 to 12.5 mg daily—some women require even more.
In one U.S. study of women with breast pain, more than half those who took 6 mg of iodine daily reported a significant reduction in their symptoms, with relief starting after three months of treatment.33 In a Canadian study, 72 percent of women with fibrocystic breast disease (FBD) who took iodine therapy reported improvement.34 (Although the vast majority of breast lumps are indeed benign, studies have shown that 30 percent of the 25 million women in the United States who suffer from FBD have a two to tenfold greater risk for developing breast cancer, so this is clearly not a condition to ignore.35)
Compelling evidence also exists for a strong relationship between iodine levels and breast cancer. A 2005 study done in Mexico showed that rats taking iodine treatments exhibited a “strong and persistent reduction” in incidence of breast cancer, possibly because of iodine’s antioxidant nature.36 Even more impressive is a 2006 study from India reporting that molecular iodine causes programmed cell death in human breast cancer cell cultures.37
Not surprisingly, in populations with low iodine intake, breast cancer rates are higher, and in cultures where iodine intake is higher, breast cancer rates are lower.38 For example, the lowest rate of breast cancer in the world is in Japan, where the average iodine intake is about 45 mg per day. By comparison, the average intake in the United States is more than 180 times lower—only 240 mcg—and is continuing to decline.
Iodine works in part because it decreases the ability of estrogen to adhere to estrogen receptors in the breast.39 The ductal cells (the breast cells most likely to become cancerous) actually have an iodine pump in them, which shows that they have the ability to actively absorb iodine. Iodine can also stop excess cell growth in the ovaries and uterus.
Iodine provides antiseptic mucosal defense in the mouth, stomach, and vagina, which boosts the immune system. This nutrient is easily one of the most powerful antiviral and antibacterial substances we know of, although unfortunately, most doctors think of iodine only in terms of thyroid health and remain vastly unaware of its many additional advantages. (For further information on iodine, read “Iodine for Health” by Donald Miller, Jr., M.D., available online at www.lewrockwell.com/miller/miller20.html.)
Several options exist for boosting iodine levels. You can eat sea vegetables or take supplements such as kelp, Iodoral, or Iogen (which delivers molecular iodine, a particularly potent form of the nutrient; see www.buyiogen.com). Another option is Nascent iodine drops (see www.thyroidnascentiodine.com), based on the work of the psychic Edgar Cayce, who channeled a way to make the iodine work better. The drops make it very easy to titrate your dose so you can take exactly the right amount for you.
You can also boost your iodine levels by applying a tincture of iodine to your skin. To do this, paint a quarter-size dot of iodine directly on your skin (you can opt to apply it to a painful spot on your breast or on the nipple, for more direct relief) once a night for two weeks. (If you get a reaction from iodine—usually seen as a skin rash or a bad taste in your mouth—just decrease your dose and proceed more slowly. This reaction, known as iodism, happens when iodine compounds release excess bromide, fluoride, and other toxins from the system, so it’s really more of a detox reaction than an iodine reaction per se.)
Be aware that if you are taking thyroid medication, increasing your iodine intake may decrease or even eliminate your need for thyroid drugs. Too much thyroid hormone can cause heart palpitations, so be sure to discuss your iodine supplementation with your health care provider, and even then, increase your iodine levels very, very slowly. (For a practical approach to using iodine on thyroid medication, see the Women’s Health Institute of Texas website at www.1-thyroid.com.)
~ TAKE COENZYME Q10. Coenzyme Q10 (also known as ubiquinone) is present naturally in the body and in organ meats. It has been shown to improve immune system functioning. Hundreds of studies have also demonstrated its ability to help those with congestive heart disease. Several studies have demonstrated that women with breast cancer have deficiencies in coenzyme Q10. Taking coenzyme Q10 in relatively high doses, 90–350 mg per day, has been associated with partial or complete remission of breast cancer.40
In chapter 7 I recommended that all perimenopausal women take 10–100 mg per day. If you are at high risk for breast cancer, I’d increase the dose to 70–100 mg per day. Since statin drugs (prescribed to lower cholesterol) decrease levels of coenzyme Q10, all women on these drugs should take this supplement.
~ TAKE IMMUNE-BOOSTING ACTIVATED HEXOSE CORRELATED COMPOUND (AHCC). This supplement, made from a natural extract of mushrooms (including shiitake), is known as a great immune system booster and is given as a standard preventive regimen to reduce infections in more than 700 Japanese clinics. One Japanese study showed AHCC works like an antioxidant and improves the immune system response of mice whose immune systems have been weakened from chemotherapy.41 Still other animal studies in both the United States and Japan show that AHCC may also enhance resistance against bacterial and viral infections.42
AHCC is also Japan’s leading alternative cancer therapy and is used in hundreds of cancer clinics all over Asia. In one study from the Kansai Medical University in Osaka that followed 269 liver cancer patients for ten years, about 80 percent of those who received AHCC after their surgery were still alive at the end of the study, compared to about 53 percent of the control group. Also, only 34.5 percent of the AHCC group suffered a recurrence of cancer, compared to 66.1 percent of those who didn’t take the supplement.43 The same researchers next performed a three-year study of 127 patients with advanced gastric and breast cancer who were taking AHCC; they showed a 40 percent increase in survival rates compared to the Japanese national average for patients of similar age with these same types of cancers. The supplement is currently being used in cancer patients at M.D. Anderson Cancer Center in Houston and Columbia University Medical Center in New York City. Clinical trials are also under way in many locations throughout the world.