Antioxidants, Epigenetics and How to Decrease the Risk of Cancer


Photograph of Peapod Courtesy of Catherine Merulpie

How Antioxidant Foods Affect your Epigenetics

You are your genes. Better stated, you are your epigenetics. If you have DNA that may increase the risk of certain cancers, can you change your own risk? Epigenetics refers to the cellular environment of our genes—how the expression of the genes are affected without changing the underlying DNA sequences.

How do broccoli and other cruciferous vegetable such as Brussels sprouts or cauliflower decrease the risk of cancer? Certain nutrients, such as sulforaphanes in broccoli and diallyl in garlic affect epigenetics by activating genes involved in the development of cancer (tumor promoters, tumor suppressor genes, DNA repair genes). Selenium, vitamin A, folate and vitamin D are also believed to impact on the development of cancer by affecting epigenetics.

Could it really be that easy? Just eat a lot of broccoli? More coldwater fish? Grape Juice? Dark chocolate? Green tea? Vitamin D supplements?

Actually, at least four factors—Timing, Quantity, Combination and Organ Exposure—play a role in how phytonutrients (beneficial food substances) affect the development of certain cancers.

Timing

The actual timing of a body organ’s exposure to a cancer fighting substance makes a difference. For example, taking folic acid when there are underlying pre-cancerous colon cancer cells in the body actually increases the risk of developing colon cancer.

Regular soy intake (preferably whole soy products such as miso) by adolescent and young women decreases their risk of breast cancer by about 15 %. Isoflavones in soy attach to the estrogen receptor and block the body’s intrinsic estrogen from attaching to estrogen receptors. By blocking estrogen from attaching to receptors, isoflavones may prevent development of breast cancer.

However, in women who already have estrogen positive breast cancer or who are on tomoxifen, soy intake is generally not recommended. In these women with current or previous history of breast cancer, isoflavones are believed to attach to estrogen receptors and mimics the effect of estrogen to promote the development of breast cancer. (But even that conventional wisdom is evolving! Stay tuned for several recent studies in breast cancer survivors that suggest that soy intake is safe, even in women who are taking anti-estrogen/progesterone receptor therapy.)
In general, whole soy foods rather than soy supplements or powders are recommended. This is an active area of breast cancer research, so hopefully the true effects of soy in women at risk for breast cancer or who have had breast cancer can be more clearly understood.

Quantity of Antioxidants Ingested

The total amount of a potential cancer preventing nutrient that is ingested is also important. In general, increasing vitamin D intake decreases the risk of certain cancers, especially breast and prostate cancer. But more is not always better! Patients who have very high blood levels of vitamin D actually increase their risk of prostate cancer. Very high intake of the combination of selenium, beta carotene and vitamin E has been shown to increase the risk of death in patients with esophageal cancer. So be cautious in your intake of supplements –more is not always better, and it is possible to have toxicity from high levels of supplements.

Combination

Combining an antioxidant with other substances makes a difference. The prime example is the use of beta carotene supplements in smokers, which actually increases the risk of lung cancer more than in smokers who did not take beta carotene. Of course we all know that quitting tobacco makes the biggest difference in decreasing lung cancer risk.
Combining fruits and vegetables with unhealthy fats (such as trans fats) rather than olive and canola oils eliminate many of their beneficial antioxidant effects.

The Organ Exposed

Finally, the organ that is exposed to the antioxidants in foods is affected in different ways. For example, the calcium in milk is believed to decrease the risk of colon cancer but may increase the risk of prostate cancer. The effects of calcium in milk cannot be explained just by the fat content of milk because in general, high fat intake increases the risk of both colon and prostate cancer.

In summary, antioxidants in food can decrease the risk of cancer by affecting the epigenetics of DNA susceptible to promoting cancer, but attention must be paid to other factors that can affect these phytonutrients.

This post is not meant to diagnose, treat or recommend any course of therapy. It provides general information on cancer genetics and nutrition. Check with your physician how these factors may impact on your health.

Last updated by Dr. Vee on August 6, 2011

Dr. Vee’s Radio Show Interview About Feeling Good During Menopause: Conversation with Dr. Nancy on Womenspeak.Com


Photograph of Couple Walking on Australian Beach Courtesy of Susinder

Photograph of Woman Courtesy of Ioana Grecu

Timeless Women Speak: Feeling Youthful At Any Age

Dr. Vee speaks with psychologist Dr. Nancy D. O’ Reilly about menopausal symptoms, healthy diet and exercise. Staying healthy mind and body are equally important!

Last updated by Dr. Vee on June 16, 2010

Non-Hormonal Treatment of Menopausal Symptoms and Four Leaf Clovers


Photograph of Woman doing Yoga Courtesy of Invictus999
Healthy Menopausal Woman Photograph Courtesy of Kathy Wynn
Photograph of Rabbit in Clover Patch Courtesy of Jack Dagley

Menopausal symptoms, primarily hot flashes, can be treated with vitamins, specific foods (soy), non-estrogenic herbs (which stimulate the body’s own estrogen levels) and phytoestrogenic herbs (natural non-hormonal agents that have estrogen like effects in the body).

Phytoestrogenic agents should not be used in women with breast cancer or other hormonally related cancers or women with blood clots. Women at high risk of getting hormone related cancers or blood clots should also not use phytoestrogens.

Food that may Relieve Menopausal Symptoms

Soy foods have isoflavins, compounds which binds to the estrogen receptor and relieve hot flashes and other menopausal symptoms. Tofu, soy milk, tempeh and soy nuts are good sources of soy.

Oh Not Again, Exercise Helps Menopause??

Regular exercise is a must for women experiencing fatigue, weight gain and hot flashes related to menopause. 30 minutes of walking five days a week is recommended.

Vitamins Useful to Menopausal Women

400 IU vitamin E may help hot flashes and night sweats. Vitamin C helps the absorption of vitamin E. B vitamins may help menopausal symptoms. Calcium, magnesium and Vitamin D are essential to prevent thinning of bones in menopausal women. Probiotics (good bacteria) such as Lactobacillus acidophilus and Bifidobacter species help with metabolism and utilization of estrogen and may help reduce vaginal yeast infections.

Ligans in flaxseed oil can stabilize hormone levels in menopausal women. Evening primrose oil or black currant oil are sources of gamma-linolenic acid (GLA), an essential fatty acid that treats menopausal symptoms.

Non-Estrogen formulations

Black cohosh (Cumicifuga racemosa) does not have estrogenic activity. Women who have gone through natural menopause rather than surgical menopause (hysterectomy) seem to respond better to this agent. Black cohosh molecules bind to receptors in the human body which regulate body temperature and hot flashes.

Black Cohosh also helps mood swings and sleep disturbances common in menopausal women. It is commonly taken in tablet form and is known to have the equivalent to 20 mg of root per tablet. Recent trials found that around 40 milligrams per day of such tablets lessened menopause symptoms in 70% of the women tested.

Black Cohosh may reduce weight gained as a result of hormone imbalance. During menopause, as estrogen levels drop, the body looks for other stores of estrogen. Fat cells contain large amounts of this hormone. The body begins to produce more fat cells as a way to boost estrogen levels. Black cohosh balances estrogen levels. It may, in turn, stop the production of fat cells.

Macafem root is a non-estrogenic herb grown in the Andean plateaus of Peru. It increases level of natural hormones in the body. Macafem can help hot flashes, night sweats, mood swings, loss of libido and irregular periods.

Keishi-bukuryo-gan, a traditional formula made up of four herbs and a mushroom, is widely used in Japan for treatment of peri-menopausal hot flashes. A variant of it in the United States can be bought over the counter as H25. However, Keishi-bukuryo-gan has not been tested in women with hot flashes related to tamoxifen and other anti-estrogen medications. It is especially effective in women who always feel cold.

Phytoestrogens

Ginkgo biloba boosts blood flow to the brain and improves concentration and cognitive function, which is important for menopausal women who often suffer from memory lapses. Ginkgo contains phytoestrogens (vegetable sources with a similar chemical structure to estrogen) which relace human hormones with plant substitutes. Because ginko is a phytoestrogen, it may increase the risk of breast cancer.

Dong quai helps painful menstrual periods and normalize irregular periods. It can increase risk of bleeding, so it should be used cautiously in women with heavy bleeding or on blood thinners. Dong quai is a phytoestrogen which may increase the risk of breast cancer

There are three common varieties of ginsing available: Native American, Korean and Chinese. They are phytoestrogens which have estrogen like effect in vagina and so they can help relieve vaginal dryness common in menopausal women. Korean ginseng is especially popular among athletes for improving performance and stamina. Ginseng is used to treat decreased libido common in menopausal women.

Red Clover (Trifolium Pratensei) is a phytoestrogen which contains the chemical compound called coumarins, which can thin blood. Use cautiously in women on blood thinners. Red Clover is used in China and Russia to treat upper respiratory illnesses. Ancient Romans and Greeks wore clover on their chest for good luck and as a way to ward off evil. Four leaf clovers felt to be especially lucky.

Last Updated by Dr. Vee on February 18, 2011

Oh, My Aching Back! (Dr. Vee Contributed to AOL Health Article)


Photograph of Golfer by Elena Weber

Photograph of Woman Exercising on the Beach by Dusan Zidar

10 Questions About Lower Back Pain

By Deborah Huso (AOL Health Writer)

According to the American Academy of Physical Medicine and Rehabilitation, 80 percent of Americans will suffer from back pain at some point in their lives, and for most of us, that means lower back pain. While a fair number of people suffering from chronic lower back pain often end up taking the surgical route, more than half of those surgeries result in no change in pain and sometimes even increase pain.

The reason, according to Mitchell Yass, physical trainer and owner of PT2 Physical Therapy & Personal Training in Farmingdale, N.Y., is that most back pain is the result of muscle weakness or imbalance.

So if you’re suffering from persistent lower back pain and seek a doctor’s advice, here are 10 questions you should ask to help get yourself on the mend, hopefully without surgical intervention:

1. What is causing my lower back pain? It’s best to rule out simple causes first. Those might include muscle weakness or spasms, spinal stenosis or disc pain, all of which can be successfully treated without surgery. Ask your doctor to give you a full physical examination.

2. What are the signs my back pain is dangerous? If you’re experiencing loss of bladder or bowel control or numbness around the anus, you may have a more serious problem, and an MRI may be necessary to diagnose the cause.

3. Could stress be causing my lower back pain? New studies have shown that lower back pain is often linked to stress. This manifestation of stress as physical pain in the body is called tension myoneural syndrome.

Craig Antell, osteopathic physician and founder of New York Rehabilitation & Wellness, says he always recommends that patients with chronic back pain who have an obvious stress factor in their lives read “Healing Back Pain” by John E. Sarno, M.D., which helps patients discover and address the link between chronic pain and mental stress.

By addressing stress, one can often relieve the muscle tension in the back that causes pain.

4. Should I use heat or ice to treat back pain? Ice will help relieve pain in the case of muscle spasm or inflammation. With chronic back pain, heat can help. Neither will treat the pain, however, but they will relieve symptoms and make you more comfortable while you recover.

5. Should I be on bed rest? Vandana Bhide, M.D., who practices internal medicine in St. Augustine, Fla., says bed rest is the worst possible prescription and can actually slow recovery.

6. Should I perform exercises to relieve and address lower back pain? Bhide recommends stretching every day before getting out of bed. While your doctor or physical therapist can recommend exercises for your specific condition, one simple thing you can do before rising in the morning is to lie on your back and pull one leg to your chest and then the other, doing each side 10 times. Then perform the same movement with both legs. Once you get out of bed, perform a cat stretch (curling and flattening your back while on all fours) 10 times.

7. Is physical therapy helpful? Physical therapy is generally the primary and most effective treatment for lower back pain, as it involves hands-on manual exercise in which a therapist will teach you exercises to address your specific pain issue. To be effective, however, you must practice the back exercise regimen at home whenever you experience back pain or to prevent it from recurring.

8. Is any over-the-counter pain medication helpful or necessary? Avoid pain medications if at all possible because they do nothing to address healing. If you need temporary relief, try ibuprofen or naproxen. Your doctor may also prescribe a muscle relaxant or steroids.

9. Should I get an X-ray or MRI? An X-ray or MRI is only necessary if your doctor has ruled out muscle weakness or spasms, bulging disc, or spinal stenosis after a complete physical examination. An MRI is essential if you’ve experienced trauma, have night pain, and or loss of bowel or bladder function, any of which can point to a severe neurological disorder or even cancer.

10. At what point may surgery be necessary, and will it help? Surgery may be necessary if you are experiencing the above symptoms, and it will help in those cases. The reason so many people who have back surgery experience no relief of symptoms is because they have been misdiagnosed. “Always make sure your physician knows the objective cause of the back pain,” says Antell. “Just treating the pain won’t fix back pain for the long-term.”

Last Updated on May 9, 2010 by Dr. Vee

Top 12 Must-Have Items for a Senior’s Medicine Cabinet


1.  Advanced Directives–Also known as a Living Will.  Includes your determination of your Healthcare Surrogate, or who you want to make medical decisions for you. 

If you have a “DNR” form that specifies that you do not want paramedics to resuscitate you in the event your heart stops beating or lungs stop breathing, this should be prominently placed near the entrance of your home or attached to your refrigerator.

2.  List of your medications, including specific doses.  Include medication allergies, including any allergy to latex.

According to a survey by AARP and the National Institutes of Health (NIH), two-thirds of people aged 50 and older use some form of complementary and alternative medicine (CAM). Less than one-third of those who use CAM talk with their doctors about it. Remember that supplements are not evaluated by the Food and Drug Administration.

The term Medicine Cabinet is used in the title of this article to emphasize the fact that supplements should be treated like other medicines. Share with your doctor any supplements you may be taking to find out any side effects or interactions with other medicines you may be taking.

3.  First Aid Kit with topical antibiotic, alcohol pads, gauze pads, paper tape, Ace wrap and bandages.

4.   I call Vitamin D the Superstar Supplement–studies suggest it may reduce the risk of high blood pressure, diabetes and certain cancers.   Vitamin D helps the absorption of calcium in the stomach.  Many more people are vitamin D deficient than previously known.  Vitamin D is important for healthy bones.  It helps the absorption of calcium in the stomach.

5.  Calcium is important to prevent osteoporosis or thinning of the bones.  Calcium supplements typically contain vitamin D as well. 

6.   Continuing this discussion about healthy bones, the combination of glucosamine and chondroitin were shown to improve the pain of moderate to severe arthritis, but was no better than placebo in mild arthritis in the GAIT study  funded by the National Center for Complementary and Alternative Medicine.

7.  Healthy joints may also benefit with omega-3 fatty acids, more commonly known as “fish oil.”  Studies show that omega-3 fatty acids may help patients with an inflammatory arthritis called rheumatoid arthritis. 

Omega 3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have also been found to improve memory. 

Fish oil is best known for helping increase the good cholesterol in the body and lowering  bad cholesterol and triglycerides (fats).  The best way to get omega 3 fatty acids is to eat fatty fish such as  salmon, sardines, tuna or mackerel twice a week. 

A landmark study conducted in Italy showed that omega 3 fatty acid supplementation after a heart attack helped reduce the risk of recurrent heart attacks.    The American Heart Association recommends 500 mg of omega 3 fatty acids daily for healthy people and 1 gm of omega 3 fatty acids for people who have known coronary artery disease. Check with your doctor before taking omega 3 fatty acids because they may increase the risk of bleeding.

8.   Cholesterol levels can also be improved by eating fiber in the diet.  The best sources of fiber are whole grains such as barley, oat bran or quinoa.   Fiber also helps prevent diverticulosis (small pouches inside the large intestine).   The more fat in the diet, the more diverticula that form.  They can become inflamed and infected and may even require surgical removal of part of the colon.    Some patients with irritable bowel syndrome or constipation benefit with fiber supplements in their diet. It is very important to drink lots of water when taking fiber supplements–approximately 64 ounces a day. 

9.    Probiotics are supplements that also help maintain good colon health.  Probiotics are microorganisms which replenish the good bacteria that normally live in our colon or large intestine.  Probiotics are especially helpful when you have a stomach virus or have to take antibiotics.

10.  A study carried out by Harvard Medical School researchers showed that regular use of aspirin after developing colorectal cancer decreased the risk of death from colon cancer.  The most common use for aspirin, though, is to prevent heart attack and stroke.  The U. S. Preventive Services Task Force (USPSTF) encourages men aged 45-79 to consider taking low dose aspirin to prevent heart attack. Women ages 55-79 should consider aspirin therapy to prevent stroke.

Like other blood thinners, aspirin should not be used by patients who have had bleeding ulcers, patients over the age of 80 (except under a doctor’s supervision), patients with bleeding strokes or people at high risk for falls.  Always consult your doctor before starting aspirin.

11.  Lutein is an antioxidant supplement which has been shown to  help slow down or prevent vision loss in patients with age related macular degeneration.   The macula is the part of the back of the eye called the retina which is involved in central vision.  

Age related macular degeneration leads to loss of central vision, sparing the peripheral vision. The macula is the part of the retina that is also most sensitive to blue light the part of the visible light spectrum that, along with ultraviolet light, can damage your eyes.  Sunglasses also prevent  penetration of blue and ultraviolet light to the macula.

12.  Sunblock SPF at least 15 should be used daily to exposed skin.  Broad spectrum sunblock prevents ultraviolet A and ultraviolet B rays.  UVA rays cause premature aging of the skin.  UVB rays can cause sunburns.  

Exposure to both types of ultraviolet rays can lead to the development of skin cancer, including melanoma, a very serious type of skin cancer.   Look for agents that contain titanium and zinc oxide. Most people do not use as much sunblock as needed to protect the skin.   One ounce, enough to fill a shot glass, is  needed to protect each of the exposed parts of the body. 

Sunblock should be rubbed into the skin, especially on the face, ears, arms and hands, 15-30 minutes before sun exposure.  It must be re-applied frequently, every two hours, even the water-resistant kind.   

The American Academy of Dermatology recommends daily use of sunblock to exposed areas of the body, not just on days you are out in the sun.   On cloudy days, up to 80% of the sun’s rays are still present to cause sun damage. This article is for informational purposes only and should not substitute for medical advice from your healthcare provider.

The author is not providing personal medical opinion, diagnosis or course of treatment. Do not delay or substitute this information for medical treatment.

Last updated May 1, 2010 by Dr. Vee