Dr. Fuhrman's nutrient-packed "Skinny Shake" as seen on The Dr. Oz Show

In preparation for my recent appearance on The Dr. Oz Show (you can watch online here), I was asked to share a recipe for a healthful drink that would support weight loss efforts and promote detoxification – something satisfying and delicious while low in calories; most important to me was that this drink would be packed with disease-fighting nutrients.

I chose a simple blended frozen drink of whole strawberries and pomegranate juice with ice plus a squeeze of lemon for a tangy flavor. Why strawberries and pomegranate juice? I did not make those choices arbitrarily – these are powerful foods with several human studies to substantiate their profound benefits.

Strawberry. Flickr: Bahadorjin

Antioxidant phytochemicals:

  • Anthocyanins (the most abundant antioxidants in berries) provide antioxidant protection on their own, plus they increase the production of cells’ own antioxidant enzymes.1 A 1.5 cup serving of strawberries increased antioxidant capacity in the blood of human subjects, building protection against oxidative damage.2
  • Pomegranate contains a unique antioxidant called punicalagin; it is the most abundant antioxidant in pomegranate, responsible for more than half of the antioxidant activity of pomegranate juice.3 Pomegranate juice has been found to reduce oxidative stress markers in healthy humans.4

Detoxification:

  • Ellagic acid, an antioxidant derived from berries and pomegranate interacts with a protein called Nrf-2 to increase expression of the body’s natural detoxification enzymes.5

Anti-cancer effects:

  • Strawberry and pomegranate extracts slowed cell growth and induced cell death in human cancer cells from several cancer types.6-9
  • Pomegranate and strawberries are both anti-angiogenic – strawberry extracts help to prevent growing tumors from acquiring a blood supply – preventing those tumors from receiving the nutrients that would allow them to grow larger.10-13
  • Pomegranate is one of the few foods (mushrooms are another) that contain natural aromatase inhibitors – this means that they inhibit the production of estrogen, which can reduce breast cancer risk.14
  • Strawberries and pomegranate have anti-inflammatory effects that may protect against cancer and other chronic diseases.5,15,16
  • Patients with precancerous esophageal lesions ate strawberries each day for six months.  The results were amazing – 29 out of the 36 patients in the study experienced a decrease in the histological grade of their lesion – this means that the progression toward cancer began to reverse, and the risk of the lesions becoming cancerous had decreased.17 

 Pomegranate. Flickr: veganheathen

Cardioprotective effects:

  • Higher strawberry intake is associated with reduced risk of death from cardiovascular disease.18
  • Human trials have found that daily consumption of strawberries decreases total and LDL cholesterol, and pomegranate phytochemicals reduce LDL oxidation (a contributor to atherosclerotic plaque development).19-22
  • Strawberry and pomegranate phytochemicals have blood pressure-reducing properties.23-25
  • In a study of patients with severe carotid artery blockages, after one ounce of pomegranate juice daily for one year, there was a 30 percent reduction in atherosclerotic plaque. In striking contrast, in the participants who did not take the pomegranate juice atherosclerotic plaque increased by 9 percent.22

Anti-diabetes effects:

  • Strawberry and pomegranate phytochemicals have actions on certain digestive enzymes that can result in reduced glucose levels following a meal.26
  • Ellagic acid, which can be derived from berries or pomegranate, reduced secretion by fat cells of an inflammatory molecule that is thought to contribute to insulin resistance.27
  • Adding strawberries to a meal was shown to reduce the insulin response in overweight adults.15

Looking at these effects all together, it is astounding what these foods can do for our health. The “Skinny Shake” has much more to offer than taste and satisfaction with minimal calories. Berries (and pomegranate) make up the second ‘B’ in G-BOMBS, my list of super foods with good reason!

Dr. Fuhrman’s Skinny Shake

Ingredients:

4 ounces pomegranate juice

1 cup frozen strawberries

1 cup of ice

Squeeze of lemon

Directions: Blend all ingredients in a high-powered blender.

 

References:

1. Shih PH, Yeh CT, Yen GC. Anthocyanins induce the activation of phase II enzymes through the antioxidant response element pathway against oxidative stress-induced apoptosis. Journal of Agricultural and Food Chemis ry 2007;55:9427-9435.
2. Cao G, Russell RM, Lischner N, et al. Serum antioxidant capacity is increased by consumption of strawberries, spinach, red wine or vitamin C in elderly women. J Nutr 1998;128:2383-2390.
3. Heber D: Pomegranate Ellagitannins. In Herbal Medicine: Biomolecular and Clinical Aspects 2nd Edition. Edited by Benzie IFF, Wachtel-Galor, S.: CRC Press; 2011
4. Aviram M, Dornfeld L, Rosenblat M, et al. Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am J Clin Nutr 2000;71:1062-1076.
5. Panchal SK, Ward L, Brown L. Ellagic acid attenuates high-carbohydrate, high-fat diet-induced metabolic syndrome in rats. Eur J Nutr 2012.
6. Stoner GD, Wang LS, Casto BC. Laboratory and clinical studies of cancer chemoprevention by antioxidants in berries. Carcinogenesis 2008;29:1665-1674.
7. Kim ND, Mehta R, Yu W, et al. Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer. Breast Cancer Res Treat 2002;71:203-217.
8. Kohno H, Suzuki R, Yasui Y, et al. Pomegranate seed oil rich in conjugated linolenic acid suppresses chemically induced colon carcinogenesis in rats. Cancer Sci 2004;95:481-486.
9. Kawaii S, Lansky EP. Differentiation-promoting activity of pomegranate (Punica granatum) fruit extracts in HL-60 human promyelocytic leukemia cells. J Med Food 2004;7:13-18.
10. Roy S, Khanna S, Alessio HM, et al. Anti-angiogenic property of edible berries. Free Radic Res 2002;36:1023-1031.
11. Khan N, Afaq F, Kweon MH, et al. Oral consumption of pomegranate fruit extract inhibits growth and progression of primary lung tumors in mice. Cancer Res 2007;67:3475-3482.
12. Toi M, Bando H, Ramachandran C, et al. Preliminary studies on the anti-angiogenic potential of pomegranate fractions in vitro and in vivo. Angiogenesis 2003;6:121-128.
13. Sartippour MR, Seeram NP, Rao JY, et al. Ellagitannin-rich pomegranate extract inhibits angiogenesis in prostate cancer in vitro and in vivo. Int J Oncol 2008;32:475-480.
14. Adams LS, Zhang Y, Seeram NP, et al. Pomegranate ellagitannin-derived compounds exhibit antiproliferative and antiaromatase activity in breast cancer cells in vitro. Cancer Prev Res (Phila) 2010;3:108-113.
15. Edirisinghe I, Banaszewski K, Cappozzo J, et al. Strawberry anthocyanin and its association with postprandial inflammation and insulin. Br J Nutr 2011;106:913-922.
16. Adams LS, Seeram NP, Aggarwal BB, et al. Pomegranate juice, total pomegranate ellagitannins, and punicalagin suppress inflammatory cell signaling in colon cancer cells. Journal of Agricultural and Food Chemis ry 2006;54:980-985.
17. American Association for Cancer Research. Strawberries May Slow Precancerous Growth in Esophagus. 2011. http://aacrnews.wordpress.com/2011/04/06/strawberries-may-slow-precancerous-growth-in-esophagus/. Accessed
18. Mink PJ, Scrafford CG, Barraj LM, et al. Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women. Am J Clin Nutr 2007;85:895-909.
19. Basu A, Lyons TJ. Strawberries, Blueberries, and Cranberries in the Metabolic Syndrome: Clinical Perspectives. Journal of Agricultural and Food Chemis ry 2011.
20. Zunino SJ, Parelman MA, Freytag TL, et al. Effects of dietary strawberry powder on blood lipids and inflammatory markers in obese human subjects. Br J Nutr 2011:1-10.
21. Basu A, Wilkinson M, Penugonda K, et al. Freeze-dried strawberry powder improves lipid profile and lipid peroxidation in women with metabolic syndrome: baseline and post intervention effects. Nutr J 2009;8:43.
22. Aviram M, Rosenblat M, Gaitini D, et al. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr 2004;23:423-433.
23. Cassidy A, O'Reilly EJ, Kay C, et al. Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr 2011;93:338-347.
24. Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis 2001;158:195-198.
25. Aviram M, Volkova N, Coleman R, et al. Pomegranate phenolics from the peels, arils, and flowers are antiatherogenic: studies in vivo in atherosclerotic apolipoprotein e-deficient (E 0) mice and in vitro in cultured macrophages and lipoproteins. Journal of Agricultural and Food Chemis ry 2008;56:1148-1157.
26. McDougall GJ, Stewart D. The inhibitory effects of berry polyphenols on digestive enzymes. Biofactors 2005;23:189-195.
27. Makino-Wakagi Y, Yoshimura Y, Uzawa Y, et al. Ellagic acid in pomegranate suppresses resistin secretion by a novel regulatory mechanism involving the degradation of intracellular resistin protein in adipocytes. Biochem Biophys Res Commun 2012;417:880-885.

It's time for our country to accept that poor diets are just as bad as smoking

If you are reading this blog, you probably already recognize what I am about to report and have read about why it is so important that we make wise eating choices.  However, most Americans are not like the average DiseaseProof reader and I’m willing to bet many people believe still believe that whether or not we get cancer depends on the genes we are dealt or even luck.  Most will agree that smoking is a cause of cancer, but what about what we eat? Will most people agree that our food choice make a difference in whether or not we get cancer down the road? Well, interestingly nutritional research scientists are now coming to the same conclusion as my father, indicating that, yes, our diets can be just as disease-promoting as smoking cigarettes. 

Cigarette. Flickr: ConanilThese findings were published by the World Cancer Research Fund in an article entitled, “Food, Nutrition and the Prevention of Cancer: A Global Perspective.” The report was the most comprehensive and systematic of its kind and involved 286 specialists who went through 500,000 scientific articles concerning 17 different types of cancer. The uncontestable findings were that 40 percent of all forms of cancer can be prevented by eating a well balanced diet, maintaining a normal body weight and participating in a moderate amount of physical activity. Head researcher, Jan Erik Paulsen, noted that the evidence shows that a bad diet is more likely to be a cause of cancer than smoking tobacco. 

The specialists on Paulsen’s team found that low carbohydrate diets that recommend red meat such as beef, pork, lamb and game, were particularly disease-promoting.  People who consume large quantities of red meat in order to keep their weight in check can end up getting cancer instead. 

What properties of red meat make it so dangerous? The researchers believe it is the combination of nitrates, heme iron and other substances found in red meats.  Nitrate reacts with heme iron to form a compound called nitrosyl hemoglobin, which can trigger certain types of cancer.  

Paulsen declared, “My theory is that heme iron is so stable that it survives the digestion of meat in the small intestine and goes on undamaged to reach the colon. Here it reacts with the metabolites (intermediate and end-products of metabolism), which are produced by the bacterial flora and forms nitrosamines, which are known to cause cancer.”

However, it is not just red meat that we should be wary of.  Unprocessed meats can be just as dangerous because they can use nitrite already in the stomach (produced from other foods) and form nitrosyl hemoglobin. Combine our diets of processed foods with animal products and limited quantities of vegetables and we’ve created the perfect cancer forming stew. 

Of course my father, Dr. Fuhrman disagrees, because he does not recommend a “balanced diet” to reduce cancer rates by 40 percent.  He recommends a nutritarian diet specifically designed with a portfolio of the world’s most powerful anti-cancer foods.  Dr. Fuhrman suggests that superior nutrition can decrease cancer death rates by 90 percent, not merely 40 percent.   This is because the dietary intervention he suggests is more rigorous and effective at preventing cancer and it is supported by tremendous evidence and clinical experience.  There are multiple studies on optimal consumption of super foods and cancer (his G-BOMBS list), and the statistics on very low rates of cancer in parts of the world that ate better more than 50 years ago before fast food and processed food became ubiquitous.  These populations had less than 10 percent of the cancer we see today. 

Cancer rates are now predicted to climb in the next few decades and the numbers aren’t pretty.  Globally, cancer rates are projected to rise by as much as 75 percent by the year 2030, while cancer rates in the poorest countries are predicted to double as more people are consuming a Western diet style.  These numbers are sad, yet what is even sadder is that many of them would have been prevented with changes in lifestyle. I think we need to begin to take responsibility as a country and begin accepting that our junk food lifestyle can no longer be acceptable.  We can make healthy eating taste great and we have the knowledge now to know which foods promote cancer and which foods prevent it.  It’s up to all of us to take care of our own bodies, but also to spread the word about eating healthfully to those we care about.  Until our nation declares that the salad should be the main dish or that we can reduce our risks of cancer by eating foods like mushrooms, cruciferous greens, and onions, we need to take this matter into our own hands and do our part. Every little bit counts.  

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Cruciferous vegetable intake improves survival in women with breast cancer

Bok choy

At the recent American Association for Cancer Research annual meeting, new evidence highlighted the importance of cruciferous vegetables for breast cancer protection

The cruciferous vegetable family:

Arugula

Cauliflower Red cabbage
Bok Choy Collards Rutabaga
Broccoli Horseradish Turnips
Broccoli rabe Kale Turnip greens
Broccolini Kohlrabi Watercress
Brussels sprouts Mustard greens  
Cabbage Radish  

The cruciferous family is unique among vegetables because of their glucosinolate content – glucosinolates give cruciferous vegetables their characteristic spicy or bitter tastes; when the plant cell walls are broken by blending, chopping, or chewing, an enzyme called myrosinase converts glucosinolates to isothiocyanates (ITCs) – compounds with potent anti-cancer effects, including:1

  • Anti-inflammatory effects – ITCs have been found to decrease the secretion of inflammatory molecules.
  •  Anti-angiogenic effects – isothiocyanates can inhibit the development of new blood vessels to limit tumor growth.
  • Detoxification of carcinogens – Some carcinogens must be converted to their active form before they can bind DNA to cause carcinogenic changes – isothiocyanates can block this transformation.
  • Preventing DNA damage – Isothiocyanates also increase the production of our body’s natural detoxification enzymes, which protect DNA against damage from carcinogens and free radicals.
  • Stopping cell division in cells whose DNA has been damaged
  • Promoting programmed cell death in cancerous cells
  • Anti-estrogenic activity – Exposure to estrogen is known to increase breast cancer risk; estrogens can alter gene expression, promoting cell proliferation breast tissue. ITCs have been shown to inhibit the expression of estrogen-responsive genes.
  • Shifting hormone metabolism – Eating cruciferous vegetables regularly helps the body to shift hormone metabolism, reducing the cancer-promoting potency of estrogen and other hormones.

Eating cruciferous vegetables produces measurable isothiocyanates in breast tissue2, and observational studies show that women who eat more cruciferous vegetables are less likely to be diagnosed with breast cancer: In a recent Chinese study, women who regularly ate one serving per day of cruciferous vegetables had a 50% reduced risk of breast cancer.3 A 17% decrease in breast cancer risk was found in a European study for consuming cruciferous vegetables at least once a week.4

What about women who already have cancer? Is it too late for cruciferous vegetables to improve their prognosis?

We know that childhood and adolescence are the most crucial timesfor environmental stimuli to affect breast cancer risk, but changes made during adulthood and even after diagnosis still have the potential to create positive changes in the body.

The new study kept track of cruciferous vegetable intake in Chinese women with breast cancer for the first 3 years after diagnosis, and followed the women for a total of 5 years. They found dose-response effects – this means that the more cruciferous vegetables women ate, the less likely they were to experience breast cancer recurrence or die from breast cancer. When the women were grouped into four quartiles of cruciferous vegetable consumption, in the highest quartile had a 62% decrease in risk of death and 35% reduced risk of recurrence compared to the lowest quartile.5

This new data supports a previous report from the Women’s Healthy Eating and Living (WHEL) study. Breast cancer survivors who reported higher than median cruciferous vegetable intake and were in the top third of total vegetable intake had a 52% reduced risk of recurrence – especially powerful since the average intakes were quite low – 3.1 and 0.5 servings/day of total and cruciferous vegetables, respectively.6

Don’t forget: cruciferous vegetables must be chopped, crushed, or chewed well for maximum benefit!

The myrosinase enzyme is physically separated from the glucosinolates in the intact vegetables, but when the plant cells are broken, the chemical reaction can occur and ITCs can be formed. The more you chop before cooking (or chew if you are eating the vegetables raw), the better. Some ITC benefit may be lost with boiling or steaming, so we get the maximum benefit from eating cruciferous vegetables raw – however, gut bacteria also have the myrosinase enzyme, so additional ITC production may occur in cooked cruciferous vegetables after we eat them. Also, we can increase ITC production from cooked cruciferous vegetables by having some shredded raw cruciferous vegetables such as cabbage, kale, collards or arugula in a salad in the same meal to supply the myrosinase enzyme, which the body can use during the digestive process.

Read more about breast cancer prevention.

 

References:

1. Higdon J, Delage B, Williams D, et al. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res 2007;55:224-236.

2. Cornblatt BS, Ye L, Dinkova-Kostova AT, et al. Preclinical and clinical evaluation of sulforaphane for chemoprevention in the breast. Carcinogenesis 2007;28:1485-1490.

3. Zhang CX, Ho SC, Chen YM, et al. Greater vegetable and fruit intake is associated with a lower risk of breast cancer among Chinese women. Int J Cancer 2009;125:181-188.

4. Bosetti C, Filomeno M, Riso P, et al. Cruciferous vegetables and cancer risk in a network of case-control studies. Ann Oncol 2012.

5. Nechuta SJ, Lu W, Cai H, et al: Cruciferous Vegetable Intake After Diagnosis of Breast Cancer and Survival: a Report From the Shanghai Breast Cancer Survival Study. Abstract #LB-322. In Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4. Chicago, Il; 2012.

6. Thomson CA, Rock CL, Thompson PA, et al. Vegetable intake is associated with reduced breast cancer recurrence in tamoxifen users: a secondary analysis from the Women's Healthy Eating and Living Study. Breast Cancer Res Treat 2011;125:519-527.