So what about the role of antioxidants for prostate cancer? Here we're talking more about
prostate cancer prevention in this particular model, although it may also be beneficial
for treatment as well. But if you imagine a non-cancerous cell in the prostate, a benign
cell, and over the course of a lifetime, these cells are exposed to a number of prooxidants.
So there's an ongoing balance between DNA damage and repair that's going on in all of
our cells all the time. It's this kind of battle that's occurring in our body, where
for example, if we're exposed to UV radiation from the environment or there's just chemical
reactions that occur in our body, environmental pollutants, obesity, these all have potential
to be proinflammatory and to damage our DNA. Likewise, well-done grilled meat is well known
to have carcinogens, the heterocyclic amines in those grill marks, as well as others. And
so, these are all constantly bombarding our cells and then our body has ways to repair
the DNA naturally. The question is, what about if we take antioxidants in various forms.
Could that potentially be preventative for prostate cancer, for example? Well, a lot
of money was spent looking at this specific subject for prevention. It was a large prospective
randomized trial where investigators, for example, put patients on either selenium (which
has some antioxidant effects) or vitamin E (which looked like it had some favorable effects),
or both, or a control group. This was called the SELECT trial. And the bottom line is that
after millions and millions of dollars were spent—important dollar —looking at this,
it turns out that vitamin E actually slightly increased the risk of prostate cancer in that
trial. And selenium was, for the most part, neutral. There were some unfavorable findings
there. So, that's why you need to do the studies. I mean, geez, what could be wrong with vitamin
E? I mean, it just sounds great, but it actually turns out if you do the study, they found
out that vitamin E increased the risk of getting prostate cancer. So certainly when patients
come in with their supplements and vitamins and everything, I'll say, "Well for sure don't
take your vitamin E." I mean unless the doctor recommends it, which I don't think I've ever
heard of. I'm sure someone would have an example and prove me wrong. But in any case, what
this study shows is that I certainly would avoid vitamin E, and overall use caution with
excessive use of vitamins and supplements. There's been a number of studies done—not
great studies, but okay studies—looking at people who take multiple vitamins and supplements.
In some cases, those patients, if they do get prostate cancer, may develop a more aggressive
prostate cancer. I mean, there's no—for a lot of the vitamins and supplements that
are available over the counter—there's no quality control over exactly what's in them.
And really, you can get all these from the whole foods. And so what you're going to hear
me prophecizing for the rest of the talk is kind of focusing on more on the whole foods
as opposed to supplements. So if we talk about the polyphenols, for example, antioxidants.
These form the colors in the fruits and the vegetables. These are chemicals within the
fruits and vegetables that form the colors and actually protect these plants from the
environment. And so, the question becomes, what color is your diet? David Hepher wrote
a great book on this if you're interested in reading that. It talks in great detail
about all the different beneficial chemicals within the colors of the fruits and vegetables,
and possibly combining those colors might be beneficial. There are a number of studies
suggesting from whole foods, that doing this is protective for prostate, colon, and breast
cancer. So, for example, if you look at it—this slide is a little hard to read. But, for example,
if you look at chili peppers, what makes up that red color is capsaicin. If you look at,
for example, at ginger, for each of these various vegetables or in some case fruits,
what creates the color in the skin is made up of specific antioxidant chemicals, and
in our view it's much more healthy instead of taking a pill that provides something,
just eat the whole food. Eat the broccoli, you know, eat the cabbage, eat the garlic.
Then you're getting a lot of benefit from that, and by mixing those, there may be benefit
from mixing those colors and chemicals that then work in combination. So, I'm a huge fan
of a whole food approach. People are still spending, you know, the National Institutes
of Health is still spending all this money trying to find that one pill, that one antioxidant,
that one nutritional supplement that you can take that will then have a significant effect,
but really what we've seen over and over again is that's not working. And so, for example,
when we do our studies we're combining whole dietary changes along with fish oil. We're
not just giving a fish oil capsule. So, for example, if you look at the red that is in
tomatoes, red grapefruit, watermelon, for example, that what makes up that red color
is an antioxidant called lycopene. And that has there have been very nice studies, for
example, on men who eat higher amounts of tomato paste and tomato sauces. That the lycopene
gets into the prostate and appears to have favorable effects within the prostate tissue,
and there's been some nice epidemiologic studies showing a decrease in incidence of aggressive
prostate cancer in patients who eat motr, for example, tomato sauce and tomato paste
products. So this is a great food, a whole food. And then, the question always comes
up, "Well what about tomatoes as opposed to tomato sauce?" Well, you're actually eating
a lot more lycopene in tomato sauce because you've crushed the tomatoes together, so you're
eating a lot more of it. Tomato sauce, typically there's olive oil in there, and the olive
oil increases the absorption of the lycopene, and probably just smashing the tomatoes together
even makes it more bioavailable. And so, a healthy food choice, for example, is tomato
sauces, you know when you're cooking or at a restaurant. And then, for example, there's
the orange that provides beta-carotene in the various
vegetables that you see here. There's the yellow from the beta-carotene and flavanoids
that you see here in this picture. And so, you know, when you walk into the market and
you see all those vegetables and all the different colors, the more you can get them together
as one happy family in your salad, the better. There are the blue and purple that also provides
antioxidants. And definitely, the white in allium and onions and scallions and garlic
also have antioxidant effects that you're getting through a whole food. The other nice
thing about the whole food approach is then you're filling yourself up and that's also
important, you know, to get full so you don't keep eating all that other stuff. So we've
talked a little bit about lycopene already. It's a potent antioxidant. In a specific study,
2+ servings of tomato sauce per week was beneficial and appears the sauce was more effective than
fresh tomatoes. Fresh tomatoes still great food, for sure. It's just to get more lycopene,
you get it in the sauce. A number of interesting studies on cruciferous vegetables as well.
The broccoli, cauliflower, cabbage, brussel sprouts, bok choy, these are rich in an antioxidant
called isothiocyanate. So you're also getting tremendous benefit from these. And pomegranate
is also a rich source of polyphenols. The only thing to be careful of with the pomegranate
is if you're going for the juice, the juice, some of those juices have a lot of sugar in
them which can provide a lot of calories. So you have to be careful in that regard.
Again, the whole food is probably better or just the juices in moderation. A lot of interesting
data on soy protein as well, and again, I'm more of
a proponent of the natural soy in whole foods like tofu, miso soup. This is a good source
of non-animal protein, but I would say caution with regard to the powder supplements. The
soy protein powder. When you give those, those actually —I would not recommend it. I recommend
against those. Those actually raise levels in your bloodstream of something called insulin-like
growth factor 1, which we know promotes growth of prostate cancer. So, I actually recommend
against a protein, a high-protein supplement, unless it's doctor recommended for various
reasons. But if you're just taking it for health purposes, those I actually recommend
against.