Solving a Colon Cancer Mystery

Solving a Colon Cancer Mystery
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Even though modern African diets may now be as miserably low in fiber as American diets, Africans still appear to have 50 times less colorectal cancer than Americans (our second leading cancer killer).

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Colorectal cancer is the second leading cause of cancer death in the United States, after lung cancer. If you look at the rates of lung cancer around the world, they vary by a factor of 10. If there were nothing we could do to prevent lung cancer, if it just arose spontaneously, happened at random, you’d assume that the rates everywhere would be the same. But since there’s such a huge variation in rates, you assume there’s some external cause, and indeed, we now know smoking is responsible for 90% of lung cancer cases. So if we don’t want to die of the #1 cancer killer, by just not smoking we can throw 90% of our risk out the window. For colon cancer, there’s an even bigger spread. So it appears colon cancer doesn’t just happen; something makes it happen. Well, if our lungs can get filled with carcinogens from smoke, maybe our colons are getting filled with carcinogens from food. Researchers from the University of Pittsburgh and the University of Limpopo sought to answer the question, “Why do African Americans get more colon cancer than native Africans?" Why study Africans? Because colon cancer is extremely rare in native African populations, like more than 50 times lower than rates of Americans, white or black.

It’s the fiber, right? Dr. Burkitt was the first to describe the low incidence of colon cancer in native Africans, ascribing it to their traditional staple diet that was high in whole grains and, therefore, fiber content. Seems you get about a 10% reduction in risk for every 10 grams of fiber a day. So hey, if it’s a 1% drop for each gram, and they’re eating upwards of 100 grams a day, that could explain why colon cancer is so rare in sub-Saharan Africa.

But wait a second, the modern African diet is highly processed and low in fiber, and yet there has been no dramatic increase in colon cancer incidence.

The modern African diet has a low fiber content, as most populations now depend on commercially produced refined cornmeal. And we’re not just talking low fiber intake; we’re talking United States of America low, down around half the recommended daily allowance. Yet colon disease still remains rare; still 50 times less colon cancer.

Maybe it’s because they’re thinner and exercise more? No, they’re not, and no, they don’t. If anything, their physical activity levels may now be even lower. So if they’re sedentary like us, eating mostly refined carbs, few whole plant foods, little fiber—like us–why do they have 50 times less colon cancer? Well, there is one difference. The diet of both African-Americans and Caucasian-Americans is rich in meat, whereas the native African diet is so low in meat and saturated fat they have total cholesterol levels averaging 139, compared to over 200 in the U.S.

So yes, they don’t get a lot of fiber anymore, but they continue to minimize meat and animal fat consumption, supporting evidence that perhaps the most powerful determinants of colon cancer risk are the levels of meat and animal fat intake. So why do Americans get more colon cancer than Africans? Maybe the rarity of colon cancer in Africans is not the fiber, but their low animal product consumption.

There is a divergence of opinion as to whether it’s the animal fat, cholesterol, or animal protein that is most responsible for the increased cancer risk, as all three have been shown to have carcinogenic (cancer-causing) properties, but it may not really matter which component is worse, as a diet rich in one is usually rich in the others.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Colorectal cancer is the second leading cause of cancer death in the United States, after lung cancer. If you look at the rates of lung cancer around the world, they vary by a factor of 10. If there were nothing we could do to prevent lung cancer, if it just arose spontaneously, happened at random, you’d assume that the rates everywhere would be the same. But since there’s such a huge variation in rates, you assume there’s some external cause, and indeed, we now know smoking is responsible for 90% of lung cancer cases. So if we don’t want to die of the #1 cancer killer, by just not smoking we can throw 90% of our risk out the window. For colon cancer, there’s an even bigger spread. So it appears colon cancer doesn’t just happen; something makes it happen. Well, if our lungs can get filled with carcinogens from smoke, maybe our colons are getting filled with carcinogens from food. Researchers from the University of Pittsburgh and the University of Limpopo sought to answer the question, “Why do African Americans get more colon cancer than native Africans?" Why study Africans? Because colon cancer is extremely rare in native African populations, like more than 50 times lower than rates of Americans, white or black.

It’s the fiber, right? Dr. Burkitt was the first to describe the low incidence of colon cancer in native Africans, ascribing it to their traditional staple diet that was high in whole grains and, therefore, fiber content. Seems you get about a 10% reduction in risk for every 10 grams of fiber a day. So hey, if it’s a 1% drop for each gram, and they’re eating upwards of 100 grams a day, that could explain why colon cancer is so rare in sub-Saharan Africa.

But wait a second, the modern African diet is highly processed and low in fiber, and yet there has been no dramatic increase in colon cancer incidence.

The modern African diet has a low fiber content, as most populations now depend on commercially produced refined cornmeal. And we’re not just talking low fiber intake; we’re talking United States of America low, down around half the recommended daily allowance. Yet colon disease still remains rare; still 50 times less colon cancer.

Maybe it’s because they’re thinner and exercise more? No, they’re not, and no, they don’t. If anything, their physical activity levels may now be even lower. So if they’re sedentary like us, eating mostly refined carbs, few whole plant foods, little fiber—like us–why do they have 50 times less colon cancer? Well, there is one difference. The diet of both African-Americans and Caucasian-Americans is rich in meat, whereas the native African diet is so low in meat and saturated fat they have total cholesterol levels averaging 139, compared to over 200 in the U.S.

So yes, they don’t get a lot of fiber anymore, but they continue to minimize meat and animal fat consumption, supporting evidence that perhaps the most powerful determinants of colon cancer risk are the levels of meat and animal fat intake. So why do Americans get more colon cancer than Africans? Maybe the rarity of colon cancer in Africans is not the fiber, but their low animal product consumption.

There is a divergence of opinion as to whether it’s the animal fat, cholesterol, or animal protein that is most responsible for the increased cancer risk, as all three have been shown to have carcinogenic (cancer-causing) properties, but it may not really matter which component is worse, as a diet rich in one is usually rich in the others.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Doctor's Note

I’ve previously suggested phytates may play a critical role as well (Phytates for the Prevention of Cancer). Resistant starch may be another player, since they cool down their corn porridge, and some of the starch can crystallize and effectively turn into fiber (the same reason why pasta salad and potato salad better feed our gut bacteria than starchy dishes served hot). I touch on it briefly in Bowel Wars: Hydrogen Sulfide vs. Butyrate but I have a lot more on resistant starch coming up. Resistant starch may also help explain Beans and the Second Meal Effect.

Fiber may just be a marker for healthier eating, since it’s found concentrated only in unprocessed plant foods. So the apparent protection afforded by high-fiber diets may derive from whole food plant-based nutrition rather than the fiber itself (so fiber supplements would not be expected to provide the same protection). Here are some videos that found protective associations with higher-fiber diets:

What might be in animal products that can raise cancer risk? Here’s a smattering:

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142 responses to “Solving a Colon Cancer Mystery

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  1. This isn’t making sense to me. If Africans aren’t now getting much fiber, why is that? If they are still eating mostly plants, what happened to the fiber? Before I watched the video, I just assumed they were eating Westernized junk food, including meat. From this it seems like they still eat plants. Where did the fiber go? And if they are still mostly whole foods plant based, why are they gaining weight? (I understand they are less physically active than what was teh norm years ago, but still…)




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    1. Good questions. From the video it seems the native African diets were low in animal product consumption and they had low cholesterol levels. Fiber intake has gone down due to more refined grains being available.




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    2. From the transcript:

      The modern African diet has a low fiber content as most populations now depend on commercially produced refined cornmeal.




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      1. Most food-aid programs from the US include large amounts of heavily processed corn meal – relating in part to the subsidies to corn farmers in the midwest. Around the world, you’ll find people who hate corn-meal mush and associate it with poverty.

        Further, the people where I live, the Mende of Sierra Leone, know that Americans prefer white rice. So they think it is better, more healthy, than the whole rice they used to eat. They assume Americans wouldn’t deliberate eat inferior food.




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        1. A likely assumption, indeed!! And the Americans assumed that the Corporations whose Brands they are loyal to wouldn’t feed them inferior food….. SURPRISE!!




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  2. I also have trouble believing that modern Africans are consuming American levels of fiber (<20 g/day) even if they're eating more refined grain. And even if this were the case, the fact they still have very low rates of colon cancer wouldn't invalidate the fiber hypothesis (increasing fiber consumption by 10 g/day lowers colon cancer risk by 10%) because cancer requires a long gestation–probably decades. It could be that modern Africans will be developing much more colon cancer after decades of eating refined low fiber diets. It is still to early to know for sure. In the meantime, the prudent course is probably to eat plenty of fiber, avoid large quantities of meat and alcohol, and probably get plenty of calcium in your food. It would be nice if Dr. Greger addressed the issue of colonoscopies, and their benefit/harm in colon cancer prevention…though this may be too political an issue for a US doctor to comment on.




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        1. Some years ago I ran across research that indicated that users of NSAIDS rarely ever developed any polyps and therefore practically never had lower bowel problems. I liked the idea as a survivor of dairy products (and the sinus issues/headaches resultant in some medical concern and testing-EEG), as well as a migraine bearer. Translation, I’ve consumed lots of NSAIDS. Might be time for me to re-examine the efficacy of such testing–as I push that “magic” age.




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          1. A huge clinical trial has shown that 600 mg/day aspirin reduced the risk of colon cancer in people at high risk. The study was Burn, J., D. et al and Capp consortium International. “A
            Randomized Placebo-Controlled Prevention Trial of Aspirin and/or
            Resistant Starch in Young People with Familial Adenomatous Polyposis.” Cancer Prev Res (Phila) 4, no. 5 (2011): 655-65. You can find the study for free at http://cancerpreventionresearch.aacrjournals.org/content/4/5/655.long.




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    1. Jason: A poster named “Gary Brown” previously discussed colonoscopies that I thought was so helpful (especially because of the link to Dr. McDougall’s article) that I saved it. Here is the post, and I highly recommend reading the linked article:

      “So I have read some information about colonoscopies. Dr. MCDougal infers that that sigmoidoscope exam is a much safer exam procedure vs most colonoscopiesjob minus the prep, mess, expense, and dangers of a perforated colon and possible issues with Anaesthesia.
      https://www.drmcdougall.com/misc/2010nl/aug/colon.pdf




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      1. Which asymptomatic population should get screened, at what age and frequency isn’t yet clear. Original studies showed decrease in mortality via occult blood screening. Subsequent studies showed this benefit to be most likely due to follow up screening by flexible sigmoids most likely due to false positive occult blood screening. The issue of flexible sigmoid vs colonoscopy is still up in the air as well. One reasonable approach is to have a flexible sigmoid done by someone who does them regularly whether that is a physician, nurse practitioner, physician assistant or registered nurse. Initial screen could be done at age 55 to 60 or sooner given other factors such as a family history of colon cancer at early age or specific genetic conditions. If multiple polyps are found on flexible sigmoidoscopy it would seem reasonable to follow up with colonoscopy. The interval for subsequent if any screening is still not well sorted out. There is a need for more research at this point but we are clearly over screening asymptomatic persons resulting in unnecessary costs and suffering. These issues are discussed by Dr. H. Gilbert Welch in his book, Should I be Tested for Cancer? Maybe not and here’s why.




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        1. Don: Thank you very much for your added input here. You paint a slightly different picture than I got from Dr. McDougall’s article. I am slowly working to sort this issue out for myself and your input is a big help at providing some balanced information. Also, thanks for the book tip. I’m adding that book to my (ridiculously long) list of books to read.




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      2. Thanks greatly for that article of McDougall’s, Thea. I was surprised that our odds of getting colon cancer were so low, and it does seem that American medicine is pushing colonoscopies onto the public willy nilly, almost–to use an overworked simile, as the NSA spies on, or at least holds the metadata of all of our phone calls, emails, and other transmittals JUST IN CASE they might come in handy. Well, colonoscopies aren’t cheap,and so sigmoidoscopies or even testing for occult blood in stool samples is probably a much more efficient (and less traumatic) way of determining who might have colon cancer. I wouldn’t undergo the indignity of a standard colonoscopy, so I opted for a ‘virtual’ colonoscopy, which is essentially a CT scan of the entire region. The bowel prep was unpleasant (three days of eating boring fiber-free foods and drinking the noxious milkshake containing radioactive dye). I won’t bother getting the test again, despite the fact my results were a bit inconclusive in the right colon area–which McDougall says is a frequent problem. It is comforting to know that the vast majority of operable or preventable cases occur before this, in the left colon, so a sigmoidoscopy ought to be sufficient. Trouble is finding someone who will do it. In the meantime, choosing a fiber and plant-rich, low meat and alcohol diet, and taking stool samples every year or so ought to be plenty for most of us. There’s a new stool assessment put out by Cologuard that is reported to be pretty accurate–though it does have a high false positive rate, probably leading to many unnecessary colonoscopies.




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        1. Jason: Nice addition to the discussion. I had never heard of a “virtual” colonoscopy. I like that idea. I’m adding it to my list of things to investigate in the future. I’m not at an age where I need one just yet. But it is coming and I want to be able to investigate all my options.

          I keep hoping that the perfect alternative to colonoscopies will come up before I need one. You never know.




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    2. Very good points!
      I would add the charts in the video are from ’80s – the average diet of many of the countries listed has since changed significantly and has become more and more Westernized with the increasingly global reach of the fast-food giants as well as the smoking habits have evolved over the last 20-30yrs.
      It would be interesting to compare the charts with some more recent ones.




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  3. Pretty convincing.

    I am sure there are confounding factors. Maybe these western Africans are fasting more (right west Africa is pretty Muslim).

    Thanks for the amazing review dr g!! It does affect how I talk to patients in the clinic!




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    1. I agree. that there’re confounding factors. According to the video, Americans eat more animal products than Africans, implying that Americans eat more animal fat than Africans. But Americans probably eat more plant-based refined oils (soy oil, peanut oil, sunflower oil, etc.) than Africans. And what about the consumption of refined sugar? Who consume more sucrose, Africans or Americans? Also what about the level of physical activity? Do Africans now sit in front of a computer or a TV all day eating deep-fried Twinkies and drinking soda?




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  4. A bit off the topic of colon cancer, but since the first table in Dr. Greger’s presentation here shows Belgium with an extremely high rate of lung cancer and Thailand with a very low rate, and he attributes 90% of lung cancer cases to smoking, I am led to infer that Belgians smoke much more than Thais–which I don’t think is remotely true. In fact, taking air pollution as a whole, I’d wager that Belgium has much less of a problem than Thailand or other countries in SE Asia. So why the tremendous disparity in lung cancer rates? I’m tempted to say diet plays a role, and this should be an obvious claim for Dr. Greger to make, since he stresses the importance of diet. Nevertheless, he doesn’t go there. There is the ‘Japanese Paradox’, which is almost as well known as the French Paradox–that Japanese men–over a third of whom smoke–live on average nearly five years longer than American men–only about one fifth of whom smoke.




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    1. The mortality data in that chart is from 1986 to 1988, and may be poor. 40% of Thai males, but only 3% of females smoke, and lung cancer incidence in Thailand has risen from 24 to 30 per 100,000 males from 1990 to 2008, and is the leading cancer among Thai males.

      There is a similar paradox of high smoking rates and but lower than expected lung cancer mortality in Japan, where statistics are much better. Cancer progression isn’t just a matter of initiating mutations. and continuing inflammation and growth signalling from diet likely play a role in progression, and there the lower animal product content of East Asian diets may be protective.




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      1. The 2008 statistics for Thai men in Table 1 of your second link show that lung cancer is the second most common cancer among men of the five major cancers assessed (lung, liver, colon, breast, cervix)–evidently, prostate cancer is not that big a problem in Thailand yet. With about 30 cases per 100,000, the lung cancer incidence is much higher than in Dr. Greger’s table linked–which you say was from 1988; that only showed about 6 cases per 100,000. Has lung cancer quintupled in the two decades from 1988 to 2008, or are they simply measuring it more accurately? Be that as it may, the recent incidence of lung cancer among Thai males is still only about half that of American men…and you say that 40% of Thai men smoke. That is about twice the rate of American men (perhaps a bit less than twice). So…twice the smoking incidence, but half the lung cancer incidence. Again, it could be the lag period between exposure to a carcinogen and diagnosis of cancer, but I suspect there are things in the Thai diet which may be protective–or things in the American diet which are harmful as far as lung cancer is concerned. Dr. Greger posted on the protective effects of green tea to help explain the ‘Asian Paradox’, but Thais drink little tea…probably no more than Americans, and certainly less than the British–who have a high lung cancer incidence. True, the British mostly drink black tea, which may not be as protective against lung cancer as green tea drunk by Japanese and Chinese.

        Thanks for the links, Darryl. Interesting.




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    2. The mortality data in that chart is from 1986 to 1988, and may be poor. 40% of Thai males, but only 3% of females smoke, and lung cancer incidence in Thailand has risen from 24 to 30 per 100,000 males from 1990 to 2008, and is the leading cancer among Thai males.

      There is a similar paradox of high smoking rates and but lower than expected lung cancer mortality in Japan, where statistics are much better. Cancer progression isn’t just a matter of initiating mutations. and continuing inflammation and growth signalling from diet likely play a role in progression, and there the lower animal product content of East Asian diets may be protective.




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  5. Many researchers believe that resistant starch is the missing detail. Africans eat a cooked and cooled maize porridge throughout the day, as well as lots of beans. Both foods are loaded with resistant starch, a type of insoluble dietary fiber which is fermented in the large intestine, significantly increasing short-chain fatty acids and improving colon health. Average American intake of resistant starch is 5-8 grams/day – far less than the 20+ grams/day recommended by scientists. Hundreds of animal studies are showing that resistant starch decreases risk of colon cancer, but it has yet to be proven in humans. Stephen O’Keefe’s latest study was a diet swap between African Americans in Pittsburgh and South Africans. Read more about that study at http://www.resistantstarch.us/?p=1.




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    1. Americans don’t get their 5/day fruit and veg. How are they supposed to get any recommended amount of resistant starch when there’s no breakdown of fiber on nutrition facts panels here in the U.S.?




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      1. The regulations on fiber labeling are moving very slowly. There are a lot of differences between different types of dietary fiber that making generalities is hard and regulations change very slowly in any case. In the meantime, educate yourself and determine if RS’s benefits could help you and then which foods and/or supplements would work. The best listing of the resistant starch content of foods within the US
        was published in 2008. http://www.ncbi.nlm.nih.gov/pubmed/18155991.




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          1. Resistant starch breaks many previously held assumptions and it is complicated. That is why I built http://www.resistantstarch.us to help explain it. With over 100 human clinical studies, and funding from many governments and research organizations, it is probably the BEST, mostly unknown ingredient out there. Maybe I’ll build a page explaining food sources soon. I’ve been writing a series of articles explaining the various health benefits in my blog recently.




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            1. Interesting compilation, but the list suggests more clarity than it merits. However, http://www.valemaisalimentos.com.br/material/2.pdf is a great reference.

              There is still a lot of confusion and discussion about levels of resistant starch in foods, as the analytical methods have changed over the years. Another analytical method was just proposed to try to correct errors in previous methods. It is actually pretty hard to measure resistant starch in foods, which are complicated matrices. In other words, old data using old methods is near meaningless. It is useful for direction and suggestion, but cannot be used in the way that is posted by freetheanimal. It was the best we could do at the time, but cannot be presented as accurate. Wish the analytical questions would be magically resolved, but we’re not there yet.




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              1. Thanks. I presume the difficulty is that there are several competing protocols for measuring how digestion resistant starch becomes, and small changes in cooking/cooling/storage can have marked effects on starch retrogradation and annealing. I liked that compilation less because any compilation of values is “correct”, than it incuded some more unusual highly resistant starches (like green plaintain flour and glass noodles) that could be part of more adventurous diets. Glass noodle salads are common in Thai cuisine and I would love try my hand at tortilla making with hi-amylose/waxy maize masa.




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                1. You are partly correct. Some of it also dates back to the weaknesses in the old fiber methods, which cooked samples to 100 degrees in order to burn off everything that was not tough enough to be fiber (primarily considering non-starch polysaccharides at the time). Those method (AOAC 991.43 and 985.29) and their variations are still being used.

                  A dedicated resistant starch method was proposed and some people use it, but it still doesn’t capture all types of resistant starch in ways that are reliable. It seems to overstate some types while under-estimating other types. Some papers use their own, laboratory based methods to estimate RS content and there is no way to tell if those values relate to anything. I trust the Murphy paper the most as I commissioned that work and I know the authors personally – they took every precaution to identify the most accurate data. I believe they’re making progress with refining the analytical methods but we have a long way to go to fully understand RS content in foods (other than it is relatively low).

                  As for your more adventurous diets, less processed will always have a greater change of resistant starch content than more processed, but you will not likely be able to get your hands on high amylose or waxy corn unless you have connections to a university research lab, and even then not likely. Those hybrids are proprietary in general and not available to anybody. My advice – eat less processed food of all kinds, but make sure you’re getting fermentable fibers.




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      2. The regulations on fiber labeling are moving very slowly. There are a lot of differences between different types of dietary fiber that making generalities is hard and regulations change very slowly in any case. In the meantime, educate yourself and determine if RS’s benefits could help you and then which foods and/or supplements would work. The best listing of the resistant starch content of foods within the US
        was published in 2008. http://www.ncbi.nlm.nih.gov/pubmed/18155991.




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    2. Americans don’t get their 5/day fruit and veg. How are they supposed to get any recommended amount of resistant starch when there’s no breakdown of fiber on nutrition facts panels here in the U.S.?




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    3. Hi Rhonda, love what you’re doing at Resistantstarch.us! Also don’t forget to check out the “Doctor’s Note” section above (right below the video) where Resistant Starch is actually talked about.




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      1. Thanks for your comments. It is nice to get feedback on the website. Regarding the additional info on “Doctor’s Note”, the O’Keefe study added resistant starch to the African American diet by adding Hi-maize resistant corn starch – which is the same ingredient used in the vast majority of the studies. Nobody seems to talk about this aspect of the study. It is really great to see that he’s planning to do more on resistant starch soon.

        Actually, the published data does not support cooked and cooled pasta as having more RS than cooked pasta – it has the same very low levels. In contrast, several studies shows that cooked and cooled potatoes have more resistant starch than cooked potatoes, although the quantities are still really low. It is far easier to eat resistant starch-fortified pasta, as it is available in every grocery store in the US and Canada (Barilla High Fiber White Pasta). If you’re close to Indiana, Aunt Millie’s uses it in their Healthy Goodness Breads as well.




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        1. Thanks for all your insights, Rhonda. I’m a bit confused about your comment on RS and what I’ll call leftover pasta (cooked, cooled, then eaten later.) I understand that the degree of retrogradation has to do with how much amylose there is in the starch as compared to amylopectin. http://www.montignac.com/en/the-factors-that-modify-glycemic-indexes/ So noodles that are made from legumes, such as cellophane (mung bean) noodles, would likely have lower glycemic impact if eaten as leftovers as compared to noodles made from wheat, correct? In other words, the amylose content is a more important factor than the RS in causing the starch to reorganize upon cooling. Is that correct?




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  6. I was enjoying a small dish of balela, a Middle Eastern bean salad, when I read this! Family loves it–there’s frequently a huge bowl in fridge. Easier to wean meat-eaters when there’s a yummy option. ;-)

    [My version is adapted from recipe that tries to recreate Trader Joe’s, only I use fewer beans (4 c of each after soaking & cooking) and substitute dry for fresh tomatoes: http://www.thesavory.com/food/recipe-how-make-trader-joes-awesome-balela-salad.html .]




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    1. Mmmm, looks good! I love bean salads in the summer and make one similar to this except I add corn kernels and use fresh basil and oregano instead of mint.




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    2. Mmmm, looks good! I love bean salads in the summer and make one similar to this except I add corn kernels and use fresh basil and oregano instead of mint.




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  7. A very recent study:
    O’Keefe, SJ et al 2015. Fat, fibre and cancer risk in African Americans and rural Africans

    We performed 2-week food exchanges in subjects from the same populations, where African Americans were fed a high-fibre, low-fat African-style diet and rural Africans a high-fat, low-fibre western-style diet, under close supervision. In comparison with their usual diets, the food changes resulted in remarkable reciprocal changes in mucosal biomarkers of cancer risk and in aspects of the microbiota and metabolome known to affect cancer risk, best illustrated by increased saccharolytic fermentation and butyrogenesis, and suppressed secondary bile acid synthesis in the African Americans.




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    1. Thanks, Darryl. Dr. Greger said it’s in his stack for next time! I appreciate you sharing that new study and supplemental information.




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      1. The only high amylose hybrids of corn are proprietary. The cornstarch from high amylose corn has been used in the food industry for 30+ years because they help give jelly beans their unique texture. (There is no resistant starch left in jelly beans, but the expansion properties of high amylose cornstarch are valued.) Thus, the high amylose hybrids are proprietary to certain starch manufacturers or have been developed in research laboratories. The resistant starch used in the South African/African American study (and in more than 70 additional clinical trials) was Hi-maize resistant starch from high amylose corn. You can buy it at KingArthurFlour.com or on Amazon. King Arthur calls it Hi-maize natural fiber.




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  8. I thought Africans ate quite a bit of chicken and chicken eggs. Along with corn (maize) and other root vegetables. Is the lower incidence of colon cancer being based solely on their low consumption of red meat then? Thanks




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  9. On the chart showing the rates of colon cancer, Connecticut is at the top of the list. Is Connecticut now a country? Something seems off here.




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    1. Looks like at the bottom of the chart it states Fig. 1 Age-standardized incidence rates for cancers of the colon and rectum in men 34-65 years. Let me know if you want more information for that reference.




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      1. So Connecticut has that much more colon cancer than any other place? That’s pretty alarming, considering that’s where I live. Am I misunderstanding the chart?




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        1. Based on that chart, yes. Keep in mind it was an old study and they only looked at men. I’ll send you it as the whole paper may make more sense.




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      2. So Connecticut has that much more colon cancer than any other place? That’s pretty alarming, considering that’s where I live. Am I misunderstanding the chart?




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    2. Looks like at the bottom of the chart it states Fig. 1 Age-standardized incidence rates for cancers of the colon and rectum in men 34-65 years. Let me know if you want more information for that reference.




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  10. The answer is the trillions of carcinogenic caffeine molecules with its ten pi-bonding electrons that create the large magnetic current fields. Benzene which we know is carcinogenic only has six pi-bonding electrons and we also consume trillions of benzene molecules which add to the high numbers in all of the epidemics diseases. Del.




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    1. To what question is this the answer? (I’m not contesting what you wrote; I’m simply puzzled as to where what you wrote fits in the ongoing discussion.)




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    2. To what question is this the answer? (I’m not contesting what you wrote; I’m simply puzzled as to where what you wrote fits in the ongoing discussion.)




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  11. The difference could also be due to intestinal parasites, which are known to lower cholesterol and change gut pH and protect their host guts. African certainly have more of these than their African American counterparts.




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    1. Intestinal parasites would not account for the results of O’Keefe’s Diet Swap, as the South Africans would still have parasites with a change in diet (if they had them to start with). When the South Africans stopped eating resistant starch and started eating more meat and fat, their intestinal ecology significantly worsened, while the Pittsburgh African Americans had the opposite effect – significant improvement in their intestinal ecosystem and reduced inflammation. I don’t think that parasites have much to do with it – the microbiota that consume foods entering the large intestine certainly do!




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    2. Intestinal parasites would not account for the results of O’Keefe’s Diet Swap, as the South Africans would still have parasites with a change in diet (if they had them to start with). When the South Africans stopped eating resistant starch and started eating more meat and fat, their intestinal ecology significantly worsened, while the Pittsburgh African Americans had the opposite effect – significant improvement in their intestinal ecosystem and reduced inflammation. I don’t think that parasites have much to do with it – the microbiota that consume foods entering the large intestine certainly do!




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  12. I couldnt find the right topic to post this question > I follow a whole-foods plant-based diet. But i keep wondering if this diet really provides superior benefits in every single health aspect (when compared to a common western-diet)? Is this really so? If not, in which health-aspects can a western-diet provide better results when compared to a whole-foods plant-based diet?




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    1. Western high-fat refined carb diets are better at helping naturally underweight people gain and maintain weight. Which can be helpful to improve female fertility. Underweight women can often stop having periods, or have them infrequently. Normally these naturally underweight women would probably not continue to be able to pass on their genes as effectively. Western diets have reduced the issue however.




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      1. dogulas: I like how you tried to come up with something. I wracked my brain and couldn’t come up with anything even though I think it is a good question. I finally decided that the question is akin to asking something like, “What are the benefits of a coke and potato chip diet?” and thus it is reasonable to say, “Nothing.”

        Having said that, I think it is key to point out that your argument would need a lot of emphasis on it’s applicability to underweight women only. It is too easy to read what you wrote (as I did the first three times) and think that you are arguing that WFPB diets tend to make women underweight and thus have fertility problems. I don’t know of any evidence for that. A SAD diet tends to make people fat. That doesn’t mean that WFPB people are underweight. Just weigh less compared to those who are overweight.

        And to the contrary on the topic of fertility, there are doctors who have been able to cure fertility problems by switching people to WFPB diets. One of the bonus sections at the end of the Forks Over Knives DVD talks about this. Also, Dr. Greger has some videos that address fertility where the WFPB diet ends up looking pretty good:
        http://nutritionfacts.org/?s=fertility

        Even when addressing the topic of a woman who for some reason has trouble keeping a normal weight, that person could easily eat high calorie whole plant foods, and I would think would do better health-wise, fertility-wise than maintaining a normal weight with unhealthy high calorie foods.

        So, I would argue that a SAD diet is better than a starvation diet for fertility purposes, but not better than WFPB. Just sharing my thoughts.




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        1. Thanks Thea! Yeah, my comment was a little bit tongue-in-cheek, or even slightly sarcastic. Notice I didn’t say a western diet makes anyone healthier but if gaining weight is the only goal, the western diet is “better” in that sense. But certainly not best, if, as you mention, the person just uses calorie-dense plant foods instead, to put on the weight.

          I completely agree with you that a whole food plant based diet, and perhaps a low-fat whole food plant based diet (since most people here wouldn’t recommend a diet centered around nuts, avocados, and coconuts (rather than using those foods more like small snacks or condiments), is best for most people.

          But, for example, my friend who eats all the whole grains and beans she cares for, with a handful or two of nuts a day and a couple avocados a week at most, and also unlimited fruits and vegetables, hasn’t regained her period for six months now after going off birth control (she typically consumes 2500 calories per day. Weighs 130 pounds and is 5’11). She has a BMI of 18, and while I think she looks very healthy and not too thin at all, and she feels healthy and vibrant, she just can’t eat enough whole grains and beans to gain weight. Doctors have all told her that she needs to gain weight (“Eat more ice cream, olive oil, anything with more fat in it”), and she knows she can do so with plant foods, but doing so by eating fatty plant foods just doesn’t make sense to her. Still, she’s going to try it for the sake of gaining the weight. To see if her secondary amenorrhea is in fact due to her lower natural weight. https://en.wikipedia.org/wiki/Amenorrhoea#Diagnosing_Secondary_Amenorrhea

          I’m not saying anyone needs to eat a western diet. Ever. There are better ways, as you say.




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          1. douglas: *Great* reply. That makes a lot of sense to me. And now I smile to think of a cheeky answer being: to gain weight…

            The story of your friend is interesting. It’s interesting to me that a woman could eat 2500 calories per day and still be underweight. Of course, being underweight can be a serious problem. I hope she is able to find a good solution.




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            1. Thank you. Yeah it’s a little crazy. It’s always possible that she overestimates the calories, even if it is on cronometer. Either way, she does eat a lot, and says she eats so often that she hardly ever feels hungry at all. So it’s just weird to her that if she supposedly needs to gain weight, she is often feeling plenty full of rice and beans. She is taller than most girls and does exercise moderately about 3-4 times a week, so I’m sure her needs are a little higher than the 1800-2000 calories for most women. Still, a little frustrating for her.

              I hope that in the end the only issue is just that she needs more time than most to recover from hormonal birth control (which is a little bit of an odd thing really — artificially preventing the natural process of ovulation for years on end). And perhaps growing up on a western diet made her body assume that if she isn’t eating loads of ice cream every week she must somehow be starving! Time will tell.




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              1. As I read the symptoms you mentioned I thought about hyperthyroidism, did you friend check for it?

                “Hyperthyroidism may be asymptomatic or present with significant symptoms.”

                […] Weight loss, sometimes significant, may occur despite a good appetite
                (though 10% of people with a hyperactive thyroid experience weight gain[7]),
                vomiting may occur, and, for women, menstrual flow may lighten and
                menstrual periods may occur less often, or with longer cycles than
                usual.[8]




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                1. We did check for that. Interestingly, while she was on birth control she had a TSH value of 3.9. We checked again about five months later, now two months off birth control, and it was 1.8, with Free T4 in range too. So…maybe she had it for all the years she was on birth control. But no signs now, outward or in the blood, to indicate so. She did have longer than normal periods (5 weeks) years ago before birth control.




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            1. Yes her siblings are of the same build.

              Eating a lot of fat, even from avocados and nuts and coconut and especially refined oils doesn’t make sense as a requirement for fertility and health because there are many populations in the world that do just wonderfully without them. We can get all the fat we need from whole grains, legumes, vegetables, and fruits. She does have a couple ounces of nuts a day and a couple avocados a week. Even that amount isn’t what you would expect to find in the wild.

              Oils are not health-promoting. And a lot of any kind of fat, including refined oils, causes inflammation and clogs arteries. https://www.youtube.com/watch?v=b_o4YBQPKtQ

              Having said all that, for the sake of gaining weight, she is going to eat those fatty foods and even oils ad libidum now to gain the weight. And go from there.

              Could she have orthorexia nervosa? What, do you eat all the crap you want, to prove you don’t? Anyway, we have found that eating in moderation doesn’t work for us. So it’s all or nothing. We love the food we eat, and we don’t eat nor crave the food we no longer consider to be food. Works for us. Sorry for my snippy comment, thank you for your thoughts.




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              1. I think it’s the all-or-nothing thinking and behaviors that may point to orthorexia. Plus the “snippy” reactivity to my question. (I appreciate your apology.)

                BTW, I don’t eat all the crap I want. I recognize there’s huge debate around many issues, including oils, within the nutritional literature. I eat some locally produced olive oil with my veggies and a dash of toasted sesame oil in a few dishes. The improvement in taste helps me consume a lot more veggies. And I can live with the controversy.




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                1. That is an interesting term. What is the term for people who refuse to eat healthy foods? I bet there isn’t one. I have plenty of patients in their 80 and even 90’s and I wouldn’t say they have a good quality of life after eating all the junk you mention. They are on various medications for heart disease, their bodies are failing them and they live in pain. Now if having “orthorexia nervosa” keeps me from aging like the average American I am all in. Yes we are living longer but also sicker lives. You can have my Cisco.




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                  1. Orthorexia nervosa is considered a form of OCD and is related to anorexia and other eating disorders. There is an inordinate preoccupation with “pure” foods that can come to interfere with “social and occupational functioning.” People die from this illness due to how progressive it is and how extreme it can become. If you are a practitioner seeing patients, it would behoove you to learn about it and be on the lookout for it. Your comment about being “all in” with having orthrexia is worrisome. P.S. I don’t eat Crisco. My 83 year old grandmother did. And I strongly agree with eating healthier to live longer and better–we’re on the same page there.




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                  2. “What is the term for people who refuse to eat healthy foods?”

                    Addicted to the sugar, fat, and salt they see advertised in the media.
                    Poor and growing up in food deserts where there were few healthy food options.
                    Uneducated and/or confused about what constitutes healthy nutrition.
                    So overworked that convenience foods that one can pop in the microwave become standard fare.
                    It’s complicated. SAD is very sad, indeed. We’re exporting it all around the globe. African nations are no exception.




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                    1. I get it . . . SAD folks are so much the norm that they’re not pathologized or labeled. Even if they’re on a bunch of meds directly related to SAD, many physicians just won’t connect the dots and use nutritional interventions. (Unless they get a label of compulsive eating, bulimia, etc) But if a person goes vegan there’s a bunch of scrutiny and judgment based on so much ignorance!

                      You don’t have to lose sleep about the orthorexia label, however. There’s a big difference between folks like us who are really interested in nutrition and improving our diets and others whose entire focus is on eating their pure foods. Do look at the diagnostic criteria https://en.wikipedia.org/wiki/.… and I think you’ll agree that these folks are suffering–physically and emotionally–and they need professional intervention. The label does need to exist so that psychotherapists and health practitioners can recognize it, diagnose it and bill insurance for treating it.

                      Thanks for this good exchange!




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    2. Western high-fat refined carb diets are better at helping naturally underweight people gain and maintain weight. Which can be helpful to improve female fertility. Underweight women can often stop having periods, or have them infrequently. Normally these naturally underweight women would probably not continue to be able to pass on their genes as effectively. Western diets have reduced the issue however.




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    3. Santiago: I wanted to give this some thought before replying. I think this is an interesting and very good question. Very few things in life are black and white. Usually there are pros and cons to every path, even if a particular path is mostly pros. So, it is reasonable to ask, “What are the cons for a WFPB (whole food plant-based) diet?” or conversely, “Where does a SAD diet shine?”

      I’m no expert, but here’s my take based on the nutrition research I have done the past 5 years: There are some fringe cases/people where a SAD diet might be better than a strict whole food vegan diet, but even then, a person could likely set up their diet to be mostly WFPB and do much better than really following SAD.

      What I mean by fringe cases are people with congenital defects or diseases acquired later on which require the person to eat meat or some form of animal protein. For example, NutritionFacts has a video about a boy who got sick when he became a vegan. Turns out, his body doesn’t make one of the non-essential amino acids. So, the boy either *has* to eat animal protein, or take a pill of that amino acid. (The boy chose the pill.) The second point to make here is that the boy can actually do better/be healthier on a WFPB diet with the pill than he would do with the SAD diet. (It’s just that the SAD diet would beat a vegan WFPB diet in the sense that the vegan diet would kill the boy…) By taking the pill, the boy avoids all the negatives that come with eating animals.

      I know of another example of a great commenter/participant on this site who says that he as a medical condition (I don’t know the details) where he has to have some small amounts of animal products in his diet. I believe him. BUT the key points are: a) he tries to keep the animal products to a minimum, b) other than those required animal products, he doesn’t eat SAD, he eats WFPB, c) this is a fringe case – not an example of how eating even some animal products would benefit humans in the general population.

      Other than those types of fringe cases, I’m not aware of any health benefit from a typical western diet. I think the SAD diet has been shown to be inferior in every way health-wise. Now, if we are not talking about health, but about other issues, then Rhonda is on to something with her answer.




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  13. I couldnt find the right topic to post this question > I follow a whole-foods plant-based diet. But i keep wondering if this diet really provides superior benefits in every single health aspect (when compared to a common western-diet)? Is this really so? If not, in which health-aspects can a western-diet provide better results when compared to a whole-foods plant-based diet?




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  14. It sounds like Africa is starving again. When Americans in the Southeast where fed poor diets of pork, cornmeal, and molasses they developed pellagra (a Niacin deficiency) abundantly. The usual cause of death was suicide. Pellagra was characterized by the 4d, dementia, diarrhea, dermatitis, and death. I sure hope those people get some Niacin or fortified grain. I am glad to hear a plant based diet, one without meat, is so protective against colon cancer. Perhaps the Africans got more Vitamin D3 than the Americans did. Did the study compare vitamin D3 levels? They could. Dr. Greger has already shown us that African stool pH is so much lower than American’s, a sign of plant based diets and protection against cancer.




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  15. As both an African and American, this is an interesting topic. Growing up in Kenya, Ugali (white cornmeal polenta) was and still is a staple. I try to make it here but it doesn’t taste the same. But even back in the 70s and 80s we made it with refined corn flour. Only occasionally did we eat whole corn flour. Still, it’s always eaten with lots of leafy greens. Another staple was whole white corn with beans and potatoes (Githeri) or mashed with pumpkin leaves or other greens (irio/mukimo). Also, no one ever ate or sold brown/whole grain rice. It was always white. I’m a little surprised that fiber is down. It’s true that we ate very little meat and fat. It was either very small pieces in a stew once or twice a week or more significant amounts on a special occasion/holiday. My grandparents were healthy and lived to 85 and 94. My parents are now in their 70s and it’s taken me a long time to realize that I should go back to eating like them.

    Those In the urban areas are getting fatter because of reduced activity (more driving) and more availability of junk and processed food. Same thing happened to me when I came to the US. I’d never struggled with weight before. Now, I’m going back to eating like a Kenyan-more plant foods, less meat and fat, and it seems to be working really well. I’m now back to eating food my grandmother used to make and would recognize. I’m 10 lbs away from my pre-US weight of 125. I’ve only recently ditched meat but I’m struggling to give up dairy and eggs at the moment.




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      1. Your website has been very instrumental in helping me not only find my way back to healthy eating but also really understanding how animal products are damaging to our health, so thank you. I’ve been sharing your videos at every chance I get.




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  16. There is another difference between african americans and africans when looking at colorectal cancer: changes in the gut microbiome over the generations through antibiotics and possibly agricultural methods for example the use of chemicals and maybe gmo’s. There is also probably cultural differences in inflammation which would be the best marker to measure. Inflammation with many variables like stress, microbiome, increasing allergies, disrupted circadian rhythms aswell as meat. There are meat eating cultures with low bowel cancer. It’s very very difficult to isolate meat volume as the cause of colorectal cancer. U need to take the same group of people with generations of low bowel cancer and low meat consumption who live together who do everything else the same and never change there environment and eat the same volume of other foods like vegetables and grains processed or not and then increase the meat of a wide ranging subgroup and watch for changes in bowel cancer rates. Then do the same experiment with another culture with genetic variances and then do it again. Otherwise people we are just drawing very very loose conclusions.




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  17. https://www.gutsense.org/fibermenace/fm_transcript.html
    You have probably already discussed this in this site, but in the time I have been following the posts I haven’t come across it, so now with this video about benefits of fiber I would like to ask, how come there is an “expert” claiming the dangers of a high fiber diet !!!??? I would like to hear your opinion about his arguments (even some published papers that he shows as “proof” that his theory is true). Thank you!




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    1. I’ll let those who are both more patient and more qualified to debate Monastryrsky’s various assertions here, but I don’t like his tendentious tone–as if only he knows the truth–and some of his conflations. As to the latter, are we talking about natural dietary fiber contained in whole foods or are we talking fiber supplements? I agree that the latter could be a problem. Taking in a lot of fiber suddenly, after previously eating not much fiber, could also be a problem, especially if we don’t hydrate.

      I probably consume on average 80-100 grams of fiber–about three times the recommended daily allowance–and I virtually never suffer from constipation (I average at least two BM’s a day), ulcerative colitis, hemorrhoids, irritable bowel syndrome, or the other ailments he warns of here. True, this is merely anecdotal evidence, but I think it is the Western low fiber diet which has been implicated in these maladies–not traditional high fiber plant-based diets. I’ve eaten high fiber foods for more than 40 years. Maybe I’m just ‘lucky’?

      1. Fiber and colon cancer. The best Monastryrsky can come up with is that the Harvard Nurses Study failed to find a significant link between increased fiber and reduced cancer (it certainly didn’t establish a correlation in the other direction: between increased fiber and increased colon cancer). Ditto for the FDA. M claims there are ‘mainstream’ studies which do in fact demonstrate a “connection” between increased fiber and polyps, though he doesn’t feature them as he did the HNS and FDA. I wonder why? Probably because they are also not terribly convincing. If they had been, he would have featured them.

      2. Fiber and breast cancer. M claims that a high fiber diet increases your risk for breast cancer. How? Because along with the fiber, you’ll undoubtedly be eating upwards of 300 grams of digestible carbohydrate. If is certainly both easy and advisable to get much less than ten times as much digestible carbohydrate as dietary fiber; a cup of cooked black beans contains 15 g. of fiber and 40 g. of total carbs. M is assuming that a “high fiber” diet contains plenty of refined carbs, fructose, and sucrose, and hence, leads to diabetes as well as breast cancer. He cites a study on breast cancer in Mexican women which states that “among carbohydrate components, the strongest associations were observed for sucrose and fructose”. It’s more than likely that the food sources highest in fructose and sucrose were artificially sweetened foods (sugar and HFCS), not the naturally occurring fructose and sucrose in, say, fruits, which have been given a clean bill of health in other studies. Anyway, one can simply avoid fruits and choose high fiber plant foods like grains, beans, and vegetables which are not high in fructose or sucrose. Notice how M changed the focus from fiber to other unidentified carbs, which may not even contain much fiber? He says that Americans have a very high incidence of breast cancer. Does he or anybody else really believe these Americans are eating a lot of fiber? In fact Americans don’t get enough fiber, as everyone constantly points out.

      3. Fiber and heart disease. Here M gets really confused here. He asserts that a high fiber-low fat diet increases heart disease, but then allows that it may actually lower HD risk–but only through a “sleight of hand” which lowers cholesterol if it is REALLY low fat…but then, he says this also isn’t any good because it also tends to lower HDL–the good cholesterol–even more than the LDL. He cites somebody I’ve never heard of (Gaby) to rebut the AHA guidelines. So much for authorities and the conventional wisdom. In any event, a high fiber diet needn’t be either low fat or high carb–though I suppose a VERY high fiber diet would tend to be both. I think I get 50-55% of my calories from carbs. M says that getting > 60% is dangerous (at least as regards breast cancer), but the WHO advises anywhere between 55% and 75% carb calories. The USDA advises 45-65%. Clearly, M is bucking another widely held belief. To which I respond, extraordinary claims require extraordinary evidence. Monastryrsky provides weak to non-existent evidence.

      I’ll stop at #3. Maybe somebody else will want to tackle the others?




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      1. Thank you for a well-composed response to an “expert” going “against the grain”. I need no further knowledge of anything this “M” fellow says.

        As to the question, ” How come there is an “expert” claiming the dangers of a high fiber diet”?

        The simple answer is to separate himself from the crowd. No one pays much attention to the aligned expert majority. Media and other opportunities to sell oneself seeks out the odd-ball, the “different” one, the novel approach…such that is entirely feasible in our world to make some serious money selling products/services to support any number of cockamamie notions.

        In the case of nutrition, it’s a sad function of the nutritional confusion that pervades our modern societies. Nutritional nonsense can make enough sense to enough people to have financial rewards. Keep this in mind next time some “Expert” comes roaring down the pike with a different take on things. Or look back at the recycling of the “Atkins” sort of thing. http://www.atkinsexposed.org/

        It won’t be long.




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        1. Kate Scott demolished M’s case as regards fiber and breast cancer in the Mexican study, so Monastryrsky seems to be unethical as well as an exaggerator and a blowhard. As you say, he takes advantage of the confusion in nutritional knowledge–as well as some undeniable malpractice in American medicine– to push his outlandish claims. The expert majority is not only not aligned with (as we can see by his deviance from WHO and USDA recommended carb intakes), but is actively maligned. I guess I’d categorize M as a romantic anarchist, who advocates eating more protein and fat from free-grazing animals, high salt and low liquid intakes, and plenty of non-distilled alcohol, as our 18th century forebears did (yes, I read parts of his blog to see where he was coming from). In short, he advocates a diet that would be sustainable for a world with 500 million inhabitants and only affordable for the top 20% of Americans. In this he is not far different from Atkins, Paleo, and the other high meat advocates (who nevertheless aren’t advocating alcohol). I’m waiting for the next pied piper to come along and advocate tobacco (naturally grown, for sure) to add to the high meat, fat, and salt cum alcohol diet. Something for EVERYBODY. At bottom, these false prophets mainly appeal to our vanity and to our appetites,and attempt to free our desires. Hence, they are profitable, as you point out.

          It is sad when Americans average only about 15 grams of fiber that M says we should be wary of exceeding that. In this he strongly diverges from the Paleo advocates, let alone True Paleo–which averaged something like 100 grams of fiber per day. So Monastryrsky seems to be selling the worst of two worlds. At least a ‘good’ Paleo diet–as advocated by Cordain– could contain up to 50 grams of fiber if it truly aimed at getting 50% of calories from fruits and vegetables. Of course we know in practice that it doesn’t, because people tend to load up the meats and animal fats more than the spinach. The whole reason for dietary discipline is to counter the natural tendency to avoid things like fiber, resistant starch, and other things which don’t “taste good”.




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    2. Ironically, I find Monastryrsky’s arguments against colonoscopies rather convincing. Nobody is wrong (or right) about everything. Nevertheless, I find his dogmatic tone irritating.




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    3. Cathie – you need not worry about this guy’s claims. I had a look at one of his claims – he says that it is false that fibre decreases risk of breast cancer (BC). He cites one study in support of this claim and provides a link to the study, so I was able to read it. He says the study found that higher carb intakes were associated with higher BC risk. This much is true. But he omitted some rather key information – the researchers broke the carb category down and they found that the significant association only occurred with sucrose (table sugar), but not with glucose, fructose or lactose. Moreover, and this is the bit that is most relevant to his claim, they found a significant interaction with fibre such the association between sucrose and BC risk was eliminated in women with the highest fibre intake. He forgot to mention that bit! Finally, he made the comment about this study that the findings were “so bad that they canceled the study”.He has just made this up and it is nonesensical – this was a case control (observational) study, not a randomised conrolled trial. So anyone who so badly misrepresents and lies about data is a charlatan and just out to make a buck.




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  18. I’d never tried polenta (African populations consume local varieties as their staple), as the local version (grits) always seemed liquidy and bland. Today I made a batch (4 c vegetable broth boiled, 1 c coarse yellow corn flour, ½ cup sliced mushrooms, tsp fresh rosemary, covered, microwaved 5 min and stirred (x3)), let it cool all day to maximize the resistant starch. It was great reheated, with and without peri-peri sauce.




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  19. Interesting video. Seems the fingers are pointing evermore sharply to the human health problems incurred by animal products. In addition to the role of dietary nutrient components (fats, protein, carbs) in analyzing the impact of a food group to our health, it seems that when evaluating the cause and mechanisms of disease (and health), we must now also ask the question of how that food source impacts our intestinal microbiota and their by-products that play a role in human health, no? Based on various reading on our microbiome, including the very good book ‘The Good Gut’ and also several videos here, it seems this interaction may be a missing link in gaining a fuller understanding of cause and correlation? Meat sitting in one’s colon certainly attracts a different set of bacteria than those that enjoy vegetarian meal!




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  20. How do the Maasi compare with other Africans on colon cancer? From wikipedia, “the Maasai diet consisted of raw meat, raw milk, and raw blood from cattle.” So they should provide a good comparison group.




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  21. I’m experiencing a frustrating conundrum. I love the starchy foods like corn, grains, and beans, and have been following a diet close to McDougall’s, which provides delicious and easy recipes. But here’s the problem. From age 12-13 and continuing 40 years I had terrible hay fever for three months every year – spring in California, summer in colder climates. I don’t know how I could have survived without antihistamines back then.

    About 20 years ago I was tested for food allergies, then, to confirm the results, I went on an elimination diet. Every time I ate a starchy food I would have some kind of reaction. The one I remember most clearly was when I added bananas. All I wanted to do was sit on the bed and stare. It was bizarre!

    To my astonishment and delight, that summer I had no hay fever! None! I remained hay fever free for about 20 years, even though I added back small amounts of starchy foods. I thought perhaps I’d had a leaky gut, which had healed without eating much starch, and that made my body more able to handle pollens.

    Then in 2010 I was diagnosed with an aggressive triple negative breast cancer. I went on a vegan all raw diet, juicing, and lots of other therapies, including low dose chemo twice over the next three years, and a mastectomy. Two years ago I shocked at least one oncologist by actually still being alive.

    I never much liked meat, but I had a tough time giving up cheese. I did, though, along with all dairy foods and eggs. I couldn’t stay warm eating only raw foods and my protein levels fell too low, so I ate more beans and other starchy foods. Then a few months ago I starting eating much more starch – beans, corn, organic wheat, etc. And this summer my hay fever is back and making up for those 20 allergy-free years! I’m so bummed. I LOVE the fiber- and resistant starch-containing foods, but I don’t love itchy eyes, sneezing and taking drugs. How can I get the good diet I need without the consequent allergic reactions?




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    1. Hi, Rebecca, I’ve read a lot of your posts with interest. Two springs ago I had hay fever so bad, I said to myself, “This will be the year I die.” (I’m 69.) This year, just before the season hit, I asked my nutrition support group, (a PlantPure Nations pod group,) if they had any ideas. One person said to look in “How Not to Die,” which I did. I tried to incorporate the things he suggested for just that month. This past spring I had NO allergies. I think, although I could be terribly wrong, that it was the amla I incorporated into my smoothies this past year.




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  22. 1) Animal meat seems to be responsabible for colon cancer
    2) Phytates reduce risk of colon cancer
    3) Iron is absorbtion is heavily reduced by phytates
    4) Iron (heme) is found in high amounts in animal meat and in low amounts in plants (non-heme)
    HYPOTHESIS:
    Could colon cancer be in large part due to an iron overload of the gut?




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    1. For those interested, the answer is YES, colon cancer is likely in part due to an iron overload as postulated (Source below: truncated list)

      New question: Does iron also play a role in the long list of cancer aspects* that respond well to phytates?
      * See same paper as above for full list.




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  23. Can anyone more knowledgeable than me comment on this article http://mbe.oxfordjournals.org/content/early/2016/04/04/molbev.msw049.full?sid=c3fde970-db6d-4f76-ab99-aac089cf271f
    Basically says that a DNA “mutation” in mainly plant based cultures (Asians 70% , Africans 52%) caused people to more readily be able to make essential fatty acids from their precursors (Infers humans all ate meat then went plant based and needed a mutation to help them cope with it? I don’t buy that line of reasoning personally). However when these people with this mutation eat western diets high in O6 oils they convert more to inflammatory compounds than those without this mutation leading to higher risk of heart disease and cancer. Which leads to articles like this: http://www.telegraph.co.uk/news/2016/03/29/long-term-vegetarian-diet-changes-human-dna-raising-risk-of-canc/
    Which seems to me just a beat up. Thoughts?




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    1. Alo: Below are links to a whole host of excellent responses to the interpretation of the study you are talking about. Bottom line: Basically, your quote is criminally misleading “journalism”–not an understanding of the actual study.
      .
      Dr. Greger: http://nutritionfacts.org/video/plant-based-treatment-for-angina/#comment-2597611517
      Dr Katz: https://www.linkedin.com/pulse/vegetarianism-nutrition-science-meets-media-nonsense-davidDr Garth Davis: https://www.facebook.com/drgarth/posts/1126374594050114?hc_location=ufi
      NF Moderator Dr. Jon: http://nutritionfacts.org/video/plant-based-diets-and-artery-function/#comment-2596819840
      NF Moderator Renae: http://nutritionfacts.org/video/almonds-for-osteoporosis/#comment-2601476959
      NF Moderator Dr. Jen: http://nutritionfacts.org/2016/03/31/dr-gregers-new-google-talk/#comment-2599942486 and http://nutritionfacts.org/2016/03/31/dr-gregers-new-google-talk/#comment-2601267177
      NF Moderator Dr. Alex: http://nutritionfacts.org/video/plant-based-treatment-for-angina/#comment-2597863794
      .
      Here’s how I put it all into perspective in my head: *Suppose* someone found out that descendants of *some* healthy people have developed an adaptation where consuming table sugar is even more unhealthy than it already is for everyone else. Thus, future generations might be even more sensitive to the negative health impact of eating Twinkies than we are today. Does that mean we should all eat a bunch of Twinkies today so that our ancestors aren’t worse off eating Twinkies? Of course not. That would be absurd. And that’s essentially (as I understand it) what the article you are quoting is saying in regards to eating meat. What’s more, that claim is a complete twist of what the actual study is actually saying.
      .
      Does that help?




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      1. Thanks for the comprehensive response Thea. Yes that makes a lot of sense. I fail to see downsides to this adaptation in the countries keeping to their traditional PB diets away from the refined Om6 oils. Funny how the telegraph article twists everything around to fit a particular narrative, which has nothing to do with the original study, rather than gain useful recommendations from the actual study itself, that could actually help people! Thanks again




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  24. Several family members have a genetic mutation called “Lynch Syndrome” which increases our chances of certain forms of cancer, including colon cancer. I have been vegan for almost 5 years now and would like to think that I am lessening my chances of getting cancer again (I am an 8 year survivor of stage 1 ovarian cancer…also a Lynch cancer). I was very lucky and would like to believe my dietary changes (healthy plant-based), will help protect me from getting cancer again, despite my genetics. Can you please speak to this?




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  25. Colon cancer runs in my wife’s family, and so we’ve done our research about it, and now abstain from animal products entirely. But I mentioned this research to a friend, and she made the claim that absolutely doesn’t apply to grass-fed beef. I know this is just an excuse to continue eating meat, but I was wondering if there was any specific research to disprove that claim?




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    1. Yes. There is a study from Uruguay, where all the beef is grass fed, that shows the more beef that is eaten, the more cancer. I can dig out the link for you if you are interested.




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        1. Hi

          Back on the laptop now ………………

          All Uruguayan beef is grass fed, organic, no hormones etc eg
          http://onpasture.com/2013/10/28/uruguay-competes-for-grass-fed-market/
          http://www.choicesmagazine.org/2007-1/foodchains/2007-1-03.htm

          And yet, the more beef Uruguayans eat, the greater their cancer risk
          ” There was a statistically significant increase in the odds of cancers of the mouth and pharynx
          (OR=1.63), esophagus (OR=3.30), larynx (OR=1.85), stomach (OR=4.02), colorectum (OR=1.78), lung (OR=1.59), sarcomas (OR=2.27), prostate (OR=1.58), bladder (OR=1.68), kidney (OR=1.96), nervous system (OR=3.12), thyroid (OR=2.38) and of non-Hodgkin’s lymphoma (OR=1.79), myeloma (OR=3.28) and all cancer sites combined OR=1.61) with high intake of total meat and similar findings were found with red meat, beef and lamb.”
          http://tier-im-fokus.ch/wp-content/uploads/2009/11/aune_2009.pdf

          This wishful thinking that grass-fed must be healthy because … well, it just must – bugger the evidence …. also applies to eg dairy products like butter. This is apparently just as false
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720277/

          Don Matesz also has some incisive comments on yhe grass fed is healthy myth
          http://donmatesz.blogspot.com/2012/09/grass-fed-animal-products-prevent.html

          As does this blogger
          http://healthylongevity.blogspot.com/2013/10/Cardiovascular-Disease-in-Ancient-Civilizations.html




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  26. Hmm, first what i think is, can we compare Africa and USA, much people go not to the hospital they go more to a medicinman or they have not enought money. Is this not imbalance between Africa and Usa?




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  27. Dear Dr Gregor,
    Could you please Kindly give me elaborate reply to these Three question. My friend who suffers from stage 4 metastatic colon cancer with diffuse metastasis in both lung fields and is on Chemotherapy and wants to know in addition to role of Fruit and vegetables in cancer mitigation ,Q 1) is there anything which one can take to reduces long term side effects from Irinotecan and 5 FU.and also wants to know Q2) does detox has any role in cancer regression or mitigation.Q 3) How many days one has to eat Fruit and Vegetables alternating with normal diet
    Thank You
    Mushtaq




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  28. Colorectal cancer rates in people under 50 have increased dramatically, study claims.
    http://www.popsci.com/colorectal-cancer-incidence-rate-millennial

    As U.S. meat consumption has increased steadily over the decades (less beef, more chicken):
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045642/

    And perhaps other eating habits add to increase cancer rates, in addition to the obesity epidemic:
    As U.S. sugar consumption has increased steadily over the decades:
    https://www.sciencedaily.com/releases/2014/11/141104141731.htm

    As did US consumption of added oils/fats and refined grains:
    http://ajcn.nutrition.org/content/91/5/1530S/T1.expansion.html
    https://www.ers.usda.gov/webdocs/publications/eib33/12198_eib33_reportsummary_1_.pdf




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    1. Dear Neil,

      In reply to my Questions, thank you for posting to me 4 emails Posts which I am sorry to say relates to Merican Life Style of Eating. As everybody knows lifestyle plays part in Pathogenesis of Cancer as does Stress.

      Unfortunately, these emails are not answers to my Questions as the Question relates to patient who has already suffered from Cancer and therefore I am sure your next Email which I hope I will receive from Your Nutritional Facts will straight away dig into Questions which were asked to be replied and answer accurately what has been asked by Questionaire.

      Stay Blessed

      Mushtaq




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      1. Mushtaq,

        Unfortunately, you made a mistake. I was not replying to your comment/questions. If you look, you can clearly see that my post is not a “Reply” to your comment (whereas your last comment was a “Reply” to my comment). See the difference? I simply made a general post in the comments to the video, as most people have done, and as you did. A recent study regarding colorectal cancer shows a stark increase in young people. This information is relevant to the video, which is why I posted my comment in this discussion.

        But since you mistakenly thought I was responding to you, I will now take the time to actually do so.

        General answer to all of your questions: Eat a whole-food, plant-based diet. It’s that simple. That’s the best defense and recovery against cancer. You can do a search on nutritionfacts.org to see which foods have been specifically shown to fight cancer. Off the top of my head, I know that garlic, broccoli, and tumeric are all foods on which Dr. Greger made videos of, showing their cancer-fighting properties.

        Specific answers to your three questions:
        Question 1.): Have your friend begin taking turkey tail mushroom supplements. They are used to help in chemo recovery, and in boosting the immune system. There are cases where those on turkey tail mushroom supplements have recovered from Stage 4 cancer. It sounds incredible, but the source is convincing. Instead of me explaining more, I urge you to watch this video. https://www.youtube.com/watch?v=7agK0nkiZpA Watch the entire video, but begin paying close attention at minute 7:50.
        If you search for Paul Stamets or turkey tail mushrooms, you can find much more information.
        Example: http://bastyr.edu/news/general-news/2012/11/fda-approves-bastyr-turkey-tail-trial-cancer-patients
        To purchase: http://www.hostdefense.com/turkey-tail

        Question 2.) You question is misguided. Our bodies constantly detox. That is the primary function of our liver and kidneys. You can help your body detox by doing two things: 1.) not toxifying it by way of poor food choices and polluted environment (e.g., polluted water, air, non-organic food, etc.); and 2.) eating a whole-food, plant-based diet, which strengthens our body. For example, eating broccoli, and especially broccoli sprouts, is especially helpful in boosting our liver’s ability to detoxify. Watch this for more info: http://nutritionfacts.org/video/the-best-detox/

        Question 3.) Again, your question is misguided. Eating fruits and vegetables should BE the NORMAL diet! That is the point of this website, nutritionfacts.org. The normal diet should only be a whole-food, plant-based diet, which means fruits and veggies everday, in addition to nuts, beans, legumes, and whole grains. That means the ideal diet/normal diet DOES NOT include added oils, added sugars, heavily-processed foods, animal products, and refined grains. Sometimes out of necessity or politeness we may need to break one or more of these guidelines. But, in my mind, there is no doubt, that the ideal diet is one that is a whole-food, plant-based one. You need to do a search for “cancer plant diet” on this website, and watch some videos of how a plant-based diet is the best method to prevent and possibly cure cancer.

        I wish your friend all the best.

        Neil

        Question




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        1. Dear Neil,

          Thanks a lot for answering so promptly, while I had posted the Question on 06.01.17.

          Dear Neil, he did buy Turkey tail Mushroom from Amazone, it is like a black powder and when Previously my friend tried to cook it, it did not taste well, he doesn’t know how to eat it, does he have take it raw when it is in powder form as he boiled it with other Vegetables, even though Turkey Tail envelope was open about 3 months ago ,will it be OK to eat it now or he has to through it, He even tried to buy Turkey tail Mushroom Spore Kit from the USA but Post office Spoiled the KIT.He takes Shitake Mushrooms boiled.

          The Patient is on Plant based diet since nearly one and a half year, but while he was off Chemotherapy for three months, his Cancer further Metastasized Diffusely in both Lung Fields but stayed stable in his Lymphatic System. Previous he used to add Olive oil on Salad which he has stopped using it after his Previous CT Scan.

          He is now on Two and a half day Fruits and for four and a half day Vegetables but also uses One and Half Cup Brown Rice /day, Does use Turmeric and Black Pepper.

          Apples are causing him the whole night and day flatulence. He is using Pear instead of Apple.

          Thank you very much, and we highly appreciate your advice and precious time.

          God bless You,

          Mushtaq

          Links:




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          1. Dear Mushtaq,

            Sorry to hear the continuing difficulties of your friend’s recovery. Wishing him a full recovery.

            Now, I want to make clear that I am not a physician, and all of my suggestions and comments are my beliefs, which are based on my great interest in, and research into, the areas of nutrition.

            Re: Turkey Tail Mushrooms.

            I have never seen black turkey tail supplements or powders. I have only seem them as being brown. I would be wary of that black-colored product that your friend bought. Throw it away.

            According to what I’ve read, and statements by Paul Stamets, one must heat mushrooms, and/or soak them in alcohol, to unlock their nutrients. In other words, our bodies cannot fully digest or break down mushrooms in their raw form. The turkey tail supplements in powder and liquid form should be ready to consume as they are. In fact, any supplement should have serving suggestions and suggestions on how to ingest on its packaging. Your friend should not be cooking turkey tail mushrooms supplements; consume them as they are. If you buy from a reputable source, the mushrooms should have already been properly prepared, and ready for consumption. A powder or liquid supplement could be mixed with any beverage (e.g., smoothie, coffee, tea, water, etc.). Only with raw turkey tails (if you grow them or find them, or if you buy whole, raw mushrooms that have been dried) do you need to prepare them yourself (via alcohol and/or heating) to extract their benefits.

            I wouldn’t bother buying the mushroom growing kit. Too much work to properly prepare the mushrooms. BUT, if you do buy a kit for medicinal mushrooms, such as reishi, turkey tail, etc., here is the preparation procedure–in italics between the lines–told to me by staff at Fungi Perfecti:
            ________________________

            For more detailed recipes and ratios, see Christopher Hobbs’ book Medicinal Mushrooms.)

            Part 1: Alcohol extraction
            Break the fruitbodies up into the smallest pieces possible. This makes for a larger surface area and thorough extraction. (It’s easier to do this while before drying.)
            Fill a quart or half-gallon canning jar halfway with the dried mushroom.
            Add the vodka, filling the jar to the top. Label it!
            Cap the jar and keep it in a warm, dark place for 4 to 6 weeks. Agitate daily.
            After about a month strain the mixture using cheesecloth, coffee filters, or a strainer.Try straining a few times to really remove all the solids.

            Part 2: Hot water extraction
            Take the alcohol-soaked mushroom pieces that are left over after straining (called the marc) and put them in a pot. Cover them with water.
            Simmer for 2 hours. The water will evaporate throughout this time.
            Allow the tea to cool before you strain it. Discard all the solids but water.
            Add this water to an equal amount of the alcohol extract. This gives you an extract that’s 25% alcohol, as the vodka was 100 proof to begin with (50% water/50% alcohol).
            You may need to do some measuring before you boil the water to make sure you have enough. Gauge the amount of liquid used in your first alcohol tincture and boil at least triple that amount of water for the hot water extraction. It may seem like a lot but it will reduce (you can always keep boiling if it doesn’t).

            Comments
            Suggested use varies depending on the size of the person and the strength of the tincture. A good standard dosage is 1/2 of a teaspoon taken 2-3x a day.
            This extract will keep for about 2 years.
            Store all extracts in a cool place in dark-colored bottles away from direct sunlight. Light can degrade constituents and reduce potency.
            An organic tincture can be made with solvents other than vodka. Glycerin, vinegar, grain alcohol, and rum are all other choices. However, glycerin and vinegar don’t store as long and may not be strong enough, while grain alcohol may be too strong.

            __________________________

            Stamets owns a company called Fungi Perfecti. He sells mushroom supplements under the brand name Host Defense. Here again I sent you the link in my previous post. Personally, I would only buy mushroom supplements from him. He’s been growing and studying mushrooms for decades. His mushrooms are grown in the USA, in a lab. When you buy mushroom supplements online from various sources, you run into a few possible problems:
            1.) many supplements do not contain what they claim. This has been shown many times over. Supplements are not regulated. Companies are to “self-regulate.” If you don’t buy from a reputable source, you may be getting little to no turkey tail. You may be getting starchy filler, for example.;
            2.) the turkey tail may not have been properly heated/cooked to allow for optimal benefits; and
            3.) mushrooms are renowned for accumulating heavy metals and toxins. If you buy your mushroom supplements from random sources online, you run the risk of digesting heavy metals and toxins. For example, I personally never buy any food or supplement that originates in ,or is made in, China. Their food safety and environmental laws are few to non-existent. Mushrooms grown in toxic Chinese soil will contain these toxic chemicals. I assume everything is contaminated from China based on past revelations. Paul Stamets, however, grows his mushrooms on organic brown rice, in controlled laboratory conditions, in Washington State, in the USA. He tests batches for toxins and heavy metals. I trust his turkey tail supplements to be the best, and safest, on the market.

            In summation, if your friend is going to take turkey tail supplements, I would buy them from Fungi Perfecti. Safety, quality, and health should not be compromised by saving a few dollars on mushrooms produced from questionable sources.

            Now your friend has cancer. So the normal serving suggestions for turkey tail may not suffice. Stamets said in the video that he had his mother–who had stage 4 breast cancer–take four turkey tail capsules in the morning and four in the evening. Perhaps your friend should do the same, or even more, in addition to the liquid mushroom extract, which I list below.

            Here are links to the products on Amazon, as it seems that you, as I, like to purchase through Amazon.

            Dried powder, in capsules:
            https://www.amazon.com/Host-Defense-Turkey-Capsules-Support/dp/B00WGROQIM/ref=sr_1_1_a_it?ie=UTF8&qid=1488556106&sr=8-1&keywords=turkey+tail+fungi+perfecti

            Liquid extract that I mentioned:
            https://www.amazon.com/Host-Defense-Extract-Support-Servings/dp/B017MYKYJS/ref=sr_1_6_a_it?ie=UTF8&qid=1488556106&sr=8-6&keywords=turkey%2Btail%2Bfungi%2Bperfecti&th=1

            This is a liquid extract of a mix of turkey tail and other mushrooms that apparently also boost immune function: https://www.amazon.com/Host-Defense-MyCommunity-Comprehensive-Servings/dp/B004C1RSLW/ref=sr_1_7_a_it?ie=UTF8&qid=1488556106&sr=8-7&keywords=turkey%2Btail%2Bfungi%2Bperfecti&th=1

            Re: Your friend’s diet.
            I see no logical reason why your friend is splitting up days when he eats fruits, veggies, and grains. Personally, I would stop this. I know of no medical or rational reason for this. Let him eat–each day, all day–as much fresh fruits, berries, veggies, seeds, nuts, and whole grains as he desires. He is very sick. He needs to consume as much good food/fuel/nutrients as his body desires. Include berries of any or all types. Examples: goji berries, blackberries, blueberries, Indian gooseberries (amla powder is the dried, powdered form), strawberries, rasberries, etc.

            Consider making smoothies for easier, and quicker, consumption. If you have a good blender, you can add any food into it. There is no “correct recipe” or perfect ratio of ingredients. Simply add fresh, whole plant foods. That’s it. For example, here are the ingredients that I throw in my smoothies; usually not all, and ratios vary: frozen fruits, fresh greens of any kind, broccoli sprouts, fresh tumeric root and some black pepper, berries; sometimes some sweet potato, amla powder ((dried Indian gooseberries) there is a Dr. Greger video on this), red beets, flax seed meal, chia seeds, and/or nuts…and enough water to get to correct consistency.

            The tumeric and black pepper is a good idea, based on videos by Dr. Greger. Also, as I mentioned earlier garlic and broccoli are two things that seem to be great at fighting cancer. Include lots of raw broccoli sprouts and garlic into your friend’s diet

            Garlic (#1 veggie to fight cancer? Maybe):
            http://nutritionfacts.org/video/1-anticancer-vegetable/
            Best way to prepare garlic (crush it and wait 10 minutes before cooking): http://nutritionfacts.org/questions/what-are-the-anti-cancer-effects-of-garlic/

            Broccoli (Best if eaten raw. Cooking damages it’s cancer-fighting components apparently. Components need to be mixed to create cancer-fighting chemical sulforophane); broccolie sprouts are best:
            http://nutritionfacts.org/video/raw-broccoli-and-bladder-cancer-survival/
            http://nutritionfacts.org/video/dna-protection-from-broccoli/
            http://nutritionfacts.org/video/biggest-nutrition-bang-for-your-buck/

            Drink green tea! Watch this new video by Dr. Greger: http://nutritionfacts.org/video/can-green-tea-help-prevent-cancer/

            Also make your friend is getting B12 supplementation, as well as Vitamin D supplementation (if he is not getting consistent sun exposure). Very critical nutrients for overall and optimal health. Dr. Greger has videos on these nutrients. You should watch them, if you have questions.

            Well, that’s it. I think I’ve exhausted my nutritional advice. I hope it helps!

            All the best to you and your friend,
            Neil




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  29. Looks like at the bottom of the chart it states Fig. 1 Age-standardized incidence rates for cancers of the colon and rectum in men 34-65 years. Let me know if you want more information for that reference.




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