Health Benefits of Drinking Water

 

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Here’s what you need to know about the benefits of drinking plenty of water.

By Dr. Nina Radcliff

ANALYSIS/OPINION:

You may know that water makes up about two-thirds of who we are – but did you know it influences 100 percent of the processes in our body?

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Yes, we are made of about 70 percent water!

But did you know that our muscles and kidneys are about 75 percent water?

Lungs about 83 percent.

Brain cells about 85 percent?

And even our bones are approximately 30 percent.

That probably explains why we feel better when we drink enough of it, everyday.

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Because of water’s abundant and varied functions in our body, it is a vital nutrient. Our body uses water in all its cells, organs, and tissues to help regulate its temperature and maintain other bodily functions.

It is also used to lubricate the joints, protect the spinal cord and other sensitive tissues, and assist the passage of food through the intestines.

The excellent ability of water to dissolve so many substances allows our cells to use valuable nutrients, minerals, and chemicals in biological processes.

In fact, to function properly, all the cells and organs of our body need water.

Every day, on an average, our body loses about 2 quarts of water through breathing, sweating, digestion – and it’s E-S-S-E-N-T-I-A-L that we rehydrate by drinking fluids and eating foods that contain high water content (soups, tomatoes, oranges).

Keeping hydrated has a huge impact on our overall health.

However, despite how crucial water is, a significant number of people fail to consume recommended levels of fluids each day.

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To understand how water is helping us – here are some great reasons why we should be hydrating with clean, natural water right now:

Your Kidneys. Water is essential for the kidneys to function. Every day, the kidneys filter around 120-150 quarts of fluid. Of these, approximately 1-2 quarts are excreted in the form of urine, and 198 are recovered by the bloodstream. When dehydrated, our kidneys resort to desperate measures in order to conserve water—meaning, decreasing urine output. However, this can also result in the buildup of waste products, electrolyte imbalances, and, if severe, acute kidney failure. And, as we start seeing temperatures rise, so too the incidence of miserable kidney stones. When properly hydrated, we maintain good urine flow and this prevents the build-up of minerals within our kidneys that can form stones.

 

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Calories. Water is void of calories, the original and healthiest zero-calorie drink. As we know, our weight is dependent on the balance of calories consumed versus burned. And, when we take in more than we use as fuel, we gain weight. Too many drinks that we commonly reach for are laden with calories (and added sugar). The average can of soda contains approximately 140 calories; a glass of wine 140 calories; and 12-ounces of unsweetened apple juice 170 calories. And, if you think you are safe with a “diet” drink that gets its sweetness from artificial sweeteners and lacks calories, think again. Research shows that they are linked to weight gain. So, the next time we want to quench our thirst, consider reaching for a glass of no-calorie water.

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Combats Dehydration-Driven Sugar Cravings. H2O is essential to a number of our body’s chemical processes, including the ability to release and tap into energy stores. Glycogen is primarily found in the liver and is our main storage form of glucose. However, when we are dehydrated, our liver cannot release glycogen into the blood stream where it can be utilized as fuel. Consequently, our body sends signals to our brain that it needs to consume something sweet—STAT! So the next time you are craving for a cookie, pastry, or something with sugar, it may not be your sweet tooth you are trying to satisfy, but, instead, your thirst.

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Combat Headaches. Headaches are one of the first signs of dehydration and there are two possible theories for this. First, is that when we do not have enough water, our blood volume decreases, and in order to prevent inadequate blood and oxygen flow to our brain, the brain’s blood vessels compensate by dilating. This causes “crowding” and pain. The other theory is that dehydration results in electrolyte imbalance and stimulates the nerves in our brain to send pain signals.

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Keeps us looking young. Our skin cells can either maintain the form of a grape or a raisin, depending on our hydration. When we are properly hydrated, they are like a grape. And, when dehydrated, our cells are shriveled up and can make wrinkles we have appear more prominent. Drinking water can keep our fountain of youth from drying up.

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Healthy Digestion. When dehydrated, our body resorts to extreme measures to conserve water. This includes “pulling” or “absorbing” water from stool before it exits our digestive tract. The result is hardening and decreased transit time of “poop”—also known as constipation.

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Stroke and Survival After Stroke. In studies by leading centers including one out of Johns Hopkins University, researchers found that nearly half of patients who presented with a stroke due to a clot were dehydrated. And, too, they did worse in the long run.

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Concentration and Energy. Approximately 80 percent to 85 percent of our brain’s weight comes from water. So it is no surprise that when our water levels are low, our brain function is affected—chemical production that signals between brain cells and nerve transmission that is responsible for thinking, movement, and memory. And when you are feeling sluggish, like your energy has been zapped or tired – this, too, is a sign of dehydration and time to reach for some clean, natural water.

Too many are living in a mildly dehydrated state—impacting their health with various irritations like headaches, joint pain, low energy, digestive issues…the list goes on. I consider H20 one of the essential building blocks of good health. Clean, natural water is important for all of us, every day!

And do check the source of your water. One of the best waters you can drink is filtered water. And don’t wait until you are thirsty to drink water as that generally means you have waited too long and are probably already dehydrated.

An age-old question is how much water is enough? The answer is not as simple as we often hear. The recommended amount of water that should be drunk everyday varies from person to person depending on factors such as level of activity, weight, diet and surrounding temperature.

According to the Institute of Medicine (IOM), an estimated adequate intake for men is approximately 13 cups a day. For women, an adequate intake is around 9 cups.

And while we have often heard the directive: “Drink eight 8-ounce glasses of water a day” (and it is close to the IOM’s recommendation for women), drinking “8 by 8” is an easy-to-remember amount that can help people on the right track in terms of water consumption.

Take time – and take note – to ensure you are getting enough. One guideline is to drink water in the morning, when you wake and too, 30 minutes before meals and about an hour or two after meals (aim not to drink excessive amounts after 7 p.m. as it may interfere with your sleep).

If you find in your day you have had very little water, I encourage you to set a timer or a smartphone reminder. The goal is to be properly hydrated, everyday – it can make a world of difference in your overall health.

Make a commitment today!!

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Today’s Fitness Tip from Mayo Clinic:

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The American College of Sports Medicine recommends drinking 2 to 3 cups of water two to three hours before your workout, and and at least 1/2 to 1 cup of water every 15 to 20 minutes during your workout.  Continue to hydrate after your workout to replenish lost fluid.

Remember, balance is key:

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Happy Hydrated Mother’s Day weekend everyone!

 

Nutrition & Breast Cancer

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Good nutrition may reduce the incidence of breast cancer and the risk of breast cancer progression or recurrence. There are many studies in progress to help further understand how diet and cancer are related. We do know, however, that improved nutrition reduces risk of chronic diseases, such as diabetes, obesity, hypertension and heart disease, and also enhances overall quality of life. It is estimated that one third of cancer deaths in the U.S. can be attributed to diet in adulthood [1].

Here are comprehensive guidelines from Natalie Ledesma, MS, RD, CSO and Ida and Joseph Friend Cancer Resource Center, UCSF Helen Diller Family Comprehensive Cancer Center and the University of California, San Francisco.

Guidelines for a Healthy Diet

o Plenty of fruits and vegetables

o High fiber – whole grains and beans/legumes

• Low fat diet with emphasis on healthy fats

• Limit processed and refined grains/flours/sugars

• Drink plenty of fluids

• Be physically active to help achieve and maintain a healthy weight

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Plant based diet

A lifelong commitment to a plant based diet may lower a woman’s risk of developing breast cancer

and may also reduce the risk of recurrent breast cancer. A plant based diet consists primarily of fruits,

vegetables, whole grains, beans/legumes, and other plant protein sources.

* All words noted with an asterisk ( * ) are defined in the glossary

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Fill your plate with approximately

50% vegetables, 25% protein,

and 25% whole grain.

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FRUITS AND VEGETABLES

Contain vitamins, minerals, fiber, and various cancer-fighting phytonutrients* (for example: carotenoids, lycopene, indoles, isoflavones, flavonols).

• Vibrant, intense COLOR is one indicator of phytonutrient* content.

• There is extensive and consistent evidence that diets high in fruits and vegetables are associated

with decreased risks of many cancers, and while results for breast cancer risk are not yet conclusive,

they are promising [2-12].

• In a study of about 3000 postmenopausal women, a protective effect for vegetables was observed [2].

SHINE ON:  Foods for Healthy, Glowing Skin

o Women who consumed 25 or more servings of vegetables weekly had a 37% lower risk of

breast cancer compared with women who consumed fewer than 9 vegetable servings weekly.

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• An epidemiological study reported a significant protective effect of vegetables against breast cancer

when case-control* and cohort* studies were considered together [4].

• A meta-analysis* – looking at the data from 17 studies [13] revealed that high vs. low vegetable

consumption was associated with a 25% reduction in breast cancer risk, but these findings were not

confirmed by collected data from 8 studies [14].

• A recent case-control* study reported women who consumed more than 3.8 servings of fruits and

vegetables daily had a lower risk of breast cancer when compared with women who consumed

fewer than 2.3 daily servings [15].

• Japanese women following a prudent dietary pattern (high in fruits and vegetables, low in fat) had a

27% decreased risk of breast cancer [5].

• A Korean case-control study* reported that a high intake of certain fruits and vegetables resulted in

a significantly lower risk of breast cancer in premenopausal (tomatoes) and postmenopausal women

(grapes and green peppers) [6].

• While no effect was observed for vegetables, increasing total fruit intake significantly lowered the risk

of breast cancer when comparing those in the highest to lowest tertile [16].

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o This effect was greater for those with estrogen-receptor positive (ER+) tumors.

• Eating a salad vegetable dietary pattern (high consumption of raw vegetables and olive oil) exerted a

significant protective effect against HER-2-positive cancers [10].

• A study assessing plasma or blood carotenoids as a marker for fruit and vegetable intake reported

that individuals in the top 1/4 had a 43% lower risk of breast cancer recurrence when compared to

those in the lowest 1/4 [17].

• However, no association was observed between fruit and vegetable consumption and breast cancer

recurrence when women consumed five servings daily vs. eight servings daily [18].

• Breast cancer survivors significantly reduced mortality by following a diet low in fat, high in

vegetables, high in fiber, and high in fruit [19].

• The combination of consuming five or more daily servings of vegetables and fruits, and accumulating

540+ metabolic equivalent tasks-min/wk (equivalent to walking 30 minutes 6 d/wk) decreased

mortality by nearly 50% [11].

o The effect was stronger in women who had hormone receptor-positive cancers.

• Vegetable intake has been inversely associated with serum insulin-like growth factor-I (IGF-I) levels [20].

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BETA-CAROTENE

• Beta-carotene is one of the 600 carotenoids that can be partially converted into vitamin A in the body.

• Carotenoids have a protective role for certain sites of cancer, including breast cancer [7, 21-24].

• Carotenoid intake was significantly associated with reduced mortality in breast cancer survivors [19].

• In various studies, serum beta-carotene levels were lower among breast cancer patients compared

to women without cancer [21,25-29].

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o One of these studies reported the risk of breast cancer to be 221% greater for women in the

lowest quartile of serum beta-carotene compared to women in the highest quartile [29].

• A case-control* study reported that increased plasma levels of beta-carotene, retinol, and total

antioxidant* status were associated with about a 50% reduced risk of breast cancer [28].

• In vitro research indicates that carotenoids may inhibit the production of breast cancer cells [30-31].

o Beta-carotene may inhibit ER+ and estrogen-receptor negative (ER-) breast tumor development

[22].

• Beta-carotene may hinder the development of breast cancer cells by inducing apoptosis*, or

programmed cell death [32].

• Research indicates that dietary sources of beta-carotene are likely much more protective than

supplemental sources against the risk of cancer [33-35].

o Women who consumed higher amounts of dietary beta-carotene, lycopene, and betacryptoxanthin

were associated with a lower risk of breast cancer among Chinese women [23].

o Dietary alpha-carotene, beta-carotene, and lycopene were inversely associated with risk of

ER+PR+ breast cancer [24].

o Dietary beta-carotene intake was inversely associated with IGF-I levels in a large case-control

study [20].

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Cruciferous Vegetables

• Some evidence suggests that the cruciferous vegetables, in particular, are associated with a

reduced risk of breast cancer [36-40].

• A Swedish study of postmenopausal women reported one to two daily servings of cruciferous

vegetables to reduce the risk of breast cancer, possibly by as much as 20-40% [37].

• Women who ate more turnips and Chinese Cabbage, in particular, significantly reduced the risk of

postmenopausal breast cancer [40].

• Consumption of cruciferous vegetables, particularly broccoli, was inversely, though not statistically

significant, associated with breast cancer risk in women [36].

• The U.S. component of the Polish Women’s Health Study found that women who consumed raw- or

short-cooked cabbage and sauerkraut 3 or more times weekly had a significantly reduced risk of

breast cancer [39].

o Cabbage that was cooked for a long time had no effect on breast cancer risk.

o Researchers suggested that glucosinolates, compounds in cabbage, may affect both the

initiation phase of carcinogenesis*, cell mutation*, and inhibit apoptosis*.

• Cruciferous vegetables appear to shift estrogen metabolism in a favorable manner; increasing

2-hydroxyestrone:16-a-hydroxyestrone [41-42]. Fowke and colleagues [42] concluded that

consuming more cruciferous vegetables across the population may very well have an impact on the

incidence of breast cancer.

• Several studies suggest that compounds found in these foods, isothiocyanates (sulforaphane), have

inhibitory effects on breast cancer cells in both cell studies and animal studies [38, 43, 44].

o One mechanism appears to be through potent inhibition of phase I and induction of phase II

detoxifying enzymes, such as glutathione-s-peroxidase [36,40,43].

o Furthermore, these compounds exhibited reduced cell proliferation and inhibited

cyclooxygenase-2 (COX-2) expression in breast cancer cells [45].

o Inhibited cell growth and induced apoptosis has also been observed [46].

• Indole-3-carbinol (I3C) is a compound found in cruciferous vegetables that has anticancer

properties and anti-proliferative effects on breast cancer cells [47].

o I3C may inhibit the growth of blood vessels that the tumor needs to grow (anti-angiogenesis)

[48].

• I3C and diindolylmethane (DIM) induce apoptosis*, or cell death, in breast cancer cells [41,49] for

both ER+ and ER- tumor cells [50].

• Furthermore, I3C and tamoxifen have been shown to act separately and/or cooperatively to inhibit

the growth of ER+ breast cancer cells [51].

• Dietary I3C may have effects that bolster immune function [52].

• Calcium-D-glucarate has been shown to inhibit beta-glucuronidase, an enzyme involved in phase

II liver detoxification. Elevated beta-glucuronidase activity is associated with an increased risk for

various cancers, particularly hormone-dependent cancers such as breast cancer [53].

Nutrient Dietary Sources Recommendation

Beta-carotene

Carrots, sweet potatoes, winter squash, cantaloupe, and mango.

Include these fruits and vegetables daily.

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Cruciferous vegetables

Arugula, broccoli, Brussels sprouts,

cabbage, cauliflower, collard greens,

horseradish, kale, kohlrabi, mustard

greens, radishes, rutabaga, turnips

and turnip greens, and watercress

Include these vegetables daily.

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Organic Produce

• Organic fruits and vegetables have fewer pesticides, lower levels of total pesticides, and less overall

pesticide toxicity than fruits and vegetables grown with chemicals. Although more research is

needed, recent evidence indicates a significant increase in antioxidants* in organic and sustainably

grown foods versus conventionally grown foods [54-58].

o Organic vegetables contained a greater concentration of phytonutrients* (phenolic acids) when

compared to conventionally grown vegetables [57,58].

• Consuming organic foods appears to increase salicylic acid, which may contribute to a lower risk of

cancer [57].

• Pesticides such as organochlorine compounds (OCC), known as environmental pollutants, have

been implicated in the etiology of estrogen-related disorders due to their potential estrogenic and

anti-estrogenic properties [59].

• Results of some studies [59-61], but not all [62] suggest that environmental exposure to

organochlorine pesticide residues or PCBs may contribute to multifactorial pathogenesis of breast

cancer.

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o In a study of women living on Long Island, New York, breast cancer risk was associated with

lifetime residential pesticide use [63].

o Organochlorine pesticide residues, including DDTs and HCHs, may increase women’s risk of

breast cancer, particularly in premenopausal women in China [60].

o Exposure to beta-HCH, an organochlorine pesticide residue, both accelerated the appearance

and incidence of breast cancer tumors when compared to control mice [61].

• The level of exposure may be integral in determining the effects of these OCC.

o One study found that when breast adipose tissue reached levels higher than 2600 ppb, women

with postmenopausal ERalpha-positive breast cancer exhibited high proliferation [64].

• Choosing organic produce will help you reduce your levels of pesticide exposure and will most likely

increase your phytonutrient* consumption.

o Although washing and peeling your non-organic fruits or vegetables may help to reduce

pesticide residues, it will not eliminate them.

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• Listed below are produce with the most and least pesticide contamination, both in terms of number

of pesticides used and the level of pesticide concentration on an average sampling. Thus, for the

fruits and vegetables shown on the most contaminated list, it is wise to buy organic. Alternatively, if

organic choices are not available, you may want to consider substituting with produce that tends to

contain the least amount of pesticides.

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Produce most contaminated by pesticides: Produce least contaminated by pesticides:

Peaches Onions

Apples Avocado

Bell peppers Sweet corn

Celery Pineapples

Nectarines Mango

Strawberries Sweet peas

Cherries Asparagus

Lettuce Kiwi

Grapes–imported Bananas

Pears Cabbage

Spinach Broccoli

Potatoes Eggplant

**Adapted from Environmental Working Group – A Shopper’s Guide to Pesticides in Produce

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It is most important, however, to eat fruits and vegetables – organic or conventional. If the

availability or cost of organic produce is a barrier, you may wish to avoid those fruits and vegetables

that have the highest pesticide residue content.

Pomegranate (Punica granatum; Punicaceae)

• Various parts of the pomegranate fruit (for example: seed oil, juice, fermented juice and peel extract)

have expressed the suppressive effects on human breast cancer cells in laboratory research [65].

• Pomegranate seed oil and fermented juice block the cancer cells’ oxygen supply, slow cell growth,

and promote cell death [66].

• Fermented pomegranate juice polyphenols* appear to have twice the anti-proliferative effect as

fresh pomegranate juice polyphenols* [67].

• Furthermore, one study suggests that pomegranate seed oil may have the greatest preventive

activity (87% reduction in lesions) compared to fermented pomegranate juice (42% reduction) [68].

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FIBER – A PLANT-BASED DIET IS NATURALLY HIGH IN FIBER

• A diet rich in natural fiber obtained from fruits, vegetables, legumes (for example: lentils, split peas,

black beans, pinto beans), and whole-grains may reduce cancer risk and/or reduce risk of cancer

progression.

• Fiber binds to toxic compounds and carcinogens, which are then later eliminated from the body [69].

• Various mechanisms have been proposed for the protective effects of dietary fiber against cancer.

These include:

o Increased fecal bulk and decreased intestinal transit time, which allow less opportunity for fecal

mutagens to interact with the intestinal epithelium [70].

o Binding to bile acids, which are thought to promote cell proliferation [71].

o Fermentation in the gut, producing short-chain fatty acids (SCFA). SCFA improve the gut

environment and may provide immune protection beyond the gut [70,71].

o Additionally, whole grains are rich in antioxidants*, including trace minerals and phenolic

compounds, which have been linked to disease prevention [71].

• Furthermore, a high fiber diet works to reduce hormone levels that may be involved in the

progression of breast cancer [70,72-75].

o A high-fiber, low-fat diet intervention found that fiber reduced serum estradiol* (estrogen breaks

down into estradiol* in the body) concentration in women diagnosed with breast cancer, the

majority of whom did not exhibit weight loss. Thus, increased fiber intake was independently

related to the reduction in serum estradiol* concentration [74].

o This decrease in estrogen levels in the blood thereby may potentially reduce the risk of

hormone-related cancers, such as breast cancer.

o Reduced levels of serum estrone* and estradiol* were observed in premenopausal women with

a greater intake of dietary fiber [73].

o Similarly, a high intake of dietary fiber was significantly associated with low serum levels of

estradiol in postmenopausal breast cancer survivors [75].

o Dietary fiber intake increases the amount of estrogen excreted in the stool [76].

• A high fiber diet is also associated with less obesity [72].

• Total dietary fiber intake, particularly from cereals and fruit, was found to significantly reduce the

risk of breast cancer in pre-menopausal, but not post-menopausal women [77].

• A recent cohort* study reported that high fiber intakes were associated with a 42% lower risk of

postmenopausal breast cancer, when comparing women in the highest quintile of fiber intake

compared to the lowest quintile [78].

An earlier prospective cohort* study, however, reported no protective effect of fiber against breast

cancer when comparing women who consumed fewer than 26 grams dietary fiber compared to

those who consumed even less [79]. This finding is not surprising given that the total grams of fiber

consumption was less than 30 grams.

o Similarly, another study that reported no significant findings compared women consuming less

than 25 grams fiber daily [80].

• Overall, case-control* studies have reported the greater the fiber intake, the lower the incidence of

breast cancer [8,81-84]. Data from prospective studies is mixed, reporting protective effects [78,85]

or no effect observed [79,80].

• Women who ate beans and lentils at least twice a week had a 24% lower risk of developing breast

cancer than women who ate them less than once a month [86].

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High-Fiber Sources

FRUITS:

Food Serving Size Fiber Grams/ Serving

Apple 1 medium 3.7

Banana 1 medium 2.8

Blackberries 1/2 cup 1.9

Blueberries 1 cup 1.3

Cantaloupe 1/2 cup 6.0

Figs (dried) 1/4 cup 6.0

Grapefruit 1 medium 3.4

Grapes 1 cup 1.6

Guava 1 medium 4.9

Kiwi 1 medium 2.6

Orange 1 medium 3.1

Pear 1 medium 4.0

Persimmon 1 medium 6.0

Prunes 1/4 cup 3.1

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GRAINS & OTHER PRODUCTS:

Food Serving Size Fiber Grams/ Serving

Amaranth 1/4 cup dry 7.4

Barley 1/2 cup cooked 3.0

Beans, black 1/2 cup cooked 8.3

Beans, red kidney 1/2 cup cooked 8.2

Beans, garbanzo 1/2 cup cooked 5.0

Bran cereals 3/4 cup Check labels (5.0-22.0)

Brown rice 1/2 cup cooked 1.4

Bulgur 1/2 cup cooked 4.0

Cream of wheat 1/2 cup cooked 0.5

Oatmeal 1/2 cup cooked 2.0

Peanuts 1/4 cup 2.9

Quinoa 1/4 cup dry 2.5

White rice 1/2 cup cooked 0.3

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VEGETABLES:

Food Serving Size Fiber Grams/ Serving

Artichokes 1 medium 6.9

Beets 1/2 cup cooked 1.7

Broccoli 1/2 cup cooked 2.3

Brussel sprouts 1/2 cup cooked 2.0

Carrots 1/2 cup cooked 2.6

Kale 1/2 cup cooked 1.3

Lima beans 1/2 cup cooked 4.5

Peas, green 1/2 cup cooked 4.4

Spinach 1/2 cup cooked 2.2

Squash, winter-type 1/2 cup cooked 3.4

Sweet potatoes (yams) 1/2 cup cooked 2.7

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SUGARS AND THE ROLE OF INSULIN*

• High sugar foods are usually highly processed and refined, low in nutrient value, and also low in

dietary fiber. In addition, these foods appear to increase serum insulin* and serum IGF-I levels [87],

which appear to stimulate cancer cell growth.

o Overexpression, or high amounts, of IGF increases mammary tumors in mice [88].

o IGF’s may work by stimulating cell cycle progression & prevent cells from premature death [89-92].

o IGF-I may promote tumor growth via upregulation of ovarian steroid secretion [92,93].

o Research indicates a synergistic effect between IGF-I and estrogen [94] as well as IGF-I and

insulin* resistance [95] in breast cancer.

• A prospective cohort* study observed a significant 310% increased risk of breast cancer in

premenopausal women who had the highest quartile of IGF-I compared to women with the lowest

quartile [88].

o A weaker association was found with fasting insulin* levels where premenopausal women in the

two highest quartiles had a 70% greater risk for breast cancer.

o In premenopausal women, women in the highest quartile of serum glucose had a 280%

increased risk of breast cancer compared with women in the lowest quartile.

o In postmenopausal women, the associations of glucose, insulin*, and IGF-I were associated

with breast cancer risk in heavier subjects (BMI>26 1).

o Overall, these findings indicate that chronic change of glucose/ sugar metabolism is related to

breast cancer development.

• Other studies support a stronger link between IGF-I and breast cancer in premenopausal women

[91,96].

• Additionally, a case-control* study in China found that IGF-I significantly increased the risk of breast

cancer [95].

• Nonetheless, a recent meta-analysis* review of 18 studies reported no overall statistically significant

association between circulating IGF-I levels and risk of breast cancer although the levels were

greater in breast cancer patients than controls [90].

o However, IGF-I levels did appear to increase breast cancer risk in premenopausal women by

almost 40%.

• Similarly, a large prospective trial reported IGF-I significantly increased risk of breast cancer

in premenopausal women under the age of 50; no significant relationship was noted for

postmenopausal women [97].

• While not all studies [98] agree, a cohort* study reported that higher insulin* levels significantly

increased risk of breast cancer for both pre- and post-menopausal women [99].

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• Recent studies indicate that high insulin* levels, increased concentration of IGF-I, and greater

abdominal fat are associated with increased risk for breast cancer [100].

• It has been suggested that decreasing IGF-I levels may be one factor that contributes to

tamoxifen’s anti-tumor activity in breast cancer therapy [101].

•Research is inconsistent regarding the association of IGF-I and disease-free survival or overall

survival [91].

• One study noted a direct association, though not statistically significant, between non-fasting serum

insulin* levels and 10-year mortality in postmenopausal breast cancer women [102].

• Among other factors, a diet low in fiber may favor the development of insulin* resistance and

hyperinsulinemia [89].

1BMI refers to body mass index, which is calculated by body weight (kg)/height2(m2).

• Hyperinsulinemia may contribute to the development of breast cancer in overweight or obese

women [103].

• Additionally, obesity and fasting hyperinsulinemia have been associated with a poorer prognosis in

women with established breast cancer [104].

• A recent case-control* study reported that carbohydrate intake significantly increased risk of breast

cancer; sucrose (table sugar) imparted the greatest risk [105]. This risk was lessened considerably

with a higher fiber intake.

• Furthermore, an Italian case-control* study found that women who consumed the highest tertile

of desserts and sugars had a 19% increased risk of breast cancer compared with women in the

lowest tertile [106].

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• The consumption of sweet foods with a high glycemic index (GI) and glycemic load (GL) have been

implicated as a risk factor for breast cancer due to their effects on insulin and IGF-I [107-110].

o Women who consumed the greatest intake of desserts (including biscuits, brioches, cakes,

puffs and ice-cream) and sugars (including sugar, honey, jam, marmalade and chocolate) had a

19% increased risk of breast cancer compared with women who consumed the least desserts

and sugars [107].

• Adding credence to the idea that blood sugar levels may affect disease progression, women who

consumed a high GI and GL diet had a 57% and 253% increased risk of breast cancer, respectively

[108].

o This effect was most pronounced in premenopausal women and those women at a healthy

body weight.

• GI and GL were both associated with an increased risk of breast cancer among postmenopausal

overweight women; this effect was most pronounced for women with ER- breast cancer [109].

• This evidence was further supported by a meta-analysis that reported GI to modestly increase the

risk of breast cancer [110].

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INSULIN HIGH TIDE. The observed link between obesity and cancer may be explained by the growthpromoting

activities of insulin and IGF-1. One theory posits that excess weight sets off a biochemical

cascade that increases insulin and, in turn, IGF-1 levels. Both hormones may activate IGF-1 receptors

on cells, which can spur cell growth and inhibit cell death pathways that usually protect against tumor

development.

E. Roell/Source: Nature Reviews Cancer, 2004

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Sugars & Insulin* – Bottom Line

• To help control your insulin* level:

o Eat a high-fiber diet with limited refined/processed foods

o Follow a low fat diet rich in omega-3 fatty acids

o Exercise

o Maintain a healthy body weight

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LOW FAT DIET

Several studies have investigated the relationship of fat and the risk of breast cancer, but the results

remain inconsistent. However, two recent trials showed some promise in the area. The Women’s

Intervention Nutrition Study (WINS) found that a reduced fat intake improves relapse-free survival

by 24% in postmenopausal women with breast cancer compared with women following a standard

diet [111]. The risk of recurrence for women with ER- breast cancer decreased by 42%. Later, the

European Prospective Investigation into Nutrition and Cancer (EPIC) Study reported that eating a

higher fat diet significantly increased the risk of breast cancer; women who had a 35% and 39% fat

diet were at a greater risk than those eating a 31% fat diet [112]. While neither of these diets would

be considered low fat, a significant effect was still observed.

eating

The potential elevated cancer risk may be, in part, due to the fact that a high fat diet stimulates

increased estrogen levels, which is associated with breast cancer growth. A study of adolescent

females found that modest reductions in fat intake during puberty resulted in significantly lower concentrations

of sex hormones (estradiol*, estrone*, progesterone) [113]. Further research is needed to

determine if in fact these lower levels lead to a reduced risk of breast cancer.

Additionally, a low fat, high carbohydrate diet may result in a significant reduction in breast density,

particularly in women going through menopause. Aim for close to 20% of your total calories from

fat, with less than 8% of total calories from saturated fat. Research indicates that the type of fat

may be of paramount importance.

Saturated Fats

• Several studies indicate a positive association between saturated fat intake from meat and

dairy products (animal sources) and cancer [114-117]. The breast cancer research, however, is

inconclusive.

• Total saturated fatty acid intake was significantly associated with breast cancer risk in cohort*

studies in postmenopausal women, but not premenopausal women [118].

• Based on a seven-day diary for evaluating saturated fat intake, a high intake of saturated fat was

reported to increase the risk of breast cancer [116].

• A meta-analysis* observed a 19% increased risk of breast cancer with greater intake of saturated

fats [119].

• Other studies, however, have not found a significant association between saturated fats and breast

cancer [120-122].

Trans-Fatty Acids

• Preliminary research indicates that these fatty acids may be associated with an increased risk of

cancer [123-126].

• Minimal research exists on the relationship between trans-fatty acids and risk of breast cancer, thus,

more research is needed for conclusive evidence. However, some evidence points to a positive

association between these fats and breast cancer risk [125,127].

• These fats may disrupt hormonal systems that regulate healing, lead to the destruction of defective

membranes, and encourage the development of cancer.

• One study reported a 40% increased risk of breast cancer in postmenopausal women who had

higher tissue levels of trans-fatty acids [128].

• Women who consumed greater amounts of trans-fatty acids significantly increased their risk of

breast cancer [126].

o Women in the highest quintile of trans-fatty acid consumption had a 75% increased risk

compared with women in the lowest quintile.

Omega-9 Fatty Acids (Monounsaturated Fats)

• Most research at this time indicates a neutral relationship [120,126] or a slightly protective effect

[122,129-131] between these fats and risk of breast cancer.

• Several case-control* studies reported that olive oil consumption, rich in omega-9 fats, resulted in a

13-34% reduction in breast cancer risk [132-135].

o One study found that women who consumed ≥8.8 g/day of olive oil had a 73% lower risk of

breast cancer [131].

• Oleic acid, an omega-9 fatty acid found in olive oil, has been observed to synergistically enhance

the efficacy of trastuzumab (Herceptin) [136,137].

• A meta-analysis*, however, that included three cohort* studies reported total monounsaturated fatty

acids and oleic acid, a type of omega-9 fatty acid, to significantly increase breast cancer risk [118].

Essential Fatty Acids (EFA)

Essential fatty acids are necessary for the formation of healthy cell membranes, the proper

development and functioning of the brain and nervous system, and for the production of hormonelike

substances called eicosanoids* (thromboxanes, leukotrienes, prostaglandins). Among other body

functions, these chemicals regulate immune and inflammatory responses.

Eicosanoids* formed from the omega-6 fatty acids have the potential to increase blood pressure,

inflammation, platelet aggregation, allergic reactions and cell proliferation. Those formed from the

omega-3 fatty acids have opposing affects. Current research suggests that the levels of essential

fatty acids and the balance between them may play a critical role in the prevention and treatment of

cancer.

Omega-3 Fatty Acids

• Research is growing supporting a protective relationship between omega-3 fatty acids [alpha

linolenic acid (ALA), eicosapentanoic acid (EPA), and docosahexanoic acid (DHA)] against the risk of

breast cancer [118,120,135-141].

• Studies show that omega-3 fatty acids inhibit breast cancer tumor growth and metastasis.

Additionally, these fats are immune enhancing.

• Mechanisms proposed for their protective effects include:

o Suppression of eicosanoid synthesis from arachidonic acid (omega-6 fatty acid), which

impedes immune function [139,142].

o Inhibit cell growth and differentiation via effects on gene expression and signal transduction

pathways [139,142].

o Alter estrogen metabolism, which reduces estrogen-stimulated cell growth [139,142].

o Effects on insulin* sensitivity and membrane fluidity [142].

• A prospective study reported that women who consumed 44 g or more of dietary marine sources of

omega-3 fatty acids reduced their risk of breast cancer by 26% when compared with women who

consumed 25 g or less [120].

• Women with the greatest EPA, DHA, and total omega-3 fatty acids in their red blood cell

membranes from fish had a 73%, 94%, and 89% lower risk of breast cancer, respectively [140].

• An inverse relationship was found between omega-3 fatty acids in breast tissue and the risk of

breast cancer [137].

o When comparing women in the highest tertile of ALA and DHA to the lowest tertile, cancer risk

was reduced by 61% and 69%, respectively.

• Preliminary research indicates that DHA may synergistically enhance taxane cytotoxicity [143]. More

research is needed, but these findings would indicate that DHA during taxane administration may

improve the effects of chemotherapy for breast cancer patients.

• Fish and plant-based foods, however, contain different types of omega-3 fatty acids.

o Fish contains EPA and DHA, two specific fatty acids that have shown promising results in the

research literature [135,140,144].

o Fish consumption in general has been associated with a protective effect against breast cancer

[136,138,140,145].

o The plant-based omega-3 fatty acid sources, such as flaxseed and others listed in the table

below, contain ALA. In an ideal environment, ALA is converted to EPA and DHA, however, this

process is inefficient [69,142,146]. On the positive side, the conversion process is enhanced by

following a diet that is low in saturated fats and low in omega-6 fatty acids [142,147].

Omega-6 Fatty Acids

• Recent studies indicate that a high intake of omega-6 fatty acids (linoleic acid, which can

be converted to arachidonic acid) promote breast tumor development and metastasis

[117,137,138,148,149].

• A meta-analysis* of 3 cohort* studies found palmitic acid, a type of omega-6 fatty acid, to be

significantly associated with an increased risk of breast cancer [118].

• Additionally, researchers reported that arachidonic acid, an omega-6 fatty acid almost exclusively

from meat, significantly increased oxidative damage as measured by urinary biomarkers [150].

• It is known that cyclooxygenase is the rate-limiting enzyme that catalyzes the conversion of

arachidonic acid to prostaglandins. Furthermore, COX-2 is known to be overexpressed in various

human cancers. In this breast cancer study, COX-2 overexpression was significantly correlated with

larger tumor size and advanced clinical stage, which indicates a poorer prognosis [149].

• A very interesting finding was reported in a prospective study that found no overall association

between omega-6 fatty acids and risk of breast cancer [120]. However, omega-6 fat consumption

increased risk by 87% in women who consumed 25 g or less of marine omega-3 fatty acids. This

effect was even greater for advanced breast cancer.

o Thus, the balance between omega-6 and omega-3 fatty acids may be of paramount

importance. This was further supported by other studies [137,138,151,152].

Fat – Bottom Line

• Less fat is better.

• Limit animal fats.

• Avoid hydrogenated fats.

• Extra-virgin olive oil, canola oil, macadamia nut oil or almond oil is preferred for salads

and cooking.

• Increase omega-3 fatty acids.

Fatty Acid Dietary Sources Recommendation

Saturated fatty acids Meats, poultry skin, baked goods,

and whole milk dairy products,

including butter, cheese, and ice

cream

Reduce or eliminate meat and

whole milk dairy products.

Trans fatty acids Margarine, fried foods, commercial

peanut butter, salad dressings and

various processed foods including

breads, crackers, cereals, and

cookies

Avoid trans or hydrogenated

fats.

Products may be labeled “trans

fat free” if they contain less

than 0.5 mg per serving.

Omega-9 fatty acids Extra-virgin olive oil, almond oil,

canola oil, macadamia nut oil,

almonds, and avocados

Include these healthy fats daily.

Limit consumption of nuts to no

more than ¼ cup with meal

or snack to limit total fat and

calories.

15

Omega-3 fatty acids:

EPA and DHA

ALA

Cold-water fish (for example:

salmon, sardines, black cod, trout,

herring), breastmilk, and DHAenriched

eggs

Flaxseeds, chia seeds, walnuts,

hempseeds, and pumpkin seeds

Include these healthy fats

daily through diet and/or

supplements.

It may be wise to consume

cold water fish or fish oil

supplements at least twice

weekly to obtain an adequate

amount of EPA and DHA.

If you choose to use a

supplement, opt for one that

is highest in EPA and DHA

concentration.

Omega-6 fatty acids:

Arachidonic acid

Linoleic acid

Meats, butter, egg yolks, whole milk,

and whole milk dairy products

Common vegetable oils, such as

corn oil, safflower oil, sunflower

oil, and cottonseed oil, and

processed foods made with these

oils

Reduce or eliminate meat and

whole milk dairy products.

Limit consumption of linoleic

acid-rich oils.

Substitute an omega-9 fatty

acid-rich oil for your current

cooking oil or fat.

Meat

• In a study of over 35,000 women, meat consumption significantly increased the risk of breast

cancer in both premenopausal and postmenopausal women [153].

o Women eating 1.75 ounces of processed meat daily increased the risk of breast cancer by

64% in postmenopausal women compared to women who did not eat meat.

• Consumption of red and fried meat quadrupled the risk of breast cancer in a case-control study in

Brazil [12].

• Meat consumption increased the risk of breast cancer risk by 56% for each additional 100 g (3.5

oz) daily of meat consumption in a French case-control study [135].

• Regular consumption of fatty red meat and pork fat increased the risk of breast cancer by 348%

and 632%, respectively in a small Brazilian study [154].

• A large case-control* study found that women who consumed very well-done meat for hamburger,

bacon, and steak had a 54%, 64%, and 221% increased risk for breast cancer, respectively [155].

o Frequent consumers of these well-done meats had a 462% greater risk of breast cancer.

16

Food Category Summary Recommendation

Fruits and vegetables One serving =

½ cup fruit or vegetable

1 cup raw leafy greens

¼ cup dried fruit or vegetable

6 oz fruit or vegetable juice

Eat 1 cup or more vegetables with

lunch and dinner.

At least 5, preferably 8-10 total

servings daily [156]

5 or more vegetable servings

3 fruit servings

Fiber Choose breads with 3 or more

grams of fiber per slice.

First ingredient on the label should

be whole or sprouted grain flour,

not white flour, unbleached white

flour, or enriched wheat flour.

Whole grains include, among

others, oats, barley, brown rice,

quinoa, amaranth, bulgur, millet,

buckwheat, spelt, wild rice, and

teff.

30-45 grams daily

This goal can be achieved

by meeting your fruit and

vegetable goal plus one

serving of legumes or at least

two servings of whole grains.

Refined carbohydrates and

sugars

Dietary sources include products

made with refined flours (for

example: white bread, white rice,

white pasta) or refined grains,

alcohol, sodas, drinks containing

added sugars, and desserts, such

as candy, cookies, cakes, and

pastries.

Limit or avoid consumption.

Meat Dietary sources include beef, pork,

and lamb.

Reduce or eliminate meat

consumption.

Avoid processed, grilled or fried

meats.

GENOTOXINS: Heterocyclic Amines (HCAs) & Polycyclic Aromatic Hydrocarbons (PAHs)

• Natural components in meat, such as amino acids, creatine*, and polysaccharide precursors,

are converted to HCAs during high-temperature cooking. HCAs are known to cause cancer in

laboratory animals [157,158].

• While human research is forthcoming, the majority of studies [155,157-162] although not all

[163,164] have observed a significant association between HCAs and breast cancer.

• Carcinogenic activity of HCA’s is affected by various dietary factors [165]:

o Factors that enhance carcinogenesis* when combined with HCAs include:

• High-fat diet

• Caffeine

17

o Factors that inhibit carcinogenesis* when combined with HCAs include:

• DHA

• Conjugated linoleic acid (CLA)

• Isoflavones

• Diallyl Sulfides (found in the allium family, such as garlic, onions, leaks, and shallots)

• Green tea catechins*

• Indole-3 carbinol

• Probiotics

• Gamma-tocopherol

• The most important variables contributing to the formation of HCAs are:

o Cooking temperature (greater than 300°F)

o Cooking time (greater than 2 minutes)

o Cooking method (frying, oven grilling/broiling, barbecuing)

• Charring of food (charcoal-broiled or smoked foods) contribute to PAHs [166].

• Meat can potentially be made “safer” to eat by being cooked in a way that does not lead to HCA

formation.

o Choose lean, well-trimmed meats to grill.

o Using marinades significantly reduces the amount of HCAs.

o Brief microwave preheating substantially reduces HCA content of cooked meat.

o Small portions require less time on the grill.

• Additionally, the type of protein cooked can also affect the concentration of HCAs. It has been

reported, for example, that chicken has more than 100 times the number of HCAs than salmon [165].

London broiled steak had more than 600 times the amount of HCAs when compared to salmon.

• Grill vegetables or meat alternatives that do not lead to the formation of HCAs or PAHs.

ALCOHOL

• Regular consumption of alcohol may increase the risk for breast cancer [167-176].

o A recent review study reported that data from many well-designed studies consistently shows

a small rise in breast cancer risk with increasing consumption of alcohol [172].

• A recent study found that as little as a half a glass of wine a day raised a woman’s risk of

developing breast cancer by 6% (increased risk by 18% in postmenopausal women) [167].

o Furthermore, 1-2 drinks a day increased risk by 21% and 2 or more drinks a day increased risk

by 37%.

o The heightened risk was more pronounced for women with ER+ and progesterone-receptor

positive (PR+) tumor types.

•Women who drank two or more alcoholic drinks daily in the five years prior to diagnosis had an

18

82% increased risk of breast cancer compared to non drinkers [173].

•A pooled analysis of six prospective studies suggests that the risk of breast cancer increases

linearly by 9% with each 10 g /day (~ 1 drink) alcohol [177]. The risk increased to 41% when

comparing women who consumed 30-60 g/day (~2-5 drinks) to nondrinkers.

•A large meta-analysis* revealed that one drink daily increased breast cancer risk by 11% [178]. A

later meta-analysis* found similar findings [179].

•Since then, another meta-analysis* reported that breast cancer risk increased by 32% and 46% in

women who consumed 35-44 g alcohol (~3-4 drinks) daily and 45 g or more (~4.5 drinks or more)

daily, respectively [170].

o For each additional 10 g of alcohol (~1 drink) daily, risk increased by 7%.

•Other studies [168] claim that one glass of alcohol daily does not increase risk, but consuming 2-5

drinks daily increases the risk of breast cancer by 40% compared to non-drinkers [168].

o Greatest risk was among heavy drinkers who were also postmenopausal and had a history of

benign breast disease or who used hormone replacement therapy (HRT) [168].

•Similarly, a French study found that drinking 10-12 g wine (~ 1-1.5 drinks) daily lowered the risk of

breast cancer, but when intake increased above 12 g daily, the risk of breast cancer increased [180].

•Among ER+ postmenopausal women, those who consumed approximately 3 drinks or more daily

had a 76% increased risk of breast cancer when compared with women who did not consume

alcohol [181].

o The association between alcohol and ER- tumors was less clearly associated.

o Additionally, there was no clear association between alcohol and premenopausal risk of breast

cancer.

•A recent cohort* study of postmenopausal women reported that alcohol consumption was

associated with an increased risk of breast cancer in ER+, but not ER- tumors [182].

•On a similar note, a recent meta-analysis reported that an increase in 10 g (~1 drink) alcohol daily

increased the risk of breast cancer, especially for women with ER+ breast cancers –ER+ (12%

risk), all ER- (7% risk), ER+PR+ (11% risk) ER+PR- (15% risk), ER-PR- (no effect) [174].

•Petri and colleagues [171] observed a stronger relationship between alcohol and breast cancer in

postmenopausal women compared to premenopausal women.

o Premenopausal women drinking more than 27 drinks per week had a 3.5% higher risk than

women who had one drink per week.

o Postmenopausal women drinking six or more alcoholic beverages per week had a 2.4% higher

risk than women who had one drink per week.

•On the contrary, women who drank about 1.5 drinks per week had a 40% greater likelihood of

developing breast cancer compared to non drinkers and this was most pronounced in women who

were premenopausal at diagnosis [175].

•Alcohol consumption (1 drink/day) during a woman’s fifties increased risk for postmenopausal

breast cancer by 12% in a large cohort* study, but statistical significance was not reached for

women in their twenties, thirties, or forties [169].

•These differing findings between pre- and postmenopausal women are likely related to the effect of

alcohol on estrogen levels. Alcohol appears to increase endogenous* estrogen levels [183-187].

•Folate, a B vitamin, may be of even greater significance with alcohol consumption. It has been

observed that women with low folate and high alcohol consumption had a 43% greater risk of

19

breast cancer when compared with nondrinkers with adequate folate intake [188].

Alcohol –Bottom Line

•It is best to limit or avoid alcohol.

ADEQUATE FLUIDS

The functions of water in the body include the following:

o Carries nutrients and waste products.

o Participates in chemical reactions.

o Acts as a lubricant and cushion around joints.

o Acts as a shock absorber in the eyes and spinal cord.

o Aids in the body’ temperature regulation.

o Maintains blood volume.

•Increased fluid intake is needed for a high fiber diet.

•Drink plenty of water daily to help meet fluid needs.

CALORIC INTAKE

•The risk of breast cancer is much higher in industrial countries than in developing countries where

women are characterized by lower energy intake and higher energy expenditure.

•Modest caloric restriction has been shown to inhibit tumor growth in animal models decrease

oxidative DNA damage [189].

•Modest caloric restriction has been shown to decrease oxidative DNA damage.

•The mechanism involved may be related to the decrease in IGF-I observed when caloric intake is

restricted [190,191].

•Furthermore, evidence suggests that a high calorie diet may increase IGF-I levels [192].

BODY MASS

•Epidemiologic evidence suggests a positive association between body mass and postmenopausal

breast cancer [193-196].

o Increasing BMI was associated with a 40% increased incidence and mortality of breast cancer

in postmenopausal women [197].

o Women with a BMI of ≥5 had a 58% increased risk of breast cancer [5].

o Obese postmenopausal women had 3.26-fold increased risk for breast cancer compared to

healthy weight women [198].

o In women with breast cancer, height and BMI were associated with postmenopausal breast

cancer [199].

20

•This effect was most pronounced in women with ER+ tumors.

o Obese postmenopausal women had a 50% increased risk for breast cancer [196].

•A recent case-control* study of 2000 women found that women who gain weight, particularly after

age 50, significantly increase their risk of breast cancer [200]. Conversely, women (young and

middle-aged) who lose weight may decrease the risk of breast cancer.

o This study suggests excess body fat increases estrogen levels, which may in turn increase the

risk for breast cancer.

o An earlier study reported similar findings with total weight gain serving as a strong predictor of

breast cancer risk, specifically among former and never HRT users [193].

•Increasing BMI was associated with a 40% increased incidence and mortality of breast cancer in

postmenopausal women [197].

•Results from a systematic review showed that, when adjusted for BMI, a larger waist size increased

risk of breast cancer among premenopausal women [202]. This study supports the idea that central

obesity is of greater concern than general obesity in regards to breast cancer risk.

o However, for postmenopausal women, a large trial found that, while general obesity was a

significant predictor of breast cancer risk, central obesity did not appear to be associated with

increased risk [203].

•Total body weight, BMI, and hip circumference were significantly associated with breast cancer risk

among HRT nonusers; obese women (BMI > 30) had a 31% greater risk compared to women with

BMI < 25 [203].

•Overweight or obesity is associated with poorer prognosis in the majority of the studies that have

examined body mass and breast cancer [204-210].

•Various studies report increased BMI or body weight to be a significant risk factor for recurrent

disease, survival, or both [204-210].

o May be related to increased estrogen [196,211,212] and elevated insulin* and IGF, which can

stimulate cell proliferation [101,204].

o Obese postmenopausal women (BMI >30) had 35% higher concentrations of estrone* and

130% higher concentrations of estradiol* compared with lighter-weight women (BMI < 22.0)

[211]. Additionally, free estradiol* and free testosterone were two to three times greater in

overweight and obese women compared with lighter-weight women.

o Recent findings indicated that oxidative damage, measured by urinary biomarkers, was

significantly greater in women with a higher BMI [150].

o Obesity among premenopausal women, however, may not be associated with increased risk

of breast cancer. Nonetheless, obesity during menstruating years is associated with obesity

throughout life and therefore to an eventual increased risk of breast cancer [132]. However,

other research suggests a stronger relationship between body weight and breast cancer in

premenopausal women [208,210].

o A cohort* study of 1300 women reported that breast cancer recurrence and death increased

with body weight in both premenopausal and postmenopausal women [158].

•Body weight prior to breast cancer diagnosis significantly increased risk of recurrence and death in

nonsmokers [208].

o Additionally, nonsmokers who gained weight after diagnosis had an elevated risk of breast cancer

death during follow-up (median, 9 years), compared with women who maintained their weight.

21

•Women with a BMI of ≥5 had a 58% increased risk of breast cancer [5].

•Research suggests a potential link between obesity, diabetes mellitus and breast cancer [214].

•Eating foods high in vitamin C, such as fruits and vegetables, may provide a protective effect from

breast cancer for overweight women (BMI>25) [215].

PHYSICAL ACTIVITY

•Low levels of physical exercise appear to be associated with the risk of breast cancer [172,195,216-218].

•Lifetime total physical activity has been associated with a decreased risk of breast cancer

[219-221].

o Some studies indicate that physical activity has a more significant effect in reducing risk of

breast cancer in postmenopausal women [222].

o Exercise between the years of 14-20 appears to be the most beneficial in reducing risk of

breast cancer [219].

•A case-control* study reported significantly reduced breast cancer risk among women who

maintained, on average, 17.6 (MET)-hr of activity/week2 from menarche onward [195]. This

decreased risk with physical activity was limited to women without a family history of breast cancer

when adjusted for BMI.

•A cohort* study reported that postmenopausal women who were most physically active (> 42.0

MET-h/week)3 at baseline had a 29% lower incidence of breast cancer than active women with the

least activity (> 0-7.0 MET-h/week) 4 [218]. This difference was greatest for women who did not use

HRT at enrollment.

•Women who engaged in regular strenuous physical activity at age 35 had a 14% reduced risk of

breast cancer compared with less active women [217]. A similar trend was observed for regular

strenuous activity at age 18 and at age 50. These findings were consistent with women who did

and did not use HRT.

•Furthermore, a prospective observational study reported that physical activity after a breast cancer

diagnosis may reduce the risk of death from this disease [216]. The greatest benefit occurred in

women who performed the equivalent of walking 3 to 5 hours per week at an average pace. The

benefit of physical activity was particularly apparent among women with hormone-responsive

tumors.

•As noted earlier, the combination of consuming five or more daily servings of vegetables and fruits,

and accumulating 540+ metabolic equivalent tasks-min/wk (equivalent to walking 30 minutes

6 d/wk) decreased mortality by nearly 50% [11].

o The effect was stronger in women who had ER+ cancers.

•Increased physical activity following breast cancer diagnosis significantly decreased the risk of

dying from breast cancer and improved overall survival when compared with women who exercised

<2.8 MET-h/wk [224].

•Survival may be enhanced by physical activity in those women who exercised the year prior to

diagnosis, especially women who were overweight or obese [225].

•Exercise was associated with improved quality of life among survivors [226,227].

22

•Physical activity can help ease cancer-related fatigue during and following cancer treatment

[228,229].

•Physical activity may reduce the risk of breast cancer through an influence on ovarian function and

a decrease in progesterone and estrogen concentrations via reduced body fat [217]. Furthermore,

exercise may increase sex hormone-binding globulin* (SHBG) levels and thereby reduce estradiol*.

•An increase in lean body mass (often achieved through physical activity) was associated with

a favorable change in 2-hydroxyestrone: 16-α-hydroxyestrone, a proposed biomarker of breast

cancer risk [230].

•Additionally, exercise reduces serum insulin levels [231], serum IGF-I levels [217,232], and improves

insulin* sensitivity [217].

•Greater physical activity in obese women was associated with significantly less mammographic

density, possibly suggesting another mechanism for the protective effect of physical activity [233].

•Healthy weight control is encouraged with an emphasis on exercise to preserve or increase lean

muscle mass.

2 This is equivalent to a 150lb individual burning 1257 kcals/week through physical activity.

3 This is equivalent to a 150lb individual burning about 3000 kcals/week through physical activity.

4 This is equivalent to a 150lb individual burning 500 kcals/week or less through physical activity.

Additional Nutritional and Lifestyle Factors for Breast Cancer Survivors

ANTIOXIDANTS* –Found in abundance in fruits and vegetables!

•Prevent oxidative damage in body cells.

o Research indicates a link between oxidant damage and breast carcinogenesis*.

•Examples of antioxidant* nutrients and non-nutrients include vitamins A, C, and E, selenium,

lycopene, and beta-carotene.

•Note that patients may be advised to NOT consume high-dose antioxidant* supplements during

chemotherapy or radiation therapy. Antioxidant* consumption via food sources and a basic

multivitamin supplement are very safe.

Selenium

•Antioxidant* that scavenges free radicals and suppresses damage due to oxidation. Also is

essential for the immune system.

•Promising evidence indicates that selenium may decrease the risk of breast cancer [234-239].

o Inhibits cell proliferation and induces apoptosis* [238,239].

•Selenium may interfere and alter estrogen receptors decreasing mammary tumor incidence [236].

• Research shows that selenium reduces the incidence of malignant cells in animal models [237], and

enhances the effects of chemotherapeutic drugs, such as [235] taxol and adriamycin [235,239].

• Toenail selenium concentrations tended to be lower in postmenopausal breast cancer patients when

compared with healthy non-cancer patients, but the differences did not reach statistical significance [240].

o Interestingly, this study also found that plasma triiodothyronine (T3) (a thyroid hormone)

concentration was positively associated with toenail selenium in breast cancer patients and

controls. T3 concentration was significantly lower in breast cancer patients compared to

healthy non-cancer patients.

• A recent study suggested the combination of selenium and iodine, typical of a Japanese diet, act

synergistically in decreasing breast cancer risk [241]. It is known that iodine plays an important role in

thyroid function. Thus, selenium status may affect both thyroid hormone status and iodine availability.

• Selenium is a precursor to the glutathione* (GSH) antioxidant* system. GSH is the principal

protective mechanism of the cell and is a crucial factor in the development of the immune response

by the immune cells [242].

o Studies suggest the ratio of selenium to glutathione* is at lower levels in breast cancer patients

[234]. Research indicates that dietary selenium supplements correct abnormal glutathione*

turnover.

Turmeric (Curcumin)

• Curcumin, the yellow pigment and active component of turmeric and many curries, is a potent

antioxidant*, that exhibits chemopreventive and growth inhibitory activity in several tumor cell lines

[243-246].

• Evidence suggests that curcumin may suppress tumor initiation, promotion and metastasis [245,247].

o This may occur through enhanced apoptosis* [243,245].

• Additionally, curcumin promotes detoxification in the liver and possesses anti-inflammatory activity,

possibly by inhibiting COX-2 activity [248,249].

Vitamin C

• Most research [250-255], although not all [7,19,256,257], has shown no protective relationship

between vitamin C and the risk of breast cancer.

o Vitamin C induces apoptotic effects on breast cancer cells [257].

• Low plasma levels of vitamin C have been associated with a greater risk of breast cancer [258].

• Dietary vitamin C has been significantly associated with reduced mortality in breast cancer

survivors [19].

• Furthermore, risk of recurrence and mortality was reduced in women who consumed vitamin C

supplements for more than three years [259].

Vitamin E

• Vitamin E acts as a cellular antioxidant* and an anti-proliferating agent. It consists of both

tocopherols and tocotrienols.

24

o Some research indicates that tocotrienols are the components of vitamin E responsible for

growth inhibition in human breast cancer cells [260].

• Research is inconsistent on the protective effects of vitamin E and breast cancer. Data from most

prospective studies have not revealed a protective relationship between vitamin E and risk of breast

cancer [250].

• Supplemental vitamin E does not consistently appear to offer protection against breast cancer [150]

although taking vitamin E for more than three years has been associated with a modest protective

effect [259]. Additionally, these researchers reported a decreased risk of recurrence and mortality

associated with long-term use of vitamin E supplements.

• However, low plasma levels of vitamin E have been associated with a greater risk of breast cancer [258].

• It was demonstrated recently that dietary vitamin E, unlike supplemental sources of vitamin E,

significantly reduced oxidative damage as measured by urinary biomarkers [150].

• Note that findings suggest that vitamin E supplements may interfere with the therapeutic effects of

tamoxifen [261].

Resveratrol

• Resveratrol is a polyphenol found primarily in red grape skins with known antioxidant and antiinflammatory

properties, and is emerging as a potent chemopreventive and anticancer drug [262].

• Resveratrol has exhibited potential anticarcinogenic activities in several studies.

o Reduced tumor growth, decreased angiogenesis, and induced apoptosis in mice [263].

o Less tumors and longer tumor latency in a rat study [264].

o May inhibit IGF-I mediated cell migration in breast cancer cells [265].

o Induces apoptosis in breast cancer cells [262,263].

o Decreased levels of vascular endothelial growth factor (VEGF) in breast cancer cells [263].

o Inhibited cell growth and regulates IGF-II in breast cancer cells [266].

• Recent evidence indicates that resveratrol and glucans have significant synergistic effects on

immune function [267].

Nutrient/Phytonutrient Summary Recommendation

Selenium Dietary sources include Brazil nuts,

seafood, enriched brewer’s yeast,

and grains.

Selenium content depends

somewhat on the amount of

selenium in the soil in which the

products are grown.

200 mcg selenium daily through

diet and/or supplements

Two Brazil nuts provide 200

mcg selenium.

Turmeric (curcumin) A deep orange-yellow spice

commonly used in curries and

Indian cuisine.

Eat liberally.

25

Vitamin C Dietary sources include various fruits

and vegetables, including papaya,

citrus fruits, kiwi, cantaloupe,

mango, strawberries, bell peppers,

broccoli, and tomatoes.

Include these fruits and

vegetables daily.

Vitamin E Dietary sources include vegetable

oils, wheat germ, sweet potatoes,

nuts, seeds, and avocados.

Eat vitamin E-rich foods

regularly.

More research is needed to

assess whether or not

supplements would be

beneficial.

Resveratrol Dietary sources include grapes,

grape products, peanuts, soy,

mulberries, and cranberries.

Eat resveratrol-rich foods

regularly.

More research is needed

to assess whether or not

supplements would be

beneficial.

Flax

• Flax may also work to block tumor growth, inhibit angiogenesis*, and enhance the immune system [268].

• Consumption of 5 or 10 g flax for 7 weeks significantly decreased blood levels of estrone* and

estradiol* [269].

• Flax has been shown to enhance the effects of tamoxifen [270].

• Flaxseed is the greatest source of mammalian lignans* [271,272], phytoestrogens found in flax,

which appear to bind with estrogen and lower circulating levels of estrogen. This action may act as

one of the protective mechanisms of flax for breast cancer.

o Lignans* facilitate the removal of estrogens via increased retention within the gut, which are

later eliminated in the feces [273,274].

• Furthermore, lignans* positively influence estrogen metabolism by improving the ratio of 2:16a

hydroxyestrone [273,274].

• A recent study indicates that flaxseed (25 g daily) and its metabolites, such as lignans*, reduced

tumor growth in patients with breast cancer [271].

• Additionally, a recent pilot study observed lower breast density with a greater intake of dietary

lignans* [275]. Dense breasts are a risk factor for breast cancer.

• Flax has been shown in vitro and in human trials to decrease tumor proliferation of breast cancer

cells [271].

• An animal study reported that flaxseed inhibited established human breast cancer growth and

reduced incidence of metastasis by 45% [272].

• Tumor growth was reduced by 26% and 38%, respectively, when mice consumed a 5% flaxseed

diet and 10% flaxseed diet compared with those who ate no flaxseed [270].

o This effect may be partially due to its downregulation of IGF-I [270,272,276], decreased cell

proliferation [270], and increased apoptosis [270].

26

GREEN TEA

• Tea contains phytonutrients* known as polyphenols* (flavonoids) that provide antioxidant* and

anticancer properties [277].

o May block the formation of cancer-causing nitrosamines* [278].

o Prevents DNA damage [279].

o May inhibit tumor growth and induce apoptosis* [280-282].

o Increase immune response [281].

o Epigallocatechin gallate (EGCG) alters gene expresssion to lower the risk of breast cancer

[283].

• There is a significant amount of in vitro and in vivo evidence suggesting tea polyphenols* have

chemopreventive agents against various cancers [280,284,285]. More human data is needed.

o Green tea and its catechin* components inhibit breast cancer growth and angiogenesis* in both

in vitro and in vivo studies.

o Studies suggest green tea extract has been successful inhibiting cell proliferation and breast

cancer [277].

• Many studies indicate a lower risk of breast cancer with green tea consumption, but more research

is needed for conclusive evidence [286-289].

• EGCG has been shown in human studies to inhibit human breast cancer cell proliferation, reduce

tumor invasion and metastasis and prevent recurrence of breast cancer in early stage cases (stage I

& II) [290-292].

• A meta-analysis* reported that drinking green tea decreased the risk of breast cancer by 22% when

comparing women with the highest vs lowest intake [286].

• A case-control study* found that green tea consumption was associated with a significant reduction

in risk of breast cancer [289].

o Risk by 13% for women consuming 1-249 g of dried green tea leaves annually.

o Risk by 32% for women consuming 250-499 g of dried green tea leaves annually.

o Risk by 41% for women consuming 500-749 g of dried green tea leaves annually.

o Risk by 39% for women consuming ≥750 g of dried green tea leaves annually.

o Moreover, protection was greater with a longer duration of drinking green tea, a greater number

of cups consumed and the more new batches prepared daily.

• However, combined studies of 35000 Japanese women found that green tea did not affect risk of

breast cancer [293].

• Research suggests that while green tea did significantly decrease tumor mass, when green tea was

combined with soy phytonutrients*, the tumor mass decreased even further [294]. Further evidence

indicates a possible synergistic relationship between soy and green tea consumption [288].

• Similarly, a synergistic effect of green tea and Ganoderma lucidum extracts on the suppression of

growth and invasiveness of metastatic breast cancers was observed [295].

• Additionally, green tea increased the inhibitory effect of tamoxifen on the proliferation of ER + breast

cancer cells [296].

• Furthermore, some evidence suggests that the association of tea catechins* and breast cancer may

depend on specific genotypes [284].

27

SOY

• Associated with reduced rates of heart disease [297-299], protection against osteoporosis

[300,301], and certain types of cancer, including breast cancer [302,303].

• While there has been contention regarding soy and breast cancer, research findings are

predominantly neutral [304], if not protective [6,305,306].

o The majority of short-term soy intervention studies conducted in premenopausal women show

a reduction in endogenous* estrogen levels in association with soy intake, and thus, possibly

protecting from breast cancer.

o The conflicting data on the effects of soy isoflavones and breast tumor growth are based on in

vitro (test tube) studies.

• Recent human research has been more promising.

o A statistically significant inverse association between plasma genistein and breast cancer was

reported among Japanese women [305].

o A recent meta-analysis of well-controlled studies that included high-soy-consuming Asians

reported a significant trend of decreasing risk with increasing soy food intake. Risk was lowest

among those who consumed ≥20 mg isoflavones daily [306].

o High soybean intake in Korean women resulted in a significantly lower risk of breast cancer in

postmenopausal women [6].

• It’s becoming more apparent that the timing of soy exposure is critical. Consumption of soy foods

or an exposure to a soy isoflavone genistein during childhood and adolescence in women, and

before puberty onset in animals, appears to reduce the risk of breast cancer later in life [307].

• The type of soy consumed may provide some insight to the inconsistent findings. It has been

demonstrated that soy processing increases tumor growth in mice for postmenopausal ER+ breast

cancer [308].

o The difference in tumor growth observed may be related to isoflavone metabolism and

bioavailability, but more research is needed [309].

o Nonetheless, these studies suggest that WHOLE SOY FOODS appear to not have a

negative effect on postmenopausal ER+ breast cancer.

o A recent cohort* study of breast cancer patients found that soy foods had no negative impact

on breast cancer survival [310,311].

• An Asian-American study on soy found that women, pre- and postmenopausal, who consumed

tofu, had a 15% reduced risk of breast cancer with each additional serving per week [302].

• Moreover, a recent trial reported that women in the highest tertile intake of tofu had a 51% decrease

risk of premenopausal breast cancer when compared with women in the lowest tertile [303]. No

statistical significant association was observed between soy intake and breast cancer risk among

postmenopausal women.

• Soy consumption has been suggested to exert potential cancer-preventive effects in

premenopausal women, such as increased menstrual cycle length and SHBG* levels and reduced

estrogen levels.

o 40 mg/day soy isoflavones increased menstrual cycle length in Western women [312].

o Research also suggests that soy isoflavones may significantly improve the

2-hydroxyestrone:16-a-hydroxyestrone ratio [313].

28

o Additionally, soy intake increases time spent in the follicular cycles, when proliferation is at its

lowest [312].

• Furthermore, vegan protein sources, such as soy, appear to decrease circulating IGF-I activity,

which may impede cancer induction [298,314,315].

• Recent literature assessing the effects of soy and tamoxifen have yielded neutral [316] or beneficial

findings [317].

o In a study of Asian American breast cancer survivors on tamoxifen, soy intake had no effect on

levels of tamoxifen or its metabolites [316].

o The combination of tamoxifen and genistein inhibited the growth of ER+/HER2- human breast

cancer cells in a synergistic manner in vitro [317].

Source Amount of Soy

Protein (gm)

Amount of Soy

Isoflavones (mg)

Miso (1 tbsp) 2 7-10*

Soybeans, edamame (1/2 cup) 11 35*

Soymilk (8 fl oz) 10 23*

Soy nuts (1/4 cup) 19 40-50*

Tempeh (1/2 cup) 19.5 36*

Tofu (4 oz) 13 39*

* Isoflavone content varies by brand

Vitamin D

• Epidemiological studies suggest an inverse relationship between sun exposure, serum levels of

25(OH)-vitamin D, and vitamin D intake and the risk of developing and/or surviving cancer [318].

o Possible mechanisms that may explain the protective effects of vitamin D may be its role as

a nuclear transcription factor that regulates cell growth, differentiation, apoptosis and a wide

range of cellular mechanisms central to the development of cancer.

o Furthermore, breast density, a factor that may increase the risk of breast cancer, was inversely

associated with vitamin D intake [319].

• The women in the Nurses’ Health Study observed a 30% reduction in risk of breast cancer

comparing the highest with lowest quintiles of 25(OH)-vitamin D levels. [320].

•Post-menopausal breast cancer risk was significantly inversely associated with serum 25(OH)-

vitamin D levels [321].

o Risk decreased as women’s levels increased from 30 nM (12 ng/ml) to ≥75 nM (30 ng/ml).

•It is now believed that the recommended vitamin D dose should be between 800 and 2,000 IU per

day.

o Research indicates that vitamin D3 (cholecaciferol) is better absorbed than vitamin D2

(ergocalciferol) [322].

29

Due to the likelihood of a biochemical deficiency without clinical symptoms or signs, a serum

25(OH)-vitamin D level is recommended.

o Optimal serum 25-hydroxy vitamin D levels have not been established though research

suggests 36-40 ng/ml may be ideal [323]. Some believe the normal level of vitamin D should be

50-60 ng/ml.

o While supplementation may be recommended, more appropriate dosing of vitamin D

supplementation can be made once a serum 25(OH)-vitamin D level has been established.

Food or Beverage Summary Recommendation

Flaxseed Good source of omega-3 fatty

acids and fiber, contains protein,

calcium, potassium, B vitamins,

iron, and boron.

Opt for ground flax seeds rather

than whole flax seeds, flax seed

oil, flax supplements to increase

bioavailability.

Flax seeds may be ground in a

coffee grinder, blender, or food

processor.

2 Tbsp ground flaxseed daily

Flax can have a laxativelike

effect, thus, it is wise

to gradually increase

consumption.

Sprinkle into various foods

and beverages, including

hot cereals, tomato sauces,

fruit smoothies, brown rice or

other grains.

Store flax in the refrigerator or

freezer.

Green tea Green tea contains does contain

caffeine though much less than

coffee or black tea.

If opting for decaffeinated green

tea, opt for those naturally

decaffeinated with water as typical

caffeine extraction results in a

significant loss of phytonutrients.

1-4 cups daily

Soy Contains various nutrients, including

protein, fiber, calcium, and B

vitamins.

Rich in antioxidants*, known as

isoflavones, namely genistein and

daidzein.

Among others, dietary sources

include soybeans, edamame, tofu,

soymilk, tempeh, miso, and soy

nuts.

Unless soy has been a part

of your diet for years,

postmenopausal individuals

with ER+ breast cancer

may be advised to limit soy

consumption to 1-3 daily

servings.

Soy supplements or

isoflavone extracts are not

recommended.

Vitamin D A fat-soluble vitamin that we generate

through skin synthesis of sunlight

(ultraviolet rays).

Dietary sources include cold-water

fish, eggs, and fortified products,

such as milk, soy milk, and cereals.

400-2000 IU daily

Maintain serum 25 (OH)-vitamin

D >35 ng/mL.

30

MELATONIN

• Melatonin is a hormone produced by the pineal gland. Its primary function involves the regulation of

the body’s circadian rhythm, endocrine secretions, and sleep patterns.

• Some research indicates that individuals with low levels of melatonin are at greater risk for breast

cancer.

• The risk of breast cancer was reduced by 33% in postmenopausal women who slept 9+ hours

compared to those who slept ≤6 hours daily [324].

o Melatonin levels were 42% higher in those who slept 9+ hours vs ≤6 hours daily.

o Previous studies have reported an increased risk of breast cancer in night-shift workers who

are exposed to light at night [325-327].

• It may be that the length of time working night shifts makes a difference as

evidenced by this study where women who reported more than 20 years of rotating

night shift work faced an increased risk of breast cancer compared with women who

did not report any rotating night shift work [326].

o In vitro and animal research has supported the protective effect of melatonin against breast

cancer [328].

o A recent study found that women with higher urinary melatonin levels had a 30-41% reduced

risk of breast cancer [329].

• Melatonin may act by:

o Inhibiting cell proliferation [330,331].

o Inducing apoptosis* [332].

o Enhancing the immune system [330,333].

• May improve survival in cancer patients by protecting the immune system from

damage caused by chemotherapy [332].

o Reducing IGF-I [334,335].

o Decreasing the number and activity of estrogen receptors, thus reducing ways that the cancer

cell connects to estrogen [336].

• Various studies indicate that melatonin may inhibit breast cancer by interfering with estrogen

pathways, thus acting in an anti-estrogenic manner [331,333,337,338].

o Melatonin decreases the formation of estrogen from androgens by inhibiting aromatase activity

[331].

• Furthermore, the combination of melatonin and retinoids* [339] as well as the combination of melatonin

and vitamin D3 [340] appear to work synergistically to inhibit the growth of breast cancer cells.

• Melatonin does have blood thinning properties, thus it is recommended to not use supplemental

melatonin 7-10 days prior to surgery.

FOOD SAFETY

• Especially important for those with weakened or impaired immune systems and while on

chemotherapy

31

• The following recommendations have been adapted from guidelines provided by the American

Cancer Society.

o Wash foods thoroughly before eating.

o Keep all aspects of food preparation meticulously clean.

o Use special care in handling raw meats, poultry, and eggs.

• Thoroughly clean all utensils, countertops, cutting boards, and sponges that

contacted raw meat.

• Thaw meats and fish in the refrigerator.

o Transfer large volumes of leftovers, such as soup, rice, or casseroles, to shallow containers and

place in refrigerator. This process ensures proper cooling.

o Do not eat perishable foods that have been left out of the refrigerator for more than two hours.

o Store foods at low temperatures (less than 40oF) to minimize bacterial growth.

o When eating in restaurants, avoid foods that may have bacterial contamination, including sushi,

salad bars, buffets, unpasteurized beverages or food products, and raw or undercooked meat,

poultry, fish, and eggs.

SUMMARY – HEALTHY BREAST CANCER DIET

• Eat 8 to 10 colorful fruit and vegetable servings daily

o Two to three pieces of fruit

o One cup or more of vegetables with lunch and dinner

o 8 fl oz vegetable juice

• Consume 30 to 45 grams of fiber daily

o You will likely meet your fiber goal if you eat 8 to 10 servings of fruits and vegetables plus one

serving of beans/legumes or at least two servings of whole grains daily.

• Avoid processed and refined grains/flours/sugars

o Keep WHITE off your plate: bread, pasta, rice, cream sauces, cakes, and more.

• Limit meats and whole milk dairy products

• Include healthy fats like cold-water fish, flaxseed, walnuts, soybeans, olive oil, avocados

• Eat 2 Tbsp ground flax daily

• Limit alcohol consumption

• Drink 1 to 4 cups of green tea daily

• Maintain serum 25 (OH)-vitamin D levels above 35 ng/mL

• Drink plenty of fluids, water or non-caffeinated beverages, daily to help meet fluid needs

• Engage in daily physical activity to help achieve and maintain a healthy weight

32

Bone Health

• Pre- and postmenopausal survivors of breast cancer are at great risk for development of

osteoporosis.

o Thus, screening and preventive strategies for osteoporosis are imperative.

• Even small amounts of increased bone mass provide great risk reduction for fractures.

• Generally, humans reach peak bone mass around 30 years. After the age of 30, the goal is to

maintain or prevent loss of bone mass.

o On average, humans lose 0.3 – 0.5% bone mass yearly after 30 years.

• First signs of osteoporosis are seen in spine, hip, and wrist.

o Symptoms include back pain or tenderness, loss of height, and slight curving of upper back.

• Risks for osteoporosis include: female, Asian or white ethnicity, age, menopause, amenorrhea, low

testosterone levels in men, sedentary lifestyle, family history, diet low in calcium, diet low in vitamin

D, excessive alcohol and tobacco use, excessive caffeine use, diet high in sodium, diet excessive in

protein or very low in protein, certain medications (diuretics, steroids, thyroid meds), celiac disease

• Many nutrients have bone-building effects, including calcium, vitamin D, phosphorus, magnesium,

vitamin K, potassium, and boron (see table below).

• Exercise increases bone mass before menopause and slows bone loss after menopause.

o Include weight-bearing exercise, such as walking, jogging, skiing, stair climbing, aerobics, and

others.

o Resistance training exercises are useful to strengthen muscles and bones.

• Recent research indicates diets high in fruits and vegetables have a positive effect on bone health.

o Good source of minerals (potassium, magnesium) that may have direct effects on bone cells.

o Counteract acid environment.

o Lower urinary calcium loss.

o Enhanced calcium bioavailability of most vegetables.

• Soy protein and/or soy isoflavones have been proposed to delay bone loss.

o May help to prevent urinary calcium loss.

o Soy contains phytosterols that mimic the actions of estrogen.

o May help to prevent rapid bone loss of menopause years.

o Studies report that soy may BMD.

• Calcium supplements

o Take 500 mg or less per meal to maximize absorption.

o Calcium citrate, lactate, or gluconate are recommended if you have iron deficiency.

• These do not decrease iron absorption like calcium carbonate.

o Calcium carbonate is least expensive, but may increase gas and bloating in some individuals.

33

• What about antacids with calcium?

o Trace minerals like zinc or iron may be less well-dissolved and absorbed with a lower stomach

acidity.

o If you’re only taking enough antacid for the purpose of calcium needs, should not present a

major problem, but not ideal.

o May interact with thyroid medication.

• DEXA (dual-energy X-ray absorptiometry) instruments allow rapid, painless, noninvasive, and highly

reproducible measurements of bone density to be made [341].

o These measurements are used to diagnose osteoporosis, low bone density, and risk of fracture

and to determine rates of bone loss or the effectiveness of treatment over time [342,343].

Bone Health – Bottom Line

• Balanced diet – high in fruits and vegetables

• Calcium

o Aim for 3 rich sources daily.

o Include a supplement if necessary.

• Vitamin D

o Meet needs from sun, multivitamin, or other supplement.

o Consider serum vitamin D test.

• Exercise

o Weight-bearing exercise for at least 30 minutes on most days.

• Good posture

• Request to have a full body DEXA scan.

34

Bone Building Nutrients

Nutrient* Dietary Sources Function Recommendation

Calcium Dairy products, canned

fish with soft bones,

beans, leafy greens

(especially collard

greens, bok choy, and

kale), tofu, almonds,

fortified products, such

as soy milk, cereal, and

orange juice

calcium absorption

and bioavailability from

foods, especially plant

sources

Vitamin D is essential for

calcium absorption.

1000-1200 mg

daily

Vitamin K Dark leafy greens, liver,

tomatoes, soybeans,

and garbanzo beans

Also produced by

intestinal bacteria

Associated with bone

turnover and urinary

calcium excretion.

90 mcg daily

Phosphorus Meat, poultry, fish, eggs,

milk, products, legumes,

and nuts

Combines with calcium to

strengthen bones.

700 mg daily

Magnesium Whole grains, nuts, seeds,

spinach, and most fruits

and vegetables

Important in calcium and

potassium uptake.

320 mg daily

Potassium Bananas, strawberries,

tomatoes, prunes,

potatoes, spinach, and

beans

Associated with

urinary calcium and

phosphorus excretion.

4700 mg daily

Boron Apples, avocados, beans,

milk, peanuts, peanut

butter, pecans, raisins,

prunes, and potatoes

Improves calcium

absorption.

effects of vitamin D and

magnesium deficiency.

2 mg daily

Zinc Seafood, meats, tofu,

whole grains, blackeyed

peas, wheat bran

and germ

Important in calcium

uptake and immune

function.

8-15 mg daily

* Vitamin D is listed in the previous table

35

Hot Flashes

• Hot flashes are a major cause of morbidity among postmenopausal women, including many

survivors of breast cancer.

• Approximately 75% of postmenopausal women who had breast cancer report experiencing hot

flashes [344].

o More than 90% of young survivors also experience hot flashes, which can be more severe and

long lasting, with iatrogenic ovarian ablation or antiestrogen therapy.

• Various non-hormonal therapies have been studied for improving hot flashes, including soy, black

cohosh, red clover, and vitamin E – none have shown much significant clinical value.

• Supplemental vitamin E at 400 IU/day [345] and 800 IU/day [346] has shown some limited efficacy

in improving hot flashes.

• Systematic reviews of randomized controlled trials have observed contradictory results, and

meta-analyses* demonstrate no statistically significant reduction of vasomotor symptoms for

phytoestrogens [347].

o Individual trials report significant reductions in vasomotor symptoms for red clover and soy

phytoestrogens.

o The placebo effect in many of these studies was quite strong [348].

o Studies assessing black cohosh and red clover have had inconsistent results, with some trials

showing benefit and some no difference compared with placebo [349].

o In one study, women receiving black cohosh reported a mean decrease in hot flash score of

20% compared with a 27% decrease for patients on placebo [350].

• Mean hot flash frequency was reduced 17% on black cohosh and 26% on placebo.

o A previous study reported reduced hot flashes with soy isoflavones by 9 to 40% in some trials,

but most trials observed no effect when compared with placebo [349].

• Black cohosh extract had no effect on serum estrogenic markers [351].

• The use of black cohosh appears to be safe in breast cancer patients [352].

• Psychoeducational interventions, including relaxation, seem to alleviate hot flashes in menopausal

women and breast cancer survivors; however, the methodological quality of published research has

been considered to be fair or poor [353].

WORDS OF WISDOM

“Let food be your medicine and medicine be your food.”

– Hippocrates

For additional information or resources, please visit the Ida and Joseph Friend Cancer Resource

Center at 1600 Divisadero St. on the first floor, or call at (415) 885-3693. The information in this

publication is designed for educational purposes only and is not intended to replace the advice of

your physician or health care provider, as each patient’s circumstances are individual. We encourage

you to discuss with your physician any questions and concerns that you may have.

36

Three Day Menu Plan: 3 Meals + Snack

This menu is based on 1600 calories, calories can be adjusted by altering portion sizes. The menu

has been designed to merely serve as a guide in making healthy food choices. Experiment with

substitutions as desired.

Day 1 Day 2 Day 3

Oatmeal, cooked (1 cup)

Soy milk (1 cup)

Flaxseed, ground (2 tbsp)

Blueberries (1/2 cup)

Green tea (2 cups)

Bagel, whole grain (1 med)

Hummus (2 tbsp)

Tomato (6 slices)

Lemon pepper

Cantaloupe (1 cup)

Green tea (2 cups)

Tofu scramble

Tofu (4 oz)

Onions (1/4 cup)

Peppers (1/2 cup)

Mushrooms (1/2 cup)

Toast, whole grain (1 slice)

Jam (1 tbsp)

Turkey sandwich

Whole grain bread (2 slices)

Turkey (2 oz)

Lettuce (1/2 cup)

Tomato (4 slices)

Red peppers (1/4 cup)

Onions (2 tbsp)

Mustard (1 tsp)

Carrots (1/2 cup)

Snap peas (1/2 cup)

Vegetable Bean Soup (2 cups)

Corn tortilla (1 med)

Green salad (2 cups)

Oil/vinegar dressing (1 tbsp)

Salad

Spinach (3 cups)

Broccoli (1/2 cup)

Carrots (1/2 cup)

Tomato (1/2 cup)

Garbanzo beans (1 cup)

Barley, cooked (1/2 cup)

Avocado (4 slices)

Olive oil (1/2 tbsp)

Vinegar, balsamic (1 1/2 tbsp)

Roll, whole grain (1 med)

Orange (1 med)

Vegetable juice (12 oz)

Granola bar (1 each)

Fruit smoothie

Banana (1 med)

Berries (1 cup)

Flaxseed, ground (2 tbsp)

Yogurt, plain nonfat (1/2 cup)

Soy milk (1 cup)

Green tea (2 cups)

Popcorn, air-popped (3 cups)

Fish (3 oz)

Pasta, whole grain (1 1/2 cups)

Tomato sauce (1 cup)

Mushrooms (1/2 cup)

Olive oil (1/2 tbsp)

Broccoli (1 cup)

Mixed fruit (1 cup)

Chicken & vegetable stir-fry

Chicken breast (4 oz)

Mixed vegetables (2 cups)

Walnuts (2 tbsp) OR

Olive oil (1/2 tbsp)

Brown rice, cooked (1 cup)

Salmon (4 oz)

Quinoa, cooked (1 cup)

Asparagus (1 cup)

Fruit salad (1 cup)

37

Recipes

Baked Tofu

Ingredients:

• 1 pound tofu, firm, drained

• 3-4 tbsp marinade or sauce (personal favorite: Veri Veri Teriyaki by Soy Vay)

Chop drained firm tofu into 1” cubes. Place tofu cubes in glass dish for baking. Pour marinade or

sauce over tofu, stir well. Place tofu in oven at 350 F for 1 hour. Stir every 15-20 minutes.

Makes four 4-ounce servings.

Nutrition Information (per 4 oz serving):

Calories: 96 Dietary fiber: <1 gm

Protein: 8 gm Sodium: 318 mg

Fat: 5 gm Calcium: 155 mg

Saturated fat: <1 gm Iron: 1.4 mg

Recipe developed by Natalie Ledesma, MS, RD, CSO

Washington Insider Salad

Ingredients:

• 1 can (15 oz) kidney beans, drained

• 1 can (15 oz) black eyed peas, drained

• 1 1/2 cups cooked barley

• 6 tbsp cilantro, chopped finely

• 1 can (11 oz) corn

• 1 1/2 cups tomatoes, diced

• 3 tbsp balsamic vinegar

• 2 tbsp olive oil

Prepare vegetables. Mix all ingredients together, and serve on a bed of dark green leafy lettuce. Add

salt and pepper to taste.

Makes 8 servings (1 cup each).

Nutrition Information (per serving):

Calories: 215

Protein: 10 gm

Fat: 4 gm

Dietary fiber: 9 gm

Recipe developed by Sous Chef Chris at the Occidental Grill, Washington D.C.

Spinach Spread

Ingredients:

• 1 package (10.5 ounces) silken tofu

• 1 tbsp lemon juice

38

• 1/4 tsp garlic powder

• 3/4 tsp onion powder

• 1/2 tsp dried tarragon

• 1/4 tsp salt

• 1 box (10 ounce) frozen chopped spinach, thawed

• 1 cup coarsely shredded carrots

• 1/4 cup chopped green onion

Puree the tofu and lemon juice in blender until smooth. Whirl in the garlic and onion powders,

tarragon, and salt just to blend. Scrape into a mixing bowl. Squeeze the spinach as dry as possible.

Stir it into the tofu, along with the carrots and green onion. Mix well. Serve with crackers, pita

triangles, or vegetables.

Makes 8 servings (1/4 cup each).

Nutrition information (per serving):

Calories: 39 Sodium: 82 mg

Fat: 1 gm Calcium: 51 mg

Saturated fat: 0 gm Carbohydrate: 5 gm

Protein: 4 gm Dietary Fiber: 2 gm

Recipe from the U.S. Soyfoods Directory, 1998.

Tofuntastico – Tofu Sauce

Ingredients:

• 1 package (12.3 ounce) silken tofu

• 1/2 cup water

• 3/4 cup fresh basil, chopped

• 4 tbsp nutritional yeast

• 3 tbsp Bragg’s liquid aminos (or tamari or soy sauce)

•1 tbsp lemon juice

•1 tsp garlic, minced

•3/4 tsp black pepper

•Alternative: Use lime/cilantro rather than lemon/basil

Blend all ingredients together in a blender or food processor. Serve over pasta, vegetables, baked

potato, or other.

Makes 6 servings (1/2 cup each).

Nutrition Information (per serving):

Calories: 47 Carbohydrate: 4 gm

Protein: 7 gm Dietary fiber: 2 gm

Fat: <1 gm

Recipe developed by Natalie Ledesma, MS, RD, CSO

39

Alaska Salmon Bake with Walnut Crunch Coating

Ingredients:

• 1 pound salmon fillets, thawed if necessary

• 2 tbsp Dijon-style mustard

• 1-2 tbsp olive oil

• 4 tsp honey

• 1/4 cup bread crumbs

• 1/4 cup walnuts, finely chopped

• 2 tsp parsley, chopped

• Salt and pepper to taste

• Lemon wedges

Mix together mustard, olive oil, and honey in a small bowl; set aside. Mix together bread crumbs,

walnuts, and parsley in a small bowl; set aside. Season each salmon fillet with salt and pepper. Place

on a lightly greased baking sheet or broiling pan. Brush each fillet with mustard-honey mixture. Pat

top of each fillet with bread crumb mixture. Bake at 450 F for 10 minutes per inch of thickness or until

salmon just flakes when tested with a fork. Serve with lemon wedges.

Makes 4 servings (4 oz each).

Nutrition Information (per serving):

Calories: 228

Protein: 20 gm

Fat: 12 gm

Omega-3 fatty acids: 1.7 gm

Adapted from Alaska Seafood Marketing Institute.

Banana Bread

Ingredients:

• 3/4 cup ground flax seed

• 1 cup mashed banana

• 1/4 cup apple juice concentrate

• 1/2 cup brown sugar

• 1/4 cup applesauce

• Egg replacer for 2 eggs or 2 eggs (Ener-G Egg Replacer is made from potato starch & tapioca

flour; works wonderfully in baked goods.)

• 1 1/2 cup whole wheat pastry flour

• 1 tsp baking soda

• 1/2 tsp salt

• Additional optional ingredients may include 1/2 cup walnuts, raisins, or chocolate chips.

Mix all ingredients together. Pour in a coated 8”x4” pan. Bake at 350 F for about 40-45 minutes.

Makes 10 servings.

Nutrition Information (per serving):

40

Calories: 168 Carbohydrate: 29 gm

Protein: 5 gm Dietary fiber: 5 gm

Fat: 4 gm Omega-3 fatty acids: 1.4 gm

Recipe developed by Natalie Ledesma, MS, RD, CSO

Dilled Salmon Salad with Peas

Ingredients:

• 1 can (15 oz) salmon, drained

• 1 package (16 oz) frozen peas, thawed

• 1/4 cup lemon juice

• 1/4 cup fresh dill (or 1-2 tbsp dried dill)

• 2 tbsp Dijon-style mustard

• 2 shallots, sliced thinly (about 1/2 cup)

• 1 bunch radishes (about 11 medium), thinly sliced

• 6 cups red leaf lettuce

• Salt and pepper to taste

Drain salmon, place in a mixing bowl, and break into pieces. Prepare the lemon juice, shallots,

radishes, and lettuce. Add to the salmon the peas, lemon juice, dill, mustard, shallots, and radishes.

Mix together gently. Add salt and pepper to taste. Serve salmon mixture over lettuce.

Makes 6 servings (2 cups each).

Nutrition Information (per serving):

Calories: 160

Protein: 17 gm

Fat: 4 gm

Dietary fiber: 5 gm

Adapted from the Women’s Healthy Eating & Living Study (WHEL) at the University of California,

San Diego. Developed by Vicky Newman, MS, RD, WHEL nutrition coordinator.

Neat Loaf

Ingredients:

• 2 cups cooked brown rice

• 1 cup walnuts, finely chopped

• 1 onion, finely chopped

• 1/2 medium bell pepper, finely chopped

• 2 medium carrots, shredded or finely chopped

• 1 cup wheat germ

• 1 cup quick-cooking rolled oats

• 1/2 tsp each: thyme, marjoram, sage

41

• 2 tbsp soy sauce

• 2 tbsp stone ground or Dijon mustard

• Barbecue sauce or ketchup

Preheat the oven to 350 F. Combine all the ingredients except the barbecue sauce or ketchup. Mix for

2 minutes with a large spoon. This will help bind it together. Pat into an oil-sprayed 5×9” load pan and

top with barbecue sauce or ketchup. Bake for 60 minutes. Let stand 10 minutes before serving.

Makes 8-10 servings.

Nutrition Information (per serving):

Calories: 204 Sodium: 248 mg

Protein: 9 gm Cholesterol: 0 mg

Fat: 9 gm

Carbohydrate: 19 gm

Recipe from The Peaceful Palate written by Jennifer Raymond (1996).

Chinese Cabbage and Radish Salad

Ingredients:

• 4 cups Chinese cabbage, quartered and then thinly sliced

• 1/4 cup radishes

• 1/4 cup red onion, thinly sliced

• 2 tbsp white miso

• 2 tbsp brown rice vinegar

• 1 tsp maple syrup

• 1 tsp dill, dried

• 2 tbsp sunflower seeds, toasted

With a fork, mix the miso, vinegar, maple syrup, and dill. Mix the vegetables and press with a plate until

submerged in liquid for about 1 hour. Fluff the vegetables to serve and garnish with sunflower seeds.

Makes 4 servings.

Nutrition Information (per serving):

Calories: 64 Carbohydrate: 9 gm

Protein: 2 gm Cholesterol: 0 mg

Fat: 2 gm Sodium: 275 mg

Source anonymous.

Quinoa/Sweet Potato Patties

Ingredients:

• 1 1/2 cups sweet potato, peeled and chopped

• 1 cup quinoa

• 2 tbsp parsley, fresh

• 1/2 tsp sea salt

42

• 2 tsp extra-virgin olive oil

Steam or bake sweet potatoes until done. Drain and mash potatoes. Wash the quinoa well and drain.

Dry toast the quinoa in a skillet until slightly browned. Meanwhile, bring a pot of water to a boil. Add

the toasted quinoa to the boiling water and cook, with lid off, for ~15 minutes. Drain well. Mix the

mashed potatoes and quinoa. Add the parsley and salt. Form 8 patties and place in a lightly oiled pan

over medium-high heat. Cook for about 5 minutes on each side and serve warm.

Makes 8 servings.

Nutrition Information (per serving):

Calories: 125 Sodium: 165 mg

Protein: 4 gm Cholesterol: 0 mg

Fat: 2 gm

Carbohydrate: 22 gm

Recipe adapted from the Vegetarian Resource Group (1997).

Nutrition Resources

Books

How to Prevent & Treat Cancer with Natural Medicine – written by Michael Murray (2002)

The Color Code – written by James Joseph, Daniel Nadeau, & Anne Underwood (2002)

Ultra Metabolism – written by Mark Hyman (2006)

Cookbooks

Cancer Lifeline Cookbook – written by Kimberly Mathai & Ginny Smith (2004)

Fat-Free and Easy: Great Meals in Minutes – written by Jennifer Raymond (vegetarian cookbook) (1997)

Lickety-Split Meals – written by Zonya Foco (1998)

One Bite at a Time – written by Rebecca Katz, Marsha Tomassi, & Mat Edelson (2004)

The Peaceful Palate – written by Jennifer Raymond (vegetarian cookbook) (1996)

12 Best Foods Cookbook: Over 200 Recipes Featuring the 12 Healthiest Foods – written by Dana

Jacobi (2005)

Newsletters/Magazines

Cooking Light http://www.cookinglight.com Fax: (205) 445-6600

Environmental Nutrition http://www.environmentalnutrition.com (800) 829-5384

Nutrition Action Health Letter http://www.cspinet.org/nah/ Fax: (202) 265-4954

Websites

American Cancer Society http://www.cancer.org (415) 394-7100

American Institute for Cancer Research http://www.aicr.org (800) 843-8114

43

Caring4Cancer – Provides up-to-date & comprehensive information on the connection between

nutrition & cancer – http://www.caring4cancer.com

Center for Informed Food Choices – Offer cooking classes in the Bay Area that emphasize plantbased

foods. http://www.informedeating.org

Consumer Lab – Evaluates quality of over-the-counter supplements http://www.consumerlab.com

Diana Dyer, MS, RD – Breast cancer survivor & dietitian http://www.cancerrd.com

Ida & Joseph Friend Cancer Resource Center – UCSF Mt.Zion http://cancer.ucsf.edu/crc

(415) 885-3693

National Cancer Institute http://www.nci.nih.gov/ (800) 4-CANCER (800-422-6237)

Oncolink – Provides information regarding clinical trials, newsgroups, psychosocial support, & more.

http://oncolink.upenn.edu

San Francisco Vegetarian Society – Monthly restaurant outings & pot-luck dinners; call 415-273-5481.

Home

The Vegetarian Resource Group – Provides vegetarian nutrition information & vegetarian recipes

http://www.vrg.org

WebMD http://my.webmd.com

44

Glossary

Angiogenesis – The formation of new blood vessels.

Antioxidant – A substance that inhibits oxidation or inhibits reactions promoted by oxygen or peroxides.

Apoptosis – Programmed cell death.

Carcinogenesis – Beginning of cancer development.

Case-Control Studies – An epidemiological study in which a group of, say, cancer patients (cases)

is compared to a similar but cancer-free population (controls) to help establish whether the past or

recent history of a specific exposure such as smoking, alcohol consumption and dietary intake, etc.

are causally related the risk of disease.

Catechin – One of the tannic acids; phytonutrient, specifically, one of the flavonoids found in green tea.

Creatine – An amino acid that is formed in the muscle tissue of vertebrates; supplies energy for

muscle contraction.

Cohort Studies – Follow-up study of a (usually large) group of people, initially disease-free.

Differences in disease incidence within the cohort are calculated in relation to different levels of

exposure to specific factors, such as smoking, alcohol consumption, diet and exercise, that were

measured at the start of the study and, sometimes, at later times during the study.

Eicosanoids – Biologically active compounds that regulate blood pressure, blood clotting, and other

body functions. They include prostaglandins, thromboxanes, and leukotrienes.

Endogenous – Originating from within, as within the body.

Estradiol – A naturally occurring powerful estrogen secreted by the mammalian ovary.

Estrone – A naturally occurring weak estrogen secreted by the mammalian ovary.

Glutathione – A polypeptide produced primarily in the liver; involved in DNA synthesis and repair,

protein and prostaglandin synthesis, amino acid transport, metabolism of toxins and carcinogens,

immune system function, prevention of oxidative cell damage, and enzyme activation.

Insulin – Insulin is a hormone produced by the pancreas in the body that regulates the metabolism of

carbohydrates and fats, especially the conversion of glucose to glycogen, which lowers the body’s

blood sugar level.

Lignans – Phytoestrogens that have a similar chemical structure to estradiol and tamoxifen; appear

to offer protection against breast cancer.

Meta-analysis – The process of using statistical methods to combine the results of different studies.

Mutation – Abnormal cell development.

Nitrosamines – Derivatives of nitrites that may be formed in the stomach when nitrites combine with

amines; carcinogenic in animals.

Phytonutrients – Plant compounds that appear to have health-protecting properties.

Polyphenols – Phytonutrients that act as an antioxidant; compounds that protects the cells and body

chemicals against damage caused by free radicals, reactive atoms that contribute to tissue damage

in the body.

Retinoids – Chemically related compounds with biological activity similar to that of retinol; related to

vitamin A.

Sex hormone-binding globulin (SHBG) – A protein in the blood that acts as a carrier for androgens

and estradiol; inhibits the estradiol-induced proliferation of breast cancer cells.

45

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melatonin: a phase II study of tamoxifen plus melatonin in metastatic breast cancer patients progressing under tamoxifen

alone. Br J Cancer 1995;71:854-856.

335. Lissoni P, Paolorossi F, Tancini G, Ardizzoia A, Barni S, Brivio F, et al. A phase II study of tamoxifen plus melatonin in

metastatic solid tumour patients. Br J Cancer 1996;74:1466-1468.

336. Hill SM, Collins A, Kiefer TL. The modulation of oestrogen receptor-alpha activity by melatonin in MCF-7 human breast

cancer cells. Eur J Cancer 2000;36(Suppl 4):117-118.

337. Cos S, Martinez-Campa C, Mediavilla MD, Sanchez-Barcelo EJ. Melatonin modulates aromatase activity in MCF-7 human

breast cancer cells. J Pineal Res. 2005;38(2):136-142.

338. del Rio B, Garcia Pedrero JM, Martinez-Campa C, Zuazua P, Lazo PS, Ramos S. Melatonin, an endogenous-specific

inhibitor of estrogen receptor alpha via calmodulin. J Biol Chem. 2004;279(37):38294-38302.

339. Czeczuga-Semeniuk E, Wolczynski S, Anchim T, Dzieciol J, Dabrowska M, Pietruczuk M. Effect of melatonin and all-trans

retinoic acid on the proliferation and induction of the apoptotic pathway in the culture of human breast cancer cell line

MCF-7. Pol J Pathol. 2002;53(2):59-65.

340. Bizzarri M, Cucina A, Valente MG, Tagliaferri F, Borrelli V, Stipa F, et al. Melatonin and vitamin D3 increase TGF-beta1

release and induce growth inhibition in breast cancer cell cultures. J Surg Res. 2003;110(2):332-337.

341. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing

Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. 1997. National Academy

Press.

342. National Osteoporosis Foundation. http://www.nof.org. 2001.

343. Heaney RP. Bone biology in health and disease. In Modern Nutrition in Health and Disease, 9th ed. Shils ME et al., eds.

1999. Williams & Wilkins.

344. Chang YC, Parker J, Dooley WC. Hot flash therapies in breast cancer survivors. Support Cancer Ther. 2006;4(1):38-48.

345. Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Invest.

2007;64(4):204-207.

346. Barton DL, Loprinzi CL, Quella SK, Sloan JA, Veeder MH, Egner JR, et al. Prospective evaluation of vitamin E for hot

flashes in breast cancer survivors. J Clin Oncol. 1998;16(2):495-500.

347. Tempfer CB, Bentz EK, Leodolter S, Tscherne G, Reuss F, Cross HS, et al. Phytoestrogens in clinical practice: a review of

the literature. Fertil Steril. 2007;87(6):1243-1249.

348. Lethaby AE, Brown J, Marjoribanks J, Kronenberg F, Roberts H, Eden J. Phytoestrogens for vasomotor menopausal

symptoms. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD001395.

349. Carroll DG. Nonhormonal therapies for hot flashes in menopause. Am Fam Physician. 2006;73(3):457-464.

350. Pockaj BA, Gallagher JG, Loprinzi CL, Stella PJ, Barton DL, Sloan JA, et al. Phase III double-blind, randomized, placebocontrolled

crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1. J Clin Oncol.

2006;24(18):2836-2841.

351. Ruhlen RL, Haubner J, Tracy JK, Zhu W, Ehya H, Lamberson WR, et al. Black cohosh does not exert an estrogenic effect on

the breast. Nutr Cancer. 2007;59(2):269-

352. Walji R, Boon H, Guns E, Oneschuk D, Younus J. Black cohosh (Cimicifuga racemosa [L.] Nutt.): safety and efficacy for cancer

patients. Support Care Cancer. 2007 Aug;15(8):913-21.

353. Tremblay A, Sheeran L, Aranda SK. Psychoeducational interventions to alleviate hot flashes: a systematic review. Menopause.

2008;15(1):193-202.

healthylife

 Thank you http://www.ucsfhealth.org

 

Health Study Says Grilled Food May Make You Fat by Maria Dorfner

barbecue10 It’s that time of year when everyone loves a good barbecue.  Now researchers at the Icahn School of Medicine at Mount Sinai in New York City warn, “Grilled Food Might Make You Fat.” Hmmm.

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It’s not even half a dozen cheeseburgers that will you do in this time.   It’s HOW that cheeseburger is cooked.  In this case, grilled on high dry heat.

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According to the Proceedings of the National Academy of Sciences, researchers there identified a common compound in grilled foods that could play a major role in the development of obesity and diabetes.

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The team, led by Helen Vlassara, a medical doctor and director of the Division of Experimental Diabetes and Aging, found that mice that were exposed on a sustained basis to the compound methylglyoxal – a type of advanced  glycation end-product (AGE) produced when cooking with dry heat –developed significant abdominal weight gain, early insulin resistance AND Type 2 diabetes.

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Additionally, AGEs have been found to lower the body’s protective mechanisms that control inflammation.

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The researchers recommend that we replace frequent grilling, which uses high dry heat, with methods that rely upon lower temperatures or more moisturee, such as stewing, poaching or steaming.

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Hmmm. I’m going to a stewing or I’m going to a steaming doesn’t quite have the same ring to it.

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If you rarely barbecue, here are some awesome healthy veggie suggestions from Derrick Riches:

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Grilling vegetables is easy. The fact that more people don’t do it is the strange thing. The general rule is to cut the vegetables into pieces that will cook quickly and evenly.

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All pieces should be of consistent thickness and no more than about 3/4 to 1 inch thick. Soak vegetables in cold water for about 30 minutes before you grill them to keep them from drying out.

Pat dry, then brush lightly with oil to prevent sticking. Do not over cook and you’ll have vegetables better than you thought possible. If you like grilling vegetables and want to try smaller things use a grilling basket to keep them out of the fire.

This list of specific vegetables will get you started.

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Asparagus: Cut off ends. Soak in water for 30 minutes to an hour. Pat dry and brush with olive oil. Place on grill, turning every minute. Remove when tips start to turn brown. You can add some extra flavor to asparagus by mixing a little sesame oil in the olive oil before you brush them.

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Bell Peppers: Cut through the middle of the pepper top to bottom. Remove stems, seeds and whitish ribs. Brush lightly with oil and grill for 2-3 minutes on each side. See Fire Roasted Peppers for more information.

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Chili Peppers: Brush with oil. Grill whole on each side, 2-3 minutes. To reduce the heat, cut off the stems and pull out the seeds.

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Corn on the cob: Gently pull back the husks but don’t remove. Remove the silk and cut off the very end. Soak in cold water for about 30 minutes. Dry and brush with butter. Fold the husks back down and tie or twist the ends. Place on grill for about 5 to 7 minutes. Turn to avoid burning.

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Eggplant: Cut lengthwise for smaller eggplants or in disks top to bottom for larger eggplants. Soak in water for 30 minutes. Pat dry, brush with oil and grill 2-3 minutes.

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Garlic: Take whole bulbs and cut off the root end. Brush with olive oil and place cut side down over a hit fire. Grill garlic bulbs for about 10 minutes or until the skin is brown.

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Mushrooms: Rinse off dirt and pat dry. Brush with oil and grill. 4-5 minutes for small mushrooms, 6-8 minutes. Use a grill basket or topper for small mushrooms.

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Onions: Remove skin and cut horizontally about 1/2 inch thick. Brush with oil and grill 3-4 minutes.

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Potatoes: There are many ways to grill potatoes. You can do them whole for a baked potato or cut into wedges, brush with olive oil, and grill until browned. Wash thoroughly and dry. Rub with oil. Wrap in aluminum foil and grill 35-40 minutes, turning occasionally.

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Tomatoes: (Yes, I know, technically a fruit) Cut in half, top to bottom. Brush with a light coating of oil and grill cut side down 2-3 minutes.

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Zucchini and Small Squash: Slice 1/2 inch thickness. Brush with oil and grill 2-3 minutes per side. Small squash can be cut down the middle and grilling in halves.

 Healthy Takeaway: Don’t grill EVERY night.  When you do, make healthy food choices and do stay active. Your abdominal fat will be fine.  Healthy Grilling, everyone! 🙂

7 Foods That Help You Sleep by Maria Dorfner

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 It’s worth repeating.  A good night’s rest is what makes you look AND feel your best. 

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Yet, texting, tweeting, blogging, emailing, facebooking and thinking in daylight can also keep you up at night.

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A good night’s sleep isn’t just about being able to wake up when the alarm goes off. It benefits your weight, heart, mind & more. 

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In a 2010 study of women age 50 to 79, there were more deaths in those that got less than 5 hours of sleep a night.

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So yes, it can affect the length of your life AND quality of life.

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Sleep also lowers stress, depression, anxiety,  improves attention and learning, keeps your mind sharp and one more thing. 

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Well-rested folks lose more fat.  That’s right. It gives a whole new meaning to Snooze You Lose.

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All great reasons to stock your refrigerator with these 7 foods that help you sleep soundly. Eat an hour before bedtime:

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1.  OATMEAL – It promotes insulin production and sleep-inducing chemicals to relax you

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2.  SMALL BOWL OF COTTAGE CHEESE WITH SLICED BANANAS – The magnesium and potassium are muscle relaxants

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3.  CHERRIES –  Melatonin controls your internal clock and cherries help to release it

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4.  TOAST – Carb rich foods produce insulin helping you relax

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5.  WARM MILK – It contains amino acid L-tryptophan and turns into 5-HTP, releasing serotonin. Calcium is good for sleep too

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6.  WHOLE WHEAT PASTA – Add fresh veggies & diced chicken with tomato sauce; high protein dish that also releases tryptophan

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7.  YOGURT SPRINKLED WITH CEREAL – You get the calcium and the carb combo to help bring on the Z-z-z-z’s

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A good night’s sleep also spurs creativity and improves your athletic performance the next day. It also curbs inflammation. Those that don’t get enough sleep have higher levels of inflammatory problems.

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If you are STILL tossing and turning or watching the clock, make sure you are doing the following:

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1.  STOP SIPPING CAFFEINE AT 2 P.M. – Check labels. You may not be aware what you’re drinking contains caffeine.

2.  DIM THE LIGHTS IN YOUR ROOM ONE HOUR BEFORE YOU TURN IN.

3.  SOAK IN A WARM BATH TO UNWIND AS SOON AS YOU GET HOME, NOT RIGHT BEFORE BED.

4.  CLOSE YOUR EYES FOR 10 MIN. AND GENTLY STRETCH BY PAYING ATTENTION TO YOUR BREATHING.

5.  THIS IS A MUST: MAKE SURE ALL YOUR GADGETS ARE TURNED OFF. PLACING THINGS ON VIBRATE DOES NOT COUNT AS OFF.  THAT SOUND CAN STILL DISRUPT YOUR SLEEP.

6.  MAKE SURE ALL CLUTTER IS REMOVED FROM YOUR BEDROOM.

THE Most Healthful Water in the World by Maria Dorfner

My prior blog was why to drink water before working out.  I didn’t say which is best.

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It reminds me of a few reasons I love Carlsbad, CA.   The sunsets are STUNNING.

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It’s a great place to be outdoors to walk, run, hike or swim if you’re athletic like me.

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BEST thing about it is WATER.  It  has THE most healthful drinking water in the world.

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I visit my brother each year, but got a place there three years ago. That’s when I got to  explore.carlsbadmineralwater3

And that’s when I learned Carlsbad Mineral Water is therapeutic alkaline water made by nature, not man.

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I called my brother who has lived in Carlsbad for 25 yrs. He never heard of it.

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He asks his then girlfriend (now wife) and she never heard of it either. I ask if they saw the spa or the large stainless steel tank that holds the water.  Neither one of them knew anything about it.  How could they miss the GIANT kiosk??!

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Look at it.  It’s a GIANT kiosk in the middle of the street.  That’s me goofing around saying, “Oh…what could THIS possibly be??” Guess my powers of observation are  honed by being a journalist.  

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The kiosk is right next to a statue of the Captain from Germany who founded Carlsbad.  They missed that too.  The water is like the water in Karlsbad, Germany, which Carlsbad was named after in the 1880’s.

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AND the water is only 50 cents per gallon. I religiously take my 6 gallon jug and fill it at the outdoor vending machine.

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The water is from an underground aquifer.

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It is naturally alkaline at pH 8.7.

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Here’s some History on H20 and why it’s THE most healthful water in the world:

Dr. Ottow Warburg won the Nobel Peace Prize in 1931 for proving that cancer can’t survive in an alkaline, oxygen rich environment but thrives in an acidic, low oxygen environment.

Think about that.  One foundation alone raised hundreds of millions of dollars, yet this proven fact discovered 81 years ago has not been studied.  Let me repeat:

CANCER CAN’T SURVIVE IN AN ALKALINE, OXYGEN RICH ENVIRONMENT.    CALL MR. GRANT!!!

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No wonder people drove 125 miles or from all over the world for this water.

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Therapeutic Carlsbad Alkaline Water ™ is amazing. Here are some benefits and I personally experienced them:

* Lubricate joints and make them stronger – improve athletic hydration

* Provide powerful anti-oxidants and fortifies the immune system

* Neutralize acidity, support pH balance, maintain strong bones

* Improve body, organ and cell hydration – easier to absorb

* Rejuvenate the skin, keep it more elastic and smooth

* Promote healthy weight loss and lifestyle

* Remove harmful toxins from the body

* Detoxification enzymes

Of course, they can’t say cures cancer, but if I had cancer I would drink it, bathe in it and swim in it.

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You can also have the water delivered to your home anywhere in Southern California.

Carlsbad Alkaline Water ™  has been proclaimed “The Most Healthful Water” by the California State Senate, and their artesian well and location have been designated by the California legislature as both a California Historic Site and a California Historic Monument. 

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The city of Carlsbad has named the Carlsbad Artesian Well a Carlsbad Historic Site and the “North County Times” newspaper wrote a story about their water and called it “Eden In A Glass.”

Nowhere else in the United States can you find so unique 9,500 years naturally aged alkaline and therapeutic water with pH 8.76 that tastes so good and has such a positive effect on your health.

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WHERE DOES IT COME FROM?

Turns out, the water comes from a 1,700 foot deep aquifer and is protected with 200 feet of non porous clay and 1,500 feet of granite rock. The water originates from the Cleveland National Forest about 40 miles east of Carlsbad completely protected from any pollution or any possible radiation fall-out. It takes about 9,500 years for the water to work its way through the substrata to their deep artesian wells just a block from the Pacific Ocean, where it is discharged at the deep bottom.

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Along the way, it is naturally enhanced with pure minerals that turn the water into a highly alkaline, therapeutic, ultrahydrating and healthful. It is not filtered munincipal water. It flows naturally into their artesian wells from the deep aquifer. It is sodium free, not carbonated, not fluridated, not chlorinated, highly alkaline (not acidic) and exceeds FDA bottled-water quality standards.

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The alkaline water has a unique pH 8.76 and TDS 50. Their source-artesian well and vending machines are licensed by the California Department of Public Health and monitored and tested weekly, as required by FDA, federal and state laws.

Many doctors and nutritionists use their alkaline water in their business and homes and highly recommend it.

History Since 1882

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MORE HISTORY:
The year was 1882 when John Frazier, former sea captain, was digging a well for his farm which covered much of today’s downtown area of Carlsbad, California.Frazier struck at 415 feet an aquifer health resort, so the named the water Carlsbad Mineral Water. Today of mineral water. encouraged by his success, he sank another well at 510 feet.
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Analysis showed the mineral water was very similar to the water from the world-famous Karlsbad, Bohemia, health resort, so they named the water Carlsbad Mineral Water. today Karlsbad is known as Karlovy Vary, Czech Republic.Frazier and many other people found the water to be very therapeutic and have experienced many positive health benefits.
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Frazier and several other businessmen formed the Carlsbad Land and Mineral Water Company. They built beautiful homes (today on is known as Ocean House Restaurant), a hotel, and spa next to the minerals wells. They also renamed the town from Frazier Station to Carlsbad after the famous California Carlsbad Mineral Water.
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In 1930, the California Carlsbad Mineral Water Hotel was built across the street from the well. The hotel was widely known for its Mineral Water Baths and was frequented by movie stars and other famous people from around the world. The Great Depression brought hard times to this hotel. The well needed repair but there was no money to do it.
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The well was lost for a number of years.In 1993 Ludvik Grigoras, a Karlovy Vary (Karlsbad, Czech Republic) native started to completely restore the old well and re-drilled another of Frazier’s wells which is naturally carbonated.Ludvik encouraged a hometown friend, renowned sculptor Vaclav Lokvenc from Karlsbad, Czech Republic, to create a 13 ft. bronze statue of Capt. John Frazier which was shipped from Europe in 1994 and is now erected at the Alt Karlsbad Historic Site.
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California Historic Site & Monument – City Historic Site  Today, Carlsbad Famous Water is being bottled again, and an elegant spa has opened in the beautiful European-style building on the site of the original we located only a few miles from Legoland.  The design and decorating were personally done by Ludvik and Veronica Grigoras to duplicate a unique ambiance of early Egypt, Rome and the Orient. All the artwork, paintings and furniture were hand painted by famous artist Robin Wallenfang.
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My brother, his wife and their one-year-old have had it delivered to their home ever since I told them about it.  They love it.  My brother is always asking how I look so much younger than him, since he’s the baby in the family.
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I don’t know.  Maybe it’s the water.  🙂
 success

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Here’s video link:  http://gloublog.net/?p=3195

In 2015, the owners of the spa read my blog and found me on Facebook to tell me they love it and they asked if I would be a spokesperson for it.  Of course. I already am. I really do love this water.  This is before I learned so many “name brand” bottled waters are tap water.  The bottom line is you can feel and see the difference when you switch.

I can’t  wait for it to be sold on the East Coast. People really need it here. Enough already with approving beverages that make people sick, taxing it and then charging to fix it –all while pretending to care about people’s health.Stop. The world is on to the sick game.

 

FOR MORE INFORMATION ON CARLSBAD MINERAL WATER VISIT:

http://www.carlsbadalkalinewater.com/

Health Tips?  Health Stories?  Contact:  maria.dorfner@yahoo.com

Lucy makeprofile4 nbc1
Maria Dorfner is an award-winning broadcast journalist specializing in health. NewsMD Communications is a division of Healthy Within Network (HWN), which she recently founded. She began her career as an intern at NBC. Since then, her stories have appeared on NBC, CBS, ABC, CNN, CNBC, FOX, DISCOVERY HEALTH CHANNEL and more. Her lifelong passion is health and well-being. She also loves creating/producing shows. She is a voracious reader and learner. When she was 5-years-old, her entire face was burned to a crisp. The doctor in Brooklyn, NY said it would end up severely scarred.  She wondered why the doctor was making her mother cry. Maria believed she’d be fine. Later when she healed, the doctor called it “a miracle.” Right then, Maria learned the power of thought.  First 4 letters in HEALTH.  It starts in your mind.  Your brain.  And your brain is made up of over 80% water. Your body follows that brain and  your body is made up of 70% water.  That’s a lot of liquid.  Think about that.

Back to first person. My theory is the quality of your health and your bodies ability to heal are linked to the quality and quantity of water inside you.  I’ve scuba dived in murky waters and clear waters.  One is toxic and destroys everything inside it; the other nourishes all. Soda, coffee & energy drinks all fall into the toxic zone creating murky waters in you. You can’t do “a cleanse” and expect to alleviate years of toxicity buildup in your body. Health is like anything else. It starts with commitment.

A lifelong commitment to stay healthy in mind, body and spirit.

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Brian Cuban Interviews Larry North about 11 Healthy Eating Myths

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A FEW TAKEAWAYS in case you missed it.  Brian Cuban asked Larry what it takes to be lean and some of his answers may surprise you.  
SHINE ON:  Foods for Healthy, Glowing Skin
If you think what you eat doesn’t matter, as long as you “work it off” –that’s a myth.  
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According to Larry North, eating healthy makes MORE of a difference than exercise.  Here are 11 Tips from Larry:
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1. You CAN get food, flavor & satisfaction in healthy meals.  Brian mentioned he doesn’t cook and eats out a lot.  Larry said he actually will call the local grocery store where they prepare take-out meals and have them cook/prepare healthy meals for him. Good suggestion.  He orders carefully when at a restaurant. He said  pieces of a cut roll & sashimi is enough.  He believes in eating a lot of good food. He says it’s all about eating. More about the food choices than exercise.
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2. #1 cause of obesity is sugary drinks. Best thing you can do is cut out sodas & sugary coffees out completely.  I’ve been saying this forever. I did so inn 2005 and feel such a difference.  I can personally tell you that your body starts to reject sugar and junk food.
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3. Genetics play a huge role, but HABITS play an even larger role.  Larry stressed that even if you have a lot of family members that are obese, you CAN make a difference by making behavioral changes.
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4. Cardio is overrated.  See #9.
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5. You CAN’T work it off. You have to eat it off (meaning WHAT you eat is more important)
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6. There’s ONE key to a good meal & fitness program. It’s SUSTAINABILITY. You have to ask yourself if you can stick with it long-term. If you can’t sustain it –it will be short-lived.
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7. Behavioral change is the key to fitness.
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8. Work out less; eat better. Larry kept stressing the importance of your food choices. I’m glad about this because I post a lot about healthy foods. I believe a lot of good health (feeling AND looking your best) is nutritional.
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9. 4 to 5 hours of exercise is enough a week.  Larry says if you’re doing more than that –it’s too much.  Brian mentioned that he loves running, but had a problem with his knee and really hates that he can’t run.  Larry said he could get the same benefits from walking –that he doesn’t need to run.
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10. It’s all about what you eat. Plan meals in advance. Larry has two books you can check out. One is “Get Fit” and the most recent is “Living Lean“.
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11.  I missed one.  It’s probably in the book!!  🙂  Wait. I recall another one.   I suppose I should write things down.  Lifting weights. He says you don’t have to spend a great deal of time lifting weights to have it make a difference.  Again, he stresses what you eat as being the most important behavior change you can make.  30 to 40 minutes of even walking 4 days a week keeps you fit when you are eating right.
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The bottom line is you do not need to be a gym rat.
CHECK OUT LARRY NORTH’S BOOK FOR MORE:
THANK YOU, BRIAN. GREAT INTERVIEW.
Link to Revolution Rant with Brian Cuban Show here:   http://tobtr.com/s/3052629.
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Stay healthy, everyone!

Why Not Serve Sushi Rolls with Brown Rice?

A recent study said 3 to 4 servings of white rice a day raises the risk of type2 diabetes.  Media strategist and CFO of Fusion TV, Kelly Lefkowitz said what a bummer that was for sushi chefs. 

Good point.  Makes me wonder…

Why don’t they make sushi rolls and serve sushi with brown rice?  I love sushi. So, the words sushi and bummer absolutely cannot coexist. 

Making sushi rolls with brown rice is just as yummy!  I’ve made my own sushi rolls using brown rice and I also request it when in a sushi restaurant.  Chef looks at me funny, but obliges. 

In fact, why not do away with white rice all together since brown rice is clearly healthier AND it’s been proven that brown rice and other whole grains LOWER Type2 Diabetes risk.  I will find out why they continue to use white rice and update this post (is there a $ factor?).  Meanwhile, let’s take a look at available health info on brown rice:

Why Brown Rice is One of the World’s Healthiest Foods

The difference between brown rice and white rice is not just color! A whole grain of rice has several layers. Only the outermost layer, the hull, is removed to produce what we call brown rice. This process is the least damaging to the nutritional value of the rice and avoids the unnecessary loss of nutrients that occurs with further processing.

If brown rice is further milled to remove the bran and most of the germ layer, the result is a whiter rice, but also a rice that has lost many more nutrients. At this point, however, the rice is still unpolished, and it takes polishing to produce the white rice we are used to seeing. Polishing removes the aleurone layerof the grain–a layer filled with health-supportive, essential fats.

Because these fats, once exposed to air by the refining process, are highly susceptible to oxidation, this layer is removed to extend the shelf life of the product. The resulting white rice is simply a refined starch that is largely bereft of its original nutrients.

HEALTH BENEFITS OF BROWN RICE

Brown rice has been ranked as an excellent source of manganese, and a good source of the minerals selenium and magnesium. The complete milling and polishing that converts brown rice into white rice destroys 67% of the vitamin B3, 80% of the vitamin B1, 90% of the vitamin B6, half of the manganese, half of the phosphorus, 60% of the iron, and all of the dietary fiber and essential fatty acids.

By law in the United States, fully milled and polished white rice must be “enriched” with vitamins B1, B3, and iron. But the form of these nutrients when added back into the processed rice is not the same as in the original unprocessed version, and at least 11 lost nutrients are not replaced in any form even with rice “enrichment.”

Here are some of the ways in which the nutrients supplied by brown rice can make an important difference in your health:

Manganese—Energy Production Plus Antioxidant Protection

Just one cup of brown rice will provide you with 88.0% of the daily value for manganese. This trace mineral helps produce energy from protein and carbohydrates and is involved in the synthesis of fatty acids, which are important for a healthy nervous system, and in the production of cholesterol, which is used by the body to produce sex hormones.

Manganese is also a critical component of a very important antioxidant enzyme called superoxide dismutase. Superoxide dismutase (SOD) is found inside the body’s mitochondria(the oxygen-based energy factories inside most of our cells) where it provides protection against damage from the free radicals produced during energy production.

Women Who Eat Whole Grains Weigh Less

A study published in the American Journal of Clinical Nutrition underscores the importance of choosing whole grains such as brown rice rather than refined grain, i.e., white rice, to maintain a healthy body weight. In this Harvard Medical School / Brigham and Women’s Hospital study, which collected data on over 74,000 female nurses aged 38-63 years over a 12 year period, weight gain was inversely associated with the intake of high-fiber, whole-grain foods but positively related to the intake of refined-grain foods.

Not only did women who consumed more whole grains consistently weigh less than those who ate less of these fiber-rich foods, but those consuming the most dietary fiber from whole grains were 49% less likely to gain weight compared to those eating foods made from refined grains.

Brown Rice is Rich in Fiber and Selenium

For people worried about colon cancer risk, brown rice packs a double punch by being a concentrated source of the fiber needed to minimize the amount of time cancer-causing substances spend in contact with colon cells, and being a very good source of selenium, a trace mineral that has been shown to substantially reduce the risk of colon cancer.

In addition to supplying 14.0% of the daily value for fiber, a cup of cooked brown rice provides 27.3% of the DV for selenium, an important benefit since many Americans do not get enough selenium in their diets, yet this trace mineral is of fundamental importance to human health. Selenium is an essential component of several major metabolic pathways, including thyroid hormone metabolism, antioxidant defense systems, and immune function.

Accumulated evidence from prospective studies, intervention trials and studies on animal models of cancer has suggested a strong inverse correlation between selenium intake and cancer incidence. Several mechanisms have been suggested to explain the cancer-preventive activities of selenium. Selenium has been shown to induce DNA repair and synthesis in damaged cells, to inhibit the proliferation of cancer cells, and to induce their apoptosis, the self-destruct sequence the body uses to eliminate worn out or abnormal cells.

In addition, selenium is incorporated at the active site of many proteins, including glutathione peroxidase, which is particularly important for cancer protection. One of the body’s most powerful antioxidant enzymes, glutathione peroxidase is used in the liver to detoxify a wide range of potentially harmful molecules. When levels of glutathione peroxidaseare too low, these toxic molecules are not disarmed and wreak havoc on any cells with which they come in contact, damaging their cellular DNA and promoting the development of cancer cells.

Not only does selenium play a critical role in cancer prevention as a cofactor of glutathione peroxidase, selenium also works with vitamin E in numerous other vital antioxidant systems throughout the body. These powerful antioxidant actions make selenium helpful in the prevention not only of cancer, but also of heart disease, and for decreasing the symptoms of asthma and the pain and inflammation of rheumatoid arthritis.

Lower Cholesterol with Whole Brown Rice

Here’s yet another reason to rely on whole foods, such as brown rice, for your healthy way of eating. The oil in whole brown rice lowers cholesterol.

When Marlene Most and colleagues from Louisiana State University evaluated the effects of rice bran and rice bran oil on cholesterol levels in volunteers with moderately elevated cholesterol levels, they found that rice bran oil lowered their LDL (bad) cholesterol.

The study, published in the American Journal of Clinical Nutrition, was divided into two parts. First, 26 subjects ate a diet including 13-22g of dietary fiber each day for three weeks, after which 13 switched to a diet that added defatted rice bran to double their fiber intake for five weeks. In the second part of the study, a randomized crossover trial, 14 subjects ate a diet with rice bran oil for 10 weeks.

While the diet including only defatted rice bran did not lower cholesterol, the one containing rice bran oil lowered LDL cholesterol by 7%. Since all the diets contained similar fatty acids, the researchers concluded that the reduction in cholesterol seen in those receiving rice bran oil must have been due to other constituents such as the unsaponifiable compounds found in rice bran oil. The scientists suggest that the unsaponifiables present in rice bran oil could become important functional foods for cardiovascular health.

But why extract just one beneficial compound from brown rice when you can reap all the cardioprotective benefits supplied by the matrix of nutrients naturally present in this delicious whole food? In addition to unsaponifiables, this whole grain also supplies hefty doses of heart-healthy fiber, magnesium, and B vitamins.

Significant Cardiovascular Benefits for Postmenopausal Women

Eating a serving of whole grains, such as brown rice, at least 6 times each week is an especially good idea for postmenopausal women with high cholesterol, high blood pressure or other signs of cardiovascular disease (CVD).

A 3-year prospective study of over 200 postmenopausal women with CVD, published in the American Heart Journal, shows that those eating at least 6 servings of whole grains each week experienced both:

  • Slowed progression of atherosclerosis, the build-up of plaque that narrows the vessels through which blood flows, and
  • Less progression in stenosis, the narrowing of the diameter of arterial passageways.

The women’s intake of fiber from fruits, vegetables and refined grains was not associated with a lessening in CVD progression.

Phytonutrients with Health-Promoting Activity Equal to or Even Higher than that of Vegetables and Fruits

Research reported at the American Institute for Cancer Research (AICR) International Conference on Food, Nutrition and Cancer, by Rui Hai Liu, M.D., Ph.D., and his colleagues at Cornell University shows that whole grains, such as rice, contain many powerful phytonutrients whose activity has gone unrecognized because research methods have overlooked them.

Despite the fact that for years researchers have been measuring the antioxidant power of a wide array of phytonutrients, they have typically measured only the “free” forms of these substances, which dissolve quickly and are immediately absorbed into the bloodstream. They have not looked at the “bound” forms, which are attached to the walls of plant cells and must be released by intestinal bacteria during digestion before they can be absorbed.

Phenolics, powerful antioxidants that work in multiple ways to prevent disease, are one major class of phytonutrients that have been widely studied. Included in this broad category are such compounds as quercetin, curcumin, ellagic acid, catechins, and many others that appear frequently in the health news.

When Dr. Liu and his colleagues measured the relative amounts of phenolics, and whether they were present in bound or free form, in common fruits and vegetables like apples, red grapes, broccoli and spinach, they found that phenolics in the “free” form averaged 76% of the total number of phenolics in these foods. In whole grains, however, “free” phenolics accounted for less than 1% of the total, while the remaining 99% were in “bound” form.

In his presentation, Dr. Liu explained that because researchers have examined whole grains with the same process used to measure antioxidants in vegetables and fruits—looking for their content of “free” phenolics”—the amount and activity of antioxidants in whole grains has been vastly underestimated.

Despite the differences in fruits’, vegetables’ and whole grains’ content of “free” and “bound” phenolics, the total antioxidant activity in all three types of whole foods is similar, according to Dr. Liu’s research. His team measured the antioxidant activity of various foods, assigning each a rating based on a formula (micromoles of vitamin C equivalent per gram). Broccoli and spinach measured 80 and 81, respectively; apple and banana measured 98 and 65; and of the whole grains tested, corn measured 181, whole wheat 77, oats 75, and brown rice 56.

Dr. Liu’s findings may help explain why studies have shown that populations eating diets high in fiber-rich whole grains consistently have lower risk for colon cancer, yet short-term clinical trials that have focused on fiber alone in lowering colon cancer risk, often to the point of giving subjects isolated fiber supplements, yield inconsistent results.

The explanation is most likely that these studies have not taken into account the interactive effects of all the nutrients in whole grains—not just their fiber, but also their many phytonutrients. As far as whole grains are concerned, Dr. Liu believes that the key to their powerful cancer-fighting potential is precisely their wholeness.

A grain of whole wheat consists of three parts—its endosperm (starch), bran and germ. When wheat—or any whole grain—is refined, its bran and germ are removed. Although these two parts make up only 15-17% of the grain’s weight, they contain 83% of its phenolics. Dr. Liu says his recent findings on the antioxidant content of whole grains reinforce the message that a variety of foods should be eaten good health.

 “Different plant foods have different phytochemicals,”he said. “These substances go to different organs, tissues and cells, where they perform different functions. What your body needs to ward off disease is this synergistic effect—this teamwork—that is produced by eating a wide variety of plant foods, including whole grains.”

Lignans Protect against Heart Disease

One type of phytonutrient especially abundant in whole grains including brown rice are plant lignans, which are converted by friendly flora in our intestines into mammalian lignans, including one called enterolactone that is thought to protect against breast and other hormone-dependent cancers as well as heart disease.

In addition to whole grains, nuts, seeds and berries are rich sources of plant lignans, and vegetables, fruits, and beverages such as coffee, tea and wine also contain some.

When blood levels of enterolactone were measured in over 850 postmenopausal women in a Danish study published in the Journal of Nutrition, women eating the most whole grains were found to have significantly higher blood levels of this protective lignan. Women who ate more cabbage and leafy vegetables also had higher enterolactone levels.

Reduce Your Risk of Metabolic Syndrome

First we were told, “Don’t eat fat, and you’ll stay trim.” After following this advice only to see obesity expand to never before seen proportions, we’re told by the food gurus, “Eating fat is fine. Shun carbohydrates to stay slim.”

In our opinion, neither piece of dietary advice is complete, accurate or likely to help us stay slim or healthy. Just as different kinds of fats have different effects in our bodies (e.g., saturated and trans fats are linked to increased risk for cardiovascular disease while omega-3 fats decrease cardiovascular disease risk), some carbohydrates, such as whole grains, are healthful while others, such as refined grains and the foods made from them, are not.

The latest research is clearly supporting this vital distinction. Refined grains and the foods made from them (e.g., white breads, cookies, pastries, pasta and rice) are now being linked not only to weight gain but to increased risk of insulin resistance (the precursor of type 2 diabetes) and the metabolic syndrome (a strong predictor of both type 2 diabetes and cardiovascular disease), while eating more wholegrain foods is being shown to protect against all these ills.

Common features of the metabolic syndrome include visceral obesity (the “apple shaped” body), low levels of protective HDL cholesterol, high triglycerides, and high blood pressure.

In one of the most recent studies, which appeared in Diabetes Care, researchers who analyzed data on over 2,800 participants in the Framingham Offspring Study, found that the prevalence of both insulin resistance and the metabolic syndrome was significantly lower among those eating the most cereal fiber from whole grains compared to those eating the least.

Prevalence of the metabolic syndrome was 38% lower among those with the highest intake of fiber from whole grains. Conversely, study subjects whose diets had the highest glycemic index and glycemic load, both of which are typically low in whole foods and high in processed refined foods, were 141% more likely to have the metabolic syndrome compared to those whose diets had the lowest glycemic index and glycemic load.

In other words, compared to those whose diets were primarily composed of whole high fiber foods: whole grains, legumes, vegetables and fruits.

The researchers concluded, “Given that both a high cereal fiber content and lower glycemic index are attributes of wholegrain foods, recommendation to increase wholegrain intake may reduce the risk of developing the metabolic syndrome.”

Our perspective at the World’s Healthiest Foods is that a way of eating that relies on the healthiest foods from all the food groups—the whole foods that contain the healthiest fats, carbohydrates and proteins—is the most effective, intelligent, and most enjoyable way to not only lower your risk of developing the metabolic syndrome, but to stay slim, vital and attractive throughout a long and healthy life.

Brown Rice and Other Whole Grains Substantially Lower Type 2 Diabetes Risk

Brown rice and other whole grains are a rich source of magnesium, a mineral that acts as a co-factor for more than 300 enzymes, including enzymes involved in the body’s use of glucose and insulin secretion.

The FDA permits foods that contain at least 51% whole grains by weight (and are also low in fat, saturated fat, and cholesterol) to display a health claim stating consumption is linked to lower risk of heart disease and certain cancers. Now, research suggests regular consumption of whole grains also reduces risk of type 2 diabetes. (van Dam RM, Hu FB, Diabetes Care).

In this 8-year trial, involving 41,186 particpants of the Black Women’s Health Study, research data confirmed inverse associations between magnesium, calcium and major food sources in relation to type 2 diabetes that had already been reported in predominantly white populations.

Risk of type 2 diabetes was 31% lower in black women who frequently ate whole grains compared to those eating the least of these magnesium-rich foods. When the women’s dietary intake of magnesium intake was considered by itself, a beneficial, but lesser—19%— reduction in risk of type 2 diabetes was found, indicating that whole grains offer special benefits in promoting healthy blood sugar control.

Daily consumption of low-fat dairy foods was also helpful, lowering risk of type 2 diabetes by 13%.

Rice pudding—quickly made by simply adding low-fat milk, cinnamon, raisins, a little honey and 1/4 teaspoon of finely grated orange peel to a cup of cooked rice, then cooking over medium heat for 5 minutes—is a delicious way to enjoy both rice and dairy.

Tune Down and Bone Up on Brown Rice

Magnesium, another nutrient for which brown rice is a good source, has been shown in studies to be helpful for reducing the severity of asthma, lowering high blood pressure, reducing the frequency of migraine headaches, and reducing the risk of heart attack and stroke. How does magnesiumaccomplish all this?

Magnesium helps regulate nerve and muscle tone by balancing the action of calcium. In many nerve cells, magnesium serves as Nature’s own calcium channel blocker, preventing calcium from rushing into the nerve cell and activating the nerve. By blocking calcium’s entry, magnesium keeps our nerves (and the blood vessels and muscles they ennervate) relaxed.

If our diet provides us with too little magnesium, however, calcium can gain free entry, and nerve cells can become overactivated, sending too many messages and causing excessive contraction. Insufficient magnesium can thus contribute to high blood pressure, muscle spasms (including spasms of the heart muscle or the spasms of the airways symptomatic of asthma), and migraine headaches, as well as muscle cramps, tension, soreness and fatigue.

But that’s far from all magnesium does for you. Magnesium, as well as calcium, is necessary for healthy bones. About two-thirds of the magnesium in the human body is found in our bones. Some helps give bones their physical structure, while the rest is found on the surface of the bone where it is stored for the body to draw upon as needed.

Brown rice can help you keep those storage sites replenished and ready to meet your body’s needs. A cup of brown rice will give you 21.0% of the daily value for magnesium.

In addition to the niacin it supplies, brown rice may also help raise blood levels of nitric oxide, a small molecule known to improve blood vessel dilation and to inhibit oxidative (free radical) damage of cholesterol and the adhesion of white cells to the vascular wall (two important steps in the development of atherosclerotic plaques).

A study published in the British Journal of Nutritionsuggests that diets high in rice protein can help protect against atherosclerosis by increasing blood levels of nitric oxide.

In this study, when researchers gave mice bred to be apoliprotein-E deficient a purified diet containing either casein, the principal protein in dairy products, rice protein or soy protein, the mice given casein developed the largest atherosclerotic lesions. (In humans as well as animals, apolipoprotein E plays an important role in cholesterol transport, so a deficiency of this protein increases risk for the development of atherosclerosis.)

Mice given rice or soy protein fared much better. In trying to understand why, the researchers evaluated blood levels of nitric oxide. Mice fed either rice or soy protein diets were found to have increased blood levels of L-arginine (the amino acid that the body uses to produce nitric oxide) and nitric oxide metabolites when compared to those given casein-based feed.

However, the L-arginine content of the rice and soy diets was not high enough to explain the amount of protective benefit they conferred, so the researchers concluded that these foods must also contain other cardioprotective compounds.

A Good Source of Fiber

The health benefits of brown rice continue with its fiber; a cup of brown rice provides 14.0% of the daily value for fiber, which has been shown to reduce high cholesterol levels, one more way brown rice helps prevent atherosclerosis.

Fiber also helps out by keeping blood sugar levels under control, so brown rice is an excellent grain choice for people with diabetes. As we mentioned above, the fiber in brown rice can also help to protect you against colon cancer since fiber binds to cancer-causing chemicals, keeping them away from the cells lining the colon, plus it can help normalize bowel function, reducing constipation.

Fiber from Whole Grains and Fruit Protective against Breast Cancer

When researchers looked at how much fiber 35,972 participants in the UK Women’s Cohort Study ate, they found a diet rich in fiber from whole grains, such as brown rice, and fruit offered significant protection against breast cancer for pre-menopausal women. (Cade JE, Burley VJ, et al., International Journal of Epidemiology).

Pre-menopausal women eating the most fiber (>30 grams daily) more than halved their risk of developing breast cancer, enjoying a 52% lower risk of breast cancer compared to women whose diets supplied the least fiber (<20 grams/day).

Fiber supplied by whole grains offered the most protection. Pre-menopausal women eating the most whole grain fiber (at least 13 g/day) had a 41% reduced risk of breast cancer, compared to those with the lowest whole grain fiber intake (4 g or less per day).

Fiber from fruit was also protective. Pre-menopausal women whose diets supplied the most fiber from fruit (at least 6 g/day) had a 29% reduced risk of breast cancer, compared to those with the lowest fruit fiber intake (2 g or less per day).

Practical Tip: As the following table shows, it’s surprisingly easy to enjoy a healthy way of eating that delivers at least 13 grams of whole grain fiber and 6 grams of fiber from fruit each day.

Food Fiber Content in Grams
Oatmeal, 1 cup 3.98
Whole wheat bread, 1 slice 2
Whole wheat spaghetti, 1 cup 6.3 Brown rice, 1 cup 3.5 Barley, 1 cup 13.6 Buckwheat, 1 cup 4.54 Rye, 1/3 cup 8.22 Corn, 1 cup 4.6 Apple, 1 medium with skin 5.0 Banana, 1 medium 4.0 Blueberries, 1 cup 3.92 Orange, 1 large 4.42 Pear, 1 large 5.02 Prunes, 1/4 cup 3.02 Strawberries, 1 cup 3.82 Raspberries, 1 cup 8.36

*Fiber content can vary between brands. Source: esha Research, Food Processor for Windows, Version 7.8

Help Prevent Gallstones

Eating foods high in insoluble fiber, such as brown rice, can help women avoid gallstones, shows a study published in the American Journal of Gastroenterology.

Studying the overall fiber intake and types of fiber consumed over a 16 year period by over 69,000 women in the Nurses Health Study, researchers found that those consuming the most fiber overall (both soluble and insoluble) had a 13% lower risk of developing gallstones compared to women consuming the fewest fiber-rich foods.

Those eating the most foods rich in insoluble fiber gained even more protection against gallstones: a 17% lower risk compared to women eating the least. And the protection was dose-related; a 5-gram increase in insoluble fiber intake dropped risk dropped 10%.

How do foods rich in insoluble fiber help prevent gallstones? Researchers think insoluble fiber not only speeds intestinal transit time (how quickly food moves through the intestines), but reduces the secretion of bile acids (excessive amounts contribute to gallstone formation), increases insulin sensitivity and lowers triglycerides (blood fats).

Abundant not just in brown rice but all whole grains, insoluble fiber is also found in nuts and the edible skin of fruits and vegetables including tomatoes, cucumbers, many squash, apples, berries, and pears. In addition, beans provide insoluble as well as soluble fiber.

Whole Grains and Fish Highly Protective against Childhood Asthma

According to the American Lung Association, almost 20 million Americans suffer from asthma, which is reported to be responsible for over 14 million lost school days in children, and an annual economic cost of more than $16.1 billion.

Increasing consumption of whole grains and fish could reduce the risk of childhood asthma by about 50%, suggests the International Study on Allergy and Asthma in Childhood (Tabak C, Wijga AH, Thorax).

The researchers, from the Dutch National Institute of Public Health and the Environment, Utrecht University, University Medical Center Groningen, used food frequency questionnaires completed by the parents of 598 Dutch children aged 8-13 years.

They assessed the children’s consumption of a range of foods including fish, fruits, vegetables, dairy and whole grain products. Data on asthma and wheezing were also assessed using medical tests as well as questionnaires.

While no association between asthma and intake of fruits, vegetables, and dairy products was found (a result at odds with other studies that have supported a link between antioxidant intake, particularly vitamins C and E, and asthma), the children’s intake of both whole grains and fish was significantly linked to incidence of wheezing and current asthma.

In children with a low intake of fish and whole grains, the prevalence of wheezing was almost 20%, but was only 4.2% in children with a high intake of both foods. Low intake of fish and whole grains also correlated with a much higher incidence of current asthma (16.7%). compared to only a 2.8% incidence of current asthma among children with a high intake of both foods.

After adjusting results for possible confounding factors, such as the educational level of the mother, and total energy intake, high intakes of whole grains and fish were found to be associated with a 54 and 66% reduction in the probability of being asthmatic, respectively.

The probability of having asthma with bronchial hyperresponsiveness (BHR), defined as having an increased sensitivity to factors that cause narrowing of the airways, was reduced by 72 and 88% when children had a high-intake of whole grains and fish, respectively.

Lead researcher, CoraTabak commented, “The rise in the prevalence of asthma in western societies may be related to changed dietary habits.” We agree. The Standard American Diet is sorely deficient in the numerous anti-inflammatory compounds found in fish and whole grains, notably, the omega-3 fats supplied by cold water fish and the magnesium and vitamin E provided by whole grains.

One caution: wheat may need to be avoided as it is a common food allergen associated with asthma.

Meta-analysis Explains Whole Grains’ Health Benefits

In many studies, eating whole grains, such as brown rice, has been linked to protection against atherosclerosis, ischemic stroke, diabetes, insulin resistance, obesity, and premature death.

A new study and accompanying editorial, published in the American Journal of Clinical Nutrition explains the likely reasons behind these findings and recommends at least 3 servings of whole grains should be eaten daily.

Whole grains are excellent sources of fiber. In this meta-analysis of 7 studies including more than 150,000 persons, those whose diets provided the highest dietary fiber intake had a 29% lower risk of cardiovascular disease compared to those with the lowest fiber intake.

But it’s not just fiber’s ability to serve as a bulking agent that is responsible for its beneficial effects as a component of whole grains. Wheat bran, for example, which constitutes 15% of most whole-grain wheat kernels but is virtually non-existent in refined wheat flour, is rich in minerals, antioxidants, lignans, and other phytonutrients—as well as in fiber.

In addition to the matrix of nutrients in their dietary fibers, the whole-grain arsenal includes a wide variety of additional nutrients and phytochemicals that reduce the risk of cardiovascular disease. Compounds in whole grains that have cholesterol-lowering effects include polyunsaturated fatty acids, oligosaccharides, plant sterols and stanols, and saponins.

Whole grains are also important dietary sources of water-soluble, fat-soluble, and insoluble antioxidants. The long list of cereal antioxidants includes vitamin E, tocotrieonols, selenium, phenolic acids, and phytic acid. These multifunctional antioxidants come in immediate-release to slow-release forms and thus are available throughout the gastrointestinal tract over a long period after being consumed.

The high antioxidant capacity of wheat bran, for example, is 20-fold that of refined wheat flour (endosperm). Although the role of antioxidant supplements in protecting against cardiovascular disease has been questioned, prospective population studies consistently suggest that when consumed in whole foods, antioxidants are associated with significant protection against cardiovascular disease.

Because free radical damage to cholesterol appears to contribute significantly to the development of atherosclerosis, the broad range of antioxidant activities from the phytonutrients abundant in whole grains is thought to play a strong role in their cardio-protective effects.

Like soybeans, whole grains are good sources of phytoestrogens, plant compounds that may affect blood cholesterol levels, blood vessel elasticity, bone metabolism, and many other cellular metabolic processes.

Whole grains are rich sources of lignans that are converted by the human gut to enterolactone and enterodiole. In studies of Finnish men, blood levels of enterolactone have been found to have an inverse relation not just to cardiovascular-related death, but to all causes of death, which suggests that the plant lignans in whole grains may play an important role in their protective effects.

Lower insulin levels may also contribute to the protective effects of whole grains. In many persons, the risks of atherosclerotic cardiovascular disease, diabetes, and obesity are linked to insulin resistance.

Higher intakes of whole grains are associated with increased sensitivity to insulin in population studies and clinical trials. Why? Because whole grains improve insulin sensitivity by lowering the glycemic index of the diet while increasing its content of fiber, magnesium, and vitamin E.

The whole kernel of truth: as part of your healthy way of eating, whole grains can significantly lower your risk of cardiovascular disease, obesity and type 2 diabetes. Enjoy at least 3 servings a day.

No idea how to cook whole grains? Just look at the “How to Enjoy” section in our profiles of the whole grains, or for quick, easy, delicious recipes, click on this link to our Recipe Assistant and select brown rice or whichever whole grain you would like to prepare.

BROWN RICE HISTORY

Rice is one of the most important foods in the world, supplying as much as half of the daily calories for half of the world’s population. No wonder that in Asian countries, such as Thailand, rice is so highly valued that the translation of the word “to eat” literally means “to eat rice.”

Asked to name the types of rice they are familiar with, people may be able to recall one or two. Yet, in actuality there is an abundance of different types of rice—over 8,000 varieties. Oftentimes, rice is categorized by its size as being either short grain, medium grain or long grain. Short grain, which has the highest starch content, makes the stickiest rice, while long grain is lighter and tends to remain separate when cooked. The qualities of medium grain fall between the other two types.

The scientific name for rice is Oryza sativa.

Another way that rice is classified is according to the degree of milling that it undergoes. This is what makes a brown rice different than white rice. Brown rice, often referred to as whole rice or cargo rice, is the whole grain with only its inedible outer hull removed. Brown rice still retains its nutrient-rich bran and germ. White rice, on the other hand, is both milled and polished, which removes the bran and germ along with all the nutrients that reside within these important layers.

Some of the most popular varieties of rice in this country include:

  • Arborio: A round grain, starchy white rice, traditionally used to make the Italian dish risotto.
  • Basmati: An aromatic rice that has a nutlike fragrance, delicate flavor and light texture.
  • Sweet rice: Almost translucent when it is cooked, this very sticky rice is traditionally used to make sushi and mochi.
  • Jasmine: A soft-textured long grain aromatic rice that is available in both brown and white varieties.
  • Bhutanese red rice: Grown in the Himalayas, this red colored rice has a nutty, earthy taste.
  • Forbidden rice: A black colored rice that turns purple upon cooking and has a sweet taste and sticky texture.

MORE RICE HISTORY

Everyone knows that rice is an ancient food, but only recently have we discovered just how ancient it is. Rice was believed to have been first cultivated in China around 6,000 years ago, but recent archaeological discoveries have found primitive rice seeds and ancient farm tools dating back about 9,000 years.

For the majority of its long history, rice was a staple only in Asia. Not until Arab travelers introduced rice into ancient Greece, and Alexander the Great brought it to India, did rice find its way to other corners of the world. Subsequently, the Moors brought rice to Spain in the 8th century during their conquests, while the Crusaders were responsible for bringing rice to France. Rice was introduced into South America in the 17th century by the Spanish during their colonization of this continent.

The majority of the world’s rice is grown in Asia, where it plays an incredibly important role in their food culture. Thailand, Vietnam and China are the three largest exporters of rice.

How to Select and Store

Rice is available prepackaged as well as in bulk containers. If purchasing brown rice in a packaged container, check to see if there is a “use-by” date on the package since brown rice, owing to its natural oils, has the potential to become rancid if kept too long.

Research recently published suggests that some non-organic U.S. long grain rice may have 1.4 to 5 times more arsenic than rice from Europe, India or Bangladesh. For this reason, select organically grown rice whenever possible. (More detailed information on this study can be found below in the Individual Concerns section.)

Just as with any other food that you may purchase in the bulk section, make sure that the bins containing the rice are covered and that the store has a good product turnover so as to ensure its maximal freshness. Whether purchasing rice in bulk or in a packaged container, make sure that there is no evidence of moisture.

Since brown rice still features an oil-rich germ, it is more susceptible to becoming rancid than white rice and therefore should be stored in the refrigerator. Stored in an airtight container, brown rice will keep fresh for about six months.

While white rice varieties should also be stored in an airtight container, they can be kept in a cool, dry place rather than the refrigerator. Stored properly, they will keep fresh for about one year.

The storage of cooked rice is controversial. Most organizations recommend 4-7 days of storage in the refrigerator at most. From all of the available evidence, however, and to err on the safe side, we believe it’s best to cook only the amount of rice you can consume during the day it is cooked, or at most, the following day.

Several potential toxins can be produced in rice under certain conditions involving time, temperature, presence of moisture, bacterial spores, or fungi. It appears that some fungi can turn one of the amino acids (tryptophan) in rice into alpha-picolinic acid, and that this substance, when excessive, can cause hypersensitivity reactions to rice in some persons.

Another mycotoxin (fungus-triggered toxin) called T-2 can also be produced in rice by the fungus Fusarium. About 300 mycotoxins are commonly found in many grains, not only rice, when these grains are allowed to become moldy.

All of the research we’ve see on these potential toxins involves cultivation and harvesting of rice at the agricultural level rather than cooking and storage of rice at home. However, we still suggest erring on the safe side here. Be sure to keep your cooked rice in a tightly sealed container when stored in your refrigerator.

Tips for Preparing Rice

Like all grains, before cooking rice, especially that which is sold in bulk, rinse it thoroughly under running water and then remove any dirt or debris that you may find. After rinsing brown rice, add one part rice to two parts boiling water or broth. After the liquid has returned to a boil, turn down the heat, cover and simmer for about 45 minutes.

To prevent them from sticking, wash medium grain and round rice (like Arborio) under cool running water before cooking.

To cook basmati rice, which has a lighter, fluffier texture, soak it in a bowl of cool water before cooking, stirring frequently and replacing the water four or five times until the water no longer has a milky appearance.

A Few Quick Serving Ideas:

Heat up cooked rice with milk or soymilk. Add in cinnamon, nutmeg, raisins and honey for a delicious rice pudding.

Make homemade vegetable sushi rolls by wrapping brown rice and your favorite vegetables in sheets of well-moistened nori.

Use rice leftovers for cold rice salads that are great for on-the-go lunches. Be creative and add either chicken or tofu plus your favorite vegetables, nuts, herbs and spices.

For a simple yet delicious lunch or dinner entrée, serve beans and rice accompanied by the vegetables of your choice.

Rice as a side dish need not be served plain – spruce it up with the toppings of your choice. Some of our favorites include nuts, sesame seeds, healthy sautéed mushrooms, and scallions.

Place rice and chopped vegetables in a pita bread, top with your favorite dressing, and enjoy a quick and easy lunch meal.

INDIVIDUAL RICE CONCERNS

Brown rice is not a commonly allergenic food and is not known to contain measurable amounts of oxalates or purines. In fact, the hypoallergenic (low-allergy) nature of whole grain, organic brown rice makes it a grain alternative commonly recommended by healthcare practitioners.

Non-Organic Rice May Contain Traces of Arsenic

Research conducted by Andrew Mehanrg and colleagues from the University of Aberdeen in Scotland has found that rice grown in the U.S. contains from 1.4 to 5 times more arsenic than rice from Europe, India or Bangladesh. However, the U.S. rice contains less of the most toxic species of arsenic than the rice tested from other nations.

U.S. long grain rice had the highest mean arsenic levels at 0.26μg/g with the highest concentration at 0.4 μg/g.

Indian rice had the least arsenic at 0.05μg/g.

Rice from Bangladesh contained the same amount of arsenic as rice from Europe at 0.15 μg/g.

Low doses of arsenic, such as those found in Meharg’s survey, do not cause acute illness; however, long term exposure may increase cancer risk. Higher levels of exposure can affect various organs including the skin and the respiratory, cardiovascular, immune, genitourinary, reproductive, gastro-intestinal and nervous systems.

Despite U.S. rice containing the highest concentrations of arsenic, it is difficult to evaluate the possible toxicity of the rice that was tested because inorganic arsenic is five to ten times more toxic than organic arsenic. In the U.S. rice, only 42% of the arsenic was inorganic compared to 81% in the Indian rice, 80% in the Bangladeshi and 64% in European rice. But, as the authors point out, organic arsenic can still cause health problems.

The arsenic contamination of U.S. rice may be the result of earlier cotton farming, which relied on arsenic-based pesticides. Land previously used to grow cotton is now used to cultivate rice, particularly in Mississippi and Arkansas.

When rice was first grown in these states, the crops often failed due to straighthead, an arsenic-induced disease. Varieties of rice were developed that are resistant to straighthead, but this increased the risk of arsenic accumulation in apparently healthy grains. The U.S. is currently reviewing all arsenic-based pesticides.

The World’s Healthiest Foods recommends erring on the side of safety. Choose organically grown rice whenever possible. For any crop to be labeled as organic, including rice, stringent testing of soils for contaminants, including arsenic, must be passed.

Nutritional Profile

Rice is an excellent source of the trace mineral manganese, and a good source of the minerals selenium and magnesium.

For an in-depth nutritional profile click here: Rice.

In-Depth Nutritional Profile

In addition to the nutrients highlighted in our ratings chart, an in-depth nutritional profile for Brown riceis also available. This profile includes information on a full array of nutrients, including carbohydrates, sugar, soluble and insoluble fiber, sodium, vitamins, minerals, fatty acids, amino acids and more.

Introduction to Food Rating System Chart

In order to better help you identify foods that feature a high concentration of nutrients for the calories they contain, we created a Food Rating System. This system allows us to highlight the foods that are especially rich in particular nutrients.

The following chart shows the nutrients for which this food is either an excellent, very good, or good source (below the chart you will find a table that explains these qualifications).

If a nutrient is not listed in the chart, it does not necessarily mean that the food doesn’t contain it. It simply means that the nutrient is not provided in a sufficient amount or concentration to meet our rating criteria.

(To view this food’s in-depth nutritional profile that includes values for dozens of nutrients – not just the ones rated as excellent, very good, or good – please use the link below the chart.)

To read this chart accurately, you’ll need to glance up in the top left corner where you will find the name of the food and the serving size we used to calculate the food’s nutrient composition. This serving size will tell you how much of the food you need to eat to obtain the amount of nutrients found in the chart.

Now, returning to the chart itself, you can look next to the nutrient name in order to find the nutrient amount it offers, the percent Daily Value (DV%) that this amount represents, the nutrient density that we calculated for this food and nutrient, and the rating we established in our rating system.

For most of our nutrient ratings, they adopted the government standards for food labeling that are found in the U.S. Food and Drug Administration’s “Reference Values for Nutrition Labeling.” Read more background information and details of our rating system.

Brown Rice
1.00 cup
195.00 grams
216.45 calories
Nutrient Amount DV
(%)
Nutrient
Density
World’s Healthiest
Foods Rating
manganese 1.76 mg 88.0 7.3 excellent
selenium 19.11 mcg 27.3 2.3 good
magnesium 83.85 mg 21.0 1.7 good
tryptophan 0.06 g 18.8 1.6 good
World’s Healthiest
Foods Rating
Rule
excellent DV>=75% OR
Density>=7.6 AND DV>=10%
very good DV>=50% OR
Density>=3.4 AND DV>=5%
good DV>=25% OR
Density>=1.5 AND DV>=2.5%

In-Depth Nutritional Profile for Brown rice

In some parts of the world, the word “to eat” literally means “to eat rice.” All varieties of rice are available throughout the year, supplying as much as half of the daily calories for half of the world’s population.

The process that produces brown rice removes only the outermost layer, the hull, of the rice kernel and is the least damaging to its nutritional value.

The complete milling and polishing that converts brown rice into white rice destroys 67% of the vitamin B3, 80% of the vitamin B1, 90% of the vitamin B6, half of the manganese, half of the phosphorus, 60% of the iron, and all of the dietary fiber and essential fatty acids. Fully milled and polished white rice is required to be “enriched” with vitamins B1, B3 and iron.

Nutrients in
Brown Rice
1.00 cup (195.00 grams)

Nutrient%Daily Value
manganese88%
selenium27.3%
magnesium20.9%
tryptophan18.7%
Calories (216)12%

This chart graphically details the %DV that a serving of Brown rice provides for each of the nutrients of which it is a good, very good, or excellent source according to our Food Rating System. Additional information about the amount of these nutrients provided by Brown rice can be found in the Food Rating System Chart. A link that takes you to the In-Depth Nutritional Profile for Brown rice, featuring information over 80 nutrients, can be found under the Food Rating System Chart.

References

  • Anderson JW, Hanna TJ, Peng X, Kryscio RJ. Whole grain foods and heart disease risk. J Am Coll Nutr 2000 Jun;19(3 Suppl):291S-9S 2000. PMID:17670.
  • Cade JE, Burley VJ, Greenwood DC. Dietary fibre and risk of breast cancer in the UK Women’s Cohort Study. Int J Epidemiol. 2007 Jan 24; [Epub ahead of print] 2007. PMID:17251246.
  • Ensminger AH, Ensminger, ME, Kondale JE, Robson JRK. Foods & Nutriton Encyclopedia. Pegus Press, Clovis, California 1983.
  • Ensminger AH, Esminger M. K. J. e. al. Food for Health: A Nutrition Encyclopedia. Clovis, California: Pegus Press; 1986 1986. PMID:15210.
  • Erkkila AT, Herrington DM, Mozaffarian D, Lichtenstein AH. Cereal fiber and whole-grain intake are associated with reduced progression of coronary-artery atherosclerosis in postmenopausal women with coronary artery disease. Am Heart J. 2005 Jul;150(1):94-101. 2005. PMID:16084154.
  • Fortin, Francois, Editorial Director. The Visual Foods Encyclopedia. Macmillan, New York 1996.
  • Jensen MK, Koh-Banerjee P, Hu FB, Franz M, Sampson L, Gronbaek M, Rimm EB. Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men. Am J Clin Nutr 2004 Dec;80(6):1492-9. 2004. PMID:15585760.
  • Johnsen NF, Hausner H, Olsen A, Tetens I, Christensen J, Knudsen KE, Overvad K, Tjonneland A. Intake of whole grains and vegetables determines the plasma enterolactone concentration of Danish women. J Nutr. 2004 Oct;134(10):2691-7. 2004. PMID:15465768.
  • Liu RH. New finding may be key to ending confusion over link between fiber, colon cancer. American Institute for Cancer Research Press Release, November 3, 2004. 2004.
  • Liu S, Willett WC, Manson JE, Hu FB, Rosner B, Colditz G. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Am J Clin Nutr. 2003 Nov;78(5):920-7. 2003. PMID:14594777.
  • McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF. Carbohydrate Nutrition, Insulin Resistance, and the Prevalence of the Metabolic Syndrome in the Framingham Offspring Cohort. Diabetes Care. 2004 Feb;27(2):538-546. 2004. PMID:14747241.
  • Most MM, Tulley R, Morales S, Lefevre M. Rice bran oil, not fiber, lowers cholesterol in humans. Am J Clin Nutr. 2005 Jan;81(1):64-8. 2005. PMID:15640461.
  • Ni W, Tsuda Y, Takashima S, Sato H, Sato M, Imaizumi K. Anti-atherogenic effect of soya and rice-protein isolate, compared with casein, in apolipoprotein E-deficient mice. Br J Nutr Jul;90(1):13-20 2003.
  • PlanetRice.net. Chinese Archaeologists Find 9,000-Year-Old Rice Seeds. http://www.planetrice.net/newspub/story.cfm?id=1021 2001.
  • Tabak C, Wijga AH, de Meer G, Janssen NA, Brunekreef B, Smit HA. Diet and asthma in Dutch school children (ISAAC-2). Thorax. 2006 Dec;61(12):1048-53. Epub 2005 Oct 21. 2006. PMID:16244092.
  • Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Long-term intake of dietary fiber and decreased risk of cholecystectomy in women. Am J Gastroenterol. 2004 Jul;99(7):1364-70. 2004. PMID:15233680.
  • van Dam RM, Hu FB, Rosenberg L, Krishnan S, Palmer JR. Dietary calcium and magnesium, major food sources, and risk of type 2 diabetes in U.S. Black women. Diabetes Care. 2006 Oct;29(10):2238-43. 2006. PMID:17003299.
  • Vogt, T. M. Ziegler, R. G. Graubard, B. I et al. Serum selenium and risk of prostate cancer in U.S. blacks and whites. Int J Cancer. 2003 Feb 20; 103(5):664-70 2003.
  • Williams PN, Price AH, Raab A, Hossain A, Feldmann J, Meharg AA. Variation in arsenic speciation and concentration in paddy rice related to dietary exposure. Environ. Sci. Technol., 2005 July;39 (15):5531-5540. 2005. PMID:16124284.
  • Wood, Rebecca. The Whole Foods Encyclopedia. New York, NY: Prentice-Hall Press; 1988 1988. PMID:15220.

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Meanwhile, here’s a recipe for Vegetable Brown Sushi Rolls from Epicurious — followed by more health benefits of brown rice.

Veggie Brown Rice Sushi Roll Ingredients

  • Scant 2/3 cup short-grain brown rice*
  • 1 cup plus 1 teaspoon water
  • 2 teaspoons soy sauce
  • 2 tablespoons seasoned rice vinegar**
  • 1 teaspoon wasabi powder**
  • 2 (8 1/4- by 7 1/4-inch) sheets roasted nori** (dried laver)
  • 1/2 Kirby cucumber, peeled, seeded, and cut into 1/16-inch-thick matchsticks
  • 1/2 carrot, cut into 1/16-inch-thick matchsticks
  • 1/2 firm-ripe small California avocado
  • 3/4 oz radish sprouts*, roots trimmed
  • Special equipment: a bamboo sushi mat**
  • Accompaniments: soy sauce for dipping; sliced gari ** (pickled ginger)
 

Preparation

Rinse rice well and bring to a boil with 1 cup water and 1 teaspoon soy sauce in a 1- to 1 1/2-quart heavy saucepan, then reduce heat to very low and simmer, tightly covered, until water is absorbed, about 40 minutes. Remove from heat and let rice stand, covered, 10 minutes.

While rice is standing, stir together vinegar and remaining teaspoon soy sauce.

Transfer rice to a wide nonmetal bowl (preferably wood, ceramic, or glass) and sprinkle with vinegar mixture, tossing gently with a large spoon to combine. Cool rice, tossing occasionally, about 15 minutes.

Stir together wasabi and remaining teaspoon water to form a stiff paste. Let stand at least 15 minutes (to allow flavors to develop).

Place sushi mat on a work surface with slats running crosswise. Arrange 1 sheet nori, shiny side down, on mat, lining up a long edge of sheet with edge of mat nearest you. Using damp fingers, gently press half of rice (about 3/4 cup) onto nori in 1 layer, leaving a 1 3/4-inch border on side farthest from you.

Arrange half of cucumber in an even strip horizontally across rice, starting 1 inch from side nearest you. (You may need to cut pieces to fit from side to side.) Arrange half of carrot just above cucumber in same manner. Peel avocado half and cut lengthwise into thin slices, then arrange half of slices just above carrot in same manner. Repeat with radish sprouts, letting some sprout tops extend beyond edge.

Beginning with edge nearest you, lift mat up with your thumbs, holding filling in place with your fingers, and fold mat over filling so that upper and lower edges of rice meet, then squeeze gently but firmly along length of roll, tugging edge of mat farthest from you to tighten. (Nori border will still be flat on mat.) Open mat and roll log forward to seal with nori border. (Moisture from rice will seal roll.) Transfer roll, seam side down, to a cutting board. Make second log in same manner, then cut each log crosswise into 6 pieces with a wet thin-bladed knife. Serve with wasabi paste, soy sauce, and ginger.

Active time: 25 min Start to finish: 1 1/4 hr. Read More at: http://www.epicurious.com

10 HEALTHY FOOD CHOICES

1.  BANANAS – Fiber, potassium keeps blood pressure in check.

  
 
 
 2.  BEANS – Fiber, protein, iron, B vitamins, zinc, magnesium, antioxidants.
  
  3.  BERRIES – Antioxidants, boost brain power.
 
  
 
4.  APPLES – Fiber, protects brain cells from tissue damaging free radicals
 
 
 
5.  OATMEAL – Fiber, omega-3‘s, helps burn belly fat
  
 
6.  SALMON – Improves mood, omega 3’s
 
 
 
 
  7.  SPINACH – Loaded with vitamins C, K, A & folate, great brain food, improves mood
 
  
 
8.  YOGURT – Boost immune system, protein
 
 
 9.  KIWI – Vitamin C, potassium
 
  
 
 
10.  PINEAPPLE –  Vitamin C, good for skin.  No knives?  Pick up easy to peel tangerines.
 
 
Related articles

Sober Up to Safe Soda and Cocktails

According to a survey conducted by the Centre for Alcohol Policy Research, 95 percent of people do not know what constitutes safe levels of drinking.  That’s a lot of ignorance. Maybe since they may be drunk, the “ignorance is bliss” adage rings true.

That said, I thought I’d take a moment to raise awareness because young people responded to the survey by saying they thought 8 or 9 drinks were “risk-free” and “safe.”  Pay attention and Sober Up youth of America and Australia.

FACT:  Safe drinking is TWO drinks per day for men and women.  Some say one for women.  For special occasions, FOUR drinks over 6 hours.

People will say things like, “Yeah…but I’m tall” or “I weigh a lot, so I can drink a lot more than the average bloke” to excuse going over that amount.  Some will even say the food they ate is absorbing the alcohol. Sober Up, excuse makers.

News Flash:  It may take longer for the alcohol to catch up with your cheeseburger and fries, but it will travel through your bloodstream just the same.  Your height, weight or food intake is not a reason to overindulge.

I never acquired a taste for beer or alcohol in my youth. It may have to do with my thought that alcohol was loaded with empty calories.  I was into fitness, even as a kid. So, my beverage of choice back then was TAB. What?

Back then, there was a commercial of Elle McPherson sauntering on a beach in a red bikini drinking TAB. I thought if I drank enough of it, I’d look like her.

I switched from the pink can to the one Paula Abdul was holding while dancing on Elton John‘s piano keys. I’m still not sure why I thought that was SO cool, but Abdul even set a fashion trend as we began wearing ties in college like Annie Hall.

Youth of America is easily influenced.  It’s not just me. Today, there are studies (see links at the end of this blog) that show teens are still influenced by what they see on television and in films.  Advertisers know this and they don’t give a hoot about your health. They care about you buying into whatever they’re selling.

It would be years before I learned the aspartame used in diet sodas increase insulin resistence, which leads to an increase in blood sugar, which leads to weight gain. That’s right.  They lied to the youth of America. I bet we can trace the “Obesity Epidemic” and “Increase in Diabetes” back to those TAB and Diet Coke commercials that brainwashed millions of us into thinking we were “healthy” if we were holding a can of diet soda in our hand.

By the time young people realize the truth, they are already: 1) old and 2)  suffering from strange ailments with unknown causes. I had cramps when I drank diet colas, and never imagined it could have been caused by the diet cola in my hand.

Another ailment so many in my own generation suffered from were infertility problems.  Lots of otherwise healthy people with healthy parents who had 3 to 6 kids with no problems were suddenly having issues.  We often joked something was in the water. Maybe something was in the SODA.  Today, if you google “toxic diet coke” on YouTube, you’ll find out the truth.  Chris Wragge at CBS interviewed Dr. Jennifer Ashton about the health dangers of diet soda and found they may increase your risk of stroke by 48 percent.  Sober Up on the Facts about Diet Soda by clicking on some of the links at the end of this article & watching the videos.

I’m happy I haven’t gone near diet soda in 7 years. I quit my diet cola and coffee addiction and now feel amazing. It wasn’t easy, but I feel incredibly healthy.

My advice to everyone is if you suffer from ANY aliment and you and/or physicians do not know the cause –look at what you’re eating and drinking FIRST.  Eliminate soda.  Your aches, pain or symptoms may mysteriously vanish naturally.  A safe soda choice is none. Unfortunately, it’s addicting so if you can’t shake your soda habit –take it one day at a time.  Try to limit it slowly until you can get rid of it completely. Switch to water as often as you can.

Back to alcohol. Is there any such thing as a smart cocktail?  Lisa Lillien says the following drinks are your best bet if you don’t want to pile on empty calories:

POMEGRANATE MARTINI.  A 4-oz. serving made with flavored vodka and pure pomegranate juice (half and half each) has about 185 calories. The juice packs a ton of flavor, plus a punch of antioxidants.

 

 

 

 

RED WINE. A glass of red wine is about 120 calories for 5 ounces.  If it’s a jumbo wine glass, she recommends not filling it to the top. Half works best.

 

 

 

 

 

 

DAIQUIRI.  A low-cal daiquiri using frozen fruit with no added sugar.  Strawberries are a good choice because they’re naturally sweet: Mix 3 partially thawed berries in a blender with ice, 1/2 oz. lime juice, and a 1 1/2 oz. shot of rum. Add just enough water to blend.

 

 

 

    RASBERRY CHAMPAGNE.  Pour champagne, then add a few raspberries. That’s about 100 calories per 5-oz. glass.

 

 

 

 

 

   SPRITZER.  Add club soda and ice to a glass of white wine and voila.

 

 

 

 

CALORIE BOMBS

 

CHOCOLATE MARTINI. Lillien says to “Beware the chocolate martini.”  It’s loaded with heavy cream and sugary syrup, which can add up to 500 calories.

 

 

 

 

WARM MULLED WINE. Loaded with honey and sugar.

 

 

 

 

 

PINA COLADAS. These favorites can top 600 calories.

 

 

 

 

  CHAMPAGNE COCKTAILS. One flute with fruit juice and sugary liqueur will run more than 200 calories.

 

 

 

 

 

Remember, the safe limit is TWO drinks or FOUR drinks over 6-hours on special occasions.  Safe soda is NO SODA.

Share this information whenever you can. If anyone drinks more than that —don’t let them drive.  An innocent person shouldn’t die because you want to get a “buzz.”  How can you tell if you have a problem with alcohol? You can take this Quiz:  http://alcoholism.about.com/od/problem/a/blquiz1.htm

When is the right age to start talking to your kids about alcohol and safe drinking?  As young as 8-years-old.  Also remember that children learn by observing you.  So, Sober Up and talk to your children and teens about drinking safely, and not driving if they consume more than that. And set a good example yourself.

Stay Healthy.  Cheers!!!

🙂

[Source for smart drinks vs. dumb drinks: http://www.hungry-girl.com]

10 Healthy Meals with Recipes

10 Healthy Meals with Recipes

By: Wendy Wu, R.D., M.S.

1) Marinated Mozzarella, Tomato, Basil in Whole Wheat Pita. Recipe.

Mozzarella, tomatoes, basil and garlic.

Whole Wheat Pita Bread

2) Sauteed Tofu with Mixed Veggies and Brown Rice. Recipe.

Tip: Throw in some mushrooms!

Mixed Veggies with Tofu and Brown Rice

3) Spinach and Chickpeas with Whole Wheat Pasta. Recipe.

Spinach and Chickpeas with Whole Wheat Pasta

4) Mesclun Salad with Tuna Fish, Avocado, Broccoli, Tomatoes, Cucumber, Mushrooms, Pumpkin seeds, Peppers with Red Vinegar and Olive Oil Dressing.

Mesclun Salad

5) Loaded Tacos filled with Shrimp, Corn Salsa, Guacamole and Cilantro. Recipe.

Shrimp Tacos with Avocado Corn Salsa

6) Curry Chicken with Brown Rice. Recipe.

Tip: Buy a jar of curry powder so you don’t need to get so many different kinds of spices.

Curried Chicken in Coconut Milk with Tomatoes and Mixed Veg

7) Homemade Sushi with Brown Rice (Shitake Mushroom and Spinach or Avocado, Shrimp, Cucumber, and Carrots). Recipe.

Shitake Mushroom and Spinach Sushi

8) Peanut Butter and Jelly with Whole Wheat Bread

Natural Peanut Butter and Jelly with Whole Wheat Bread

9) Homemade Pizza on a Pita. Recipe.

Tomato-Two Cheese Pizza with Mushroom and Basil

10) Chicken Soup with Whole Wheat Pasta. Recipe.

Quick chicken whole wheat pasta soup

Do you have any Healthy Meal ideas you’d like to share? Post them here.