A common nutritional complaint
regarding American eating habits is
that the culture tends toward a mono-diet,
meaning that only a handful of
foods account for most of the diet.
Favored foods typically include, either
directly or in derived and hidden
forms, corn, wheat, soy, potatoes,
canola oil and a few other items along
with foods based on these as feed, such as the meat, fish
and fowl raised on them. There are a number of reasons
for the narrowness of this range, one of the most powerful
being subsidies to agriculture. Staple crops and foods are
subsidized and relatively inexpensive whereas fresh fruit and
vegetables along with most foods not on the favored lists of
subsidies are expensive. One result is what economists term
"externalities," in this case costs borne by individuals and
society, such as poor health, higher medical and medical
insurance costs along with shorter life spans. In contrast
to the results of typical American eating habits, experience
commonly demonstrates that merely increasing the range
of food choices with an emphasis on fresh as opposed
to canned, frozen and preserved foods can introduce
considerable benefits. Similar benefits sometimes can be
achieved through the proper use of dietary supplements
with the catch, however, that not all supplements match
the purposes for which they are being taken. (Note: some
foods do well frozen, such as corn, peas and many fruits,
especially berries; canning is more limited, but includes,
for example, tomatoes. However, most vegetables need to
start off fresh!)
Foods Rescue the Prostate
It is not necessary to consume large amounts of exotic
nutrients to obtain significant benefits. In 2013 a group of
British researchers performed a six month long experiment
in which 203 adult males with prostate cancer consumed
either a placebo or a simple supplement mixture consisting
of powdered pomegranate, turmeric, green tea and broccoli.1
Only the green tea was an extract, and even then providing
roughly the same amount of actives as found in a cup or
two of brewed green tea. Consumed three times a day, the
active arm was comprised of:
- broccoli powder (Brassica oleracea) 100 mg
- turmeric powder (Curcuma longa) 100 mg
- pomegranate whole fruit powder (Punica granatum) 100 mg
- green tea 5:1 extract (Camellia sinensis) 20 mg, equivalent to 100 mg of crude green tea
After six months, the researchers found that prostate-specific
antigen (PSA) levels, a possible marker for
prostate cancer, were 63 percent lower among those taking
the supplement than among those taking the placebo.
This significant result was achieved with really quite tiny
amounts of everyday foods and, except in the case of the
green tea, these were not even extracts.
A number of studies have demonstrated that quite a
range of compounds found in everyday foods are protective
not just against prostate cancer, but also against many
other cancers, as well. As another example, ursolic acid
(found in apple peels and rosemary herb) in combination
with turmeric’s ingredient curcumin or resveratrol (found
in grapes and berries) blocks the uptake of glutamine by
cancer cells yet do not interfere with the metabolism of
normal cells—glutamine is a nutrient cancer cells need in
order to grow.
Plant Colors, Plant Nutrients and Nutritional Synergy
Current government health recommendations include five
servings per day of fruit and vegetables along with the
suggestion that nine servings would be better. Unfortunately,
this type of recommendation tends to be a bit misleading in
that some fruits and vegetables are vastly more nutritious
than others. For instance, cabbages in general are sources of
compounds including isothiocyanates and indoles. However,
cabbage-family members such as bok choy are comparatively
light in nutrition compared with purple cabbage, which is
rich in anthocyanidins as well as the expected precursors of
sulforaphane. Similarly, leaf lettuces tend to be much more
nutrient rich than is head lettuce. Below is a rough overview
of some of the phytonutrients matched to associated colors
in plants. There is a large degree of overlap and many
phytonutrient polyphenols are almost colorless in the amounts found in foods. We tend to not associate black
tea and coffee with nutrition, but the former is a source of
theaflavin and the latter, if not overly roasted and freshly
brewed, is a good source of chlorogenic acids.
Red—lycopene, associated with tomatoes, pink grapefruit
and watermelon; anthocyanidins (cyanidin literally meaning
"red color") associated with berries, other highly colored
fruit, beets
Red/Purple—anthocyanidins, resveratrol and related
compounds found in berries, other highly colored fruit,
beets and eggplant, also found in black and other beans,
black rice
Yellow/Orange—alpha- and beta-carotene, beta-cryptoxanthin;
sources include carrots, citrus fruit, squashes, sweet potatoes, cantaloupes; hesperidin and
diosmin are found in citrus fruit; rutin, related to hesperidin,
is found in buckwheat
Yellow/Green—lutein, zeaxanthin, quercetin, catechin,
epicatechins, ellagic acid, isothiocyanates and indoles found
in peppers, kale, cabbage, many other green vegetables,
green tea; the best single source of highly bioavailable
lutein and zeaxanthin is the yolk of eggs from hens allowed
to eat grass and insects
White/Green—allicin and related compounds, rutin in
garlic and onions; isothiocyanates and indoles are found
in cabbage family members, including cauliflower; many
flavonoids; quercetin glycosides, phloretin glycoside (apple
skin), chlorogenic acid and epicatechin found in "white"
fruits (apples, pears), eggplant, green tea, freshly brewed
coffee (chlorgenic acid)
Various polyphenols and other phytonutrients provide
benefits, many of which overlap, but some of which are
special to one or another family of compounds. One
huge payoff from variety is that there can be unexpected
synergisms. This is an issue dealt with in these pages
several years ago in the article, "Beyond Synergy—the Entourage Effect in Nutrition and Herbalism." (Total Health,
September 2015) It is worth repeating here a key example
described in that essay.
At the 219th American Chemical Society National
Meeting held in San Francisco on March 26–30, 2000
researchers associated with the company Polyphenolics
presented studies that supported supplementing the diet
with special plant-derived nutrients and consuming more
whole fruits and vegetables. One of my associates pointed
out that antioxidant vitamins are present in the human body
at levels typically twenty to several hundred times the level
of plant polyphenols. This is one reason that so much less
research has focused on the antioxidant vitamins in foods
and relatively little research has been done on the antioxidant
roles of the other compounds present. By 2000, however,
it already was becoming clear that these non-vitamin plant
antioxidants have an impact on the antioxidant status of
the body that is much beyond their representation in the
blood and tissues. For instance, at the conference it was
explained that an extract from grape seeds given to human
volunteers led to a much greater increase in the antioxidant
capacity of the subjects’ blood than was theoretically
possible based on the compound alone. This was a finding
that called for explanation. A second set of tests helped to
clarify the result of the first—the same grape seed extract
demonstrated significant synergism when tested in vitro
with the antioxidant vitamins C and E, either alone or in
combination.
To establish a quantitative baseline for the antioxidant
power of each of the compounds, tests used the standard
cupric ion generation of oxidation to look at the impact
of combining our grape seed extract (Vixox Gold™) with
vitamins C and E to gauge the synergy of the combinations.
Vitamin C, vitamin E and grape seed extract were each
tested individually to determine their effects at several
concentrations. These baselines were added to yield the
"Sum of Individual Inhibitions" which then was compared
with the "Actual Inhibitions When Tested Together." The
Actual Inhibitions minus the Sum of Individual Inhibitions
times 100 yielded the percent of Synergism. This series
of in vitro tests thus allowed the investigator to elegantly
demonstrate the concentrations of maximal synergism
amongst the three antioxidants. Strong synergism was
shown for Vinox Gold™ plus vitamin C, for Vinox Gold™
plus vitamin E, and, finally, for Vinox Gold™ plus vitamin C
and vitamin E.
Synergisms in the ranges shown here are good examples
of why it is that consuming a diet rich in fruit and vegetables
is so much more successful in terms of health than is eating
a diet based on refined carbohydrates, protein and fats.
Cautionary Tales Regarding Supplements
Refining the "big three" macronutrients and then "adding
back" nutrients/micronutrients loses the benefits of the
plant compounds that otherwise are present in the original
sources of carbohydrates and in partially refined oils, such as olive and sesame oils. Supplements are useful, but they
do not take the place of fresh food properly prepared in
a diet emphasizing adequate variety. Moreover, there are
other reasons for being careful about the use of non-food
interventions.
A good example, one that shows the overlap of how
we sometimes use over-the-counter drugs and nutrients,
is drawn from sports. Almost all of us, whether inclined
towards athletics or not, have experience with soreness from
exercise beyond our current level of physical preparation.
"Weekend warriors" are familiar with this and so are high
school, college and professional athletes. To overcome
soreness from exertion beyond our capacity, it is common
to take pain relievers. Hard physical training even in healthy
you individuals, of course, is itself associated with post-exercise
soreness.
To prevent this, researchers at various centers have
explored whether taking aspirin or similar compounds can
prevent the development of post-exercise soreness. The
findings of these experiments were that taking aspirin or
some other non-steroidal anti-inflammatory can, in fact,
mitigate the development of soreness. That was the positive
finding. The not-so-positive finding was that this approach
also prevented improvements based on training or overload
effects! It turned out that a certain amount of local damage
to the tissues caused by overload is required to induce
improvements in exercise capacity based on training.
That was a bit of a surprise even if, in scientific
terms, it also was a very interesting and useful finding.
More surprising still were the results of a variation on
the theme of using NSAIDs prophylactically to prevent
muscle pain. Researchers reasoned that tissue damage was
due to, among other things, localized oxidative challenge
associated with tissue damage. Instead of NSAIDs, classic
powerful antioxidant vitamins and compounds were
provided: vitamin C, E and N-acetyl cysteine (NAC). As
was the case with the pre-workout use of NSAIDs, these
antioxidants taken in quantity before training sessions did
reduce soreness. Just as in the case of the NSAIDs, they
also reduced the benefits of training.
More recently still, reports have emerged showing that
very high dose resveratrol (250 mg) interferes with the
benefits of exercise training.2 This finding is not limited
to resveratrol and potentially extends to quite a number of
nutrients:
"support for beneficial effects of resveratrol in human
[sic] is weak and studies even show that resveratrol
supplementation, similarly to supplementation with
other antioxidants, can counteract the positive effects of physical activity. Regular physical activity remains
the most effective way of maintaining and improving
vascular health status and caution should be taken
regarding potential interference of supplements on
training adaptations."3
It should be pointed out that such negative findings are
balanced by other positive findings. In another study with
older individuals 65–80 years of age, 500 mg per day
resveratrol, although it did not improve cardiovascular
risks compared to exercise alone, did improve the number
of functional mitochondria in muscle and "subjects that
[sic] were treated with RSV had an increase in knee extensor
muscle peak torque (8 percent), average peak torque (14
percent), and power (14 percent) after training, whereas
exercise did not increase these parameters in the placebotreated
older subjects."4,5
These findings can be reconciled in a variety of ways.
For instance, one implication is that high dose resveratrol
might be cycled to improve muscle quality and function,
then removed from the cycle to allow for the emergence of
other benefits. Those readers interested in further exploring
the use of antioxidants in exercise and aging might do well
to consult "Oxidative stress: role of physical exercise and
antioxidant nutraceuticals in adulthood and aging."6
A second and more serious type of caveat emptor case
involves taking a cocktail of supplements and finding that
one of these undoes the benefits of the others. Several
years back, a group of researchers at Georgetown University
Medical Center, of whom I was one, examined whether
avoiding insulin resistance, which is associated with aging,
might lengthen life span in rodents as indicated by previous
studies using caloric-restricted animals. We assessed
whether consuming niacin-bound chromium (NBC)
alone or in a formula containing other so-called "insulin
sensitizers" would overcome various manifestations of
aging and extend life span in Zucker Fatty Rats (ZFR).7 As
we report in the abstract of our research, we "compared many metabolic parameters of ZFR
fed NBC alone (n=12) or NBC in a unique formula
(n=10) to a control group (n=10). In addition to NBC,
the formula contained Allium sativum, Momordica
charantia, Trigonella foenum-graecum and Gymnema
sylvestre. The formula group received roughly ½ as
much NBC daily as the NBC group. At week 44, all
rats still lived, and no abnormalities in blood count
(CBC), renal, or liver functions were found. In the two
treatment groups compared to control, circulating
glucose levels were significantly lower, with a trend
toward lower HbA1C. Relatively elevated cholesterol
and triglyceride concentrations occurred in the
formula group. Compared to control, the NBC group
had increased average lifespan (21.8%), median
lifespan (14.1%), 30th percentile survival (19.6%), and
maximum lifespan (22%). Despite similar beneficial
effects on the glucose and blood pressure systems,
a difference in aging was also found when the NBC
group was compared to the formula group. When all
rats in the other two groups had died, four in the NBC
group continued to live at least a month longer."
The fact that the life extension benefits of supplementation
with chromium were undone by the inclusion of the other ingredients despite similar improvements in markers, such
as blood glucose and blood pressure, was the source of
considerable discussion in our group. My position at the
time was and remains that the "insulin sensitizer" approach
is beneficial. However, one of the ingredients in the formula,
Gymnema sylvestre, is not an insulin sensitizer; instead, it is
an inducer of insulin release from the pancreas, thus can
elevate insulin levels or prevent a lowering of such levels
even in conjunction with better insulin sensitivity. Elevated
levels of circulating insulin are damaging the arteries and to
many systems of the body regardless of any apparent benefit
in terms of lowering circulating glucose and HbA1C. Adding
this inappropriate ingredient to the mix negated benefits
in terms of actual final endpoints, in this case extended
lifespan, as opposed to improving mere markers.
Conclusion
The American diet notoriously tends to be restricted in
terms of the range and types of foods included. Surprisingly
small changes in the diet that increase the variety of
polyphenols and other nutrients, mostly plant-derived,
can lead to quite outsized effects in terms of benefits. As
described above in one example, plant nutrients equal to a
small portion of a well-designed curry plus a cup of green
tea yielded significant returns in terms of prostate health.
Dietary supplements can be useful aids to enlarging the
range of nutrients consumed each day, but supplements do
not take the place of fresh food properly prepared and eaten
in variety. Moreover, supplement interactions are not always
obvious and need to be observed carefully.
Endnotes
- van Die MD, Williams SG, Emery J, Bone KM, Taylor JM, Lusk E, Pirotta MV. A Placebo-Controlled Double-Blinded Randomized Pilot Study of Combination Phytotherapy in Biochemically Recurrent Prostate Cancer. Prostate. 2017 May;77(7):765 –75.
- Gliemann L, Schmidt JF, Olesen J, Biensø RS, Peronard SL, Grandjean SU, Mortensen SP, Nyberg M, Bangsbo J, Pilegaard H, Hellsten Y. Resveratrol blunts the positive effects of exercise training on cardiovascular health in aged men. J Physiol. 2013 Oct 15;591(20):5047–59.
- Gliemann L, Nyberg M, Hellsten Y. Effects of exercise training and resveratrol on vascular health in aging. Free Radic Biol Med. 2016 Sep;98:165–76.
- Alway SE, McCrory JL, Kearcher K, Vickers A, Frear B, Gilleland DL, Bonner DE, Thomas JM, Donley DA, Lively MW, Mohamed JS. Resveratrol Enhances Exercise-Induced Cellular and Functional Adaptations of Skeletal Muscle in Older Men and Women. J Gerontol A Biol Sci Med Sci. 2017 Nov 9;72(12):1595 –1606.
- Pollack RM, Barzilai N, Anghel V, Kulkarni AS, Golden A, O’Broin P, Sinclair DA, Bonkowski MS, Coleville AJ, Powell D, Kim S, Moaddel R, Stein D, Zhang K, Hawkins M, Crandall JP. Resveratrol Improves Vascular Function and Mitochondrial Number but Not Glucose Metabolism in Older Adults. J Gerontol A Biol Sci Med Sci. 2017 Nov 9;72(12):1703 – 09.
- Simioni C, Zauli G, Martelli AM, Vitale M, Sacchetti G, Gonelli A, Neri LM. Oxidative stress: role of physical exercise and antioxidant nutraceuticals in adulthood and aging. Oncotarget. 2018 Mar 30;9(24):17181– 98.
- Preuss HG, Echard B, Clouatre D, Bagchi D, Perricone NV. Niacin-bound chromium increases life span in Zucker Fatty Rats. J Inorg Biochem. 2011 Oct;105(10):1344 – 9.
