An important yet vastly underrated lifestyle decision is what foods we decide to eat every day.

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Combat aggressive forms of prostate cancer

Eat your veggies - a resounding chorus around the dinner table - takes on new meaning in the context of fueling yourself at a cellular level. In 2007, a study published in the Journal of the National Cancer Institute (JNCI) showed that the incidence of extraprostatic extension of prostate cancer decreased with increasing vegetable intake.  

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Dr. Victoria Kirsh, the first author of the JNCI paper, based on her study of 29,361 men in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial via food-frequency questionnaires and prostate cancer incidence reports. After an average of four years of annual evaluations, the researchers found that overall vegetable consumption had a significant association with aggressive prostate cancer incidence.

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Perhaps it's surprising, but Dr. Kirsh's team found that increasing vegetable - not fruit - consumption is associated with a decrease in prostate cancer risk. The research subjects with the highest consumption of vegetables had a 40% decreased risk for aggressive prostate cancer compared with people who hardly ever ate vegetables.

 

Another surprising finding from this study is that cruciferous vegetables offer a protective benefit where different types of crucifers offer varying ability to prevent prostate cancer. 

         

Click here to see the abstract of Dr. Kirsh's article, "Prospective Study of Fruit and Vegetable Intake and Risk of Prostate Cancer." Published in 2007 by the Journal of the National Cancer Institute. 

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Reduce your prostate cancer risk

Another medical researcher, Dr. Jennifer H. Cohen, noted the extensive and consistent evidence that high fruit and vegetable intakes are associated with decreased risks of many cancers. Yet, the results for prostate cancer risk have been inconsistent in the literature of cohort studies. 

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So, she did what all great scientists do and created a population-based case-control study to examine the associations of fruit and vegetable intakes with prostate cancer risk. The research team recruited 628 case participants from King County, WA and 602 control participants from the same population matched to case participants by age.

 

The results were astonishing and statistically significant. First, the team validated the results of Dr. Kirsh's study in finding that eating fruit doesn't confer any benefit to prostate cancer prevention. Then, the researchers found that men who consumed 28 or more servings of vegetables per week displayed a 35% decrease in prostate cancer risk. Finally, men who consumed 3 or more servings per week of cruciferous vegetables boosted this statistic to a 41% decrease in prostate cancer risk. The key takeaway from these studies points to cruciferous vegetables as powerful anticarcinogenic agents.

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Click here to see Dr. Cohen's full article, "Fruit and Vegetable Intakes and Prostate Cancer Risk." Published in 2000 by the Journal of the National Cancer Institute.  

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What's your response to research?

Here's some food for thought. For some people, the statistic that a diet high in cruciferous vegetables is linked to a 35%-48% reduction in prostate cancer risk is enough for them to immediately begin making healthy lifestyle choices. 

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Here’s some food for thought. Scientific findings are true whether we like them or not. For some people, the opposition isn't to science itself but to the solutions, such as curbing carbon emissions or investing in greener technologies to address climate change. Scientific American called this phenomenon solution aversion in their 2017 blog: "Who Are You Calling Anti-Science: Those who reject vaccines or the climate consensus often embrace other areas of research."  

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For some people, it's difficult to implement the solution but they are not opposed to the science or solution. No matter where you fall in the spectrum of broccoli enthusiasts to vegetable avoidance, the power of believing in yourself can make all the difference in the world to make powerful changes in your life. 

 

​For some people who use their intuition or other social determinants for decision making, it intuitively makes sense that eating fresh vegetables should have some positive health benefits. The studies led by Dr. Kirsh and Dr. Cohen illustrate the power of vegetables to significantly lower you risk for prostate cancer and decrease your risk of aggressive forms of the disease. Also, medical research offer us the gift of knowledge that cruciferous vegetables are heavy hitters in an anticarcinogenic diet.

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Knowledge is power. No matter what your preferred pathway is for understanding the world, acknowledging that certain food groups confer health benefits is an important step. Not all vegetables are equal in their anticarcinogenic properties. According to the National Cancer Institute's article on Cruciferous Vegetables and Cancer Prevention, nutrient-dense cruciferous vegetables pack the most power in cancer prevention. Other crucifers such as bok choy, daikon, and watercress are less nutrient dense but can be helpful too.

 

The Chemistry of Broccoli

In our quest to prevent cancer, medical researchers are studying plant chemistry to improve human health. “We’re just starting to scratch the surface in quantifying the role of the many small molecules found in plants,” says Dr. Elizabeth Sattely, Associate Professor of Chemical Engineering at Stanford and HHMI Investigator. “Now, we are looking at how the chemicals in the food that we eat can directly impact our health.”  

 

Dr. Astrid Steinbrecher from the German Cancer Research Center published a cohort study in 2009 that followed 11,405 men for an average of 9.4 years. The goal of this study was to determine the impact of secondary plant metabolites -  called glucosinolates - found in cruciferous vegetables. Although the analysis was based on food consumption questionnaires, the large sample size points to an amazing profile of men who eat crucifers. Those with the highest consumption of crucifers - compared to those with the lowest consumption - decreased their risk for prostate cancer by approximately 32%. 

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Click here to see Dr. Steinbrecher's full article, "Dietary Glucosinolate Intake and Risk of Prostate Cancer in the EPIC-Heidelberg Cohort Study." Published in 2009 in the International Journal of Cancer. 

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Click on the image below to geek out on the chemistry of glucosinolates and learn what happens to broccoli when you chop or cook it. "The Chemistry of Broccoli" by Andy Brunning, Compound Interest 2019, is licensed under CC BY-ND 2.0.

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Glucosinolates

It's important to know that cancer researchers have investigated cruciferous vegetables precisely because of their demonstrated ability to reduce prostate cancer risk. In other words, the questions posed by medical researchers are: what exactly are the protective attributes of these vegetables and what are their mechanisms for fighting cancer?

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Studies have shown that the metabolic products of glucosinolates contain powerful anticarcinogenic properties. The metabolic products of glucoraphanin and glucobrassicin (sulforaphane and indole-3-carbinol, respectively) have been the subject of intense research. Understanding the principles of biochemistry would help humanity conquer cancer if we knew precisely what to do with regards to our glucosinolate consumption as well as control for other lifestyle factors. 

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Dr. Gregory W. Watson, postdoctoral fellow at the Moffitt Cancer Center, reviewed existing medical literature on the well-established targets of sulforaphane and indole-3-carbinol and more recent evidence supporting these agents for their prostate cancer prevention. Glucoraphanin and glucobrassicin break down into the bioactive phytochemicals, sulforaphane and indole-3-carbinol (I3C), which further breaks down into diindolylmethane (DIM). These 3 phytochemicals are responsible for the anticarcinogenic properties associated with cruciferous vegetables by (1) blocking the growth of cancer cells, (2) triggering cancer cell death, and (3) altering the epigenetic activity that enables cancer cells to proliferate.

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The knowledge captured by Dr. Watson is significant because knowing the specific biochemistry of crucifer glucosinolates that attack cancer cells helps explain why broccoli and other cruciferous vegetables are so powerful at preventing prostate cancer.  

 

Click here to see Dr. Watson's full article, "Phytochemicals from Cruciferous Vegetables, Epigenetics, and Prostate Cancer Prevention." Published in 2013 by the American Association of Pharmaceutical Scientists.

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Crucifers reduce other major diseases

According to the most recent statistics from the CDC, cardiovascular disease is the leading cause of death in the United States closely followed by cancer. What are the chances that crucifers might help reduce your risk for the various cardiovascular diseases, such as coronary artery disease, heart attack, and stroke?

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In 2011, Dr. Xianglan Zhang from Vanderbilt University began researching the relationship between diet and heart disease. His research team tracked 134,796 people over the course of a decade to study how crucifer consumption could impact their risk for cardiovascular disease. Baseline assessments were conducted via live interviews and follow-up evaluations were conducted through food frequency questionnaires.

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The great news is that Dr. Zhang found that eating fruits and vegetables reduces mortality from cardiovascular diseases as well as total mortality. This outcome was especially evident for cruciferous vegetable intake, which displayed a direct dose-response pattern. Findings from this study support the theory that overall vegetable intake (specifically cruciferous vegetables) will decrease your risk of cardiovascular disease and promotes overall health. 

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Stroke 

There is a growing body of research on the power of vegetables to rid humanity of many diseases that continue to stalk our species. Kaumudi Jinraj Joshipura is a Renaissance woman: she is an Indian dentist-scientist, biostatistician, epidemiologist, and adjunct professor of epidemiology at the Harvard T. H. Chan School of Public Health. One of her areas of interest is the interrelationship among lifestyle factors and ischemic stroke. 

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She created a longitudinal study of 114,279 American participants to determine the effect of fruit and vegetable intake on their risk for ischemic stroke. Participants' diets were evaluated every two years: participants from the Nurses’ Health Study had follow ups over 14 years and participants from the Health Professionals’ Follow-up Study had follow ups over 8 years.

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And much like the findings from Dr. Zhang’s study above, KJ Joshipura's results were particularly pronounced when it came to cruciferous vegetable intake. Data from this study supports the protective role of cruciferous vegetable consumption against ischemic stroke.

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Click here to see Dr. Joshipura's full article, "Fruit and Vegetable Intake in Relation to Risk of Ischemic Stroke." Published in 1999 by the Journal of the American Medical Association (JAMA). 

 

Guidelines from the American Cancer Society (ACS) 

The ACS guidelines were updated in June 2020 to reflect a shift from a reductionist or nutrient‐centric approach to the concept of dietary patterns. This focus on dietary patterns reflects how people actually eat.

 

People eat whole foods (not nutrients) that represent an overall dietary pattern, which taken together, can modify their cancer risk. There is epidemiological evidence and controlled intervention trials that suggest healthy dietary patterns are associated with reduced risk for cancer, especially colon and breast cancer.

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• Get to and stay at a healthy body weight throughout life. If you’re overweight or obese, losing even a few pounds can lower your risk for some types of cancer.
   

• Adults should get 150-300 minutes of moderate-intensity physical activity per week, or 75-150 minutes of vigorous-intensity physical activity, or a combination. Getting 300 minutes or even more will give you the most health benefits.

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• Eat a colorful variety of vegetables and fruits, and plenty of whole grains and brown rice.

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• Avoid or limit eating red meats such as beef, pork, and lamb and processed meats such as bacon, sausage, deli meats, and hot dogs.
   

• Avoid or limit sugar-sweetened beverages, highly processed foods, and refined grain products.
   

• It is best not to drink alcohol. But if you do, women should have no more than 1 drink per day and men should have no more than 2. A drink is 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits.