Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Thursday, June 4, 2009

Prostate, Prostatitis, Cancer, Causes and Cures

Prostate problems are pervasive, and progressive in the U.S. -- approximately a quarter of a million prostate cancers are diagnosed each year. Chronic inflammation due to age or diet enhances prostatitis and cancer.

Prostate Surrounds Male Urethra

The prostate is a sexual organ. It responds to sexual stimuli, both physical and hormonal, and as a consequence is vulnerable to the same hazards: infection, inflammation, cycles of elaboration and cancer. The prostate straddles the male urethra and inflammatory swelling of the prostrate can strangle the flow of urine from the bladder. The prostate contributes part of the seminal fluid and backward flow of bacteria from the urethra into the prostate can be a source of infection.

Prostate Cells Require Testosterone for Growth

The prostate tissue responds to testosterone. The ebb and flow of testosterone, associated with sexual activity, results in increased production of prostate fluid containing proteins and other components that enhance performance of sperm in the female reproductive tract. The bottom line here is that prostate tissue and derived prostate cancer, responds to testosterone. For this reason, prostate cancer treatment has been based on blocking testosterone stimulation by removal of sources of testosterone and blocking testosterone receptors.

Testosterone Starvation Is Prostate Cancer Treatment

Testosterone, estrogen and vitamin D receptors are all cytoplasmic and the hormone/receptor complexes act as transcription factors to alter nuclear gene expression. It would be expected that prostate cancer, as well as breast, cervical, ovarian, testicular, etc. will respond in a complex manner to steroid hormones, including androgens, estrogens and vitamin D.

Cancer Requires NF-kB Activation

The common biochemistry supporting all cancers is inflammation that is required for proliferation in tissue. Central to inflammation is the transcription factor NF-kB. Inhibitors that block the activation of NF-kB also stop cancer. Most of these blockers are effective against cancer cells grown in culture flasks, because the inhibitors are taken directly into the cells and make contact with NF-kB (or stabilize the NF-kB inhibitor IkB.) Curcumin from turmeric, is one of the most potent inhibitors of NF-kB activation. It is very effective in cultures, but is only modestly effective against inflammation when eaten.

It is difficult to treat secretory tissues, such as prostate, breast, uterus, etc., because much of the tissue is separated from the blood circulation. Thus, infections in these tissues are harder to treat with antibiotics.

Prostatitis Results from Urinary Infections

The prostate is prone to chronic infections. Thus, urinary tract infections (UTIs) can lead to prostate infections (prostatitis). These chronic infections can contribute to chronic systemic inflammation. One symptom of chronic inflammation is depression (treated with SSRIs, antidepressants) another symptom is premature ejaculation (also treated with SSRIs.) Prostatitis-based inflammation can also set the stage for cancer.

Transglutaminase Autoantigen

Autoimmune diseases are also associated with chronic inflammation. One of the common autoantigens in autoimmune disease is tissue transglutaminase (tTG). Celiac is a classic example of the involvement of tTG, since tTG acts on the glutamine amino acids of gluten and converts them into glutamic acid residues. In the process tTG becomes covalently attached to the gluten. The strong heparin binding domains of tTG also facilitate its uptake and processing as an immunogen under inflammatory conditions and result in antibody production to both tTG and gluten. Anti-tTG antibodies and inflammation can also lead to attack on other tissues, such as the thyroid and skin, leading to a variety of celiac-associated autoimmune conditions.

The prostate produces its own transglutaminase. I think it is likely that prostatitis in some cases progresses to an autoimmune disease and prostate transglutaminase is a likely candidate for one of the autoantigens involved. This also predicts an association with celiac and a requirement for chronic systemic infection with a likely elevation of C-reactive protein and inflammatory cytokines (IL-1, IL-6, TNF). Deficiency of vitamin D and omega-3 fatty acids are probably major contributors. Increased risk attributed to consumption of a high fat diet and meat, is probably actually due to inflammation from a high carbohydrate diet and high omega-6 vegetable oils (or perhaps corn-fed meat.)

Protect Prostate with Anti-Inflammatory Diet

Prostate problems are frequently assumed to be a natural result of advancing age, but they are actually symptoms of mismanaged chronic inflammation. Men should not just stand and wait for prostate problems.

Avoidance and treatment of prostate problems seems to be an obvious application for an anti-inflammatory diet and lifestyle.

37 comments:

Bill said...

"Increased risk attributed to consumption of a high fat diet and meat, is probably actually due to inflammation from a high carbohydrate diet and high omega-3 vegetable oils (or perhaps corn-fed meat.)"

Should it not be high omega-6 vegetable oils?

Dr. Art Ayers said...

Bill,
Thanks for the correction. Omega-6 vegetable oils at high levels, e.g. using corn or soy oils for cooking, is a major source of inflammation. Feeding grain to cattle makes unhealthy beef. Free range chickens produce better eggs and meat than corn fed chickens.
Art

Calvin said...

Question: why don't young men, with their raging testosterone levels develop prostate cancer? Hello . . . really think about it . . . prostate cancer is not a disease of high T levels; rather, it is a disease of too much estrogen (contrary to what you've all been told--just like cholesterol causes heart disease--in most cases high cholesterol is just the bodies way to compensate [provide the building blocks] for declining downstream hormones). Most xenobiotics are estrogenic (xenoestrogens); xenobiotics are ubiquitous in modernity, compete with what little T most aging males have anyway, and as in women with endometriosis excessive estrogen causes the proliferation of cell growth--cancer.

And yes, excessive omega 6's cause inflammation, as does excessive sugar, both of which can promote cancer.

Calvin said...

One more thing . . .

You wrote: Prostate Cells Require Testosterone for Growth

The prostate tissue responds to testosterone. The ebb and flow of testosterone, associated with sexual activity, results in increased production of prostate fluid containing proteins and other components that enhance performance of sperm in the female reproductive tract. The bottom line here is that prostate tissue and derived prostate cancer, responds to testosterone. For this reason, prostate cancer treatment has been based on blocking testosterone stimulation by removal of sources of testosterone and blocking testosterone receptors.

Another problem with higher estrogen and lower testosterone in men is their libido is analogous to a limp noodle, which causes prostate fluid to stagnate, which can further enhance prostate disease outlook. Conventional medicine would love to take your money, perform surgery, add some radiation, liberal chemo, and then add a dash of more estrogen to basically castrate what little of your manhood that is left--prognosis--not too good, cancer relapse, pretty darn good--quality of life--I guess that depends on how much you love all the good things that healthy T levels provide, e.g. sense of well being, confidence, and yes libido, etc.

Personally, I find it much easier to prevent prostate cancer, rather than deal with the consequences. E.g. clean up your environment--get rid of all those polluting environmental chemicals in you diet and life.

By the way Art, as an interesting follow-up: do you have the percentages of both men & women that, say by age 60 have already been diagnosed with prostate cancer (men) or uterine fibroids/endometriosis? Of course, you could look at this by country, or industrialized country/people, . . . . anyway, I feel that this may be worth some folow-up.

Cheers

Dr. Art Ayers said...

Calvin,
There is no claim that testosterone causes prostate problems. Testosterone (and estrogens) are needed for growth of most prostate cancers. Both steroid hormone receptors are present on prostate cancer cells. If the receptors are blocked the cancer cells stop growing. Blocking inflammation pathways also stops cancer cells.

Environmental estrogens have always been abundant. The organic material in soil is made of plant wall lignin, which breaks down naturally to release a huge variety of organic compounds, many of which are estrogenic.

We can connect the dots and show that increasing diet-based inflammation leads to autoimmunity and autoimmunity leads to cancer. We haven't shown that man-made estrogenic compounds cause prostate problems. The epidemiology is simply is not there.

I am not even convinced that more sensitive areas of physiology are suffering significantly to indicate that environmental estrogens are a major problem for humans. Dietary phytoestrogens seem to be more important.

Xenobiotics are ubiquitous, but in low amounts. I think that they are problems, but the basic composition of processed food diets is a more severe problem. In my opinion, if we cleaned up all of the contaminating manmade chemicals, the impact on reduced disease would be less than 10%. If we shifted to more natural, anti-inflammatory diets, disease would be reduced by at least 90% in the US.

Thanks for you comments.

Kevin said...

Hi Dr A,

Since I have BPH this topic hits home. I've read that prostate cancer can be testosterone-sensitive or testosterone-insensitive. The insensitive form doesn't respond to androgen deprivation, chemical or physical (castration).

The radio guy, Don Imus, recently said he's been treating his prostate cancer by eating three Habaneros daily. He claims it has dropped his PSA dramatically. I found one abstract showing resoluton of prostate cancer in vitro from capsaicin treatments.

Any ideas what could be happening at the biochemical level?

TIA,

kevin

Dr. Art Ayers said...

Kevin,

Capsaicin (hot pepper) binds to the heat receptor and stimulates an anti-inflammatory response via the vagas nerve. Castor oil (ricinoleate) binds to the same receptor and has the same response. Menthol binds to the cold receptor and also stimulates an anti-inflammatory response. Thus, for a burned finger, you could apply capsaicin, castor oil or Vicks (menthol) and observe relief from pain and inflammation.

Since the anti-inflammatory response is only vaguely mapped to the original location of stimulation, the burned finger could also be treated by Vicks applied to the wrist.

Application of a castor oil pack to the abdomen is used for treating abdominal pains, such as menstrual cramps. Ingestion of capsaicin may treat prostate inflammation by the same general anti-inflammatory response. Since most of the immune cells of the body reside temporarily in the walls of the intestine, ingested capsaicin might act via anti-inflammatory effects in the gut.

Capsaicin might also have dramatic effects if applied topically near the prostate, but obviously great care must be taken. Castor oil applications would make a lot more sense. I would think that an overnight application of a castor oil pack to the lower abdomen might reduce prostate inflammation.

Reducing inflammation by these methods will be helpful, but temporary. I think that the fundamental problem is dietary. Go to the bottom of the prostate article and follow the link to my diet suggestions. They should be helpful within a week and should support medical therapy.

Good luck and let me know how it works.
Art

Kevin said...

Hi again,

I remember your article from earlier this year suggesting a connection between estrogen and prostate disease. I started an antiinflammation diet after reading it. I can't say it has made for any dramatic changes for better or worse. I still get up to pee at 3AM. Perhaps less volume but still getting up.

We talked about DMSO. I use it for epicondylitis but haven't seen it affect the BPH symptoms. I will probably try the hot peppers for a while, it can't hurt. :-)

kevin

Dr. Art Ayers said...

Kevin,
I am surprised that an anti-inflammatory diet doesn't have a noticeable impact. Maybe you are still low on vitamin D.

The tendonitis is a classic indicator of systemic inflammation. You could follow your resolution of dietary inflammation by relief in your tendonitis. For example, start with 2000 IU of vitamin D per day. After a week, increase by 2000 IU per day. Repeat until you have relieved the symptoms. I think that 10,000 IU per day has proven safe even for pregnant women. You could do the same thing with fish oil (EPA, DHA) capsules. I would be shocked if this doesn't fix your tendonitis.

After your tendonitis is under control, I would expect you to sleep through the night.

I think that some people get relief by eating stewed tomatoes for breakfast and skipping the toast. Make sure that the tomatoes are contaminated with high fructose corn syrup.

Good luck. Let me know how it works.
Art

Kevin said...

Thanks, I'll try the vit D and fish oil.

kevin

Melchior Meijer said...

Art,

How about the role of chronic hyperinsulinaemia and elevated IGF's? Gary Taubes argues convincingly that most cancers are basically a disease of constantly elevated insulin like growth factors. Mistakes are made constantly at the cellular level, but you need the presence of a high octane fuel to give these new species a chance to survive and proliferate.

And about gluten: don't you think gluten and WGA are potentially problematic to all of us, not only to celiacs?

Kind regards,

Melchior Meijer.

Dr. Art Ayers said...

Melchior,
There is at least circumstantial evidence for the involvement of insulin, insulin-like growth factors and other growth factors such as midkine in cancers. The expression patterns of their receptors target the major organs for cancer, esp. prostate.

Most of these growth factors bind to heparan sulfate proteoglycans and some of their receptors also have heparin-binding domains, indicating that heparan sulfate modulation, e.g. syndecans, during inflammation may be a formative step in cancer development.

NF-kB, the inflammatory transcription factor, is essential for cancer progression and this transcription factor shuts down many heparan genes. It turns up heparanase.

Thus, there are numerous metabolic inputs that terminate in growth factors needed for cancers. Many of the inputs are diet-based sources of inflammation, such as insulin and insulin-like growth factors.

The prostate seems to be particularly prone to diet-based inflammation and prostatitis should respond to an aggressive anti-inflammatory diet.

Thanks for your comments.
Art

Dr. B G said...

Art,

There is some evidence that wheat and dairy (and grain-fed meat, see 2nd abstract) are associated with lower serum vitamin D levels. Prof Loren Cordain has also unpublished data supporting wheat/grains somehow deactivating enzymes in the skin for vitamin D activation.

I'd love to hear your thoughts and any hypotheses (esp regarding poss heparin role or immune system ramifications.

Reduced plasma half-life of radio-labelled 25-hydroxyvitamin D3 in subjects receiving a high-fibre diet.
Batchelor AJ, Compston JE.
Br J Nutr. 1983 Mar;49(2):213-6.

Nutritional factors in human cancers.
Giovannucci E.
Adv Exp Med Biol. 1999;472:29-42.

Thank you,
G

Dr. Art Ayers said...

G,
That paper on vitamin D excretion and fiber/grain suggests that fiber consumption alters the gut metabolism of vitamin D to enhance loss of vitamin D from the blood. The Corbain work suggests that grain consumption lowers skin production of vitamin D.

It seems difficult to separate the grain into its components to see which are altering vitamin D metabolism. Eating grain includes ingestion of starch, gluten, lectins and phytic acid. These components can act directly on intestinal cells or they can impact the gut flora.

One known impact is that starch produces a rapid rise in blood sugar, insulin production, glycation and inflammation. Inflammation could alter vitamin D metabolism.

Gluten in celiacs results in inflammation via immunological interactions. The interaction of gluten specifically involve transglutaminase, which is also a major player in autoimmunity and cancer. Gluten could be a major player in gut responses and the impact of gluten on insect gut transglutaminases should be examined to identify the evolutionary adaptations involved in grain gluten.

I don't think that lectins/WGA are significant. Wheat without WGA would seem to be easily engineered, but there doesn't seem to be an obvious advantage.

Phytic acids are associated with the benefits of dietary fiber. They are also metal chelators. If they are already saturated with metals before ingestion, they shouldn't be a problem for metal shortage. Phytic acid may compete with some heparin-binding.

The mechanism of fiber/grain alteration of vitamin D metabolism remains obscure to me. These observations are consistent with recent findings that people living in Florida and Southern California and exposed to ample sun, still have low vitamin D. They are grain fed and chronically inflamed. They can use sunshine to produce vitamin D and they readily secrete what they have.

Low vitamin D is also inflammatory.

These papers suggest an inversion of the food pyramid to dramatically reduce grains and carbs.

Supplementary vitamin D at 2,000-5,000 IU of D3 per day, should go a long way toward improving health everywhere.

Thanks for the articles and comments.
Art

Melchior Meijer said...

Art,

Thank you for the extensive answer. You gave me some new factors and pathways to google with ;-).

BTW, I saw you worked at the Karolinska Institute in Stockholm. Johan FrostegÄrd from KI is doing some very exciting research into the possible role of gluten in atherosclerosis. He uses blood samples collected by Staffan Lindeberg during his Kitava Study.

Melchior.

Cristian said...

Prostate. 2009 Apr 1;69(5):480-93

The vitamin D receptor agonist elocalcitol inhibits IL-8-dependent
benign prostatic hyperplasia stromal cell proliferation and inflammatory
response by targeting the RhoA/Rho kinase and NF-kappaB pathways.

Penna G, Fibbi B, Amuchastegui S, Corsiero E, Laverny G, Silvestrini E,
Chavalmane A, Morelli A, Sarchielli E, Vannelli GB, Gacci M, Colli E,
Maggi M, Adorini L.
BioXell, Milan, Italy.

BACKGROUND: Benign prostatic hyperplasia (BPH) is characterized by an
important inflammatory component. Stimulation of human prostate stromal
cells from BPH tissues with proinflammatory cytokines leads to secretion
of IL-8, a chemokine involved in BPH pathogenesis. The vitamin D
receptor (VDR) agonist elocalcitol can arrest prostate growth in BPH
patients, but its mechanism of action in this pathology is still
incompletely understood. METHODS: IL-8 levels were measured by real-time
RT-PCR and ELISA. NF-kappaB translocation and COX-2 expression were
evaluated by confocal microscopy. RhoA and Rho-kinase (ROCK) gene
expression and functional activity were studied by real-time RT-PCR,
immuno-kinase assays, Western blot analysis, confocal microscopy, and
cell invasion. RESULTS: Stimulation of BPH cells with IL-8 activates the
calcium-sensitizing RhoA/ROCK pathway, as demonstrated by the increased
membrane translocation of RhoA and by phosphorylation of the ROCK
substrate myosin phosphatase target subunit 1 (MYPT-1). In agreement
with these data, C3 exoenzyme, a selective RhoA inhibitor, inhibits
IL-8-induced invasion of BPH cells. The VDR agonist elocalcitol
significantly inhibits IL-8 production by BPH cells stimulated with
inflammatory cytokines, and IL-8-induced proliferation of BPH cells. In
addition, elocalcitol inhibits IL-8-induced membrane translocation of
RhoA and MYPT-1 phosphorylation in BPH cells, and inhibits
dose-dependently their IL-8-dependent invasion. The inhibition induced
by elocalcitol of IL-8 production by BPH cells is accompanied by
decreased COX-2 expression and PGE(2) production and by arrest of
NF-kappaB p65 nuclear translocation, associated with inhibition of the
RhoA/ROCK pathway. CONCLUSIONS: These data provide a mechanistic
explanation for the anti-proliferative and anti-inflammatory properties
of elocalcitol in BPH cells. (c) 2008 Wiley-Liss, Inc.

Dr. Art Ayers said...

Cristian,
The vit.D and BPH paper shows the impact of inflammation and vit.D in controlling prostate hyperplasia. It also involves heparan sulfate to mediate RhoA membrane interactions.

Thanks for the input.

Anonymous said...

Dr. Art,

Thanks for sharing this information. I'm writing in hopes you can answer what all doctors have failed in treating. I'm 36 years old. I have suffered from prostate inflammation for several years (since age 25). Non-bacterial by the most part. I have anxiety and depression on and off, and have taken many antidepressants. When my prostate is inflamed, I ejeculate quick and have no control, i'm sore after ejaculation, flacid erections and lower sex drive. I have been given antibiotics, hot baths,etc, but the problem persists. I also have a slight gynecomastia, tendonitis in the arms, and dermatitis in one hand. Somehow I think my body is inflammed. The prostatitis burns down there, then turns into golf ball feelling, but no bacteria present. If I ejeculate daily, that will too trigger the prostatitis. It is causing problems in my personal life, and it ruined my last relationship, when prostatitis lasted for 8 months.

I would really appreciate if you could provide some specific advice.

Dr. Art Ayers said...

Anonymous,
I think that all of your problems could be based on chronic dietary inflammation compounded by gut flora disrupted by antibiotics.

You could use your tendonitis as an indicator of simple systemic inflammation. Then watch your tendonitis and other symptoms disappear as you treat your inflammation:
1) Test serum vit.D; correct deficiency with vit.D3 supplements and retest (>70 ng/ml)
2) Follow the recommended anti-inflammatory diet that I outline on this blog: low carb/grain, no HFCS or trans fats, eliminate vegetable oils (use olive and coconut oil, and butter), eat meat/fish/eggs/veggies, supplement with fish oil
3) After your vit.D is normal and you have started the diet with most of your calories from saturated fats, you can gradually increase your fish oil by two capsules per day, until the tendonitis stops.
4) Normalize your gut flora by increasing probiotics, pectin and inulin. The goal is normal stools, without constipation.
5) Make sure that you don't have any gum disease or dental infections that could contribute to inflammation.
Normal prostate and sexual function is a symptom of health. This diet should treat your skin, prostate and depression problems.

Let me know about your progress.

Anonymous said...

Dr. Art,

Thank you very much for your response and recommendation. I'll follow the steps your outlined. One quick question. How long should I wait between Serum VitD tests?

Thank you very much.

Adrian (Anonymous)

Dr. Art Ayers said...

Anonymous,
If your doctor gives you a substantial dose of vit.D3 after finding a deficiency and you then supplement with 2-5,000 IU per day, I would expect that a test after a month should show that you have resolve the deficiency. Some people who just supplement after finding a deficiency don't overcome the deficiency and that would also show in a month.

Vinnie said...

Hello...
I have a question for Dr. Art Ayers.
I have been having problems with prostatitis. I am 36 years old, have had tail bone pain (burning/aching in my tailbone...noticable when I sit at my office job) and have blood in my ejaculate off and on during the past year. In addition, after ejaculation, I notice that I really ache for a few days. When a blood test was done by my doctor, he found that I had very low levels of vitamin D in my blood. Could the low levels of vitamin D be causing my prostatis symptoms? My doctor recommended taking 5,000 IU of vitamin D every day. Would I start to notice my symptoms improve in a short amount of time (a few hours after taking the vitamin D)? (Seems like the pain in the tailbone has decreased already...might be my imagination but am wondering)
Is there a link to hematospermia and low levels of vitamin D?

Dr. Art Ayers said...

Vinnie,
I can only give you my impressions from a familiarity with some of the prostatitis literature. I think that a typical progression for prostatitis is from a urinary tract infection that backs up into the prostate. Inflammation of the prostate could include slight hemorrhaging.

The inflammation could be aggravated by low vitamin D and chronic inflammation. In most cases, a low serum vit.D would respond only very slowly to 5,000 IU/d of vit.D3. If you are improving in symptoms, then it would be a good idea to have your serum vit.D checked again. Exposure of your skin to sunlight would also help.

I would of course suspect that you also have dietary contributions to your inflammation and would recommend the anti-inflammatory dietary guidlines linked at the top of this blog. All of these should help your prostatitis. Some people find cranberry juice helpful for urinary tract infections.

Thanks for your questions.

Paul said...

Dr. Ayers : I found the reading material very interesting ! I have suffered from chronic nonbacterial
prostatitis for a long time. Whenever I asked the doctors what I could do .. diet etc. they all replied nothing ! I will try the vitamin doses you recomended. I was prescribed Flomax. I took it for two days; then because of side effects , I stopped. Thanks !

Dr. Art Ayers said...

Paul,
The diet that I recommend to reduce inflammation is more than the supplements. Please look at my anti-inflammation diet suggestions.

Paul said...

Dr. Ayers : I am a little confused about the grains. I have been eating multi grain bread etc. for years, as I thought it was the most healthy.Also, I did not take any vitamin D prior to reading your article. I started taking 2000 mg. per day. Is that adequate ?

Dr. Art Ayers said...

Paul,
The grains and especially wheat cause multiple health problems. The gluten interacts with enzymes that attach to it and stimulate immune responses to both gluten fragments and the transglutaminase enzyme. That immune response initiates other autoimmune diseases from thyroiditis to gum disease.

The lectins in wheat may also cause problems. The bran is quite unhealthy because it is not readily digested by colon bacteria and provides bound phytic acid that chelates minerals. Thus, eating bran can contribute to deficiency diseases.

The high starch of grains also contributes to elevated blood sugar levels and the special modified carbohydrate regions in the starch contribute to the growth of problematic gut bacteria such as Klebsiella. Starch also contributes to intestinal yeast infections.

Thus, grains and especially whole grains do not contribute to a healthy diet. Other non-starchy vegetables are better sources of soluble fiber, e.g. pectin and inulin, that provide better sources of complex polysaccharides that are digested by gut flora in the colon.

The health claims for grains are all marketing hype.

It is difficult to guess how much vit.D3 you should be taking, because the supplement is used to compensate for other sources of inflammation, such as omega-6 vegetable oils. If you have chronic inflammation, it will also take more D3 supplement, because your skin production of vit.D will be compromised. It is best to test your serum D, supplement as needed and then test again to make sure that the supplementation worked.

Thanks for the questions.

Anna said...

Paul,

Most of the "evidence" for whole grains and wheat in particular come from correlations from epidemiological data, not intervention studies (correlation does not prove causation - an important point to always keep in mind). Turns out, modern whole grain eating in industrial societies is also a marker for affluence, non-smoking status, education, access to health care, and a host of other factors that probably have more to do with better health than whole grains do. The healthy user bias figures into it as well (people concerned about their health tend to do more of what is recommended for health than those that don't pay particular attention to their health).

Guess what kind of bread sells better at a Whole Foods in an upscale area and guess what kind of bread sells better at grocery store where a significant portion of the customers receive food stamps...

Various parties, including the USDA (which represents the business interests of US agriculture, even though it later was charged with giving health advice); food processors (who can turn a few cents worth of grains into a $5 loaf of "healthy whole grain" loaf of bread or box of cold cereal); various health organizations like the AHA and the ADA, which receive considerable funding from food processors and revenue from selling "seals of approval" on products; and so on, have latched onto the epidemiology as if it proves causation, which it doesn't, not by a long shot. Well, literacy is also correlated to shoe size ;-).

Your curiosity about the confusing assertions on grains is good - keep asking questions, keep digging. There is a lot of good information on the negative effects of grains and wheat in particular in the biomedical literature and in some recent books; it is fairly easy to find with the internet & some very informed bloggers like Dr. Ayers *if you are looking for it*, but because it conflicts with some powerful interests, it isn't well publicized in the mass media (unlike the correlation claims) and you might have to dig a bit in places unfamiliar to you (seeing as you are reading Cooling Inflammation, you probably have already figured that out, so I mention this mainly to encourage you to keep looking). What has come to light about the negative effects of wheat in recent years is merely the tip of the iceberg.

Anna said...

Paul,

Part two (I tend to be too wordy and blogger doesn't like that)

Keep in mind, the wheat of today is far different than the wheat of even just a few generations ago, let alone a few hundred or thousand years ago. Hybridization for characteristics useful to producers, processors, and so on have increased the gluten content and increased dramatically the use of wheat worldwide. In earlier times, harvesting wheat was slower (which affected certain anti-sprouting enzymes); wheat was freshly ground (or else it quickly went rancid), and some of the anti-nutrient compounds were neutralized by soaking, sprouting, long fermentation with wild yeast sourdough preparations. Breadmaking could take days from start to finish. Contrast that to todays industrial bread, dare I say even some "artisan" breads, that are made in large quantities of pre-ground stale and perhaps rancid flours, with quick-rise yeasts - breadmaking can take mere hours. A good example is a home bread machine - using an ingredient called "vital wheat gluten" with high protein wheat flour to boost dough rising performance, a loaf can be completed in less than two hours! So clearly, the context of our modern wheat has changed. Our children will show different effects from eating wheat than our grandparents or great grandparents did (and that's already happening, with gluten intolerances on the rise - much of the research on celiac disease is taking place in Italy, of all places!).

So I encourage you to continue to circle the issue of wheat's impact on health, learning about it from a variety of angles beyond the special interests of wheat purveyors and boosters (or those that profit from their sponsorship), THEN draw your conclusions, keeping in mind that the biomedical research on wheat continues to evolve, as will the conclusions.

Paul said...

Thanks Anna for your input.
I really was not aware of the process and the potential harm from it. Now I am wondering if I should even eat bread , or if I do what kind ? I hope this does not include oatmeal as well !

Dr. Art Ayers said...

Paul,
The gluten problem with grains results from proteins that have long stretches of glutamine that interact with the enzyme transglutaminase. Antibodies are made against the other parts of the gluten and the enzyme. All of the small grains (except rice) use these glutamine-rich proteins for protection from insects and are problems for humans. Oats have less than wheat. Wheat has been bred to have more gluten, because the gluten is needed for bread making.

Another problem with grains is the high starch content. Many people crave carbs, to maintain an elevated blood sugar in the presence of high insulin. It is much safer for most people to use fats for calories rather than carbs. Note the obvious association of diseases to grain usage. Grains and substantial amounts of carbs are simply not needed in the diet and the liver does just fine in producing needed glucose from fat.

Thanks for your comments.

Paul said...

Dr. Ayers what is your opinion of Pygeum for prostate enlarement ?

Thanks Paul

Giorgio470 said...

Dr Ayers,
Thanks for your informative blog!
I have been on medication (tamsulosin) for BPH for about 6 years. In the last year my symptoms have gotten much worse even on the flomax.
Also I have been on a low carb diet for aboout a year and half. I was originally inspired by Dr. Eades writings and only discovered your blog recently when researching inflammation. Consequently I have increased my intake of veggies and probiotics, vit D and am experimenting with lactulose.... as I have been struggling with constipation since going low carb.
You mention glutamine for healing the gut.. how does this work and how much would one take?

The urologist i see wants me to have a biopsy of my prostate as my PSA has gone from 3 to 6 recently. Needless to say I am a bit nervous about this!! But whatever the test shows, I am determined to have the best diet I can to stay healthy
Thanks in advance for any advice you have

George

Dr. Art Ayers said...

George,
The good news is that most men suffering from swollen prostate glands will see a decrease in symptoms within a week of shifting to an anti-inflammatory diet, such as I have outlined on this blog.

The presence of constipation explains the suspected autoimmune basis for inflammatory swelling of your prostate. Constipation indicates a dysfunctional gut flora in the colon. That means that you can eat veggies, i.e. soluble fiber, which should support the growth the the colon gut bacteria that produce normal stools, but you lack the required diversity of bacteria, so the undigested fiber passes through as constipation. This can continue permanently, regardless of your diet, unless you add the needed bacteria.

Soil Bacteria and Fiber = Healthy Gut/Immunity

It is difficult for people to realize and nurture the complexity of the interaction between food, flora and physiology. We have to actively recruit thousands of species of different bacteria to establish the diverse community (150 different types of bacteria) needed to sustain our nutrition and the development of our immune system.

For example, in your case, I suspect that your immune system is attacking your prostate tissue, i.e. autoimmunity, because of inadequate Clostridium spp. of bacteria in your colon, needed to cause the development of Tregs, the part of your immune system that suppresses autoimmunity.

Clostridium species are abundant in soil and as components of a healthy gut flora. At some point in the past, antibiotic treatments or odd diets, and isolation from other sources of soil bacteria, resulted in a loss of these bacteria from your gut. That loss of gut flora produced (perhaps via gluten intolerance) your prostate condition.

The gut flora are also needed to produce the part of your immune system that is attacking your prostate. That is why further assault on the immune system, indirectly with more antibiotics, can sometimes provide relief from the attack. (The same thing happens for acne treatments.)

The problem is how to reconstruct a functional gut flora by introducing new bacteria, when most of the sources of soil bacteria also contain pathogens and parasites. The fact that your immune system is also compromised and potentially susceptible to infection makes the approach more challenging. It would be nice to use another healthy person as a filter to just pass on beneficial bacteria. Healthy kids who play in the mud or pets that dig in the soil, would rub off good candidate bacteria. Gardening and eating local raw produce are additional sources.

Excess hygiene and isolation is unhealthy. The recent flu hysteria and promotion of "anti-microbial" treatments will result in an overall decline in community health with a rise in gut flora-based maladies, such as allergies and autoimmune diseases.

A healthy anti-inflammatory approach also includes checking and adjusting your serum vit.D. You might also consider the possibility that you are depleting your vitamin C and glutathione reserves and might benefit from appropriate supplements, e.g. NAC.

Thanks for your questions. Let me know how you are doing.

Giorgio470 said...

Thanks for your thorough reply! Ive had BPH for at least 7 years, and on meds for it for 6. I was never constipated until I started the low carb diet about a year and a half ago.

I am trying to improve my gut flora as best I can. Eating some raw organic veggies, whatever I can get at the supermarket.. (we are under about 3 feet of snow here, so gardening will have to wait till spring!)
Also lactulose and probiotics and Im adding glutamine now.

As I said, apart from the veggies, Ive been following pretty much the diet you outline...

I havent used antibiotics for many years but I was using Ibuprofen for quite a while - I
have since stopped.

I have been considering a whey protien product that claims to boost glutathione with more bio available cystine than regular whey protein...
Or is NAC better to use?

I also take vit D and started to go to a tanning place for vit d as well!

The pain can be excruciating at times, usually at night. I am getting to the point where I will try almost anything - surgery if necesary.. Im not sure when I will have the biopsy..but need to know if there is any cancer, then consider what treatment is best..in the meantime I will do my best with diet and supplements...

Thanks again for your insights!
George

Dr. Art Ayers said...

George,
I would also try omega-3 oils/fish oil with more saturated fats.

Have you looked into low dose Naltrexone?

What about a vacation in a warm place with lots of contact with new bacteria or a fecal transplant.

Working on the inflammation will bring quicker results, but a cure will require fixing your gut flora.

Keep me posted.

Giorgio470 said...

Thanks Dr. Art,
Yes I am taking omega 3 fish oil and a fair amount of saturated fats in meats and coconut oil etc.
Unfortunatly a warm vacation is not in my budget right now.

I hadnt heard of Nalterxone, but I will try it..I have some on order.

As for a fecal transplant, I would definitley try it if I could find somewhere around here to do it.. Ive read some reports of people doing it on their own, using a family member or friend as a donor... Dont know if I have anyone I could ask about it..

The lactulose is really helping with constipation for now

Thanks for your help!
George