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Diet and Myeloma (Part Four) You’ve Got to Accentuate the Positive, Eliminate the Negative…

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Diet and Myeloma (Part Four) You’ve Got to Accentuate the Positive, Eliminate the Negative…

Danny just forwarded me Part Four of his latest research project about the connections about Diet and Myeloma.

Until recently, the vast majority of conventional medical myeloma experts were still quoted as saying that there was no direct connection between diet and multiple myeloma.

I heard this with my own two ears several times on myeloma teleconferences–and then at my first ASH in New Orleans in December of 2009.

While these docs were most often referring to the causes of multiple myeloma, patients were pretty much told to eat whatever they wanted–with in reason, of course.

The exception was green tea, which Danny covers today.

But like a lot of things myeloma related, we “have come a long way, baby!”  There are knew drugs and drug combinations–and new research showing us how what we eat (and don’t eat) may in fact make a difference.

One of our older readers emailed me a suggestion.

She mentioned how it was difficult for her to read the white lettering on the burgundy background in the “box shadow” that I have been placing around Danny’s columns.

While she agrees the technique looks good and makes them stand-out, she requested I consider using another technique.

Do you know what?  I agree with her.  And as always, I aim to please.  So lets try this for today’s column…

Diet and Myeloma (Part Four) You’ve Got to Accentuate the Positive, Eliminate the Negative…

What does Bing Crosby’s advice in December 1944 have to do with our challenge?

Sometimes in life, I think that suggestions on what to do to be more successful are less important than knowing about the catastrophic “potholes” that can derail your entire plan.

So, in today’s column we are going to dig further into things to watch out for, while also looking more for foods and spices to emphasize too. Inadvertently, through the many questions on Pat’s protocol for the winter, we’ve already stumbled into this terrain—the questions on asparagus and L-Glutamine.

We already know that lots of refined carbohydrates and hi-sugar levels may not be good for our condition, but there are other questions.

What about meat? Although much made of the dangers of meat consumption and cancer—the famous China Study (T. Colin Campbell, 2005), evidence extending this to myeloma is not at all conclusive. While is true that the incidence of myeloma in China is lower than just about any other place on the planet (1.1 cases per 100,000 males in China vs. 4.7 in the U.S. population), we do not know at all if this lower incidence comes from less meat consumption or something else. For instance, it could be from increased consumption of fish, complex carbohydrates vs. refined ones, the much greater use of sugars and dairy products in the U.S. diet (which were smoking guns in the study of the Connecticut women).  Or it could even be something altogether different: genetic differences in the population or variation in the exposure to environmental toxins.

Moreover, both the study of 179 Connecticut women and another (Tavani et. al., 2000) found no statistical association of red meat consumption and myeloma. (Other studies, however, have shown cured and smoked meats to be a negative influence on several cancers). If red meat came in as a neutral influence on myeloma risk, however, fish consumption showed itself a large positive. Several studies (including that of the Connecticut women) have repeatedly found that eating more fish was also associated with a lower chance of developing multiple myeloma (see Alexander et al., 2007 for a summary).

http://onlinelibrary.wiley.com/doi/10.1002/ijc.22718/pdf

In particular, the evaluation of Fritschi et al. (2004) reported statistically significant lower levels of developing myeloma in people eating fatty fishes such as salmon, herring, sardines and tuna than leaner fish such as cod.

Could eating fish help moderate the disease once we have it? While we don’t know the answer to that question, I feel safe recommending more fish for protein in our diet.

Also from Alexander et al.’s attention-numbing survey of myeloma-related epidemiology, we learn that the amount of food you eat is also likely important. Not too much! For instance a study of 37,000 post-menopausal women with a waist circumference greater than 36 inches had double the risk of developing multiple myeloma. Similarly, a Canadian study found a doubled risk in people who were determined to be obese by their Body Mass Index [BMI].

For spices, in your diet, we’ll later talk a lot more about turmeric and curcumin when we discuss supplements, but for now, I recommend that all of you Indian food lovers that have curry cravings go ahead and indulge them. Turmeric with black pepper is a great spice combination to add to whatever—soups being a good opportunity. And if you don’t like curry and turmeric, then you might look into them and find ways to bring them into your diet.

Eliminate the negatives. Such as?

Dr. James Berenson of the Institute for Myeloma and Bone Cancer Research in Los Angeles has some helpful ideas on diet. Firstly, he suggests that artificial sweeteners may be dangerous, “Many of these have tested positive for cancer in animals,” he says, specifically singling out Acesulfame-K, Aspartame and Saccharine. Berenson says that avoiding artificial sweeteners and holding sugar intake to moderate levels is his number one dietary recommendation for those of us who suffer myeloma.

And not coincidently, a recent study of aspartame, the ubiquitous Nutrasweet—found that it very actively promotes angiogenesis– growth of fledgling blood vessels that can support cancer growth—precisely the thing we are trying to halt when we take Revlimid. Lenalidomide is a potent anti-angiogenic compound.

http://www.ncbi.nlm.nih.gov/pubmed/20837131

So, out with diet sodas, and artificial sweeteners in general. (one exception may be Stevia).

Berenson also believes that artificial colors, MSG and nitrates (the later found in preserved meats) are also useful to avoid. He also believes that Vitamin D levels are important in myeloma patients as they are often deficient. We’ve already touched on that in our earlier discussions, but it keeps coming up: important to have both good sources of Vitamin A and Vitamin D in our diets. Since Vitamin D is easily low in wintertime, supplements may be helpful.

Finally, I also want to include some cautions on foods related to our chemo treatments. We have evidence that green tea (and supplements with EGCT), while likely beneficial the rest of the time, should be avoided on Velcade days and perhaps those just after.

http://bloodjournal.hematologylibrary.org/content/113/23/5927.abstract

Same for Vitamin C supplements; best to avoid them on Velcade days.

http://www.myelomabeacon.com/news/2009/11/18/vitamin-c-inhibits-anti-myeloma-activity-of-velcade/

So, by avoiding what might be a disadvantage and emphasizing what might help, perhaps we can make 2012 just a little brighter and healthier.

We already mentioned that Revlimid is an anti-angiogenic compound. Next time, we will explore that arena and even find some foods you can eat that might have similar properties—although not nearly so powerful. Still, every little advantage might help.

As always, thanks for the work you do on our behalf, Danny!

It’s pretty easy to tell that Danny is a research scientist in his day job–except that I find his writing easy to follow and understand.  I don’t edit his copy, except to highlight a few points I feel are especially important in bold.

I will comment a bit about Danny’s thoughts about Diet and Myeloma this weekend, and I hope that you will join-in and comment, too.

Feel good and keep smiling!  Pat