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Diet and Multiple Myeloma (Part 8): What about dairy? Good night, Vienna

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Diet and Multiple Myeloma (Part 8): What about dairy? Good night, Vienna

Let’s start the new week off right!  Here is the latest nutritional column from our friend, Danny Parker.  Note:  One of Danny’s reference links weren’t complete and isn’t working correctly.  I will correct it as soon as I can reach him…

Diet and Multiple Myeloma (Part 8):  What about dairy?  Good night, Vienna

For the first time since my stem cell transplant a year ago, I have resumed a normal work schedule in my job at the University. My normal schedule includes some distant annual travel to a delightful conference in Austria. The whole experience this year, during remission has been a bit trying, coordinating my CBCs, all the drugs and supplements I take, eating the right foods and staying rested. There are some nice things: my little box of pre-washed radishes are coming in handy to keep my isothiocyanate levels up and they have beautiful cress in the form of Feldsalat here.

Then there is the effort to stay germ free while neutropenic; Purell everywhere and a use of a mask on trains and planes—and still failing, but that’s a different subject.

I want to talk about Austrian cooking—the home of rich food and over-the-top desserts. Yes, I love the coffee house atmosphere of Vienna where you’re encouraged to while away the hours, dallying with desserts laden with custards and sprayed with confectionary sugar.  So, while you listen to Bach’s Kaffee Cantata and see if you can read an Austrian newspaper, you’ll have to order your own beverage ohne schlag—or else you get a big hat of whipped cream on the cup dotted with powdered chocolate. Sachertore,  Apfelstrudel…it goes on.

And it is just as tasty as it sounds. Downright addictive, in fact.

Still, as much as I enjoyed the last week, I know that a steady diet of the delicacies of the heyday of the Austro-Hungarian empire may not be the best thing for staying in remission with multiple myeloma.

Well, there is the obvious thing, you’ll remember about having excessive weight—that problem is a given with rich foods. But that’s not the only potential problem.

Maybe you’ll recall from the study I quote often about the dietary habits of the 179 Connecticut women. There were associations with the likelihood of developing myeloma and the consumption of rich dairy products.

While milk consumption itself, did not appear in the list of significant variables, foods including cream did show up repeatedly.

The statistical markers for increased risk included rich foods such as cream soups and sweetened dairy products such as ice cream– a wildly unpopular finding. Similarly, the study found increased risk from milk and cream-laced custards and puddings. For some reason cream and particularly, cream with sugar appeared repeatedly—a finding that the study authors took note of within their conclusions.

And beyond that single study there are other indicators that there might be an issue with consumption of rich dairy products. Interestingly, two studies, summarized by Alexander et al. suggested statistically significant increased risk from the consumption of butter—one study with that finding in Yugoslavia and another in Italy.

Only two studies, right? Well, no. Beyond that is the worrisome fact in the back of my mind that the countries where myeloma incidence is lowest are in Asia where dairy consumption is also low. Coincidence?  While my love of lobster bisque would like to hope so, the facts coming from research in Japan is less happy. In 2007, researchers there surveyed 11,349 persons and concluded that dairy consumption—particularly from butter, was associated with leukemia and multiple myeloma deaths, although the sample was too small to break these apart (see ‘Discussion’ p. 40 of the article).

Drat!  In any case, I think it likely for our treatment-addled readers, that this type of news is most unwelcome. More pleasure losses: full-fat lattes, ice cream, butter, puddings, cream soups…Terrible.

Well, folks, I’m just the messenger–reporting on what the limited information suggests. You can choose, as many in the myeloma field do, that you just don’t believe it. You can eat anything you want with myeloma and it makes no difference.

That’s one choice.

But I work with numbers a lot in my day job and I believe statistics provides some clues about life and how the inter-related systems work. And this one, coming from various directions, suggests that cream and butter consumption may not be good for us, and particularly when it is mixed with sugar. Will I eliminate these wonderful things in my own life?  No, but I might limit them. More olive oil, less butter.  Less cream, lower fat milk and almond milk with some things which I find okay. As for the cream desserts? Goodbye Vienna.

But after that hard news, I have some good news too.

There is a class of cheeses that have something in them that looks to be helpful against myeloma. That something is Vitamin K2– menaquinone.  It’s a fat-soluble vitamin that is essential in blood clotting; indeed our blood would not clot without it. It also turns out to be vital for our bone health. And beyond that, there is increasing evidence in the myeloma world from Tsujioki et al. (2006) that Vitamin K2 appears to help induce apoptosis myeloma cells—a fancy way of saying Vitamin K2 kills them.

The study concludes: VK2 could be a possible treatment for myeloma patients, particularly those who are not suitable candidates for intensive cyto-reductive chemotherapy due to age and/or complications.”

For sure that’s a good thing. Another welcome thing is that Vitamin K2 occurs from fermentation processes and is in the most concentrated fashion in hard cheeses such as Parmesan, Asiago as well as Jarlsberg, Emmenthal and Gouda. (It also occurs in a strong malodorous fermented soy product—Natto–that the Japanese love, but I’m not a fan.)

And yes, you can buy Vitamin K2 as a supplement, but a word of warning. It can help to increase blood clotting—and those of us taking Revlimid are already at risk for deep vein thrombosis. So, probably best not to take such a supplement while you are on this class of immuno-modulatory drugs.

And heck, here are some cheeses that look like there are actually good for us. Dairy! So, what might a healthy meal be for a myeloma patient wanting to take advantage of Vitamin K2?

Pizza!  Thin whole wheat crust, tomato sauce cooked in olive oil (remember that?), dotted with your choice of the above cheeses. For more protein, consider marinated tuna or sautéed chicken, but avoid pepperoni and the cured meats). Then out of the oven, top the bubbly pie with a mixture of fresh basil (ursolic acid) and fresh watercress (isothiocyanates). No, it’s not Dominos, but it’s pretty darned good just the same.  And each slice is all the more satisfying knowing you may be helping yourself at the same time.

At least with such luxuries, I guess I can live without Vienna. At least until next time….

WOW!  Danny must really love us!  Continuing his column, even while working in Europe.  Thanks, good friend!

I’m going to add my thoughts about dairy and sugar consumption tomorrow.

Until then, lay-off the donuts this morning and you just might feel better–which will help you keep smiling!  Pat