Time to finish-up the last contraindicated foods and supplements on my list of no-no’s for multiple myeloma patients:
6) Too much alcohol
7) Otherwise healthy things not to take with Velcade
9) Alpha lipoic acid
10) Concentrated antioxidant supplements
Too much alcohol? This started a firestorm of comments; both serious and tongue-in-cheek. Once again, Danny Parker stepped-up and wrote a copious response to the “too much alcohol” controversy:
The inverse relationship between alcohol consumption and myeloma has been replicated in one study after another by researchers all around the world for years now. I’ve already written extensively about this in December of 2011:
The fact that reduced myeloma risk with alcohol consumption has been shown independently by one study after another and by one research group after another makes me believe it is real and a potentially important influence.
As to Nancy’s question as to whether alcohol consumption could be a false carrier for other influences: Yes such things are a common problem in statistics and there are methods of sorting them out. For instance if tea-totalling was a carrier for exposure to pesticides and herbicides in agricultural occupations, it would be possible to evaluate that confounding situation.
In conventional statistics, Analysis of Covariance (ANCOVA) is used where the independent variables are interacted with each other (Alcohol consumption * Agricultural occupation dummy variable) to see which is the real carrier of decreased myeloma risk. It is a statistical method of finding the real drivers when there is possible association between independent variables.
I am not certain this had been done in previous myeloma research on alcohol influence, but I strongly suspect that it has.
Moreover there was a very recent research paper of pooled studies on this exact question—just came out last week. (Thanks to Dr. Orlowski for pointing it out). There were nearly 9,000 subjects in the study from around the world.
Take a look. You’ll see that they controlled for Body Mass Index (BMI), education levels and smoking in a manner likely using non-parametric version of the same statistical methods. The conclusion was as before: a significant influence of alcohol consumption at decreasing the risk of developing myeloma.
But does this same beneficial of alcohol consumption influence extend to patients under treatment?
That is hard to say, although one can argue that patients with low levels of disease are likely to benefit. While no doctor will recommend that you take up a serious drinking habit, Dr. Brian Durie does recommend red wine to some of his patients. “Malbec is a most cost effective way to get a good amount of possibly beneficial polyphenols,” he jokingly mentioned at a doctor-patient seminar last May.
I’m with him all the way on that—count me in.
Kidding aside, I figured this one was a no-brainer. Too much alcohol (exceeding two or three servings daily) may damage a patient’s already fragile immune system. And since alcohol is simple sugar, if nothing else it sticks the drinker with a bunch of empty calories.
Let’s move on to the long-winded catch-all, “Otherwise healthy things not to take with Velcade.” These include green tea, eating grapefruit or drinking grapefruit juice and, according to myeloma specialist, Dr. Ken Anderson, Vitamin C:
And if you read yesterday’s post, alpha lipoic acid (ALA), too. It wouldn’t surprise me if there are more. Please chime-in if you have read about others.
I miss taking #8 on my list, glucosamine. I had been taking glucosamine to help joint pain in my knees for almost a decade. I truly believed it helped. If I stopped using it for several days, my knees hurt. That was enough evidence for me.
But I don’t take it anymore and here’s why. A 2008 paper by Ohwada et al stated that a substance called hyaluronic acid caused multiple myeloma cells to become resistant to the steroid, prednisone, rendering it ineffective as a treatment. Apparently, hyaluronic acid increases connective tissue providing a framework in which myeloma cells can hide from attack.
Since dexamethasone is basically just “prednisone on steroids” (pun intended; dexamethasone is 6 times stronger), Danny convinced me that dropping glucosamine was a good idea.
Fortunately taking curcumin and ginger–both effective anti-inflammatory supplements–seemed to help make-up for dropping glucosamine from my pill box.
I covered alpha lipoic acid extensively in yesterday’s post, so let’s move on to the last culprit on my list, concentrated antioxidant supplements. I have made my position about this clear over the years. I believe it is a mistake to be pumping our bodies full of cell repairing antioxidant supplements, while chemotherapy is trying to destroy myeloma cells by cutting-off their nutrient supply in our bone marrow.
Don’t get me wrong. Eat all the acai and blueberries you like. Antioxidants from food sources are a good thing! But taking over-the-top concentrated antioxidant supplements; not a good idea.
In a week or so I’ll review some of the good things we should eating to help our meds work better and our bodies function at their best. Until then, have an awesome Labor Day weekend! Hopefully you can spend time with family and friends.
So dump the diet soda, skip the cupcakes and enjoy some grilled salmon with organic potato salad and crisp, fresh greens. Sounds pretty tasty to me!
Feel good and keep smiling! Pat