General Wellness

Radio show transcript from last week Friday.

This week’s medical moment is based on a listener’s request and is a very important topic. In this age of information overload, it can be very confusing who to trust when getting information from the media, social media and the internet. Unfortunately, anyone, regardless of credentials, can post and publish whatever they want and they will likely gather followers very easily. 

From the perspective of the listener, you can literally find support for whatever you want to believe if you look hard enough.

To make matters worse, search engines like Google will advertise and suggest sites to you which are based on your searches and what you read, or even listen to, making it easy to get a distorted, one sided perspective.

I will use a specific example of a health claim I was asked to comment on which is the danger of plant compounds called lectins, a topic I wanted to speak about anyway. The idea that lectins are unhealthy and that we should avoid them at all costs has been popularized by the web influencer Dr. Steven Gundry, and it is a complete distortion of what is actually true.

Dr. Gundry has impressive credentials. He is an accomplished pediatric heart surgeon who was a professor and chairman of cardiothoracic surgery at Loma Linda University. After many years of being a surgeon, he went into preventative medicine and runs experimental clinics in Palm Springs and Santa Barbara, California. He is the author of several books promoting a low-carbohydrate diet, including the NYT bestseller “The Plant Paradox”. One of its most controversial claims is that humans should avoid all foods that contain compounds called lectins, arguing that they cause inflammation and are partly responsible for most modern diseases. However, scientists and dietitians have called his claims pseudoscience.

Lectins are a very large family of protein molecules which bind carbohydrates. At least 200 different types have been identified and the reality is that, just like fiber, each type of plant has a unique form of lectin. Lectins on one cell recognize and bind to surface carbohydrates on another cell and in doing so, they protect the host plant from microbial infection. The same features that lectins use to defend plants in nature may cause problems during human digestion. They resist being broken down in the gut and are stable in acidic environments, features that protect plants in nature. 

But lectins are also present in humans. They actually play many important roles in the human body, including:

• Boosting our immune response
• Improving cell to cell communication
• Assisting in tissue development
• They are antioxidants, protecting cells from damage. 
• They slow digestion and stabilize blood sugar. 
• And they can even help prevent cancer.

The main lectin containing foods that are on Dr. Gundry’s do-not-eat list include legumes like beans and lentils, certain grains like quinoa and vegetables like tomatoes and mushrooms. 

The real issue is that when not properly prepared, plant lectins can cause gastrointestinal issues and can prevent absorption of important nutrients. But when properly cooked, the lectins are inactivated. No food is good when consumed in excess or when not properly prepared. Heck, even apples have arsenic in the seeds. So, does that mean you should never eat apples? Of course not because you could never eat enough apples to get sick since you’d fill up and vomit long before you get arsenic poisoning! The healthiest mushroom to eat is the simple button mushroom. You should limit eating it raw since, like lectins, it also contains a toxin, which is also inactivated when cooking. 

In fact, small amounts of any toxin actually stimulate our bodies to protect itself. This phenomenon is known as hormesis.  There is truth in the saying “That which does not kill you makes you stronger”.

All the hubbub about lectins started after an incident in 1988 in Japan. As Japan started to westernize their diet, the population started to become unhealthier. The government organized a “Healthy Eating Day” and were promoting eating more vegetables, including beans. At one site where food was made for the public, a batch of red beans was under cooked and a number of people developed some bloating, cramping and diarrhea. Red beans contain large amounts of a particularly irritating lectin. Despite reports of hospitalizations and serious illness, there were no actual documented cases of such events and everyone recovered without complications. 

The most important message is not to avoid beans but to cook them properly! Beans are regularly consumed by all the healthiest and longest lived societies.

When it comes to information you gain from any source, you need to be skeptical, educate yourself and read all sides of an issue before deciding not only what to eat but also which medications to take or what medical treatment to pursue.

Also, as a general rule, if someone is promoting a specific health topic and sells a product on their website to deal with that problem, beware. Dr. Gundry sells a number of supplements on his site, including an anti-lectin supplement called “Lectin Shield”. That’s not to say that anyone selling anything is immediately dishonest, but you just need to do your research.

And remember that Science is not truth. Science is the pursuit of truth. True scientists change their views based on the most recent evidence, which is constantly evolving. Be cautious of anyone who sticks with an idea at all costs, just because they want it to be true or they were taught something 20 years ago. Medical students are told that by the time they graduate from medical school in 4 years, half of what they learn will be out of date. 

Knowledge evolves. We should evolve along with it.

See you next time.

Benefits of Soy

The topic of soy products and their impact on health is very hotly debated in the nutrition world. Some say it causes a variety of ailments including breast cancer, infertility, allergies, autoimmune issues and even “man boobs”. But these rumors are mostly nonsense. There is a lot of fear mongering and misinformation which I would like to clarify.

First of all, what is soy? Soybeans are in the legume family which also includes black beans, chickpeas and lentils. As a class of food, they are extremely healthy and are one of the staples of all the longest lived and healthiest populations in the world. In Asian countries, soybeans, in one form or another, have been consumed for thousands of years, having been domesticated around 3000 years ago. It’s been grown in the US since the 1700’s. Today, 95% of the soy grown in the US, and about 80% worldwide, is fed to animals. The majority of this is non-GMO and heavily pesticide laden. Remember that you are not just what you eat. You are also what you eat eats!

Soybeans are very nutritious with lots of vitamins and minerals as well as protein, fiber and plant compounds called phytochemicals. The most hotly discussed phytochemicals are isoflavones, which are also called phyto-estrogens. These are compounds which have a similar configuration to human estrogen and are blamed for causing breast cancer. But this is not true. In fact, these phyto-estrogens are protective against hormonal cancer like breast cancer and prostate cancer.

In mammals, there are 2 kinds of estrogen receptors, alpha and beta. The alpha receptor is the one which stimulates breast cancer cells to grow and also causes inflammation. The beta receptor downregulates breast cancer cell growth and reduces inflammation. Phytoestrogens are what are called selective estrogen receptor modulators. They bind preferentially to the beta receptor rather than the alpha receptor by 1600% greater affinity. There has only been one study showing a link between breast cancer and soy and it was done in rats many years ago. Massive doses of soy were used and the receptors were overwhelmed so it was not surprising that there was a link. But humans are not rats, and humans don’t consume massive quantities of soy. No human studies have shown any link. In fact, the opposite has been shown. Soy has a protective effect. 

Dairy, on the other hand, is full of mammalian estrogen. Just think of what milk is. It’s a cow’s breast milk. Just like human breast milk, it is produced to grow babies. Except cow’s milk is designed to grow a baby calf from 100 to 1000 pounds, a tenfold growth, in only 1 year. It contains almost 10x more protein and massive amounts more of other growth hormones than human milk. It is also full of mammalian estrogens which do preferentially bind to those breast cancer promoting alpha receptors. 

Prostate cancer also is significantly influenced by estrogen hormones and unnecessary growth factors. The prostate epithelial cells actually have estrogen receptors, mostly beta, which down-regulate prostate cell growth.

One need only look at what happened in Japan and China. In those countries, where soy has been consumed for thousands of years, there was virtually no breast or prostate cancer. In fact in Japan in the early 1970’s, prostate cancer rates were in the single digits! But as soon as the American diet, consisting of more processed foods as well as dairy and meat, was introduced, those cancer rates started to climb and now are similar to what we see in the West. 

The preferential binding of estrogen receptors also helps with many perimenopausal symptoms like hot flashes. Hot flashes are a rare symptom in soy-consuming cultures.

Soy is also a great source of calcium and increases bone density. It is a much better source of calcium than dairy, which is actually linked to poor bone health, despite its health claims. The societies like the US and Sweden who consume the most dairy also have the highest osteoporosis rates.

As compared with women who did not consume any soy products, regular soy consumers had 30-40% less breast cancer. Only 1 cup of soy milk or 1/2 cup of tofu led to a 30% decreased risk of breast cancer. By blocking the animal estrogen receptor, soy acts like a “natural Tamoxifen”, the most commonly prescribed chemotherapy agent used as a maintenance drug in breast cancer patients. Tamoxifen’s principal mechanism of action is  by its binding to the estrogen receptor and the blocking of the proliferative actions of estrogen on mammary epithelium. Studies have shown that regular consumption of soy products results in a 60% drop in occurrence and recurrence of breast cancer and a 29% drop in death from breast cancer which is the same as the results from taking tamoxifen, without all the side effects. This also includes estrogen negative breast cancers. Soy, bound to the beta receptor, also inhibits the enzyme aromatase. This enzyme, which is found in fat cells, converts various other hormones like testosterone and estradiol, made in the adrenal glands, into estrogen. So, not only do soy isoflavones block the harmful estrogen receptor site but they actually help to decrease the amount of estrogen your body produces. 

Consuming soy products is particularly important for adolescents, especially girls, with respect to minimizing the risks for developing breast cancer as adults. Studies clearly show that there is a decreased risk of breast cancer and prostate cancer in adults who consumed soy products when they were much younger.

By the way hops, a plant used to brew beer, has a much higher concentration of phytoestrogens than soy products which partly explains the “man-boobs” heavy beer drinkers get. 

Soy products also lower LDL cholesterol and improve blood pressure. The highest soy consumers had the lower all-cause mortality risk by 21% as compared with non soy consumers in one study.

Soy also contains a naturally anti-angiogenic compound called genisteine. This helps reduce the formation of new blood vessels by all cancerous tumors, leading to shrinkage and even disappearance of tumors.

As far as soy and fertility are concerned, again, just look at Asian countries. Their populations have gradually risen for thousands of years and their diet is based on soy. There is no evidence that soy causes fertility problems. On the other hand, studies have shown that me who consume the most dairy have the poorest sperm counts and motility.

Soy consumption can affect thyroid function, but only in people who already have thyroid issues and have borderline or low iodine intake, the most common cause of thyroid disease to begin with.

Some people are allergic to soy. It is actually the third most common food allergen, after dairy which is #1, followed by eggs. Soy allergy is still pretty uncommon only affecting 1 in 2000 people. This is 40x less frequent than dairy allergy which affects 1 in 50. This is a separate issue from lactose intolerance which affects 1 in 3 Americans but 70% of the population worldwide. Soy allergy is also 10x less common than the other common food allergies like fish, eggs, shellfish, nuts, wheat and peanuts. 

You should always buy organic, non-GMO soy. 80% of the soy grown in the US is genetically modified (GMO), not organic and is heavily sprayed with chemicals. In addition, processed foods that contain soy usually contain non-organic and genetically modified soy so please READ LABELS! If it doesn’t say it’s organic, assume it is laden with chemicals. Non-GMO alone is not enough. 

And not all allergies are truly allergies. Another reason to avoid non-organic products, especially soy, is that the chemicals used to grow them, can cause allergy-like reactions. It’s the chemicals.

Soy contains lectins known as soybean agglutinins (SBAs) which have been shown to cause inflammation and increase gut permeability. Furthermore, the phytic acid and other protein inhibitors in soy inhibit nutrient absorption. But just like other beans, proper cooking, fermentation and sprouting eliminates up to 95% of the lectins and acids, leaving just enough to actually be beneficial to human health.

Soy comes in many forms. The healthiest are edamame, the actual soy bean pods, and fermented forms such as miso, tempeh and natto. Tofu and soy milk are also good but a little more processed. Regardless of the form you consume, again, make sure it is organic and non-GMO. It is better to stay away from hyper-processed forms of soy such as soy isolates, often found in processed foods and plant protein powders.

All plants contain all amino acids, essential or not. Some foods have higher concentration of the essential ones, which are amino acids we can;t produce ourselves and must consume. Soy is one of those foods, high in essential amino acids. Other plant sources of complete protein include quinoa, hemp, buckwheat, mycoprotein (quorn, a type of mushroom grain), rice and beans, humus and pita bread and even a peanut butter sandwich with whole grain bread.

Only ½ a cup of soy milk or ½ serving of tofu, provides enough phytoestrogens to lower breast cancer risks by up to 10%. The higher the “dose”, the greater the benefit.

In addition to having a beneficial impact on hormonal cancer rates, other cancers were also reduced, including: esophageal, stomach, colon and even lung cancers, not to mention the improvement in the cardiovascular system.

SOY and the Environment.

I mentioned above that soy is one of the most pesticide-laden food crops (cotton is actually the most contaminated crop in general) and you should look for organic soy to consume. Some people accuse soy of being very environmentally unfriendly because of the the land use required to grow it. It is true that soy crops destroy a huge amount of land however, 80% of that soy goes to feed animals. Most of the soy which humans consume is in the form of unhealthy soy oil and only 4% goes towards foods like tofu, seitan, soy milk and other soy products. 

Soy is very healthy and switching from animal protein sources to plant protein sources, including soy, is healthier for you, as well as very positively impactful on the planet. Not to mention, animals don’t die in the production of soy!

For more about soy and breast cancer, and breast health in general, look up breast surgeon Dr. Kristi Funk’s book “Breasts: The Owner’s Manual“.