Is soy safe? – part 2

As you tuck into a delightful tofu and veggie stir-fry, or maybe even some tofu ice-cream, is there a lingering doubt? Is this really doing me good? Am I contributing to the prevention of breast and prostate cancer, or am I, as some would have us believe, contributing to their increased likelihood?

If so, you need the answer to this question: Do the phyto-oestrogens in soybeans act like oestrogen or Tamoxifen? Need a full explanation? Let us go Out on a Limb again, follow on from the earlier post this week where we explored the soybean itself, and using the evidence-base available, explore how cancer and soy beans interact, but first




Thought for the day


The doctor of the future will give no medicine,
But will instruct his patient in the care of the human frame,
In diet and in the cause and prevention of disease

                    Thomas Edison, 1902



WHY LINK SOY and BREAST CANCER?
1. There are historically low breast cancer incidence rates in Asia, where traditional soyfoods are a staple.

2. Research demonstrates isoflavones in soy may exert anti-oestrogenic effects.

3. Some epidemiologic data shows a higher soy intake results in a lower breast cancer risk.

4. Rodent studies demonstrate soy protects against carcinogen-induced mammary cancer.

HOW BREAST CANCER is AFFECTED by OESTROGEN
In broad terms, there are 2 types of breast cancer; oestrogen positive and oestrogen negative. Our discussion relates to oestrogen positive cancers in particular and these make up about 70% of all breast cancers.

Oestrogen positive cancers are aggravated by oestrogen (the main female sex hormone). How this happens is that on the surface of oestrogen positive cancer cells there are receptors for oestrogen. When an oestrogen molecule comes into proximity with such a receptor, it attaches (but does not go into the cell) and creates a cascade of reactions within the cell that speeds up the cancer’s progression.

In earlier times, removal of the ovaries was attempted as a way to reduce oestrogen levels in women with breast cancer. But oestrogen is made in other parts of the body, so only in exceptional circumstances has this proven useful.

Many people will have heard of tamoxifen. This was heralded as a breakthrough drug as, while it does attach to the oestrogen receptors, it does not cause the internal reaction. Therefore, tamoxifen blocks natural oestrogen from having its adverse affects.

Unfortunately, tamoxifen does aggravate uterine tissue and is associated with increased uterine cancer, but on balance it remains a widely used anti-cancer drug. Simply put, tamoxifen is an oestrogen antagonist.


WHAT OESTROGEN IS IN SOY?

There are 3 main oestrogen-like chemicals in soybeans; genistein, daidzein, and glycitein.

They are present in their beta glycoside forms: genistin, daidzin, and glycitin, hence you may see them written differently.

Genistin/genistein, daidzin/daidzein, and glycitin/glycitein account for approximately 50–55%, 40–45%, and 5–10% of total isoflavone content, respectively in soybeans.

Older adults in Japan and Shanghai, China, typically consume between 25 and 50 mg/day of isoflavones and probably no more than 5% of these populations consume more than 100 mg/day. In contrast, people in the United States and Europe consume an average of less than 3 mg/day.

Isoflavones have a chemical structure similar to human oestrogen but bind to estrogen receptors more weakly. Significantly, it has been suggested that genistein, which is the best-studied isoflavone, along with the other isoflavones may act like tamoxifen as estrogen receptor blockers.

What has also drawn attention in recent years are conflicting concerns that isoflavones may stimulate the growth of existing estrogen-sensitive breast tumors. These concerns are based on evidence gathered from studies involving tissue cultures and rodents. However, they do contrast with the human epidemiological evidence that shows among Asian women higher soy intake is associated with a nearly one-third reduction in breast cancer risk and that Japanese breast cancer patients, in comparison to Western women, exhibit better survival rates even after controlling for stage of diagnosis.

SOY for the PREVENTION of BREAST CANCER



In Asia, isoflavones are consumed as traditional soy foods and not in pure or processed forms. Epidemiological data associates lifetime, and particularly pre-adolescent consumption of traditional soy with a decreased risk of breast cancer development in humans.

An Asian-American study on soy found that women, pre- and postmenopausal, who consumed tofu, had a 15% reduced risk of breast cancer with each additional serving per week.

Wu AH, Ziegler, et al. Tofu and risk of breast cancer in Asian- Americans. Cancer Epidemiol Biomarkers Prev. 1996;5(11):901-906.


Another trial reported that women in the highest tertile intake of tofu had a 51% decrease risk of premenopausal breast cancer when compared with women in the lowest tertile. In this study, no statistical significant association was observed between soy intake and breast cancer risk among postmenopausal women.

Hirose K, Imaeda N, Tokudome Y, Goto C, Wakai K, Matsuo K, et al. Soybean products and reduction of breast cancer risk: a case-control study in Japan. Br J Cancer 2005;93(1):15-22.

Messina and colleagues published a major review on this subject in 2008 and I consider it to be one of the very the best review articles on this topic. To quote:

The conclusion drawn from this extensive review of the available literature is that currently there is little evidence to suggest that any potential weak estrogenic effects of dietary isoflavones have a clinically relevant impact on breast tissue in healthy women. Limited data suggest this is also the case for breast cancer survivors.

This evidence includes multiple trials showing no effects on breast proliferation or mammographic density and considerable epidemiologic data showing either no effect or a modest protective role of soy/isoflavone intake on breast cancer risk.

Based on this evidence it seems unlikely that isoflavone consumption at dietary levels (i.e. <100 mg/day) elicits adverse breast cancer-promoting effects in healthy women or breast cancer survivors not undergoing active treatment.

Messina MJ and Wood CE; Nutrition Journal 2008.  To read in full, CLICK HERE http://www.nutritionj.com/content/7/1/17

SOY and its AFFECTS on BREAST CANCER
When this article was first posted in 2008, there was no data to support the notion that soyfoods or isoflavone supplements could improve the survival of breast cancer patients.

Several earlier studies suggested that whole soy foods appeared to have no negative or positive effect on breast cancer. For example the following two studies found soy foods had no negative impact on breast cancer survival.

Boyapati SM, et al. Soyfood intake and breast cancer survival: a followup of the Shanghai Breast Cancer Study. Breast Cancer Res Treat. 2005;92(1):11-17.

Nishio K, et al. Consumption of soy foods and the risk of breast cancer: findings from the Japan Collaborative Cohort (JACC) Study. Cancer Causes Control. 2007;18(8):801-808.
This, and other evidence, prompted Messina and colleagues in their 2008 review quoted above to state:

Available data on breast cancer recurrence and mortality provide some assurance for breast cancer patients that soyfoods/isoflavone supplements, when taken at dietary levels, do not contribute to recurrence rates although more data are clearly needed to better address this issue.

However, in 2009, following more analysis of the Shanghai study, strong new evidence was published showing significant benefits of consuming soy for women with breast cancer in terms of better survival and less cancer recurrence, making Messina’s claim outdated.

Women consuming soy in the highest quartile had a 29% lower death rate over the 4 year follow up, and 32% reduced risk of recurrence. The protective effect was present regardless of oestrogen receptor status of the cancer, or whether tamoxifen was used or not.

This study provided the most compelling evidence to date of a benefit for soy consumption by women with breast cancer (as opposed to no harm). It is important because it shows a benefit for increased soy consumption irrespective of oestrogen receptor status or tamoxifen use.

Shu XO et al. Soy food intake and breast cancer survival; JAMA. 2009 Dec 9; 302(22):2437-43.

The trend of this study was confirmed in 2013 when another study demonstrated soy food intake is associated with longer survival and low recurrence among breast cancer patients.

Zhang, Y.F., et al., Positive effects of soy isoflavone food on survival of breast cancer patients in China. Asian Pac J Cancer Prev, 2012. 13(2): p. 479-482.

More recently still, a major review from the World Cancer Research Fund International’s Continuous Update Project Report: Diet, Nutrition, Physical Activity, and Breast Cancer Survivors has examined a total of 85 studies involving 164,416 women. Included has been analysis of specific evidence related to soy and its interaction with breast cancer.

This major study makes modest conclusions The evidence was sparse and generally consistent, and is suggestive of an inverse relationship between consumption of foods containing soy and all cause mortality. 

Translation? From what solid evidence there is so far, it seems that soy is likely to be helpful; the evidence for it being unhelpful is not there. Conclusion? It is coming after a few more pieces of the puzzle are put into place!


BEWARE:  NATURAL SOY, PROCESSED SOY – DIFFERENT OUTCOMES
It may be that the non-traditional soy foods do create problems. Significantly, soy protein isolates do not contain many of the bioactive components present in whole soy. As we clarified in Part 1, refined products include soy flour and its processed derivatives.


Research has demonstrated that soy protein isolates (85–90% soy protein) do stimulate the growth of

estrogen-dependent tumors. Another study evaluated the relative effects of different degrees of soy processing on the growth of pre-existing tumors and demonstrated that consumption of isoflavones in increasingly purer or more highly enriched forms may have a proportionally worse effect on estrogen-dependent tumor growth.


Allred CD,et al. Soy processing influences growth of estrogen-dependent breast cancer tumors. Carcinogenesis 2004;25:1649-1657.

Some research has shown that soy processing increases breast cancer growth in mice. This may be related to isoflavone metabolism and bioavailability, but more research is needed.

Allred CD, et al. Soy processing influences growth of estrogen-dependent breast cancer tumors. Carcinogenesis 2004;25:1649-1657.

SOY AND TAMOXIFEN
There has also been some concern expressed that soy products may actually interfere with the action of tamoxifen itself. However, recent studies examining the interaction between soy and tamoxifen have yielded neutral or beneficial findings.

In one study, soy intake had no effect on levels of tamoxifen or its metabolites.

Wu AH, et al. Tamoxifen, soy, and lifestyle factors in Asian American women with breast cancer. J Clin Oncol. 2007;25(21):3024-3030.

In another, the combination of tamoxifen and genistein inhibited the growth of human breast cancer cells in a synergistic manner in vitro.

Mai Z, et al. Genistein sensitizes inhibitory effect of tamoxifen on the growth of estrogen receptor- positive and HER2-overexpressing human breast cancer cells. Mol Carcinog. 2007;46(7):534-542.

SOY and CHEMO
One study reported that soy’s main phyto-oestrogen genistein, enhanced the cytotoxic effect of the chemotherapeutic agent adriamycin at low doses against the human breast cancer cell. This enhancing effect was mainly attributed to the increase of necrotic-like, rather than apoptotic, cell death.

Satoh H, Nishikawa K, Suzuki K, et al. Genistein, a soy isoflavone, enhances necrotic-like cell death in a breast cancer cell treated with a chemotherapeutic agent. Res Commun Mol Pathol Pharmacol.2003;113–114:149–158.

SOY and YOUNG GIRLS
Of great interest is research that demonstrates eating soy foods during childhood and adolescence in women, and before puberty onset in animals, appears to significantly reduce the risk of breast cancer later in life.

SYNERGISTIC EFFECTS OF SOY
Research evidence indicates a possible synergistic relationship between soy and green tea consumption.

SOY AND THE AUTHORITIES
The American Cancer Society in 2006 concluded that breast cancer patients can safely consume up to three servings of traditional soyfoods per day, although the group advised against the use of more concentrated sources of isoflavones such as powders and supplements.

The United States Health and Human Services Agency for Healthcare Research and Quality (AHRQ) conducted a review of the available studies and found little evidence of substantial health improvements and no adverse effects, but also noted that there was no long-term safety data on estrogenic effects from soy consumption.

The AHRQ report notes that future studies of the health effects of soy need to better address the complex relationship between health and food components, including how variations in the diets, lifestyles, and health of participants might affect the results.

Also, studies that substitute practical amounts of soy products into people's diets would better address the question of whether people should make the effort to include more soy in their diet.

The Cancer Council of New South Wales released a statement saying scientific research suggests that overall the moderate consumption of soy products does not appear to present a risk to women with breast cancer, and there is equivocal evidence that consuming large amounts of soy products may have a protective effect against developing breast and prostate cancer. However, the Council does not recommend taking soy dietary supplements as there is no evidence they are either effective or safe at preventing or treating cancers.

WHAT RUTH and I DO
We regularly eat organic tofu and soy yoghurt (which Ruth makes from Bonsoy). Ruth drinks small amounts of soymilk (mostly Bonsoy in teas), but I do not – I do not like it and have teas and dandelion coffee black). We eat some tempeh but only have silken tofu by mistake when eating out!

We avoid processed soy products and read labels to avoid the myriad of foods with these products added to them.

MY OWN CONCLUSIONS and RECOMMENDATIONS
In answer to the key question, I conclude the phyto-oestrogens in soy act like tamoxifen, not like oestrogen. I also conclude:
1. Traditional soy foods are almost certainly safe and warrant being a part of a healthy diet for healthy people. I recommend them. I particularly recommend regular soy consumption for young and adolescent girls; but then lifetime consumption seems ideal.

2. Processed or refined or concentrated soy products run the real risk of being problematic for everyone. I do not recommend them.

3. For women with breast cancer, the best evidence currently available suggests traditional soy foods, eaten in traditional amounts are likely to be safe and may well be helpful in reducing recurrences and extending survival. I recommend them.

RELATED BLOGS
Coconut oil – are you nuts?

Food for life – what to eat when

RESOURCES
You Can Conquer Cancer – the revised edition has many other explanations like this one on soy. What type of protein and how much? Which are the best fats to eat and to avoid, and so on. This book is about prevention and long-term good health, as well as cancer recovery.

NOTICEBOARD
Ruth and I leave this week to present our final meditation retreat for the year, Meditation Under the Long White Cloud at Mana retreat centre amidst the peace and beauty of the Coromandel Peninsula in New Zealand.

Then we travel down south to the exquisite landscape at Wanaka to present the 5 day cancer residential program, Mind, Meditation and Healing from November 10 - 14. It will be a delight to be back in New Zealand once more.

Is soy safe?

Major new research has been published regarding soy. Posting this new evidence on my Facebook page has led to a great discussion and revealed that soy still polarizes people. What is the truth?

Will soy give you breast cancer or protect you? Will soy produce breasts in young boys? Protect girls from ever increasingly early onset of puberty? Does it speed up breast cancer, or make a useful contribution to both preventing and recovering from it? Does it really protect from difficulties during menopause?

It seems some people would have us believe soy is full on toxic. Others point to the low rates of breast cancer and menopausal difficulties in Asian women, link this to their regular soy consumption and suggest soy is something we would all benefit from.

So this is to revisit an earlier post on these matters that was evidence-based. To re-examine the science behind soy and breast cancer so we can bring some logic and clarity to this often steamy debate. Then I will tell you what Ruth and I actually do, and not shirk from drawing 3 compelling conclusions and making recommendations, but first

Thought for the day 
Meditation (reflection) first purifies its own source, ie, the soul, from which it arises.
Then it regulates the inclinations, directs activity, moderates excess, shapes morals, 
Makes life honest and regulated, 
And mediates knowledge of divine as well as human things.

It is this which replaces confusion with order, 
Checks the inclination to lose oneself in uncertainty, 
Gathers together that which is dispersed, 
Penetrates into that which is hidden, 
Discovers that which is true and distinguishes it from that which merely appears as such, 
And brings to light fiction and lie.
                    St Bernard of Clairvaux

Soy products have gained widespread popularity in the West over the last 50 years. But whether they are really safe, and especially what to recommend in regard to breast cancer has been an issue of great contention this last decade. It is an area I have taken a great deal of interest in. I have read widely, spoken to many authorities and fielded many questions.

What follows then is a major piece that is evidence-based and comes in two parts, much of which first appeared on this blog in July and August of 2013, and now seems to warrant a re-run. This is the first blog I have repeated, albeit with some important research updates since one year ago.

The aim is firstly to bring further understanding to the soy bean itself. Particularly when it comes to nutrition, I am of the view that if we can understand the principles, then the details follow fairly simply and we will have the confidence to make good choices.

And then in Part 2, how does soy interact with breast cancer? Does it cause or prevent breast cancer? And what of its role for those who have developed breast cancer – does it help or hinder?

As it seems the answers to these questions may well vary depending upon what type of soy foods we eat, let us begin by understanding the range of options available.

THE SOY BEAN (Glycine max)  

3 Forms – raw, traditional, processed

1. The raw soybean (or soya bean as it is called in the UK) is a legume that originated in East Asia but is now classified as an oilseed rather than a pulse by the FAO. There are 2 main types, those used for eating (which make up about 15% of world production), and those for oil (85%).

Raw soybeans contain trypsin inhibitors that make them toxic to humans and all other monogastric (single stomached) animals.

Happily, cooking with "wet" heat destroys the enzyme and solves this problem, so all edible forms of soy have been, or need to be cooked.

2. The traditional use of soybeans falls into 2 categories:
i) Non-fermented foods including tofu, tofu skin and soy milk.

ii) Fermented foods including soy sauce, miso (fermented soybean paste), and tempeh.

Fermentation does lower the phytoestrogen content found in the raw beans. People have claimed that historically soybeans were only used after fermentation, and we shall investigate whether or not this would seem to be a relevant issue.

3. Processed soy products are a more modern phenomena and usually stem from soy flour (made by roasting and grinding the beans) and its products.

One of the most common is TVP (Texturized Vegetable Protein – a similar form of which can be
made from wheat, oats and cotton seeds). TVP is a de-fatted soy flour product that is a by-product of extracting soy oil. It has a protein content equal to that of meat and is often used as a meat substitute or extender.

Fat-free (defatted) soybean meal is a significant and cheap source of protein for animal feeds and many prepackaged meals.

Processed soy may be found in many things from vegetable sausages to Mars bars.

SOY BEAN FACTS 
GMO 
In 1997, about 8% of all soybeans cultivated for the commercial market in the United States were genetically modified. In 2010, the figure was 93%. Unless a soy product stipulates that it is GMO free, or organically grown, it is almost certain to contain at least some genetically modified beans.

Soy oil 
Soy beans have a high oil content; around 20% and soy oil accounts for about 65% of all oil used in commercial and home cooking. However, soy oil is low in Omega 3 fatty acids and high in Omega 6s. The ratio of Omega 3 to 6 in soy oil is only .13 : 1, whereas in flaxseed oil it is 3.45 : 1; so for all the nutritional reasons why flaxseed oil is good for regular use, soy oil is not.

Tofu usually contains under 10% fat, so the oil type is not a major issue when eating it – unless you have very particular needs.

Soy protein
Soy beans are high in protein: around 38 - 45%.

Soybeans are an excellent source of complete protein. A complete protein contains in the one food all the essential amino acids in a good balance necessary for human health. Meat is well known as a complete protein and concerns have been raised (probably in a way that is highly over rated) that vegetarians may miss out on some amino acids.

So, as confirmed by the US Food and Drug Administration, soy is a good source of protein for vegetarians and vegans. Soy protein has the nutritional equivalent of meat, eggs, and casein for human growth and health.

Tofu – how it is made 
Soaked soybeans are ground; water is added and boiled.  The pulp is then removed leaving soymilk. Next, a natural mineral coagulant such as calcium sulphate, magnesium chloride, or a mixture of both is added, leading to the soymilk curdling. The curds are removed, placed in cloth-lined forming boxes and varying amounts of pressure applied to form soft, regular, firm or extra firm tofu.

The firmer the tofu, the higher the protein and fat levels.

Silken tofu is made when either calcium sulphate or glucono-delta-lactone is added to a thick, rich soymilk. The mixture is put into a package that is then heated to activate the coagulation and produce the tofu in the package. 

Typically, tofu contains between 10 and 15% protein and 5 to 9% fat.  It is relatively low in carbohydrates and in fiber (as the pulp was removed), making it easy to digest.

Soy production and the environment

Soybeans produce
1. At least twice as much protein per acre compared to most other major vegetables or grains.

2. Five to 10 times more protein per acre than land set aside for grazing animals to make milk.

3. Up to 15 times more protein per acre than land set aside for meat production.
Environmental groups have reported increased soybean cultivation in Brazil has destroyed huge areas of Amazon rainforest. However, most of the soybeans produced in this area are actually grown for livestock fodder and oil production.

Conclusion?  There is great environmental merit in eating less meat and more soybeans.

STILL TO COME
The burning question – what impact does soy have on breast cancer? How is breast cancer actually affected by oestrogen? Do the phyto-oestrogens (natural, oestrogen-like substances) in soybeans cause breast cancer, or do they protect from it? Does soy help or hinder in recovering from breast cancer?

Part 2 will be posted Thursday

RELATED BLOG
Eating Well, Being Well

RESOURCES
You Can Conquer Cancer – the revised edition has many other explanations like this one on soy. What type of protein and how much? Which are the best fats to eat and to avoid, and so on. This book is about prevention and long-term good health, as well as cancer recovery.

NOTICEBOARD
Ruth and I leave this week to present our final meditation retreat for the year, Meditation Under the Long White Cloud at Mana retreat centre amidst the peace and beauty of the Coromandel Peninsula in New Zealand.

Then we travel down south to the exquisite landscape at Wanaka to present the 5 day cancer residential program, Mind, Meditation and Healing from November 10 - 14. It will be a delight to be back in New Zealand once more.

Ian Gawler Blog. Cancer stem cells - what you need to know

Cancer stem cells have been controversial but they may provide an important key in understanding why cancer can recur years after apparently successful initial treatment and point to the need for new treatment approaches.

Obviously this is directly relevant to anyone with cancer, but for those who are well, are lurking cancer stem cells a concern?

So this week, what are cancer stem cells? Where do they come from? What can we do about them? Did you know for instance, that turmeric is one of few things claimed to be able to destroy breast cancer stem cells and as such it make sense for anyone with breast cancer, or concerned about breast cancer, to consume it regularly.

Cancer stem cells are one of the fascinating areas of new research I have been studying, updating and preparing to share with a wider audience during the rapidly approaching speaking tour up the East Coast starting in early July. So more details on that this week too, but first




Thought for the day

If your mind is empty, 
It is always ready for anything; 
It is open to everything. 

In the beginner’s mind there are many possibilities, 
In the expert’s mind there are few.

Suzuki Roshi, Zen master







Given not so many people know about cancer stem cells, this may be a useful blog to share.

There is a mystery in cancer medicine that is not spoken of much, probably because up until recently, no-one really knew the answer. The question is, how is it that cancer can be treated, all sign of it removed, and then years later it recurs? And how can we stop that happening.

To understand we need to consider basic cancer theory. 
As most will know, cancer tends to begin in one location and then, if left unchecked, has a habit of spreading to other places. In the past, the classic way this spread was thought to happen was by cancer cells separating from the initial mass of cancer, and then by them gaining access either to the blood stream or lymphatics and travelling to other parts of the body to re-establish themselves there.

This is why “follow-up” chemotherapy is often recommended after initial surgery – to “mop up” any stray or so-called “rogue cells”. Clearly, however, cancer can lie dormant for years after a first occurrence before appearing again as secondary cancer. How?

What is a stem cell?
Stem cells are precursor or basic cell types. Generally, stem cells are able to develop into many different cell types in the body. When a stem cell multiplies, the resulting cells either continue on as stem cells or, under the right conditions, they can develop into a particular type of cell – muscle, blood, brain, breast etc.

There are two types of stem cells. Embryonic stem cells can make all the different types of cell in the body, while adult stem cells generally can only make the types of cells they directly relate to – so a muscle adult stem cell only leads to muscle cells.

What is a cancer stem cell?

Some cancers are thought to develop from ‘rogue’ faulty stem cells. Cancer stem cells were first
positively identified in 1998. Cancer stem cells share many characteristics with normal stem cells, including self-renewal and differentiation and while hotly debated for years, recent studies have shown that cancer stem cells do have the ability to regenerate new cancers.

For a good general reference paper: Lobo et al. The biology of cancer stem cells.  Annu Rev Dev Biol. 2007;23:675-99. CLICK HERE

Just last month, a team from University of Oxford and the Karolinska Institutet in Sweden, claims to have proven conclusively that cancer stem cells exist.

Why are cancer stem cells important?
If cancer stem cells are as significant as thought, cancer could be eliminated by eliminating cancer stem cells. Targeting cancer stem cells would also mean any cancer cells left over from initial treatments could not sustain themselves.

Dr. Woll, the lead author from the Oxford study says that while the findings are not sufficient to offer patients new treatments today, they do pave the way for developing more effective therapies that target specific stem cells to eliminate cancer.

He also cautions that their study only looked at cancer stem cells in one type of cancer, and that the "identity, number and function of stem cells in other cancers are likely to differ from that."

Reference: Woll P S, et al. Myelodysplastic Syndromes Are Propagated by Rare and Distinct Human Cancer Stem Cells In Vivo. Cancer Cell, DOI: 10.1016/j.ccr.2014.03.036, published online 15 May 2014.

What risks are involved?
Unfortunately, it seems most cancer stem cells are resistant to current cancer treatments. More disturbingly, there is growing evidence that the classic treatments of chemotherapy and radiation actually increase the activity and aggressiveness of breast cancer stem cells – “enrichment” as it is called.

It seems that while chemotherapy may reduce the size and volume of breast cancer, in doing so, it increases the cancer stem cell ratio, making whatever may be left even more malignant.

Reference: Lagadec et al. Radiation-induced reprogramming of breast cancer cells. Stem Cells. 2012 May; 30(5):833-44. doi: 10.1002/stem.1058.

What natural answers are available?
At last some good news! Several herbs and vegetables have been shown in basic research to target breast cancer stem cells specifically.


1. Tumeric and black pepper

Curcumin (in turmeric) and piperine (in black pepper) separately, and in combination, inhibit breast stem cell self-renewal but do not cause toxicity to differentiated cells.

Reference: Kakarala et al. Targeting breast stem cells with the cancer preventive compounds curcumin and piperine. Breast Cancer Res Treat 2010 Aug;122(3):777-85. doi: 10.1007/s10549-009-0612-x. Epub 2009 Nov 7.



2. Cruciferous vegetables (cauli, cabbage broccoli), particularly broccoli sprouts
These vegetables contain high levels of sulforaphane that has been reported to inhibit pancreatic tumour-initiating cells and breast cancer stem cells. The reference here is a particularly good one for those who like the science!

Reference: Li Y et al. Implications of cancer stem cell theory for cancer chemoprevention by natural dietary compounds. J Nutr Biochem. 2011 Sep;22(9):799-806. doi: 10.1016/j.jnutbio.2010.11.001. Epub 2011 Feb 4.

3. Soy – especially the fermented types
Contains genistein which as well as significantly targeting breast cancer cells by promoting apoptosis or cancer cell death, also has been shown to inhibit breast cancer stem cells.

Reference: Fan P et al. Genistein decreases the breast cancer stem-like cell population through Hedgehog pathway. Stem Cell Res Ther. 2013 Dec 11;4(6):146. [Epub ahead of print]

4. Resveratrol

Found in the skin of red grapes, dark chocolate and blueberries, reseveratrol significantly suppresses breast cancer stem cells.

Reference: Pandey PR et al. Resveratrol suppresses growth of cancer stem-like cells by inhibiting fatty acid synthase. Breast Cancer Res Treat. 2011 Nov;130(2):387-98. doi: 10.1007/s10549-010-1300-6. Epub 2010 Dec 29.





For a thorough account of recent theory relating to breast cancer stem cells by Velasco-Velazquez et al, CLICK HERE

Many questions remain to be answered about cancer. 
More studies are needed to determine precisely how different cancers grow and how they resist treatment. Do all tumours contain cancer stem cells? What genes, proteins or other molecules are involved in their development and behaviour? Does a cancer’s immediate surroundings, or ‘microenvironment’; do epigenetics affect how cancer stem cells behave? How can we be free of cancer stem cells? Do natural therapies offer real hope?

The answers to these questions will shape future cancer treatment strategies.

NOTICEBOARD
1. Meditation in the Desert  : August 29 – September 7 
Come, join Ruth and myself along with like-minded people for 7 days of meditation in the extraordinary atmosphere of the Central Australian desert, followed by several days of close contact with senior local indigenous leaders.

Secure your place with a deposit. For details CLICK HERE

2. Cancer and Beyond – Last minute opportunity!

This is the 5 day follow up cancer residential program Ruth and I present at the Gawler Foundation’s Yarra Valley centre in just a couple of weeks. This program was fully booked 2 months ago, but some unfortunate last minute cancellations mean you may be able to attend.

Call the Foundation on +61 3 59671730 or see the details on my website, CLICK HERE.

                             Yoga with Ruth - one of the great opportunities of this program

3. IAN’S EAST COAST TOUR 

 HEALTH, HEALING and the MIND – from JULY onwards



Starting in early July Ruth and I will be travelling right up the East Coast to Cairns, across to Mt Isa and Alice Springs, then down to Adelaide. A road trip with a difference, giving talks along the way.


Hope to see many of you along the way. There will be the chance for a refresher, to help get back on
track if needed; but also exciting new information and the opportunity to meditate together and to deepen the experience of what meditation really is.

A good opportunity to share what we do with family, friends and colleagues.


FULL DETAILS – CLICK HERE  and please do share the link.

                                                             
                                                                With Lionel Fifield at the Brisbane Relaxation Centre last year.

                                                               

Ian Gawler Blog: Is soy safe? – part 2

Please note: This blog has been re-posted as there were some technical issues in the original post.

As you tuck into a delightful tofu and veggie stir-fry, or maybe even some tofu ice-cream, is there a lingering doubt? Is this really doing me good? Am I contributing to the prevention of breast and prostate cancer, or am I, as some would have us believe, contributing to their increased likelihood?

If so, you need the answer to this question: Do the phyto-oestrogens in soybeans act like oestrogen or Tamoxifen? Need a full explanation? Let us go Out on a Limb once again, follow on from last week’s exploration of the soybean itself, and explore how cancer and soy beans interact.



Then news of my next workshop; this time in one of Mt Macedon’s most beautiful estates, complete with a gorgeous garden. Duneira on Saturday August 24th. But first




Thought for the day
The doctor of the future will give no medicine, 
But will instruct his patient in the care of the human frame, 
In diet and in the cause and prevention of disease.
                                         Thomas Edison, 1902




WHY LINK SOY and BREAST CANCER?
1. There are historically low breast cancer incidence rates in Asia, where traditional soyfoods are a staple.

2. Research demonstrates isoflavones in soy may exert anti-oestrogenic effects.

3. Some epidemiologic data shows a higher soy intake results in a lower breast cancer risk.

4. Rodent studies demonstrate soy protects against carcinogen-induced mammary cancer.

HOW BREAST CANCER IS EFFECTED BY OESTROGEN
In broad terms, there are 2 types of breast cancer; oestrogen positive and oestrogen negative. Our discussion relates to oestrogen positive cancers in particular and these make up about 70% of all breast cancers.

Oestrogen positive cancers are aggravated by oestrogen (the main female sex hormone). How this happens is that on the surface of oestrogen positive cancer cells there are receptors for oestrogen. When an oestrogen molecule comes into proximity with such a receptor, it attaches (but does not go into the cell) and creates a cascade of reactions within the cell that speeds up the cancer’s progression.

In earlier times, removal of the ovaries was attempted as a way to reduce oestrogen levels in women with breast cancer. But oestrogen is made in other parts of the body, so only in exceptional circumstances has this proven useful.

Many people will have heard of tamoxifen. This was heralded as a breakthrough drug as it attaches to the oestrogen receptors, but does not cause the internal reaction and so blocks the effects of oestrogen. Unfortunately, it does aggravate uterine tissue and is associated with increased uterine cancer, but on balance it remains a widely used anti-cancer drug. Simply put, tamoxifen is an oestrogen antagonist.

WHAT OESTROGEN IS IN SOY?
There are 3 main oestrogen-like chemicals in soybeans; genistein, daidzein, and glycitein. They are present in their beta glycoside forms: genistin, daidzin, and glycitin, hence you may see them written differently.

Genistin/genistein, daidzin/daidzein, and glycitin/glycitein account for approximately 50–55%, 40–45%, and 5–10% of total isoflavone content, respectively in soybeans.

Older adults in Japan and Shanghai, China, typically consume between 25 and 50 mg/day of isoflavones and probably no more than 5% of these populations consume more than 100 mg/day. In contrast, people in the United States and Europe consume an average of less than3 mg/day.

Isoflavones have a chemical structure similar to human oestrogen but bind to estrogen receptors more weakly. Significantly, it has been suggested that genistein, which is the best-studied isoflavone, along with the other isoflavones may act like tamoxifen as estrogen receptor blockers.

What has also drawn attention in recent years are conflicting concerns that isoflavones may stimulate the growth of existing estrogen-sensitive breast tumors. These concerns are based on evidence gathered from studies involving tissue cultures and rodents. However, they do contrast with the human epidemiological evidence that shows among Asian women higher soy intake is associated with a nearly one-third reduction in breast cancer risk and that Japanese breast cancer patients, in comparison to Western women, exhibit better survival rates even after controlling for stage of diagnosis.

SOY FOR THE PREVENTION OF BREAST CANCER
In Asia, isoflavones are consumed as traditional soy foods and not in pure or enriched forms. Epidemiological data associates lifetime, and particularly pre-adolescent consumption of traditional soy with a decreased risk of breast cancer development in humans.

An Asian-American study on soy found that women, pre- and postmenopausal, who consumed tofu, had a 15% reduced risk of breast cancer with each additional serving per week.

Wu AH, Ziegler, et al. Tofu and risk of breast cancer in Asian- Americans. Cancer Epidemiol Biomarkers Prev. 1996;5(11):901-906.

Another trial reported that women in the highest tertile intake of tofu had a 51% decrease risk of premenopausal breast cancer when compared with women in the lowest tertile. In this study, no statistical significant association was observed between soy intake and breast cancer risk among postmenopausal women.

Hirose K, Imaeda N, Tokudome Y, Goto C, Wakai K, Matsuo K, et al. Soybean products and reduction of breast cancer risk: a case-control study in Japan. Br J Cancer 2005;93(1):15-22.

Messina and colleagues published a major review on this subject in 2008 and here I quote from what I consider to be one of the very the best review articles on this topic:

The conclusion drawn from this extensive review of the available literature is that currently there is little evidence to suggest that any potential weak estrogenic effects of dietary isoflavones have a clinically relevant impact on breast tissue in healthy women. Limited data suggest this is also the case for breast cancer survivors.

This evidence includes multiple trials showing no effects on breast proliferation or mammographic density and considerable epidemiologic data showing either no effect or a modest protective role of soy/isoflavone intake on breast cancer risk.

Based on this evidence it seems unlikely that isoflavone consumption at dietary levels (i.e. <100 mg/day) elicits adverse breast cancer-promoting effects in healthy women or breast cancer survivors not undergoing active treatment.

Messina MJ and Wood CE; Nutrition Journal 2008.  For the full reference, CLICK HERE 

SOY AND ITS AFFECTS ON BREAST CANCER
Several earlier studies suggested that whole soy foods appeared to have no negative or positive effect on breast cancer. For example the following two studies found soy foods had no negative impact on breast cancer survival.

Boyapati SM, et al. Soyfood intake and breast cancer survival: a followup of the Shanghai Breast Cancer Study. Breast Cancer Res Treat. 2005;92(1):11-17.

Nishio K, et al. Consumption of soy foods and the risk of breast cancer: findings from the Japan Collaborative Cohort (JACC) Study. Cancer Causes Control. 2007;18(8):801-808.

This, and other evidence, prompted Messina and colleagues in their 2008 review quoted above to state:

Available data on breast cancer recurrence and mortality provide some assurance for breast cancer patients that soyfoods/isoflavone supplements, when taken at dietary levels, do not contribute to recurrence rates although more data are clearly needed to better address this issue.

Currently there are no data to support the idea that soyfoods or isoflavone supplements improve the prognosis of breast cancer patients.

However, in 2009, following more analysis of the Shanghai study, strong new evidence was published showing significant benefits of consuming soy for women with breast cancer in terms of better survival and less cancer recurrence, making Messina’s claim seem outdated.

Women consuming soy in the highest quartile had a 29% lower death rate over the 4 year follow up, and 32% reduced risk of recurrence. The protective effect was present regardless of oestrogen receptor status of the cancer, or whether tamoxifen was used or not.

This is the most compelling evidence to date of a benefit for soy consumption by women with breast cancer (as opposed to no harm). It is important because it shows a benefit for increased soy consumption irrespective of oestrogen receptor status or tamoxifen use.
Shu XO et al. Soy food intake and breast cancer survival; JAMA. 2009 Dec 9; 302(22):2437-43.
For the full reference, CLICK HERE

BUT BEWARE:  NATURAL SOY, PROCESSED SOY – DIFFERENT OUTCOMES
However, it may be that the non-traditional soy foods do create problems. Significantly, soy protein isolates do not contain many of the bioactive components present in whole soy. As we clarified last week, refined products include soy flour and its processed derivatives.

Research has demonstrated that soy protein isolates (85–90% soy protein) do stimulate the growth of estrogen-dependent tumors. Another study evaluated the relative effects of different degrees of soy processing on the growth of pre-existing tumors and demonstrated that consumption of isoflavones in increasingly purer or more highly enriched forms may have a proportionally worse effect on estrogen-dependent tumor growth.

Allred CD,et al. Soy processing influences growth of estrogen-dependent breast cancer tumors. Carcinogenesis 2004;25:1649-1657.

Some research has shown that soy processing increases breast cancer growth in mice. This may be related to isoflavone metabolism and bioavailability, but more research is needed.
Allred CD, et al. Soy processing influences growth of estrogen-dependent breast cancer tumors. Carcinogenesis 2004;25:1649-1657.

SOY AND TAMOXIFEN
There has also been some concern expressed that soy products may actually interfere with the action of tamoxifen itself. However, recent studies examining the interaction between soy and tamoxifen have yielded neutral or beneficial findings.

In one study, soy intake had no effect on levels of tamoxifen or its metabolites.
Wu AH, et al. Tamoxifen, soy, and lifestyle factors in Asian American women with breast cancer. J Clin Oncol. 2007;25(21):3024-3030.

In another, the combination of tamoxifen and genistein inhibited the growth of human breast cancer cells in a synergistic manner in vitro.
Mai Z, et al. Genistein sensitizes inhibitory effect of tamoxifen on the growth of estrogen receptor- positive and HER2-overexpressing human breast cancer cells. Mol Carcinog. 2007;46(7):534-542.

SOY AND YOUNG GIRLS
Of great interest is research that demonstrates eating soy foods during childhood and adolescence in women, and before puberty onset in animals, appears to significantly reduce the risk of breast cancer later in life.

SYNERGISTIC EFFECTS OF SOY
Research evidence indicates a possible synergistic relationship between soy and green tea consumption.

SOY AND THE AUTHORITIES
The American Cancer Society in 2006 concluded that breast cancer patients can safely consume up to three servings of traditional soyfoods per day, although the group advised against the use of more concentrated sources of isoflavones such as powders and supplements.

The United States Health and Human Services Agency for Healthcare Research and Quality (AHRQ) conducted a review of the available studies and found little evidence of substantial health improvements and no adverse effects, but also noted that there was no long-term safety data on estrogenic effects from soy consumption.

The AHRQ report notes that future studies of the health effects of soy need to better address the complex relationship between health and food components, including how variations in the diets, lifestyles, and health of participants might affect the results. Also, studies that substitute practical amounts of soy products into people's diets would better address the question of whether people should make the effort to include more soy in their diet.

The Cancer Council of New South Wales released a statement saying scientific research suggests that overall the moderate consumption of soy products does not appear to present a risk to women with breast cancer, and there is equivocal evidence that consuming large amounts of soy products may have a protective effect against developing breast and prostate cancer. However, the Council does not recommend taking soy dietary supplements as there is no evidence they are either effective or safe at preventing or treating cancers.

WHAT RUTH AND I DO
We regularly eat organic tofu and soy yoghurt (which Ruth makes from Bonsoy). Ruth drinks small amounts of soymilk (mostly Bonsoy in teas), but I do not – I do not like it and have teas and dandelion coffee black). We eat some tempeh but only have silken tofu if ordered by mistake when eating out! We avoid processed soy products and read labels to avoid the myriad of foods with these products added to them.

MY OWN CONCLUSIONS and RECOMMENDATIONS
In answer to the key question, I conclude the phyto-oestrogens in soy act like tamoxifen not like oestrogen. Based on the evidence available, soy eaten in its traditional forms acts as an oestrogen antagonist, making it helpful in preventing and overcoming both breast cancer and prostate cancer. I also conclude:

1. Traditional soy foods are almost certainly safe and warrant being a part of a healthy diet for healthy people. I recommend them. I particularly recommend regular soy consumption for young and adolescent girls; but then lifetime consumption seems ideal.

2. Processed or refined or concentrated soy products run the real risk of being problematic for everyone. I do not recommend them.

3. For women with breast cancer, the best evidence currently available suggests traditional soy foods, eaten in traditional amounts are likely to be safe and may well be helpful in reducing recurrences and extending survival. I recommend them.

RELATED BLOGS
Is soy safe? - Part 1

Coconut oil – are you nuts?

Food for life – what to eat when

RESOURCES
You Can Conquer Cancer – the revised edition has many other explanations like this one on soy. What type of protein and how much? Which are the best fats to eat and to avoid, and so on. This book is about prevention and long-term good health, as well as cancer recovery.

NOTICEBOARD
1. NEXT WORKSHOP in the Melbourne region: Inner Peace, Outer Health

Mt Macedon on Saturday August 24th, 10am (arrive 9.30) to 4.30pm

Duneira is an exquisite heritage hill station property on the slopes of Mt Macedon. The garden is like a meditative space, so beautiful and filled with majestic trees. I love being there!

Then the house itself is grand enough to host good sized but still quite intimate events. There is a tradition now at Duneira of hosting community events that range from music to personal development and Ruth and I have become regulars.

So, fancy a nice drive to a beautiful place for a meaningful event? If so, CLICK HERE





2. MEDITATION in the DESERT

The experience of a lifetime. Seven day meditation retreat with Ian and Ruth in the extraordinary, natural meditation space of the Central Australian Desert, followed by a few days being in the company of senior local indigenous leaders.

For full details, CLICK HERE










3. IMAGES, WORDS AND SILENCE


Five day retreat/training for everyone interested in Insight, Healing and Wellbeing.

At the Foundation's centre in the Yarra Valley with Drs Ruth and Ian Gawler and Dr Nimrod Sheinman, world authority on the use of creative imagery for healing and personal development.

For full details, CLICK HERE

Is soy safe?

Often I am asked “Are soybeans and their products safe to eat?” It seems some people would have us believe soy is full-on toxic. Others point to the low rates of breast cancer and menopausal difficulties in Asian women, link this to their regular soy consumption and suggest soy is something we would all benefit from.

Wherein lies the truth? Let us go Out on a Limb once more and examine the science behind soy and breast cancer so we can bring some logic and clarity to this often steamy debate. Then I will tell you what Ruth and I actually do, and not shirk from drawing some compelling conclusions and making recommendations.

Also a reminder Meditation in the Desert starts September 6th and we do have a couple of places still available.  LINK HERE. Attached is an amazing aerial shot of the desert taken near to where we go in the Western MacDonnell Ranges. Just like an aboriginal painting. Or is that Fred Williams?! The picture is even more remarkable full screen.

But first

Thought for the day
If information alone could change people, 
Everyone would be skinny, rich and happy.
                                              Les Brown, composer and band leader

Soy products have gained widespread popularity in the West over the last 50 years. The supermarkets are full of them and they are added to so many pre-prepared foods, yet whether they are really safe, and especially what to recommend in regard to breast cancer has been an issue of great contention this last decade. It is an area in which I have taken a great deal of interest. I have read widely, spoken to many authorities and fielded many questions.

What follows then is a major piece in two parts which aims firstly to bring understanding to the soy bean itself. Particularly when it comes to nutrition, I am of the view that if we can understand the principles, then the details follow fairly simply and we will have the confidence to make good choices.

And then next week, how does soy interact with breast cancer? Does it cause or prevent breast cancer? And what of its role for those who have developed breast cancer – does it help or hinder? And what about prostate cancer and our health in general?

As it seems the answers to these questions may well vary depending upon what type of soy foods we eat, let us begin by understanding the bean itself.

THE SOY BEAN (Glycine max)
1. The raw soybean (or soya bean as it is called in the UK) is a legume that originated in East Asia but is now classified as an oilseed rather than a pulse by the FAO. There are 2 main types, those used for eating (which make up about 15% of world production), and those for oil (85%).

Raw soybeans contain trypsin inhibitors that make them toxic to humans and all other animals with a single stomach. Happily, cooking with "wet" heat destroys the enzyme and solves this problem, so all edible forms of soy have been, or need to be cooked.

HINT: Do not sprout soybeans unless you plan to cook them.

2. The traditional use of soybeans fall into 2 categories:
i) Non-fermented foods including tofu, tofu skin and soy milk.

ii) Fermented foods including tamari (traditionally made pure soy sauce), miso (fermented soybean paste), and tempeh. Fermentation does lower the phytoestrogen content found in raw beans. People have claimed that historically soybeans were only used after fermentation, but we shall investigate whether or not this would seem to be a relevant issue.

3. Processed soy products are a more modern phenomena and usually stem from soy flour (made by roasting and grinding the beans) and its products.

One of the most common is TVP (Texturized Vegetable Protein – which also can be made from wheat, oats and cotton seeds). TVP is a de-fatted soy flour product that is a by-product of extracting soy oil. It has a protein content equivalent to that of meat and is often used as a meat substitute or extender.

Fat-free (defatted) soybean meal is a significant and cheap source of protein for animal feeds and many prepackaged meals. It is used widely. Processed soy may be found in many things from vegetable sausages to Mars bars.

SOY BEAN FACTS 

GMO 
In 1997, about 8% of all soybeans cultivated for the commercial market in the United States were genetically modified. In 2010, the figure was 93%. Unless a soy product stipulates that it is GMO free, or organically grown, it is almost certain to contain at least some genetically modified beans.

Soy oil 
Soy beans have a high oil content; around 20%; and soy oil accounts for about 65% of all oil used in commercial and home cooking. However, soy oil is low in Omega 3 fatty acids and high in Omega 6s. The ratio is .13 : 1, whereas flaxseed oil is 3.45 : 1; so for all the reasons why flaxseed oil is good for regular use, soy oil is not.

Tofu usually contains under 10% fat, so the oil type is not a major issue when eating it – unless you have very particular needs.

Soy protein
Soy beans are high in protein: around 38–45%.

Soybeans are an excellent source of complete protein. A complete protein contains in the one food all the essential amino acids in a good balance necessary for human health. Meat is well known as a complete protein and concerns have been raised (probably in a way that is highly overrated) that vegetarians may miss out on some amino acids.

Soy protein has the nutritional equivalent of meat, eggs, and casein for human growth and health. So, as confirmed by the US Food and Drug Administration, soy is a good source of protein for vegetarians and vegans.

Tofu – how it is made 
Soaked soybeans are ground; water is added and boiled.  The pulp is then removed leaving soymilk. Next, a natural mineral coagulant such as calcium sulfate, magnesium chloride, or a mixture of both is added, causing the soymilk to curdle. The curds are removed, placed in a cloth-lined box and varying amounts of pressure applied to form soft, regular, firm or extra firm tofu.

The firmer the tofu, the higher the protein and fat levels.

Silken tofu is made when either calcium sulfate or glucono-delta-lactone is added to a thick, rich soymilk. The mixture is put into a package that is then heated to activate the coagulation and produce the tofu in the package. 

Typically, tofu contains between 10 and 15% protein and 5 to 9% fat.  It is relatively low in carbohydrates and in fibre (as the pulp was removed), making it easy to digest.

Soy production and the environment
Soybeans produce

   . at least twice as much protein per acre compared to most other major vegetables or grains.

   . five to 10 times more protein per acre than land set aside for grazing animals to make milk.

   . up to 15 times more protein per acre than land set aside for meat production.

Environmental groups have reported increased soybean cultivation in Brazil has destroyed huge areas of Amazon rainforest. However, most of the soybeans  grown contribute to livestock fodder and oil production, so there is still great environmental merit in eating less meat and more soybeans.

NEXT WEEK

How is breast cancer affected by oestrogen? Do the phyto-oestrogens (natural, oestrogen-like substances) in soybeans cause breast cancer, protect from it, help or hinder recovering from it? And what of soy and prostate cancer and our health in general?

RELATED BLOG
Eating Well, Being Well

NOTICEBOARD

1. Meditation in the Desert September 6th to 15th


Seven days meditating in one of the world’s best natural meditation environments, followed by several days hanging out with senior local indigenous people. A rare chance to glimpse something of this sadly disappearing, or at least, dramatically changing, traditional culture.


To the right, the view of the Western MacDonnell Ranges from Hamilton Downs where we sit to meditate.


Just a couple of places still available. For enquiries LINK HERE or ring +61 3 59666130

2. Meditation classes in Albury, 6th August 2013
Kaye Ellis is someone I know well and can recommend. Her next meditation course in Albury runs weekly for 6 consecutive weeks beginning on Tuesday 6th August 2013 at 2pm. Each class runs for 1 and a half hours. Kaye does not charge for the courses but asks that if able, participants donate $10 per session which she then gives to the Gawler Foundation.

Details about the course and Kaye’s interest in meditation can be found at meditationalbury.weebly.com. Contact Kaye Ellis: kaye.ellis3@gmail.com

GREAT TED TALK
Your genes are not your fate, with Dean Ornish. To find out how to change your genes, LINK HERE

The 2 top ways to develop mindfulness in daily life.

We all notice how good it feels when someone gives us their full and undivided attention. This is mindfulness. Really being interested, really giving our full attention to someone or something; and doing it non-judgementally.

This week, the 2 best ways to develop mindfulness, news of next week’s workshops in Perth and Denmark, breaking news on soy and cancer, and some great other events. But first

Thought for the week
The miracle is not to walk on water. 
The miracle is to walk on the green earth, 
Dwelling deeply in the present moment and feeling truly alive.



                                                                         Thich Nhat Hanh

Mindfulness is a particular state of mind that is easy to learn, relevant to everything we do, alleviates stress and generates joy! No wonder it is becoming trendy. And being easy to research, the scientists love it. There is now good science to support the claims that mindfulness will enhance your health and wellbeing, and support healing in general.

How then to best develop mindfulness? There are two great ways; both relatively simple, both of great benefit to practise.

Jon Kabat-Zinn is an American who has helped popularise this way of training our minds. He defines mindfulness as focussing our attention on our current moment experience, deliberately and non-judgementally.

By contrast, being mindless is when we are doing something and our mind is elsewhere; thinking of someone or something else, dwelling on the past or fantasising about the future.

Now of course, mindlessness is pretty normal – as in very common! This is why most of us benefit from training to be more mindful; more focussed, more present.

Step 1: Focussed mindfulness

To learn to become more mindful, we begin by practising what we call focussed or deliberate mindfulness. This is where we focus our attention on just one thing, deliberately and with no judgement.

So this can be as simple as formally paying attention to the sounds around about us, to our breath, our body; whatever one thing we choose to focus upon with our attention, while at the same time, we aim to remain like a non-judgemental observer; as much as possible, free of internal commentary, free of judgement.

There is a natural peace in simply being mindful. We practice and begin to appreciate this. With our minds open, curious, aware; we notice whatever it is that we have chosen to focus upon. No need to force anything, or deny anything. Open. Aware. Free of judgement. Mindful. So easy.

Of course, when we aim to be mindful our mind can wander; we can become distracted or simply “space out”. Again, we benefit from noticing this. Whenever necessary, we bring our mind back to the focus of our mindfulness.

Remember too the benefits of relaxation. Everything is easier in a relaxed body. So as we practise mindfulness, we will benefit from consciously relaxing our bodies.

Step 2: Open mindfulness

Open mindfulness is the next step. This is as simple as being fully aware of whatever comes into our awareness at this particular moment. No more, no less. Rather than choosing to focus on something in particular as we do with focussed mindfulness, now we simply notice whatever it is that comes to our attention.

Maybe it is the sounds around about us, maybe our own thoughts, some sensations from our body. We simply notice whatever it is that does come to our awareness and we aim to do so free of any commentary, free of any judgement.

First we practise open mindfulness formally, sitting as we would for meditation. Then we experiment with open mindfulness in the course of our normal day. Mindfulness teaches us to be more present, more in the present moment and soon we begin to notice a wonderful thing.

There is actually no stress in the present moment. No anxiety either. We create stress and anxiety by excessive, unhelpful thinking and this necessitates that we are "out of time". To be stressed we need to think about and be affected by the past or the future; we need to be out of time. In the present there is only peace.

As we practise and learn to be more mindful, we learn to give more attention to the present moment. Of course memories from the past are still useful and planning for the future makes good sense. But now we do not dwell on them. We remember the past with an increasing fondness. We do all we can towards an ideal future, and we learn to combine this with going with the flow.

The bonus: Mindfulness in daily life

The formal practice of mindfulness translates directly into daily life. The more we learn to give our full attention to whatever or who ever we are engaged with, the better everything flows. This is why mindfulness is such a good practice to learn and develop in formal sessions, and then to take with you into daily life.

Of course, mindfulness also quite naturally leads into the deeper stillness of meditation. So many good reasons to develop mindfulness.

NEWS

1. COMING WORKSHOPS with Ian and Ruth; and links to the details

Perth  
April  4; Evening dinner and talk with Verity James and Ian, along with Ross Taylor launching You Can Conquer Cancer in the West.

13 – 14: Weekend workshop: A New Way of Living

Denmark 
April 5; Evening dinner and conversation for health professionals

April 6; Day workshop: Creating Health & Preventing Disease


2. H.H. THE DALAI LAMA COMING to AUSTRALIA in JUNE

BEYOND RELIGION, THE BENEFITS OF LIVING ETHICALLY

How fortunate are we! This will be the Dalai Lama’s ninth visit to Australia and this time His Holiness will provide thought provoking scope to explore the positive impact of ethical behaviour on ourselves, our loved ones, fellow human beings, communities, countries and ultimately our shared global community.

Based on His Holiness book, Beyond Religion, Ethics for a Whole World, His Holiness will discuss how to put ethics into practice in everyday life.

THE VISIT SCHEDULE
14th – 16th June – Sydney Teachings: Jewel Lamp: A Praise of Bodhichitta

16th June – Sydney Public Talk: Ethical Mindfulness in Everyday Life

18th June – Melbourne Public Talk: Compassion, the Foundation of Wellbeing

19th June – Braybrook, Vic; Teachings: The Heart Sutra and Eight Verses for Mind Training

21st June – Adelaide Public Talk: The Quest for Happiness

23rd June – Darwin Public Talk: Ethics in Our Shared World

23rd June – Teachings: The Four Noble Truths

Visit the website for further information and to book tickets: www.dalailamainaustralia.org

3. Mindfulness, Meditation, Wellness and their connection to corporate America's Bottom Line

Arianna Huffington discusses the growing trend in corporate America to take steps -- meditation, yoga, mindfulness trainings -- to reduce stress and improve health and creativity.

Arianna comments “Even a quick look at what's happening in the American workplace shows that it's a seriously split-screen world. On the one hand, there's the stressful world of quarterly earnings reports, beating growth expectations, hard-charging CEOs, and focusing on the bottom line -- the world that is the usual focus of CNBC and Squawk Box.

On the other hand, there's the world populated by the growing awareness of the costs of stress, not just in the health and well-being of business leaders and employees, but on the bottom line as well.

Interested? Link here.

4. COMMUNITY and SUSTAINABILITY in the YARRA VALLEY

I have been asked to speak on Meditation and Sustainability in my local community in a few weeks. A nice opportunity if you care to visit the Upper Yarra Valley, meet some of the locals and learn more about sustainability.

Yarra Valley ECOSS: Community Festival - Celebrating Sustainability in the Yarra Valley
10 - 4 pm Sunday 21st, April 2013;    Yarra Junction Parklands. Including the Upper Yarra Museum and The Sport and Aquatic centre (Mel ref 288 D7)

Workshops and speakers     Great live music      Market stalls
Butter making, hay baling, blacksmithing and old time children games
Open day at the Sports and Aquatic centre
Scooter & BMX Demonstrations    Scrumptious food     Woman's Red Tent
Recycled Fashion parade    Alternate transport Display       Solar and pedal powered stage

5. Breaking research news

Soy Products Improve Survival in Women with Lung Cancer - March 27, 2013

Soy products can improve survival from lung cancer, according to a new study published in the Journal of Clinical Oncology. In the Shanghai Women’s Health Study, 444 women were diagnosed with lung cancer. Researchers examined the women’s diets before and after their cancer diagnosis. Those who ate the most soy products cut their risk of dying by nearly half, compared with women who ate the least amount of soy.

Previous studies have shown that soy products reduce the risk of developing lung cancer, and have a similar ability to reduce the risk of breast and prostate cancer.

Yang G, Shu XO, Li HL, et al. Prediagnosis Soy Food Consumption and Lung Cancer Survival in Women. J Clin Oncol. Published online on March 25, 2013.

Yang G, Shu XO, Chow WH, et al. Soy food intake and risk of lung cancer: evidence from the Shanghai Women's Health Study and a meta-analysis. Am J Epidemiol. 2012;176:846-855.

RELATED BLOG
Meditation in 4 easy steps

RESOURCES
BOOK: Meditation - an In-depth Guide

CDS: Meditation - a complete path

Mind Training

Meditation in the Desert - come to Central Australia and experience the heart of mindfulness and meditation


Ian Gawler Blog: Eating well, Being well – and the new edition of “You Can Conquer Cancer” is released.

What a delight to speak at the Gawler Foundation’s conference this last weekend, presenting dietary guidelines and some of the exciting research linking nutritional changes with increased survival.

Great chance to catch up with old friends like Petrea King and Dr Craig Hassed and to have the honour of sharing the stage with them. Then there was the opportunity to meet up again with people who came to groups in days gone by. People like the lady who had secondary breast cancer 7 years ago and looks radiantly well. When asked what had helped her most, she thought for a moment, then shared the fact of learning to love herself enough to really care about what she ate, how often she meditated and so on. A real confirmation of Jess' guest blog from last week. Her new husband chimed in with how much he admires her capacity to make those choices and stick by them; how diligent she is.

Lots of new people to meet as well and my new edition of “You Can Conquer Cancer” arrived mid morning on the Saturday, hot of the press as they say! That’s synchronicity for you.

I had the opportunity to speak on the therapeutic potential of food – a vast topic!

A key point. Anyone who might be silly enough these days to say there is no evidence that changing your diet can improve cancer outcomes is just not keeping up with the research.

At the conference I shared 17 recent studies that come from the last few years and typify the exciting times we live in as research is making clear the powerful the between what you eat and cancer recovery. For over 30 years my clinical experience has been that food can be used therapeutically in cancer medicine, now we are getting some good confirmation via the research.

In the new edition of “You Can Conquer Cancer”, there are several fully rewritten chapters on cancer and food and nutrition, providing the detail of how to put all this into action; how to convert the theory into a meal.

The new book is just that, virtually a new book given the rewrite has been so thorough. So for anyone dealing with cancer, for anyone keen on not getting cancer, for anyone interested in a comprehensive, healthy lifestyle, the new book is recommended.

As promised here are the research articles linking cancer and nutrition, reproduced via “Out on a Limb”, and the dietary guidelines in summary. Again, the details are in the new book.

1. NUTRITION & LIFESTYLE prevents 40% of breast cancers by
i) Being lean
ii) Exercising 30 mins/day
iii) One alcoholic drink/day - max
iv) Women breastfeeding exclusively for 6mths
                                     Based on 954 studies: AICR & WCRF 2009

2. FOOD & EXERCISE SAVE LIVES
A major review of breast, colorectal, and prostate cancer concluded:
i) Observational studies suggest a low-fat, high-fibre diet might be protective against cancer recurrence and progression.
ii) There is more support for physical activity, with a dose response for better outcomes.
                                     Davies, N J, Br J Cancer, 2011
      More detail:Blog:  Let food be your medicine – 18 & 25/6/2012

3. LIFESTYLE CHANGES AFFECT BREAST CANCER RECURRENCES
i) Healthy weight decreases secondaries by 40 – 50% c.w. being obese.
ii) Seven or more alcoholic drinks per week almost doubles the risk of cancer in the opposite breast.
iii) Smoking & drinking:  increases the risk of cancer in the opposite breast by 7.2 times.

4. META-INFLAMMATION FEEDS DEGENERATIVE DISEASES
Meta-inflammation is low-level, systemic inflammation:
   - A major factor in most chronic degenerative diseases including cancer
   - Modern nutrition is a significant “inducer”
          Egger,G ACNEM Journal, Mar 2012, Vol 31 No 1 P12-14
 Inflammation potentiates active cancers.
 Improve the diet, reduce inflammation, assist recovery.

5. WESTERN DIET is BAD NEWS
High intake of meat, fat, refined grains & sugary desserts is associated with a
3x increase in colon cancer recurrence and death
                 Meyerhardt, JA et al, JAMA 2007;298:754-764

6. LOW CARBS REDUCE RISK of CANCER DEATH
High carbohydrate intake and high glycaemic load is associated with a
2x increase in colon cancer recurrence and death.
But only in the overweight and obese.
             Meyerhardt JA et al, J Natl Cancer Inst Nov 2012

7. Differential Stress Resistance
FASTING
For normal cells – increases protection
For cancer cells – increases vulnerability
Fasting around chemotherapy leads to:  
i) Better outcomes
ii) Less side-effects
                             Lee C, Volgo et al, Sci Trans Med 2012

8. CUT the CAMOUFLAGE, CURE the CANCER
Cancer’s “camouflage” seems to rely on the protein CD47.
Animal trials show anti-bodies to CD47 remove the camouflage, allowing the body’s immune system to recognise and destroy cancer.
                          Wellingham SB et al, Proc Nat Academy Sci, 2012
                          More detail: Blog - 2 April 2012

9. Multivitamins Reduce the Risk of Developing (or Dying) of Cancer
A very large randomized trial over 11 years concluded multivitamins produced:
1. No effect on prostate cancer
2. 12% risk reduction in total for developing all other cancers
3. Also, a 12% reduction in the risk of dying from cancer (not statistically significant)
                                   Gaziano, MJ et al, JAMA Oct 2012

10. Multi-vitamins & Breast Cancer
Another big study concluded:
1. Multivitamins are not harmful
2. Improved outcomes with radiation, or radiation and chemotherapy
3. Consistent multivitamins use before and after diagnosis, eating more fruits and vegetables, as well as being more physically active is associated with better overall survival.

           Kwan ML et al, Breast Ca Res Treat. 2011 Nov;130(1):195-205

11. SOY is Safe for Breast Cancer
This is the conclusion drawn from this extensive review of the available literature
              Messina MJ and Wood CE; Nutrition Journal 2008

12. MILK increases the risk of Prostate Cancer
Higher levels of cow’s milk consumption in boy’s is strongly associated with an increased risk of prostate cancer in men
                              Torfadottir et al; Am J Epidemiol, 2012

13. TELOMERES are protective, DNA—protein complexes at the end of chromosomes.
Telomere shortness is emerging as a powerful indicator of disease risk, progression, and premature mortality in many illnesses, including cancer.

Telomere shortening is counteracted by the cellular enzyme telomerase.

Increased telomerase activity is associated with
      1. Reduced disease risk generally
      2. Increased cancer survival    
      3. A longer, healthier life

There is a statistically significant inverse relationship between telomere length and both cancer incidence and mortality
                     Willeit P et al, JAMA 2010;304 (1): 69–75

14. WHAT INCREASES TELOMERASE ? 
1.  LIFESTYLE PROGRAMS  - LIKE TGF
          After 3 mths, 10% increase
                            Ornish, D et al, 2008,The Lancet Oncology

 2.  LIFESTYLE FACTORS
            HARMFUL EFFECTS  . Smoking
                                                      . Processed meats
                                                      . High BMI – overweight, obese
            HELPFUL EFFECTS    . Vitamins C,D & E, + Folate
                                                       . Omega 3 Fatty Acids
                            Lin j, Epel E, Blackburn E, 2011, Mutation Research

3.  MEDITATION - The Shamatha Project
       After 3 mth intensive retreat, 30% increase
                                            Jacobs TL, Wallace A, Blackburn E et al,
                                                    2010, Psychoneuroimmunology Jnl

4.  SPECIFIC HERBS   –  Product B – a combination of telomerase activating herbs. For details go to iangawler.isagenix.com

15. TUMERIC & PEPPER target breast cancer stem cells
Turmeric (curcumin) and black pepper (piperine) separately, and in combination, inhibit breast cancer stem cell self-renewal
      Kakarala, M et al, 2010, Br Ca Research & Treatment, Vol 122, No 3, 777-785

16. CURCUMIN (turmeric)
Reduces the side-effects and increases the benefits of radiotherapy
                              Jagetia G C; Adv Exp Med Biol, 2007

17. POMEGRANATE JUICE targets Prostate Cancer
8 ozs each day increases PSA doubling time - by almost 4 times : from 15 – 54 mths
                              Pantuck et al. 2006 Clin Ca Research
                              Pantuck et al. Abstract of follow-up Am Soc Clin Onc 2008

DIETARY GUIDELINES
In broad terms: ADOPT a PLANT-BASED, WHOLEFOOD DIET

1. READ the summary of The Wellness Diet

2. STUDY and APPLY the detail in the new edition of “You Can Conquer Cancer”

3. LISTEN to the 2 food CDs

4. ENJOY the recipes in “Eat Well, Be Well”

5. SEEK personal help if needed

6. DELIGHT in the fact, and the tastes of eating well

RESOURCES

1. DOCTORS & INTEGRATIVE MEDICINE
When you need a doctor trained in nutritional medicine, refer to

i) The Australian College of Nutritional Medicine (ACNEM)
   www.acnem.org

ii) The Australasian Integrative Medical Association (AIMA)
   www.aima.net.au

2. You Can Conquer Cancer – buy the new edition online (or over the phone) via the Foundation’s bookshop and support the Foundation – NOTE: check to make sure you order the new edition, not the old one!

3. CDS 
i) Eating Well, Being Well – Outines the Gawler Wellness Diet – the key to good health for everyone.

ii) Eating for Recovery – Outlines the Gawler Healing Diet specifically developed for people dealing with cancer. Please Note: This CD builds upon the information on "Eating Well, Being Well”. For those dealing with cancer, you need both CDs for completeness.

RELATED BLOGS

DNA and the dangly bits

Food 101 – what fuel goes into your tank?

Eating for recovery