GIGO

GIGO: geek-speak for "garbage in, garbage out." What you get is only as good as what you put in.

In the case of the human body, that would be food. Everybody knows Americans have a food problem. Around 25 percent of us are clinically obese. Another 25-50 percent could stand to lose some weight. "Meals" of fast food, candy bars, soda. We don't walk, don't exercise, won't even take a flight of stairs if there's an elevator. I could go on about this, but let's get back to leukemia.

My doctor told me I could eat anything — before, during, and after chemo. (The only exception was alcohol, which can depress the immune system.) We asked him if there were things I should be eating, things that might help. He said no, they didn't know of any specifically helpful foods. He advised against supplements because he thinks they don't work, but he said (in so many words) that he had no data to back this up.

Typical. Most doctors know zip about nutrition. Med schools don't teach it. Doctors are trained, formally or informally, to see the body as a homeostat that regulates its own levels and can't be much affected by the particular food you take in. Thankfully, this is finally beginning to change.

I already wrote about the foods I can't eat until my neutrophil counts recover (fresh fruit, raw meat/fish, leftovers — basically anything that might have little nasties growing in it.) But what about food, or nutrients, that might actually help? Can I maximize my chances in the standoff that's about to start?

The best source I found is Food, Nutrition and the Prevention of Cancer: a global per-
spective (Nov. 2007, just released). This 537-page monster is a state-of-the-art report, a five-year project of the World Cancer Research Institute. A huge panel of scientists reviewed the relevant literature and summarized the consensus findings. The bibliography is 95 pages of tiny type. It goes through every type of cancer, outlining what's known about the preventive and harmful effects of various foods and food groups.

No huge surprises here, but some very clear recommendations. Excess weight — not just obesity, but even a few extra pounds — promotes cancer. Diet and exercise help in weight control. But more specifically, minimize animal-based foods of all types, especially red meat and dairy, and maximize fruits and non-starchy vegetables. Any amount of alcohol increases overall cancer risk, especially for head and neck cancers, but this effect is not large below the 2-glass-a-day margin that's protective against heart disease.

As for leukemia, it's not the same as other cancers. The report doesn't spend much time on it — just 2 pages (319-320). Intriguing here is the report that leukemia incidence is much higher (2-3x) in highly developed countries, and rates are rising. Sounds prima facie like a lifestyle disease.

Here are the leukemia-specific dietary risk/benefit factors the report identifies:

• Good: vegetables, fruits, polyunsaturated fats, alcohol
  
• Bad: milk, dairy, red meat, saturated fat, overweight/obese
  

The Cancer Center gave us a handout on "superfoods" that can help prevent cancer, or even combat the disease if you already have it. The big ones are these:

• Yogurt (live-culture only)
• Garlic
• Carotenoids (in carrots and green leafy vegetables)
• Cruciferous vegetables (broccoli, brussel sprouts, cabbage, and cauliflower)
• Legumes (beans, seeds)

The expert report discusses all this too, and I confirmed much of it on PubMed. These foods' effects aren't small, either; they're pronounced. Chemicals in garlic are the subject of very active drug research, as are the various lactobacillus strains in yogurt. When is this stuff finally going to filter through to the clinicians? They should be telling everyone, at every visit.

In reviewing this literature, I noticed a (for me) new emphasis on probiotics — yogurt and fermented foods, such as tempeh and kefir, that contain beneficial microorganisms — and "prebiotic" foods, which those organisms require in order to grow in your gut. Prebiotics are mostly fiber-containing foods such as fruits, vegetables, whole grains. Eat your oatmeal.

Did you know that 90 percent of the cells in your body — aren't yours?

Of the trillions and trillions of cells in a typical human body — at least 10 times as many cells in a single individual as there are stars in the Milky Way — only about 1 in 10 is human. The other 90 percent are microbial. These microbes — a term that encompasses all forms of microscopic organisms, including bacteria, fungi, protozoa and a form of life called archaea — exist everywhere. They are found in the ears, nose, mouth, vagina, anus, as well as every inch of skin, especially the armpits, the groin and between the toes. The vast majority are in the gut, which harbors 10 trillion to 100 trillion of them.

This comes from Fat Factors, an astonishing NY Times Magazine story published in summer 2006. (You need a subscription to read the story, but if you have trouble getting access, email me.) Too much to review here. The punch line:

“Humans are superorganisms... whose metabolism represents an amalgamation of microbial and human attributes.” [Scientists] call this amalgamation — human genes plus microbial genes — the metagenome.

If this is true — and it seems totally obvious once you learn that we're unable to digest almost anything without the gigantic colonies of microbes in our guts, with which we've co-evolved over countless millennia — we are only starting to understand human health. And it will not be at all surprising to learn that probiotics can play a major role in preventing cancer.