Whole-Food Guide for Breast Cancer Survivors (16 page)

Oxidative Stress

Your body continually combines the oxygen you breathe with nutrients from the food you eat to produce energy
.
One result is
oxidation
: the stripping of an electron from each atom or molecule the oxygen combines with, creating what biochemists call free radicals (which we’ve mentioned a number of times previously). Since electrons come in pairs, when molecules lose an electron, they “steal” electrons from other molecules. These molecules then “steal” electrons from other molecules, and so on.

Free-radical activity is a normal part of being alive, and when it is under control, it’s part of the engine that drives metabolism. But heavy metals, toxic food, smoking, and all sorts of other internal and external assaults—even an imbalance of nutrients—can rev up this process. This is
oxidative stress
. Unchecked, oxidation can behave like an out-of-control fire, damaging cells, tissues, and organs indiscriminately—the dangerous chain reaction known as
free-radical damage
. In an attempt to repair such damage, the body calls for an immune response, which, in turn, initiates inflammation, and this causes even more free-radical generation. It’s a vicious cycle.

One way to keep inflammation and oxidative stress under control is to eat a diet rich in antioxidants. Eight to twelve servings a day of fruits, vegetables, or both should do the trick (see appendix A for tips on incorporating more fruits and veggies into your daily routine).

Weight and Blood Sugar

Keeping your weight in check is crucial for preventing inflammation, as well as conditions associated with it and obesity, such as heart disease and diabetes. Research indicates that
visceral fat
(the fat located deep in the abdominal area) is more metabolically active than other types of fat, secreting large amounts of inflammatory cytokines (Maury and Brichard 2010). The good news? Maintaining a healthy weight greatly reduces and, in some cases, even eliminates inflammation.

Remember that the hormone insulin, itself, is associated with inflammation (see chapter 6). So, the lower you can keep your fasting glucose and insulin levels, the less you will have to worry about them as a source of unwanted inflammation.

Stress and Sleep Deprivation

In addition to diet, certain lifestyle choices may contribute to inflammation. According to Dr. Isaac Eliaz (pers. comm.), who practices integrative medicine in Sebastopol, California, both stress and sleep deprivation can lead to inflammation through the elevation of the hormone
cortisol
. Chronic stress, Dr. Eliaz explains, leads to the overproduction of cortisol, the body’s most abundant stress hormone. This rise in cortisol disrupts normal hormonal function, raising blood sugar levels and contributing to the inflammatory cascade.

Excessive Exercise

Everyone feels better with regular exercise. While improving physical fitness and enhancing overall well-being, it may also strengthen the immune system. It’s tempting to be impatient and ignore our bodies’ protests when we are trying to reach a physical goal, but be careful! When combined with inadequate rest and other stresses, overexercising, sometimes called “overtraining syndrome,” can lead to an impaired immune system and inflammation (MacKinnon 2000). One theory as to what causes this chain reaction is that your overtaxed muscles and tissues trigger the release of pro-inflammatory cytokines, the proteins that act as messengers between the cells. When sufficient rest is allowed, pro-inflammatory cytokines facilitate the healing process—but only if rest is allowed. That’s why we often feel better if we rest after a long bike ride and why it’s best to alternate periods of exercise with periods of healing, recuperative rest.

Assessing Your Inflammation Status

Other than some obvious signs—puffy gums, sore joints, chronic nasal stuffiness—how can you tell if your inflammation levels are higher than they should be? Several tests can be useful here.

C-Reactive Protein

C-reactive protein
(CRP) is a powerful inflammation marker. The production of CRP is an indispensable part of the inflammation process, and its measurement mirrors the level of inflammation in the body
.
We believe that measuring inflammation with a high-sensitivity CRP test (HS-CRP), a simple blood test, is one of the most important steps you can take if you have had cancer. If the results are elevated, above 1.0, then it’s time to take action to bring down your CRP levels. You might want to retest at three-month intervals. If you don’t have cancer but have risk factors, you might consider having the test run on an annual basis as part of your regular physical exam. Some practitioners like to look at other inflammatory markers. A complete inflammatory profile might include, interleukin-1 (IL-1) beta, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF).

Fibrinogen

Fibrinogen
is a protein produced by the liver that helps the blood to clot properly. Its levels increase in reaction to inflammation, so if inflammation levels are high, it may be wise to check fibrinogen levels as well. We recommend that fibrinogen levels range between 215 and 300 milligrams per deciliter of blood. Bringing levels into normal range has the added benefit of keeping the blood flowing more smoothly, making it more difficult for metastases to develop.

Food Sensitivity Panel

If your inflammatory markers remain stubbornly high, consider the possibility of food allergies or sensitivities
.
Common allergens like casein (from dairy) and gluten (from wheat) are known to spark an inflammatory cascade in sensitive individuals. So, one way to cool inflammation on a cellular level is to pay attention to foods that may cause headaches, digestive upset, or skin eruptions, like acne or eczema. Keep in mind that as we age, foods that may not have bothered us before, like dairy and wheat, may trigger chronic low-grade inflammation. Even seemingly innocuous foods, when eaten repeatedly, can cause a food sensitivity to develop. If you think you might have a food sensitivity, we recommend going on an elimination diet for two weeks to see how you feel. We deal with the specifics of this later in the chapter. You might also consider doing a food allergy panel through one of the labs listed in appendix B, available through your nutritionist or other holistic practitioner.

Thermography to Assess Breast Inflammation

Breast thermography provides one of the best visual clues of the presence of inflammation in breast tissue. Since inflammation often accompanies precancerous changes to the breast and since it always produces heat, measuring the temperature of the breasts can provide us with vital information.

Temperature measurement as a means of assessing health has its roots in ancient Greece, when Hippocrates covered his patients’ bodies with a thin slurry of mud and, as it dried, observed temperature differences around diseased organs. With the advent of military infrared heat detection technology, specialized cameras were developed that could produce a detailed picture showing how the heat is distributed over the body. This picture could then be analyzed with computer software to determine regions of abnormal heat, suggesting injury or disease.

When it comes to breast health, here’s how it works, according to Robert Kane (pers. comm.), a board-certified clinical thermologist who maintains a busy thermal-imaging interpretation practice in Redwood City, California: “Heat is produced in the breast by normal tissue metabolism and is carried to the surface by the blood supply. Our bodies naturally release heat to the environment in the form of infrared energy to maintain a normal body temperature of 98.6 degrees Fahrenheit. This energy can be captured and visualized by a special infrared detector inside the thermography camera.”

Normal breast tissue produces a characteristic temperature pattern when visualized with thermography. On the other hand, fast-growing, abnormal breast tissue (cancerous or precancerous) will produce heat through its faster metabolism. This heat travels through the circulatory system to the surface of the skin, where it can be detected using a thermographic camera (Yahara et al. 2003). What’s more, as mentioned earlier, cancerous tissue can create its own blood supply via the process of angiogenesis, or new blood vessel formation (Anbar 1994). Both of these occurrences can translate into temperature changes at the surface of the breast and provide a means of detection with the thermographic camera.

Thermography findings are less dependent on the
size
of the abnormal tissue and are more directly related to the degree of inflammation, growth rate of the tissue, and metabolic activity (Gautherie et al. 1982). The more inflamed, aggressive, and metabolically active the tissue, the more likely that a trained interpreter will see it on a thermogram. Since highly inflamed, precancerous growth represents the highest likelihood that cancer will develop, we consider thermography to be an excellent addition to standard breast imaging (mammography, MRI, or ultrasound) to help identify smaller lesions that are growing quickly and may appear between annual examinations.

Perhaps even more important, thermography provides invaluable feedback if you’re attempting to lower your risk of recurrence through lifestyle and nutrition, allowing you to see if your actions are effective. In short, just as thermography can be used to identify physiological signs that precede cancer and signal future risk, you can also use it to track the success of your anti-inflammatory strategies, adding a great deal to your peace of mind between conventional screenings.

Guidelines for Lowering Inflammation

Exactly how does diet influence inflammation? Let us count the ways.

Change Your Oil

The type of fat that you eat is, quite possibly, the most important dietary factor affecting the level of inflammation in your body. That’s because fats are precursors to both pro-inflammatory and anti-inflammatory chemicals. Note that we are
not
saying that
all
fat is bad for you. Fat is as necessary to good health as protein, carbohydrates, and nutrients. But there is a world of difference between healthy fats and unhealthy fats.

Unhealthy
Fats
Are
Objectionable

• Fats stimulate a variety of chain reactions in your body. Picture a line of dominoes. When you push on the first one, the rest topple. Inserting unstable or unhealthy fats into the system will eventually cause the system to collapse in the same way, as they initiate a domino effect that ends with a host of pro-inflammatory
  eicosinoids
  (molecules composed of fatty acids) running rampant.
  
• When you consider that every cell in your body is surrounded by a lipid (fat) layer that is just the right consistency to let all necessary nutrients
  in
  while allowing all the critical waste material to pass
  out
  , you can see that altering the composition of that cell membrane is risky business. Yet, that’s exactly what unhealthy fats do. You can think of it like this: they actually gum up your cell membranes, preventing nutrients and wastes from passing in and out as they should.
  
• Trans fats are among the worst offenders (Mozaffarian et al. 2004). Although they exist nowhere in nature, they line supermarket shelves in large quantities in the form of snack foods, fried foods, baked goods, and vegetable shortening. Trans fats also create a wealth of free radicals that damage healthy cells and trigger inflammation. Hundreds of studies have now confirmed the unhealthy link between trans fats and inflammation (see for example, ibid.).
  

Don’t Believe Everything You Read

According to nutrition educator Mira Dessy, author of the blog
Grains & More
(grainsandmore.blogspot.com), the label on packaged foods doesn’t tell the whole story. Loopholes in labeling laws allow manufacturers to list “0 trans fats” if the amount present is less than .5 gram per serving. Keep in mind that a serving size is not the same as a portion size, so you may be getting more trans fats in your snack than you bargained for.

MIND YOUR EFAS

EFAs, or
essential fatty acids
, are fats that the body can’t live without and that we can’t synthesize internally and therefore must obtain from food sources. The EFAs we need to survive are known as the omega-6 fatty acids and the omega-3 fatty acids. Simply put, omega-6 fatty acids start the fire of inflammation, and omega-3 fatty acids put it out. Since we need to both start and stop inflammation, we need both types of fat. That’s why nature provided us with plenty of both. Most grains, nuts, and seeds contain large amounts of omega-6 fats. These fats work their way up the food chain in several ways. For example, cattle that are fed grass create meat and dairy products that are high in omega-3 fats. These days, cows are fed primarily corn and soy in feedlots, which produces much higher levels of omega-6 fats in the meat and dairy products that result. Because of this and the ubiquitous presence of corn, soy, canola, and other omega-6–rich vegetable oils in processed food and on supermarket shelves, our fat consumption habits have changed dramatically in the last century. Whereas our ancestors are believed to have eaten about twice as many omega-6 fats as omega-3 fats, many experts believe Americans now eat fifteen to seventeen times more omega-6 fats than omega-3 fats (Simopoulos 2006). The result is an unbalanced inflammation response.

An ideal balance of omega-6 to omega-3 fats would go a long way in keeping inflammation under control. Omega-3 fats act as natural COX-2 inhibitors, much like ibuprofen or celecoxib (such as Celebrex), but without the potential side effects. You will want to get your omega-6 fats from whole grains, seeds, and nuts, and to avoid the refined, bleached, and processed oils you find on supermarket shelves (corn, soy, canola, safflower, and so on). And you’ll want to incorporate more omega-3 fats into your diet by adding wild salmon, halibut, sardines, and occasional tuna, and by eating lots of flaxseeds, chia seeds, and walnuts, all high in omega-3 fats. Salmon is a particularly rich source of eicosapentaenoic acids and docosahexaenoic acids, the two potent omega-3 fatty acids that are so proficient at extinguishing inflammation. Try to include some oily fish, such as wild Alaskan salmon, in your diet twice a week. If your CRP levels are not where they should be, you might consider adding a fish oil supplement to your regimen, which has proven to be a valuable asset in keeping cancer at bay.