Superfluous Foods

Every year the health editors launch a new Superfood. Blueberries, kale, kombucha, sea buckthorn, green tea, yerba mate, so passé … What’s new?

According to a recent meta-analysis, which summed up no fewer than 80 prospective cohort studies, one of the most powerfully chemoprotective of foods is the humble carrot. Carrot consumption apparently reduces overall cancer risk by as much as 20% (1). The magic marker is, allegedly, alpha-carotene.

The authors described the inverse association between carrot intake and cancer as “robust,” and recommended that “carrot consumption should be encouraged, and the causal mechanisms further investigated in randomised clinical trials.” Well, pardon my skepticism. 

‘What’s up, doc?’, I hear you ask.

Former US President Elmer Fudd (George Bush Jr) said it best. “There’s an old saying in Tennessee — I know it’s in Texas, probably in Tennessee — that says, fool me once, shame on — shame on you. Fool me — you can’t get fooled again.’ (2).

Carrots contain the phytonutrient / pro-vitamin beta-carotene, named after the carrots from which it was first extracted. Initial epidemiological mapping, and in vitro and pre-clinical research suggested that beta carotene was chemo-preventive. According to a 1988 critical appraisal in Nutrition Research (3), ‘human prospective and retrospective studies strongly indicate that beta-carotene protects against lung cancer’. And I believed it.

By 1996, however, the bloom was well and truly off the carrot. The ATBC and CARET studies discovered that far from being chemo-protective, beta-carotene supplements increased the risk of lung cancer in smokers and those exposed to asbestos (4, 5). 

The cancer industry heaved a sigh of relief, and nutritionally-inclined scientists shifted their focus to the brassica vegetables (ie 6). Here too, unfortunately, early enthusiasm based on epidemiology and in vitro studies has not yet translated into convincing clinical benefits.

Scientific hoplites pinned their hopes on hops which contain hopium, AKA the polyphenol xanthohumol (7), apples (8, 9), onions (10, 11), bananas (11), citrus (12), tea (13) and even fish (14); but despite a proliferation of pharmacologically plausible mechanisms and a generally benign growth of observational studies, no prospective, double-blind and randomized trial has yet shown clear and consistent benefits associated with any food and with any cancer.

Nor are they likely to. The concept of a synthetic or natural magic bullet that could slay the protean monster of cancer is Pasteurian and therefore, I believe, misplaced. Due to the diversity and genetic instability of cancers, and the resulting inevitability of chemo-resistance to mono-therapies, we should be thinking of broadly chemo-preventive or chemo-hostile environments which present multiple barriers to cancer success.

Such environments are not new. In fact, they are traditional, and the evidence shows that they were – and are – powerfully protective.

Non-communicable diseases including the cancers were far less common in our deep past (15) and in more recent cultures, including mid-Victorian England (16, 17) and others (18, 19); and they are relatively rare today among vestigial groups including hunter-gatherers (20) and forager-gardeners (21). 

Cancers become more common as we age, but this trend does not appear to be caused by ageing per se (22, 23). Cancers and most non-communicable diseases can best be thought of as the end-result of chronic intoxication (23, 24), the progressive failure of checkpoint mechanisms, or – perhaps more profoundly – as evolutionary mismatch disorders (25, 26). 

The term ‘evolutionary mismatch disorders’ refers to diseases which are caused when genetically determined traits that evolved in a species in its original environment, and were advantageous in that environment, became maladaptive after that species encounters a new environment. In our case, this is primarily the new dietary environment that we entered in the 20^th century, as traditional foods were increasingly replaced by ultra-processed or industrial foods; aka the ‘nutrition transition’.

This happened at different times in different countries. In the USA, the transition started between the 1930’s and the 1950’s (27).

Today, dietary shift and the non-communicable diseases are accelerating most rapidly in the emerging economies (28).

One glaring example of evolutionary mismatch disorders can be seen in the enormous disparity in colon cancer rates, which are 15 times higher in African Americans (65:100,000) than in rural South Africans (<5:100,000) (29). Other examples occur in those animal species we have coerced into our near-orbit.

Welcome to the machine

I have written previously about the high frequency of degenerative disease in domestic animals (30, 31). Similar changes develop in livestock kept on the industrial farms known as Concentrated Animal Feeding Operations (CAFOs). These systems were developed in the 1950’s for poultry, leading to widespread chickenisation and domestic agri-colonialism (32). Pigs followed in the 60’s, with cattle CAFOs taking off in the 1970’s.

Indian cows, as anyone who has spent time in south and southeast Asia knows, are as free-range as all cows used to be. In Ayurvedic medicine cows’ urine (Gomutra) is used to treat diabetes (ie 33), and pre-clinical work shows that it does indeed contain compounds which lower blood sugar levels (34, 35). 

In contrast, consider the steers and heifers on death row in the beef CAFO’s. 

The combination of over-feeding and forced inactivity would be expected to create the same metabolic dysfunction as it does in humans, and in the late stages of the finishing phase, during which beef cattle typically gain 3 or more lbs per day (36), steers develop inter-muscular and then intra-muscular fatty infiltration (37). I have been reliably informed that they also develop glycosuria.

Inter-muscular fatty infiltration is associated with insulin resistance, chronic inflammation, metabolic syndrome, and diabetes (38). Intra-muscular fatty infiltration is a hallmark of human diabetics, in whom it is closely linked with insulin resistance, mitochondrial loss and sarcopenia (39).

If beef cattle in the CAFOs were not slaughtered before their time, they would progress from metabolic syndrome to type 2 diabetes and go on to acquire the same liver, kidney and other health problems that we see in humans, most of whom today live in urban CAFO’s, eat the cafoteria diet (40), and sicken and die accordingly. 

Unfortunately for us, and just when we needed them most, large elements of the healthcare system have been coopted. When the US diabetes association recommends recipes containing up to 60g of white sugar (41, 42), it is hard to escape the impression that they are more concerned with creating good business than good health. 

This is particularly unforgiveable at a time when the pathogenic mechanisms which link the modern diet with the pandemics of non-communicable disease are increasingly well understood. Glycemic mis-match is one of these, together with chronic inflammatory stress, dysbiosis and Type B malnutrition, and for each of these drivers of disease there is a counter-measure, or antidote.

In individuals using those antidotes and in groups who return to a traditional diet, the non-communicable diseases become far less frequent and superfoods become superfluous. 

In order to reach the goal of better public health, however, we will need both carrots and sticks. We should reward consumers by offering dishes which are delicious, healthy, convenient and inexpensive, and punish those producers who continue to sell fast foods / slow poisons.

The good news is that the former strategy is now underway, and the latter is under consideration, in some quarters. I will examine this in more detail, and review a do-it-yourself chemo-preventive dietary approach recently published in Medical Research Archives, in my next post.

In the meantime, for anyone still interested in alpha-carotene, boil carrots until tender and then puree them to get the best bang per buck (44, 45). 

That’s all folks!

Next week: Ashes to ashes.

References

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2. https://www.youtube.com/watch?v=KjmjqlOPd6A
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