1. Health is a part of our being that should be treated in the most careful way by everyone, we forget often that every organism has its own way to react to food, supplements, diets etc. It`s almost impossible to foresee, foreknow.

Posted at 8:37AM on Sep 12th 2006 by sally

2. I too like to rely primarily on a healthy diet for nutrients both for general health and for fighting cancer, but I've gotten tired of the line that a healthy diet will basically meet my needs. I think it's a cop out; at least for me it is. On the other hand, I'm wary when buying supplements, looking for indications that they are good supplements, because there are so many worthless and dangerous ones in the market and the FDA has been hamstrung in its enforcement efforts.

For prostate cancer patients like me, a normal diet is going to fall short in some of the areas that look important based on a growing body of impressive but not yet conclusive evidence. Our key needs according to current evidence seem to be lycopene, selenium, vitamin E, fish oil, soy isoflavones, and vitamin D3. (There are others that are not as well established but that look promising, such as green tea, mentioned in this blog.) It is not at all difficult to get enough lycopene from diet, but it is very difficult for many of us to get 200 mcg daily of selenium, for example. While you can get a lot from Brazil nuts, they are not always in season, and other dietary sources of selenium will not provide enough for many of us. Although a few of us live in areas with selenium rich soil such as the high plains of Nebraska and the Dakotas and get enough from local produce, those of us on the Atlantic Coast and Pacific Northwest, to name just two areas, do not. Vitamin E (with gamma tocopherol), fish oil, and vitamin D3 can also be difficult to work into the diet in recommended quantities.

Research on vitamin D3 is exploding after the realization that the old standard of 400 IU was okay for preventing deficiency disease in children but inadequate for adult needs. While the sun makes a lot of D3 for those of us at the right latitudes, it is inadequate in winter, and sun exposure requires care due to the skin cancer risk. I'm following a recommendation to supplement with 2,000 units a day. I've been using a relatively inexpensive off-the-shelf pure vitamin D3 supplement available at my local drug store, but I just got my vitamin D test results back and I'm only at 54 (Quest test: vitamin D 1,25-Dihydroxy). While that's at the upper end of the reference range, it's not that impressive at the end of the summer. I understand there is substantial variation in the quality of D3 supplements, and I plan to switch. (I also get supplemental D3 as part of a calcium/D3 supplement to help prevent a decrease of bone density for patients on hormonal blockade therapy.)

The quality of saw palmetto supplements is so varied that it may explain the fact that results of studies of the effect of saw palmetto supplements on prostate cancer are all over the map. Permixon, a European brand, has been extensively studied and its quality confirmed.

Jim

Posted at 4:37PM on Sep 12th 2006 by Jim Waldenfels

3. Before we put this issue to bed with a healthy diet, consider the example of folic acid. Before it was discovered that folic acid prevented birth defects, there were simply a lot more birth defects. Nowadays, pregnant women could get folic acid through a healthy diet, but in acknowledgement of the pitfalls of the diet recommendation alone, they are advised to take folic acid as a preventive supplement to decrease the likelihood of birth defects. It is impossible to foresee whether an intervention will ultimately end up protecting one person, but it is entirely possible to see population-wide reductions in defects, or any better outcome - let's say GI illnesses in the case of addition to chemicals in water, or exercise in cardiovascular disease - clear population improvements, weighed against potential harm and expense of the intervention, OFTEN indicate individuals using preventive measures, with foreseeable better outcomes on population levels (to clarify the analogy - wouldn't you rather be in the "good arm" of a clinical trial, knowing that even in that arm not everyone improves?).

In my opinion, as science progresses, we should put more money and research into prevention. In the meantime, we are exposed to more and more carcinogens in our lives, and should try to do everything we can to prevent cancer. It is hard to tell what works and what doesn't because of the way research works in this country, and yes, green tea should not be allowed to contain lead, (also: be wary of who is funding a single study before you take its results to heart), but let's face it, the overall death toll from supplements does not even approach that of prescription drugs. It seems rash to close oneself off to an area with such promise that is being understood more and more each day. The latest body of evidence available would not support individuals abandoning supplementation (p.s. I researched cancer prescription drugs for a living for several years).

Posted at 4:28PM on Sep 15th 2006 by LeeAnne