Proposed Pharmacy Bill – Unjustified

The Consumers Association of Penang is disappointed at the Ministry of Health’s decision not to separate the roles of dispensing and prescribing.  Cleared the Ministry of Health has bowed down to the pressure of the powerful medical lobby in refusing to create a system of separation of duties in prescription and dispensing. Separation of dispensing and prescribing is the norm in developed countries. It is most ironic that a nation aspiring to attain high-income status by 2020 takes a retrogressive stand in healthcare practices.

It is completely unjustifiable to say that this is to cater to the needs of patients especially in rural areas. Countries like India and Indonesia with large rural populations have long practised separation of dispensing and prescribing with no issues. It is the universal norm that doctors diagnose and prescribe while pharmacists audit and dispense. To make a policy decision and legislate against this universal practice is absolutely mind-boggling and unfair. On what basis does the Ministry of Health deny a profession of its fundamental role?

What should be of paramount importance to the Ministry of Health as custodians of public health  is medication safety – which has been identified by leading health organisations like World Health Organisation, US Food and Drug Safety and UK’s National Health Safety as the main priority in addressing patient safety challenges.

A 2007 US Institute of Medicine report showed that medication errors originate most often during the medication prescribing process. At least half of these prescribing errors are detected and corrected when pharmacists review the safety and appropriateness of the medication.  Having the same doctor prescribe and dispense as in Malaysia eliminates that safety net.

Standards of general practice in Malaysia are still not up to international mark. We still have doctors not labelling their medications and giving patients just a plastic envelope with some pills in it.  It is also common practice that the staff handling medications is not trained for the job.  Hence there is no check for the safety and appropriateness of the prescription and any potential-medication related problems. This should be the primary concern of the Ministry of Health.

CAP urges the Attorney-General to reject this bill as it contravenes the basic principle of medication safety.

Press Statement, 27 September 2017

Fast Food Chains Must Stop Feeding Us with Meats Sourced from Antibiotic-Fed Animals

On the occasion of World Consumers Rights Day the Consumers Association of Penang calls on the authorities to ban the use of antibiotics in animal feed.

We also call on the fast food chains to stop feeding Malaysians with meats sourced from antibiotic-fed farm animals.

The European Union and many countries have banned the non-medical use of antibiotics in animal feeds to combat the crisis caused by antibiotic resistance. Many antibiotics, including the most potent ones, are becoming increasingly ineffective against diseases – causing a global public health crisis.

Antibiotics are routinely introduced in animal feeds as growth promoters. In the US, 70% of antibiotics are used for animals. In Malaysia the use of antibiotics in animal feeds continues unabated.

Consumers International, the global umbrella body for consumer associations around the world, launched a report which highlighted the failure of fast food chains to phase out the selling of products made of meats from animals raised with the routine use of antibiotics.

According to the report, McDonald’s has commitments in only 2 (US and Canada) out of the 100 countries they operate in.

KFC has made no meaningful commitment and Subway has made a commitment in only 1 out of the 111 countries which they operate in.

In Malaysia, there is sufficient evidence to show that antibiotic resistant bacteria are present in the many food products sold in Malaysia.

The Department of Veterinary Services in 2012 found that half of domestic chickens tested were found to be resistant to 3 types of antibiotics. Imported chickens have even higher levels of antibiotic resistance, with 50-87% of them having resistance to different types of antibiotics.

Furthermore, 75% of live chickens sold at wet markets in Selangor tested positive for Campylobacter. And 25-95% of the bacteria were resistant to different types of antibiotics. More than a third of bacteria samples showed multidrug resistance.

Frozen burger patties taken from supermarkets and retail shops showed the presence of multidrug-resistant strains of Listeria monocytogenes in nearly half of the samples.

The routine overuse of antibiotics in animal farms in Malaysia is not surprising.  During a CAP survey in Kedah and Perlis, we found the antibiotic erythromycin to be widely available in shops selling animal feed. We were told that the antibiotic should be routinely fed to the animals as a growth promoter.

Erythromycin is also used for treatment of diseases in human beings. In the same survey we could also buy erythromycin at pharmacies in the rural areas without a prescription, flouting our laws

Antimicrobial or antibiotic resistance is one of the most serious health threats Malaysia faces. Infections from resistant bacteria are now common and some pathogens have even become resistant to multiple types or classes of antibiotics. With the increasing ineffectiveness of ‘drugs of last resort’, we are on the brink of a public health disaster.

Left unchecked, antibiotic resistance will kill 10 million a year in 2050. It is expected to kill 4.73 million in Asia alone.

In view of the catastrophic antibiotic resistance crisis, CAP urges the Ministry of Health and Agriculture to:

·         Ban antibiotics use in animal feeds in light of the EU ban on antibiotics in animal feed

·         Create a national system to monitor antibiotic use and abuse in food animals

·         Educate and train livestock farmers on the responsible use of antibiotics

CAP also calls upon consumers to stop patronizing fast food chains that are not phasing out the use of meats from antibiotic-fed farm animals.

To reduce their exposure to antibiotic residues and antibiotic resistant bacteria, consumers should avoid taking fast foods and reduce their intake of meat.

Press Statement, 15 March 2016

Antioxidants – Food’s amazing healing powers

broccoliThere's something magic in food that can save you from virtually every disease and it’s described in one word: antioxidants. Here’s what everyone should know about this miracle food substance.
Antioxidants are basically nature’s anti-ageing medicine. It protects against free radical damage in the body. Free radicals are unstable, high-energy, electrically charged molecules that can damage DNA and cell membranes. Cell damage of this sort could increase the risk of cancer and countless other illnesses.

Here’s how cell damage happens. Oxygen, the very stuff that gives life, can also take it away. Our cells are continually besieged by toxic forms of oxygen, causing bodily deterioration. Attacks by continual bursts of oxygen reactions, or destructive oxygen reactions in the body, clog arteries, turn cells cancerous, make joints give out and make the nervous system malfunction.

This process, called oxidation, is so gradual and internally painless, occurring over years in incessant microsecond bursts of destruction, that you don’t notice it until the cumulative damage gives rise to what we call symptoms of disease — inflammation, failing vision, chest pain, poor concentration and cancer.

Many destructive oxidants, which cause this process, come from the environment (eg: air pollutants, toxic industrial chemicals, pesticides, cigarette smoke and drugs).

The good news is that there is a way to slow down the destructive process — by feeding your cells antioxidant food compounds, mostly from plant food (fruits and vegetables) that strike down, intercept and extinguish rampaging oxygen molecules and even repair some of the damage.

Scientists have discovered an array of potent plant antioxidants with exotic names like quercetin, lycopene, lutein and glutathiones as well as the more familiar nutrients like Vitamins C and E, beta carotene and the trace mineral selenium that can save you from many health misfortunes.

These and many other substances in food may play a role in helping to prevent diseases such as cancer, cardiovascular disease, macular degeneration, and Alzheimer’s disease as they have the ability to neutralise free radicals, which are toxic by-products of natural cell metabolism.

The human body also produces antioxidants, but the process is not 100% effective and that effectiveness declines with age. Hence intake of antioxidants is highly advisable.

But studies show that you need to eat antioxidants as food, not swallow its extract in pill form. Research indicates there is little benefit from ingesting supplements. A better way, according to nutritionists at the Mayo Clinic, Rochester, Minnesota, US, is eating a diet rich in antioxidant-containing foods (USA Today, February 2008).

Food, rather than supplements, may boost antioxidant levels because they contain an unmatchable array of antioxidant substances. A supplement may contain a single type of antioxidant or even several. However, foods have thousands of different kinds, and it is not known which of these substances confer the benefits.

Take for example, carotenoids [responsible for the red, orange, and yellow hues of plant leaves, fruits, and flowers (as well as the colours of some birds, insects, fish, and crustaceans)], which are potent antioxidants. Some 600 different carotenoids are known to occur naturally, and new carotenoids continue to be identified.

Some examples of carotenoids include: Lycopene (that gives tomatoes their red colour), lutein and zeaxanthin (in corn and in leafy greens such as kale and spinach) and beta carotene (in carrots, spinach, peaches and sweet potatoes) alpha-carotene (found in carrots, pumpkin, and red and yellow peppers) and cryptoxanthin (from oranges, tangerines, peaches, nectarines, and papayas).

Similarly, about 600 variations of the antioxidant flavonoids, anthocyanins (colour pigments found in red/purplish fruits and vegetables, including purple cabbage, beets, blueberries, cherries, raspberries and purple grapes) exist naturally in nature.

Anthocyanins: Many Medicinal Values

Anthocyanins, an antioxidant that has received less attention than other flavonoids, has far-reaching effects. According to a report in Nutrition Science News (December 2001), many anthocyanins found in common foods, protect against a variety of oxidants through a number of mechanisms.

For example:
• Red cabbage anthocyanins protect animals against oxidative stress from the toxin paraquat.
• Cyanidins, found in most fruit sources of anthocyanins, have been found to “function as a potent antioxidant in vivo” in recent Japanese animal studies.
• In other animal studies, cyanidins protected cell membrane lipids from oxidation by a variety of harmful substances.
• Additional animal studies confirm that cyanidin is 4 times more powerful an antioxidant than Vitamin E.
• The anthocyanin pelargonidin protects the amino acid tyrosine from the highly reactive oxidant peroxynitrite.
• Eggplant contains a derivative of the anthocyanidin called nasunin, which interferes with the dangerous hydroxyl radical-generating system — a major source of oxidants in the body.

Studies show anthocyanins’ positive influences on a variety of health conditions. One reason is their anti-inflammatory properties, which affect collagen and the nervous system — as well as the heart.

In studies, protection from heart attacks through administration of grape juice or wine was strongly tied to the ability of the anthocyanin-rich products to reduce inflammation and enhance capillary strength and permeability, and to inhibit platelet formation and enhance release of nitric oxide (a chemical produced in the lining of the blood vessel, which is important for heart health).

Here’s how this antioxidant works for some health conditions.

In the course of inflammation, enzymes damage connective tissue in capillaries, causing blood to leak into surrounding tissues. Oxidants are released and further damage blood-vessel walls.

Anthocyanins protect in several ways. First, they neutralise enzymes that destroy connective tissue. Second, their antioxidant capacity prevents oxidants from damaging connective tissue. Finally, they repair damaged proteins in the blood-vessel walls.

Animal experiments have shown that anthocyanins effectively prevents inflammation and subsequent blood-vessel damage.

Anthocyanins’ anti-inflammatory ability has been shown to help dampen allergic reactions. In one study, Bulgarian researchers gave animals histamine and serotonin, both of which cause allergic reactions and increase capillary permeability. The animals were supplemented with a variety of flavonoids. Anthocyanins were found to have the strongest anti-inflammatory effect of any flavonoid tested.

Brain and Neurodegenerative Diseases.
Anthocyanins’ effects on inflammation help explain many of their protective effects elsewhere in the body. The brain is particularly vulnerable to oxidative damage. Test-tube studies show that nasunin protects lipids in animal brain tissue from oxidation.

Anthocyanins may have other potential benefits for humans. In the laboratory, they have been found to inhibit some human tumour cells. Cyanidin and delphinidin inhibit epidermal growth factor receptor in cancer cells, while malvidin is less effective.

Anthocyanins also have the ability to protect both large and small blood vessels from oxidative damage, including microvessel damage from high blood-sugar levels that cause complications in diabetics (In diabetic retinopathy, which damages eyesight, leaking, damaged capillaries is a chief cause).

It is a formidable antagonist to the following diseases:

One of the most serious diabetic complications is retinopathy, which can cause blindness. Retinopathy occurs when the body attempts to repair leaking, damaged capillaries, but does so by overproducing abnormal proteins.

Anthocyanins not only prevent capillaries from leaking in the first place, they also prevent abnormal protein proliferation. In one Italian study, 30 out of 40 people with retinopathy showed significant improvement after taking anthocyanin daily for several weeks. None of the control subjects improved.

Because they protect large blood vessels, anthocyanins are excellent atherosclerosis (diseased and clogged arteries) fighters — in fact, it is the first line of defence against atherosclerosis. Anthocyanins prevent a key step in atherogenesis, oxidation of low-density lipoproteins (LDL — ie “bad” cholesterol, associated with arterial plaque formation). In test tube studies, bilberry* (a type of berry popular in the west) in even trace amounts effectively protects against LDL oxidation.

(*Researchers in a US Department of Agriculture-funded study concluded that bilberry is a “more potent” antioxidant than Vitamin C, or BHT (commonly used as a preservative).

Foetal retardation
In a human study conducted in Europe, researchers found that 55 women with intrauterine growth retardation (which manifests as a decreased rate of foetal growth), who took anthocyanins, experienced decreased oxidated LDL levels by almost 1½ times in 2 months. LDL levels rose in the control group.

Popular Folk Medicine
The use of anthocyanins for therapeutic purposes has long been supported by both epidemiological and anecdotal evidence.

The roles of anthocyanin pigments as medicinal agents have been well accepted in folk medicine throughout the world, and, in fact, these pigments are linked to an amazingly broad-based range of health benefits.

For example, anthocyanins from Hibiscus sp have historically been used in remedies for liver dysfunction and hypertension; and bilberry (Vaccinium) anthocyanins have an anecdotal history of use for vision disorders, microbial infections, diarrhoea, and diverse other health disorders. [Source: Journal of Biomedicine and Biotechnology, 2004; 1 December, 2004(5): 306-313]

Most Potent in Its Natural Form
"In terms of biological activity in the human body, an anthocyanin pigment is (almost) never acting independently. Typically, anthocyanins and other flavonoid components, or anthocyanins and other nonflavonoid phytochemicals, are interacting together in order to provide full potency … There are over 4,000flavonoids … with … large complex structures in the mixtures. Bioflavonoids like anthocyanins occur in mixtures within edible foods … Any plant containing anthocyanins includes a complex phytochemical cocktail.” says Mary Ann Lila from the Department of Natural Resources & Environmental Sciences, College of Agricultural Consumer and Environmental Sciences, University of Illinois, US.

For complete nutrition insurance, it is thus best to eat foods rather than supplements.

Antioxidant-rich foods also offer an array of health benefits, such as being high in fibre, protein, and other vitamins and minerals and low in saturated fat and cholesterol.

Though supplements containing antioxidants generally are considered safe, it’s best to avoid them as studies have now determined that they may not offer the same protection as food source antioxidants and may, in fact, be harmful, or toxic in higher doses (as is the case for Vitamin E).

Food: Best Antioxidant Insurance
Antioxidants are found in many foods. These include fruits and vegetables, nuts, grains, and some meats, poultry and fish. Some of the better food sources are:

  • Berries (blueberries, blackberries, raspberries, strawberries, and cranberries) (Note: Berries were a large part of early man’s diets. Our ancestors probably ate far more anthocyanins than we do. Some researchers feel that, by comparison, we are deficient in anthocyanins.)
  • Beans (small red beans and kidney, pinto, and black beans)
  • Fruits (many apple varieties with peels, avocados, cherries, green and red pears, fresh or dried plums, pineapple, oranges, and kiwi)
  • Vegetables (artichokes, spinach, red cabbage, red or white potatoes with peels, sweet potatoes, and broccoli)
  • Beverages (green tea, coffee, red wine, and many fruit juices)
  • Nuts (walnuts, pistachios, pecans, hazelnuts, and almonds)
  • Herbs (ground cloves, cinnamon or ginger, dried oregano leaf, and turmeric powder)
  • Grains (oat-based products)
  • Dessert (dark chocolate)

Cooking Methods and Antioxidant Levels
Some vegetable cooking methods may be better than others when it comes to maintaining beneficial antioxidant levels, according to a study in the Journal of Food Science. Results showed that, depending on the vegetable, cooking on a flat metal surface with no oil (griddling) maintained the highest antioxidant levels.

Researchers at the University of Murcia and the University of Complutense in Spain examined how various cooking methods affected antioxidant activity by analysing 6 cooking methods with 20 vegetables.

The 6 cooking methods were boiling, pressure-cooking, baking, microwaving, griddling and frying. Their findings showed the following:

  • The highest antioxidant loss was observed in cauliflower after boiling and microwaving, peas after boiling, and zucchini after boiling and frying
  • Green beans, beets and garlic were found to keep their antioxidant levels after most cooking treatments
  • The vegetables that increased their antioxidant levels after all cooking methods were green beans (except green beans after boiling), celery and carrots
  • Artichoke was the only vegetable that kept its high antioxidant level during all the cooking methods

Griddle-cooking helped maintain the highest levels of antioxidants, produced the lowest losses while “pressure-cooking and boiling [led] to the greatest losses, says lead researcher A. M. Jiménez-Monreal.

“In short, water is not the cook’s best friend when it comes to preparing vegetables.” (Source: Institute of Food Technologists)


For more information on Foods to Prevent Cancer, Foods to Prevent Heart Disease and Food Better Than Supplements, please see Utusan Konsumer May-June 2009.

Read about how protective foods like fruits and vegetables give us the antioxidants that we need in the CAP Guides, Fruits – A Nutrition Guide and Vegetables – A Nutrition Guide

What our ancestors knew about food

Our early ancestors ate plants and fruits that had therapeutic effect on the body as well as providing nutrition. Since the dawn of civilisation, man has relied on the forests, fields and gardens for medicines.

Early physicians who used food as the mainstay prescription against disease knew nothing of germs they could not see, or of hormones or cholesterol, and how painkillers and anticoagulants actually work, let alone how to test foods for such pharmacological properties.  

What they knew — from their own experience and that of their ancestors and kisnpeople — is that Mother Nature is the greatest pharmacist.

– In ancient Egypt, consumption of cabbage was considered a cure for as many as 87 diseases; consumption of onions could cure 28.  Cruciferous vegetables (cabbage and broccoli) were cultivated primarily for medicinal purposes and were used therapeutically against headache, deafness, diarrhoea, gout and stomach disorders.

– The ancient Romans believed that lentils were a cure for diarrhoea and conducive to an even temper.  Raisins and grapes had many medicinal uses and were incorporated into oral preparations, enemas, inhalations, and topical applications.

– In ancient China, the legendary Shen Nong (who is credited with introducing agriculture to China), was said to have tasted all the plants and waters to know which was poisonous or beneficial. In the course of his experiments, he was poisoned at least 70 times.

– In the 11th century, a king named Tang from the Shang dynasty was reputed to have a cook who cooked soups for the king when he was ill. The soups were credited with bringing the king back to health.

Food as a healer in Chinese culture

The Chinese have a proverb, “Whatsoever was the father of a disease, an ill diet was the mother”.  Food’s extraordinary effects on bodily functions have long been known and acknowledged in Chinese culture.  The Chinese believe that ordinary food can be used as remedies.  

In his book, Eating Your Way to Health, Cai Jingfeng shares some of the Chinese food therapies for health.

Neutral food

– Black beans — to blacken hair and to ease post-partum pain
– Soybeans — for anaemia, asthma and to promote lactation
– Carrots — to prevent night blindness and promotes digestive function
– Chrysanthemum — for fever, also relieves dizziness

Cold food

– Banana — for constipation and haemorrhoids
– Freshwater clams — for fever and detoxifying
– Cucumber — for fever, sore throat and red eyes
– Pear — for thirst and constipation

Cool food

– Bitter almond  for chronic bronchitis
– Celery — for hypertension
– Duck — hypertension with dizziness
– Watermelon — for sore throat and to relieve summer heat

Hot food

– Chili — to stimulate the appetite
– Black and white pepper — warm up the body
– Clove — warms the spleen and stomach, stops vomiting

Warm food

– Aniseed — relieves intestinal spasm
– Beef — for the tendons and bones
– Garlic — for dysentery
– Coriander — for skin rashes

From ancient cure to modern medicine

Today mainstream scientists are increasingly reaching back to the truths of ancient folk medicine and dietary practices for clues to remedies and antidotes for our modern diseases.  

Serge Renaud, a biologist and epidemiologist at INSERM, the French government main research institution was once quoted as saying, “(T)wo millenia ago, the Greeks were eating a delicious diet as healthful as any we now know in the world … we have to look at Mother Nature and see what people have been doing for thousands of years.”

Countless scientific tests now confirm that foods can act as anticoagulants, antidepressants, antiulcerants, antithrombotics, analgesics, tranquilisers, sedatives, cholesterol reducers, cancer fighters and cancer chemopreventives, hormones, fertility agents, laxatives, antidiarrhoeal agents, immune stimulators, biological response modifiers, antihypertensives, diuretics, decongestants, anti-inflammatory agents, antibiotics, anti-viral agents, anti-nausea agents, cough suppressants, blood vessel dilators, bronchial dilators and so on (Carper, 1993).

The result: Food is being redefined by science as a powerful medicine — medicine you can use in preventing and curtailing diseases of all kinds and in boosting mental and physical energy, vigour and well-being.

Food: A reliable therapy

– “There is hardly a health problem or natural bodily process that is not influenced in some fashion by the substances you put in your mouth.  Make no mistake about it — eating is not a trivial event for the billions upon billions of cells that constitute your being.  The act of eating is of great consequence, a communion with nature that promotes life or death.”
~ Jean Carper in Food — Your Miracle Medicine

– “Diet has the distinction of being the only major determinant of health that is completely under your control.  You have the final say over what does and does not go into your mouth and stomach.  You cannot always control the other determinants of health, such as the quality of the air you breathe, the noise you are subjected to, or the emotional climate of your surroundings, but you can control what you eat.  It is a shame to squander such a good opportunity to influence your health.”
~ Andrew Weil, M.D. in Natural Health, Natural Medicine

– “Let your food be your medicine and your medicine be your food.”
~ Hippocrates, father of modern medicine (460-359 BC)

For stories and reflections on nature by the ancients, thinkers and ecologists, read the CAP Guide, Natural Wisdom

Foods to prevent cancer

Taking supplements does nothing to fight cancer. In some cases, some supplements can be downright unsafe.  In January 2009, an editorial in The Journal of the National Cancer Institute (JNCI) noted that most trials had shown no cancer benefits from vitamins.  Several large credible studies, including research into the effects of Vitamins C and E and beta carotene, found the supplements did not seem to help prevent cancer.
“What we’re seeing is many of them (supplements) are not appearing to be beneficial in the way that we had anticipated and could be harmful,” said Professor Jane Figueiredo, assistant professor of preventative medicine at the University of Southern California’s Keck School of Medicine in Los Angeles (Globe and Mail, 11.3.09).

“The prospects for cancer prevention through micronutrient supplementation have never looked worse,” said Alan Kristal of the Fred Hutchinson Cancer Research Center in Seattle and Scott Lippman of the department of thoracic/head and neck medical oncology at the University of Texas M.D. Anderson Cancer Center. (Source: Globe and Mail)

What is not useful for cancer
Where cancer is concerned, based on scientific evidence, the following supplements belong in the trash:

Folic acid supplements — may promote cancer.  Several studies have associated folic acid, a B vitamin, with lower risk for some cancers. However, like several other vitamins, there is evidence that folic acid may be protective in moderate doses, but when consumed at very high amounts, may actually promote cancer. New research suggests that men who take folic acid supplements may be putting themselves at significantly greater risk for developing prostate cancer.

Beta carotene supplements – useless against cancer. Two independent studies showed that beta carotene supplements increased lung cancer risk in smokers. In December 2007 the American health advocacy group Center for Science in the Public Interest petitioned the Food and Drug Administration to require labels on beta-carotene supplements warning smokers about the risk. Beta carotene supplements also increased the risk of other cancers, heart attack, and stroke. But foods that contain beta carotene seem to reduce cancer risk.

Vitamins C and E supplements – won’t help prevent cancer.  This was the finding of a large long-term clinical trial in the US.  

What Experts Say

Eat Whole Foods. Not isolated compounds in supplements.  And eat a variety of foods.  Food is very complex.  There isn’t a single element in a particular food that does all the work in fighting disease.  Vitamins and nutrients in food interact with each other to produce benefits greater than any single one can deliver. Many health groups and experts recommend consuming antioxidants (eg: Vitamins C and E), through foods instead of supplements.  (Antioxidants are substances that may protect the body’s cells against free radical damage, which contributes to heart disease, cancer and other diseases.)  

They also recommend exercise and other lifestyle measures to beat cancer.

Here’s what they say:

  •  American Cancer Society nutritional epidemiologist Marjorie McCullough, ScD: “It is an old-fashioned message but it is important to eat a variety of foods, including plenty of fruits and vegetables.  If people really would do this it would go a long way to ensuring that they get the nutrients and phytochemicals that may be important for reducing their cancer risk.”
  •  Jennifer Crum, a nutritionist at the New York University Cancer Institute: “When you take the nutrient out of its natural environment, it may not be protective … When people make small changes for their health — exercising for 20-30 minutes a day, eating better — we see lower rates of cancer recurrence.” (Useful Tip: Begin by making small changes, such as exercising a little bit longer or adding another vegetable a day to your diet.)
  •  Dr Howard Sesso, assistant professor of medicine in the division of preventive medicine at Brigham and Women’s Hospital in Boston, US: “There are things we know about cancer prevention: eat a well-balanced diet, maintain a healthy weight, don’t smoke, and exercise regularly.”
  •  The American Institute for Cancer Research (AICR) recommends seeking cancer protection from a diet high in a variety of plant foods instead of relying on dietary supplements.

At the AICR’s annual research conference on 6 November 2008, a panel of leading scientists discussed the state of the evidence on dietary supplements and their effects on cancer risk and concluded that getting nutrients from whole foods rather than dietary supplements is best.

Robert S. Chapkin, Ph.D., of Texas A&M University, who specialises in research on omega-3 fatty acids in fish, said nutrients in whole foods may work together with dietary fibre to “superactivate the system”, and increase cancer protection in the large intestine by triggering a response that attacks damaged cells.

A protective set of reactions occur in the body when phytochemicals from broccoli (isothiocyanates) and garlic (organosulfur compounds) are eaten. Shivendra V. Singh, Ph.D., of the University of Pittsburgh discussed evidence indicating that these substances are more than just antioxidants.  Under certain conditions they exhibit pro-oxidant effects in ways that seem to specifically target tumour cells.

What to Eat

What can you eat to prevent cancer? The US non-profit Cancer Cure Foundation recommends the following foods, which have the ability to help stave off cancer and some can even help inhibit cancer cells.

  •  Avocados are rich in glutathione, a powerful antioxidant that attacks free radicals in the body by blocking intestinal absorption of certain fats. They also supply even more potassium than bananas and are a strong source of beta-carotene. Scientists also believe that avocados may also be useful in treating viral hepatitis (a cause of liver cancer), as well as other sources of liver damage.
  •  Broccoli, cabbage and cauliflower have a chemical component called indole-3-carbinol that can combat breast cancer by converting a cancer-promoting estrogen into a more protective variety. Broccoli also has the phytochemical sulforaphane, a product of glucoraphanin — believed to aid in preventing some types of cancer, like colon and rectal cancer. Sulforaphane induces the production of certain enzymes that can deactivate free radicals and carcinogens. The enzymes have been shown to inhibit the growth of tumours in laboratory animals. 
  •  Carrots contain a lot of beta carotene, which may help reduce a wide range of cancers including lung, mouth, throat, stomach, intestine, bladder, prostate and breast. Some research indicated beta carotene may actually cause cancer, but this has not proven that eating carrots, unless in very large quantities (2-3 kg a day), can cause cancer. In fact, a substance called falcarinol that is found in carrots has been found to reduce the risk of cancer, according to researchers at Danish Institute of Agricultural Sciences. In tests, isolated cancer cells grow more slowly when exposed to falcarinol.
  •  Chilli peppers contain a chemical, capsaicin, which may neutralise certain cancer-causing substances (nitrosamines) and may help prevent cancers such as stomach cancer.  At a cellular level, capsaicin induces a state called apoptosis (programmed cell death) in the cancer cells. You could say that it causes the cancer cell to commit suicide.
  •  Cruciferous vegetables (eg: broccoli, cauliflower, kale, Brussels sprouts, and cabbage) contain two antioxidants, lutein and zeaxanthin that may help decrease prostate and other cancers.
  •  Flax contains lignans, which may have an antioxidant effect and block or suppress cancerous changes. Flax is also high in omega-3 fatty acids, which are thought to protect against colon cancer and heart disease.
  •  Garlic has immune-enhancing allium compounds (dialyl sulfides) that appear to increase the activity of immune cells that fight cancer and indirectly help break down cancer-causing substances. These substances also help block carcinogens from entering cells and slow tumour development. Diallyl sulfide, a component of garlic oil, has also been shown to render carcinogens in the liver inactive. Studies have linked garlic — as well as onions, leeks, and chives — to lower risk of stomach and colon cancer. Dr Lenore Arab, professor of epidemiology and nutrition at the UNC-CH (University of North Carolina at Chapel Hill) schools of public health and medicine and colleagues analysed a number of studies and reported their findings in the October 2000 issue of the American Journal of Clinical Nutrition. According to the report, people who consume raw or cooked garlic regularly face about half the risk of stomach cancer and two-thirds the risk of colorectal cancer as people who eat little or none. Their studies didn’t show garlic supplements had the same effect. It is believed garlic may help prevent stomach cancer because it has anti-bacterial effects against a bacterium, Helicobacter pylori, found in the stomach and known to promote cancer there.
  •  Grapefruits, like oranges and other citrus fruits, contain monoterpenes, believed to help prevent cancer by sweeping carcinogens out of the body. Some studies show that grapefruit may inhibit the proliferation of breast-cancer cells in vitro. They also contain Vitamin C, beta-carotene, and folic acid.
  •  Red grapes contain bioflavonoids, powerful antioxidants that work as cancer preventives. Grapes are also a rich source of resveratrol, which inhibits the enzymes that can stimulate cancer-cell growth and suppress immune response. They also contain ellagic acid, a compound that blocks enzymes that are necessary for cancer cells — this appears to help slow the growth of tumours.
  •  Studies show that consumption of green and yellow leafy vegetables has been associated with lower levels of stomach cancer.
  •  Kale has indoles, nitrogen compounds which may help stop the conversion of certain lesions to cancerous cells in estrogen-sensitive tissues. In addition, isothiocyanates, phytochemicals found in kale, are thought to suppress tumour growth and block cancer-causing substances from reaching their targets.
  •  Mushrooms — A number of mushrooms appear to help the body fight cancer and build the immune system — eg: Shiitake, maitake, reishi, Agaricus blazei Murill, and Coriolus Versicolor.  These mushrooms contain polysaccharides, especially lentinan, powerful compounds that help in building immunity. They are a source of beta glucan. They also have a protein called lectin, which attacks cancerous cells and prevents them from multiplying. They also contain thioproline. These mushrooms can stimulate the production of interferon in the body. Extracts from mushrooms have been successfully tested in recent years in Japan as an adjunct to chemotherapy. The best-selling cancer medicine PSK (Protein-bound polysaccharide) is made from the Coriolus Versicolor. Maitake mushroom extract is PCM4 (an over-the-counter food supplement promoted for cancer in the US and Europe).
  •  Nuts contain the antioxidants quercetin and campferol that may suppress the growth of cancers. Nuts are one of nature’s best sources of selenium. (Brazil nut, for example, contains 80 micrograms of selenium, which is important for those with prostate cancer.) Selenium has been shown to improve the efficiency with which DNA repairs itself after exposure to damaging free radicals. Nuts also contain omega-3 fatty acid. The omega-3 fatty acids block a protein that has been shown to increase sensitivity to carcinogens in laboratory studies. (Note: Some people are allergic to the proteins in nuts, so if you have any symptoms such as itchy mouth, tight throat, wheezing, etc, after eating nuts, stop and seek help to eliminate this allergy.)
  •  Oranges and lemons contain limonene which stimulates cancer-killing immune cells (lymphocytes, for example) that may also break down cancer-causing substances.
  •  Papayas have Vitamin C that works as an antioxidant and may also reduce absorption of cancer-causing nitrosamines from the soil or processed foods. Papaya contains folacin (also known as folic acid), which has been shown to minimise cervical dysplasia and certain cancers.
  •  Raspberries contain many vitamins, minerals, plant compounds and antioxidants known as anthocyanins that may protect against cancer. According to a study reported by Cancer Research in 2001, rats fed diets of 5-10% black raspberries saw the number of esophageal tumours decrease by 43-62%. Research reported in the journal Nutrition and Cancer in May 2002 shows black raspberries may also thwart colon cancer. Black raspberries are rich in antioxidants, and are thought to have even more cancer-preventing properties than blueberries and strawberries.
  •  Seaweed & other sea vegetables contain beta-carotene, protein, Vitamin B12, fibre, and chlorophyll, as well as chlorophylones – important fatty acids that may help in the fight against breast cancer. Many sea vegetables also have high concentrations of the minerals potassium, calcium, magnesium, iron and iodine.
  •  Soy products like tofu contain several types of phytoestrogens — weak, nonsteroidal estrogens that could help prevent both breast and prostate cancer by blocking and suppressing cancerous changes. There are a number of isoflavones in soy products, but research has shown that genistein is the most potent inhibitor of the growth and spread of cancerous cells. It appears to lower breast-cancer risk by inhibiting the growth of epithelial cells and new blood vessels that tumours require to flourish and is being scrutinised as a potential anti-cancer drug.  However, there are some precautions to consider when adding soy to your diet. Eating up to 4-5 ounces of tofu or other soy a day is probably ok, but research is being done to see if loading up on soy could cause hormone imbalances that stimulate cancer growth.
  •  Sweet potatoes contain many anticancer properties, including beta-carotene, which may protect DNA in the cell nucleus from cancer-causing chemicals outside the nuclear membrane.
  •  Teas. Green tea and black tea contain certain antioxidants known as polyphenols (catechins) which appear to prevent cancer cells from dividing. Green tea is best, followed by black tea (herbal teas do not show this benefit). According to a report in the July 2001 issue of the Journal of Cellular Biochemistry, these polyphenols that are abundant in green tea, red wine and olive oil, may protect against various types of cancer. Dry green tea leaves, which are about 40% polyphenols by weight, may also reduce the risk of cancer of the stomach, lung, colon, rectum, liver and pancreas, study findings have suggested. Green tea also contains the phytochemical epigallocatechin gallate (EGCG), which binds to a protein found on tumour cells and dramatically slows their growth.
  •  Tomatoes contain lycopene, an antioxidant that attacks roaming oxygen molecules, known as free radicals, that are suspected of triggering cancer. It appears that the hotter the weather, the more lycopene tomatoes produce. They also have Vitamin C, an antioxidant which can prevent cellular damage that leads to cancer. Watermelons, carrots, and red peppers also contain these substances, but in lesser quantities. It is concentrated by cooking tomatoes.  Scientists in Israel have shown that lycopene can kill mouth cancer cells. An increased intake of lycopene has already been linked to a reduced risk of breast, prostate, pancreas and colorectal cancer. (Note: Recent studies indicate that for proper absorption, the body also needs some oil along with lycopene.)
  •  Tumeric (curcuma longa), a member of the ginger family, is believed to have medicinal properties because it inhibits production of the inflammation-related enzyme cyclo-oxygenase 2 (COX-2), levels of which are abnormally high in certain inflammatory diseases and cancers, especially bowel and colon cancer. In fact, a pharmaceutical company Phytopharm in the UK hopes to introduce a natural product, P54, that contains certain volatile oils, which greatly increase the potency of the tumeric spice.

According to a report in Medical News Today (29 March 2007), the following foods also show promise against cancer.  

  •  High-fibre foods.  A dietary component found in most whole grain foods, beans, nuts and other high-fibre items shows promise in animal studies as a potent weapon for preventing prostate cancer. The compound, inositol hexaphosphate (IP6), was fed to animal models of prostate cancer and resulted in up to a 66% reduction in tumour size in comparison to control animals that were given water instead, says Rajesh Agarwal, Ph.D., a professor in the Department of Pharmaceutical Sciences at the University of Colorado Health Sciences Center in Denver, in the US.
  •  Apple juice.  Drinking cloudy apple juice (unfiltered apple juice, along with its fibre) daily may help prevent colon cancer.  Researchers in Germany say that drinking 2-3 glasses of cloudy apple juice per day may help keep colon cancer at bay. In a 10-week study using a mouse model for colon cancer, animals that were fed either cloudy apple juice or a potent extract of the juice showed a 38% and 40% reduction (respectively) in benign tumours of the small intestine, an indicator of its potential to fight colon cancer, in comparison to control animals that were given water instead of juice, according to Clarissa Gerhäuser, Ph.D., a researcher with the German Cancer Research Center in Heidelberg. The anticancer effect is likely due to a potent class of antioxidants called procyanidins, the researcher says. A widely publicised recent study by a group of researchers in Poland found that cloudy apple juice also is richer in antioxidants — up to 4 times higher — than clear apple juice.
If you are a cancer patient, diet may still help. According to Science Daily (24 October 2008), preliminary findings from a 5-year US government-funded study by University of California-Riverside shows eating fruits and vegetables can improve cancer patients’ response to chemotherapy. In all cancer patients the leading cause of death continues to be the resistance of tumour cells to chemotherapy, a form of treatment in which chemicals are used to kill cells.  

Ingesting apigenin can help, the study says.  Apigenin is mainly found in fruits (including apples, cherries, grapes), vegetables (including parsley, artichoke, basil, celery), nuts and plant-derived beverages (including tea and wine). It has been shown by researchers to have growth inhibitory properties in several cancer lines, including breast, colon, skin, thyroid and leukaemia cells. It has also been shown to inhibit pancreatic cancer cell proliferation.

The study, published in the online early edition of the Proceedings of the National Academy of Sciences, suggests developing safe chemotherapy via naturally occurring agents such as apigenin.

Read about how protective foods like fruits and vegetables give us the antioxidants that we need to prevent cancer in the CAP Guides, Fruits – A Nutrition Guide and Vegetables – A Nutrition Guide