What to Look For When Checking for Breast Self

Millions of women in the world positive breast cancer and largely too late to realize it. Before the late notice, immediately do the examination early with BSE.

Someone that has no risk factors can still develop breast cancer. Screening and early detection is the right tool to reduce the risk of death caused by this disease.

Only a few risk factors that can be done to prevent breast cancer, such as avoiding hormone replacement therapy for long-term, having a child before age 30, breastfeeding, avoiding overweight with doing exercise and proper diet, and limiting alcohol consumption. There is data that suggests that vitamin A, C, and E can protect against breast cancer, but further research is needed to prove it. Currently, the most important for every woman is to lower the risk by doing a screening mammogram on a regular basis, doing breast self-exam, and see a doctor regularly.

Breast self examination (BSE) is one way to detect abnormalities in the breast. BSE can do yourself at home each month after the menstrual cycle. Make a benchmark date for the conduct BSE tests on the dates that you will remember, such as pay bills.

What must be realized while doing BSE?
1. Palpable lump.
2. Thickening of the skin.
3. Changes in size and shape of the breast.
4. Skin shrinkage.
5. Discharge from the nipple when not nursing.
6. There is pain in the breast without any obvious cause.
7. Swelling of the upper arm.
8. Palpable lump in the armpit or neck.

If abnormalities are found as described above, or feel no change compared to the situation in the previous month, then immediately consult a doctor for further examination.

Risk factors for breast cancer:
1. First got my period at age less than 10 years.
2. Experiencing menopause (menopause) after the age of 50 years.
3. Not married.
4. It never bear children.
5. First child after age 35 years.
6. Never breastfed children.
7. Have had breast surgery are caused by abnormal benign or malignant breast tumors.
8. Having a family member suffering from cancer.

The Big Sleep

This blog usually focuses on diet, because that's my specialty. But if you want Whole Health, you need the whole package: a diet and lifestyle that is broadly consistent with our evolutionary heritage. I think we all know that on some level, but a recent paper has reminded me of it.

I somehow managed to get on the press list of the Annals of Internal Medicine. That means they send me embargoed papers before they're released to the general public. That journal publishes a lot of high-impact diet studies, so it's a great privilege for me. I get to write about the studies, and publish my analysis at the time of general release, which is the same time the news outlets publish their stories.

One of the papers they sent me recently is a fat loss trial with an interesting twist (1; see below). All participants were told to eat 10% fewer calories that usual for two weeks, however half of them were instructed to sleep for 8 and a half hours per night, and the other half were instructed to sleep for 5 and a half hours*. The actual recorded sleep times were 7:25 and 5:14, respectively.

Weight loss by calorie restriction causes a reduction of both fat and lean mass, which is what the investigators observed. Both groups lost the same amount of weight. However, 80% of the weight was lost as fat in the high-sleep group (2.4/3.0 kg lost as fat), while only 48% of it was lost as fat in the low-sleep group (1.4/2.9 kg lost as fat). Basically, the sleep-deprived group lost as much lean mass as they did fat mass, which is not good!

There are many observational studies showing associations between insufficient sleep, obesity and diabetes. However, I think studies like that are particularly vulnerable to confounding variables, so I've never known quite what to make of them. Furthermore, they often show that long sleep duration associates with poor health as well, which I find highly unlikely to reflect cause and effect. I discussed one of those studies in a post a couple of years ago (2). That's why I appreciate this controlled trial so much.

Another sleep restriction trial published in the Lancet in 1999 showed that restricting healthy young men to four hours of sleep per night caused them to temporarily develop glucose intolerance, or pre-diabetes (3).

Furthermore, their daily rhythm of the hormone cortisol became abnormal. Rather than the normal pattern of a peak in the morning and a dip in the evening, sleep deprivation blunted their morning cortisol level and enhanced it in the evening. Cortisol is a stress hormone, among other things, and its fluctuations may contribute to our ability to feel awake in the morning and ready for bed at night.

The term "adrenal fatigue", which refers to the aforementioned disturbance in cortisol rhythm, is characterized by general fatigue, difficulty waking up in the morning, and difficulty going to sleep at night. It's a term that's commonly used by alternative medical practitioners but not generally accepted by mainstream medicine, possibly because it's difficult to demonstrate and the symptoms are fairly general. Robb Wolf talks about it in his book The Paleo Solution.

The investigators concluded:

Sleep debt has a harmful impact on carbohydrate metabolism and endocrine function. The effects are similar to those seen in normal ageing and, therefore, sleep debt may increase the severity of age-related chronic disorders.

So there you have it. Besides making us miserable, lack of sleep appears to predispose to obesity and diabetes, and probably sets us up for the Big Sleep down the line. I can't say I'm surprised, given how awful I feel after even one night of six hour sleep. I feel best after 9 hours, and I probably average about 8.5. Does it cut into my free time? Sure. But it's worth it to me, because it allows me to enjoy my day much more.

Keep your room as dark as possible during sleep. It also helps to avoid bright light, particularly in the blue spectrum, before bed (4). "Soft white" bulbs are preferable to full spectrum in the evening. If you need to use your computer, dim the monitor and adjust it to favor warm over cool colors. For people who sleep poorly due to anxiety, meditation before bed can be highly effective. I posted a tutorial here.

1. Nedeltcheva, AV et al. "Insufficient Sleep Undermines Dietary Efforts to Reduce Adiposity." Annals of Internal Medicine. 2010. Advanced publication.


* The study was a randomized crossover design with a 3 month washout period, which I consider a rigorous design. I think the study overall was very clever. The investigators used calorie restriction to cause rapid changes in body composition so that they could see differences on a reasonable timescale, rather than trying to deprive people of sleep for months and look for more gradual body fat changes without dietary changes. The latter experiment would have been more interesting, but potentially impractical and unethical.

Diet of Soybean Make Skin Youthful

Anyone know that soy beans are high protein. Which probably is not many people know that soy is a major source of isoflavones which have been shown to have a number of benefits for the body, one of which makes the skin stay young.

Extract in soy protein containing estrogen in the form of substances called isoflavones or phytoestrogens.
The impact of eating phytestrogen wrinkles will be reduced. Same effect as the result of hormone therapy to reduce skin aging.

Study against 26 women aged 30-40 years, known isoflavone consumption for three months proved able to withstand the conditions do not become severe wrinkles and improve skin elasticity.

In addition to changing role of estrogen, soy also functions as an antioxidant that can protect the body against cancer because it neutralizes free radicals, which originated from the polluted environment. Estrogen enough could also help fertility.

Depending Preparations

To ensure our body's cells are supplied by isoflavones, then we should eat soy-based foods every day.

Apart from tempeh, tofu and soy milk, recently more and more soy-based foods. The amount of isoflavones in soybeans varies, depending on how its processing. Flour roasted soybeans and soy isoflavones contain the highest, much higher than tempeh, tofu, or soy milk. Moreover, soy isoflavones in soy could be damaged if the product is processed by frying.

The Japanese are the most high soy consumed in Asia. On average they ate about 31 grams of soy per day. Various soy products are very popular there. For example, edamame (boiled soybeans) are commonly used as a snack.

Breast Cancer Can Be Prevented

More than a third of breast cancer cases actually do not have to happen if a woman was willing to exercise more frequently and reduce the consumption of fatty foods. Similarly, warnings delivered by health experts.

More sophisticated drug therapies, early detection and screening mammogram is able to dramatically slow the cancer, but the focus is preventive action should be campaigned through lifestyle changes.

What can be achieved maximally by screening measures have been achieved. We can not do more. It is time to move on to other things, that changes in lifestyle. According to the International Agency for Research on Cancer, the agency under the WHO, 25-30 per cent of cancer cases can be prevented, so far people more often associate with cancer genetics than lifestyle.

Genes have existed for thousands of years, but the longer the cancer cases continues to increase. Of course this has nothing to do with genes.

The experts found the majority of breast cancer get fuel from estrogen, a hormone produced by fat tissue. Therefore, experts suspect, the more overweight a person, the more estrogen they produced so that it can provide fuel for cancer. Even on skinny women, experts believe exercise can help reduce cancer risk because fat can be converted into muscle.

Breast cancer is now more leads in young women. 20 years ago cancer was more common in women over the age of 50 years, now many women aged under 30 who have breast cancer.

Lifestyle, including diet, smoking, lack of exercise, including stress in daily life haari, could be one cause of breast cancer.

Potatoes and Human Health, Part III

Potato-eating Cultures: the Quechua

The potato is thought to have originated in what is now Peru, on the shores of lake Titicaca. Native Peruvians such as the Quechua have been highly dependent on the potato for thousands of years. A 1964 study of the Quechua inhabitants of Nuñoa showed that they obtained 74% of their calories from potatoes (fresh and chuños), 10% from grains, 10% from Chenopodia (quinoa and cañihua), and 4% from animal foods. Total energy intake was 3,170 calories per day (1).

In 2001, a medical study of rural Quechua men reported an average body fat percentage of 16.4% (2). The mean age of the volunteers was 38. Body fat did increase slowly with age in this population, and by age 65 it was predicted to be about 20% on average. That's below the threshold of overweight, so I conclude that most men in this population are fairly lean, although there were a few overweight individuals.

In 2004, a study in rural Quechua women reported a body fat percentage of 31.2% in volunteers with a mean age of 35 (3). Body fat percentage was higher in a group of Quechua immigrants to the Peruvian capital of Lima. Among rural women, average fasting insulin was 6.8 uIU/mL, and fasting glucose was 68.4 mg/dL, which together suggest good insulin sensitivity and glucose control (4). Insulin and glucose were considerably lower in the rural group than the urban group. Blood pressure was low in both groups. Overall, this suggests that overweight is common among Quechua women.

Rural Quechua are characteristically short, with the average adult man standing no more than 5' 2" (2). One might be tempted to speculate that this reflects stunting due to a deficient diet. However, given the fact that nearly all non-industrial populations, including contemporary hunter-gatherers, are short by modern standards, I'm not convinced the Quechua are abnormal. A more likely explanation is that industrial foods cause excessive tissue growth in modern populations, perhaps by promoting overeating and excessive insulin and IGF-1 production, which are growth factors. I first encountered this hypothesis in Dr. Staffan Lindeberg's book Food and Western Disease.

I don't consider the Quechua diet to be optimal, but it does seem to support a reasonable level of metabolic health. It shows that a lifetime high-carbohydrate, high glycemic index, high glycemic load diet doesn't lead to obesity or insulin resistance in the context of a traditional diet and lifestyle. Unfortunately, I don't have more detailed data on other aspects of their health, such as digestion.

Potato-eating Cultures: the Aymara


The Aymara are another potato-dependent people of the Andes, who span Peru, Bolivia and Chile. The first paper I'll discuss is titled "Low Prevalence of Type II Diabetes Despite a High Body Mass Index in the Aymara Natives From Chile", by Dr. Jose Luis Santos and colleagues (5). In the paper, they show that the prevalence of diabetes in this population was 1.5%, and the prevalence of pre-diabetes was 3.6%. The prevalence of both remained low even in the elderly. Here's a comparison of those numbers with figures from the modern United States (6):

That's quite a difference! The prevalence of diabetes in this population is low, but not as low as in some cultures such as the Kitavans (7, 8).

Now to discuss the "high body mass index" referenced in the title of the paper. The body mass index (BMI) is the relation between height and weight, and often, but not always, reflects fatness. The average BMI of this population was 24.9, which is very close to the cutoff between normal and overweight (25).

Investigators were surprised to find such a low prevalence of diabetes in this population, despite their apparent high prevalence of overweight. Yet if you've seen pictures of rural native South Americans, you may have noticed they're built short and thick, with wide hips and big barrel chests. Could this be confounding the relationship between BMI and body fatness? To answer that question, I found another paper that estimated body fat using skinfold measurements (9). That study reported that both men and women remained relatively lean throughout life (ages 4-65), with only two of 23 subjects classified as overweight on the basis of body fat percentage, and none classified as obese.

Back to the first paper. In this Aymara group, blood pressure was on the high side. Serum cholesterol was also a bit high for a traditionally-living population, but still lower than most modern groups (~188 mg/dL). I find it very interesting that the cholesterol level in this population that eats virtually no fat was the same as on Tokelau, where nearly half of calories come from highly saturated coconut fat (10, 11). Fasting insulin is also on the high side in the Aymara, which is also interesting given their good glucose tolerance and low prevalence of diabetes.

Potato-eating Cultures: the Irish

Potatoes were introduced to Ireland in the 17th century. They were well suited to the cool, temperate climate, and more productive than any other local crop. By the early 18th century, potatoes were the main source of calories, particularly for the poor who ate practically nothing else. In 1839, the average Irish laborer obtained 87% of his calories from potatoes (12). In 1845, the potato blight Phytophthora infestans struck, decimating potato plantations nationwide and creating the Great Famine.

There isn't much reliable information on the health status of the Irish prior to the famine, besides reports of vitamin A deficiency symptoms (13). However, they had a very high fertility rate, and anecdotal reports described them as healthy and attractive (14):

As far as fecundity is concerned, the high nutritional value of the potato diet might have played a significant role, but little supportive evidence has been presented so far... What is known is that the Irish in general and Irish women in particular were widely described as healthy and good-looking. Adam Smith's famous remark that potatoes were "peculiarly suitable to the health of the human constitution" can be complemented with numerous observations from other contemporary observers to the same effect.

Controlled Feeding Studies

Starting nearly a century ago, a few scientists decided to feed volunteers potato-only diets to achieve various research objectives. The first such experiment was carried out by a Dr. M. Hindhede and published in 1913 (described in 15). Hindhede's goal was to explore the lower limit of the human protein requirement and the biological quality of potato protein. He fed three healthy adult men almost nothing but potatoes and margarine for 309 days (margarine was not made from hydrogenated seed oils at the time), all while making them do progressively more demanding physical labor. They apparently remained in good physical condition. Here's a description of one of his volunteers, a Mr. Madsen, from another book (described in 16; thanks to Matt Metzgar):

In order to test whether it was possible to perform heavy work on a strict potato diet, Mr. Madsen took a place as a farm laborer... His physical condition was excellent. In his book, Dr. Hindhede shows a photograph of Mr. Madsen taken on December 21st, 1912, after he had lived for almost a year entirely on potatoes. This photograph shows a strong, solid, athletic-looking figure, all of whose muscles are well-developed, and without excess fat. ...Hindhede had him examined by five physicians, including a diagnostician, a specialist in gastric and intestinal diseases, an X-ray specialist, and a blood specialist. They all pronounced him to be in a state of perfect health.

Dr. Hindhede discovered that potato protein is high quality, providing all essential amino acids and high digestibility. Potato protein alone is sufficient to sustain an athletic man (although that doesn't make it optimal). A subsequent potato feeding study published in 1927 confirmed this finding (17). Two volunteers, a man and a woman, ate almost nothing but potatoes, lard and butter for 5.5 months. The man was an athlete but the woman was sedentary. Body weight and nitrogen balance (reflecting protein gain/loss from the body) remained constant throughout the experiment, indicating that their muscles were not atrophying at any appreciable rate, and they were probably not putting on fat. The investigators remarked:

The digestion was excellent throughout the experiment and both subjects felt very well. They did not tire of the uniform potato diet and there was no craving for change.

In one of his Paleo Diet newsletters titled "Consumption of Nightshade Plants (Part 1)", Dr. Loren Cordain referenced two feeding studies showing that potatoes increase the serum level of the inflammatory cytokine interleukin-6 (22, 23). However, one study was not designed to determine the specific role of potato in the change (two dietary factors were altered simultaneously), and the other used potato chips as the source of potato. So I don't find these studies particularly relevant to the question at hand.

Just yesterday, Chris Voigt of the Washington State Potato Commission embarked on his own n=1 potato feeding experiment as a way to promote Washington state potatoes. He'll be eating nothing but potatoes and a little fat for two months, and getting a full physical at the end. Check out his website for more information and updates (18). Mr. Voigt has graciously agreed to a written interview with Whole Health Source at the end of his experiment. He pointed out to me that the Russet Burbank potato, the most popular variety in the United States, is over 135 years old. Stay tuned for more interesting facts from Mr. Voigt in early December.

Observational Studies

With the recent interest in the health effects of the glycemic index, a few studies have examined the association between potatoes and health in various populations. The results are all over the place, with some showing positive associations with health, and others showing negative associations (19, 20, 21). As a whole, I find these studies difficult to interpret and not very helpful.

Anecdotes

Some people feel good when they eat potatoes. Others find that potatoes and other members of the nightshade family give them digestive problems, exacerbate their arthritis, or cause fat gain. I haven't seen any solid data to substantiate claims that nightshades aggravate arthritis or other inflammatory conditions. However, that doesn't mean there aren't individuals who are sensitive. If potatoes don't agree with you, by all means avoid them.

The Bottom Line

You made it to the end! Give yourself a pat on the back. You deserve it.

In my opinion, the scientific literature as a whole, including animal and human studies, suggests rather consistently that potatoes can be a healthy part of a varied diet for most people, and they probably do not generally promote digestive problems, excessive fat gain or metabolic dysfunction.  Nevertheless, I wouldn't recommend eating nothing but potatoes for any length of time. If you do choose to eat potatoes, follow these simple guidelines:

• Don't eat potatoes that are green, sprouting, blemished or damaged
• Store them in a cool, dark place. They don't need to be refrigerated but it will extend their life
  
• Peel them before eating if you rely on them as a staple food
  

Enjoy your potatoes!

Potatoes and Human Health, Part II

Glycoalkaloids in Commonly Eaten Potatoes

Like many edible plants, potatoes contain substances designed to protect them from marauding creatures. The main two substances we're concerned with are alpha-solanine and alpha-chaconine, because they are the most toxic and abundant. Here is a graph of the combined concentration of these two glycoalkaloids in common potato varieties (1):

We can immediately determine three things from this graph:

• Different varieties contain different amounts of glycoalkaloids.
• Common commercial varieties such as russet and white potatoes are low in glycoalkaloids. This is no accident. The glycoalkaloid content of potatoes is monitored in the US.
  
• Most of the glycoalkaloid content is in the skin (within 1 mm of the surface). That way, predators have to eat through poison to get to the flesh. Fortunately, humans have peelers.

I'll jump the gun and tell you that the generally accepted safe level of potato glycoalkaloids is 200 mcg/g fresh weight (1). You can see that all but one variety are well below this level when peeled. Personally, I've never seen the Snowden variety in the store or at the farmer's market. It appears to be used mostly for potato chips.

Glycoalkaloid Toxicity in Animals

Potato glycoalkaloids are undoubtedly toxic at high doses. They have caused many harmful effects in animals and humans, including (1, 2):

• Death (humans and animals)
  
• Weight loss, diarrhea (humans and animals)
  
• Anemia (rabbits)
• Liver damage (rats)
  
• Lower birth weight (mice)
  
• Birth defects (in animals injected with glycoalkaloids)
  
• Increased intestinal permeability (mice)

However, it's important to remember the old saying "the dose makes the poison". The human body is designed to handle a certain amount of plant toxins with no ill effects. Virtually every plant food, and a few animal foods, contains some kind of toxic substance. We're constantly bombarded by gamma rays, ultra violet rays, bacterial toxins, free radicals, and many other potentially harmful substances. In excess, they can be deadly, but we are adapted to dealing with small amounts of them, and the right dose can even be beneficial in some cases.

All of the studies I mentioned above, except one, involved doses of glycoalkaloids that exceed what one could get from eating typical potatoes. They used green or blemished potatoes, isolated potato skins, potato sprouts or isolated glycoalkaloids (more on this later). The single exception is the last study, showing that normal doses of glycoalkaloids can aggravate inflammatory bowel disease in transgenic mice that are genetically predisposed to it (3)*.

What happens when you feed normal animals normal potatoes? Not much. Many studies have shown that they suffer no ill effects whatsoever, even at high intakes (1, 2). This has been shown in primates as well (4, 5, 6). In fact, potato-based diets appear to be generally superior to grain-based diets in animal feed. As early as 1938, Dr. Edward Mellanby showed that grains, but not potatoes, aggravate vitamin A deficiency in rats and dogs (7). This followed his research showing that whole grains, but not potatoes, aggravate vitamin D deficiency due to their high phytic acid content (Mellanby. Nutrition and Disease. 1934). Potatoes were also a prominent part of Mellanby's highly effective tooth decay reversal studies in humans, published in the British Medical Journal in 1932 (8, 9).

Potatoes partially protect rats against the harmful effects of excessive cholesterol feeding, when compared to wheat starch-based feed (10). Potato feeding leads to a better lipid profile and intestinal short-chain fatty acid production than wheat starch or sugar in rats (11). I wasn't able to find a single study showing any adverse effect of normal potato feeding in any normal animal. That's despite reading two long review articles on potato glycoalkaloids and specifically searching PubMed for studies showing a harmful effect. If you know of one, please post it in the comments section.

In the next post, I'll write about the effects of potatoes in the human diet, including data on the health of traditional potato-eating cultures... and a curious experiment by the Washington State Potato Commission that will begin on October 1.


*Interleukin-10 knockout mice. IL-10 is a cytokine involved in the resolution of inflammation and these mice develop inflammatory bowel disease (regardless of diet) due to a reduced capacity to resolve inflammation.

Doubling Tea Benefits

It seemed there was no denying the health benefits of tea. However, do you know an easy way to improve the efficacy of tea? Simply add the lemon juice into the tea, the disease-fighting antioxidants in tea will increase two-fold.

Adding 2-3 teaspoons of citrus (lemon, lime, or grapefruit) into a cup of green tea can increase the stability of catechins (antioxidant prevention of cancer, stroke , and heart disease) in an amount sufficient to digest up to five times. Cathecins present in almost all types of tea, but because this component is not stable in non-acidic environments, such as in digestion, which can be absorbed by the body usually less than 20 percent.

Interested to try? Enter one bag teabag into a cup of boiling water for 3-5 minutes before adding lemon juice to ensure higher levels of antioxidants.