Monthly Archives: August 2016

The Shocking Truth About Methionine: Part II

recap

In my last post, I discovered that many types of cancers have an absolute requirement for the essential amino acid methionine. When methionine is absent from petri dishes, malignant cells don’t grow and sometimes even die out completely. Normal cells in petri dishes can do ok without methionine provided they’re given homocysteine, methionine’s metabolic precursor.

That’s what happens in the lab. But how would it work in the real world? Methionine is in a lot of foods, especially animal foods. Yet becoming a Vegan wouldn’t be enough to eliminate dietary methionine –  it’s also abundant in seeds, nuts, soy, and beans. Besides, most every food has some amount of methionine, so a completely methionine-free diet isn’t feasible. And browsing through all those nutrition tables trying to approximate methionine content per typical portion was starting to drive me a bit crazy. aint nobody got time for that emoji

Still, if I could stick to an ultra-low methionine diet, would that help shrink my tumors? Is such a diet practical, or even safe? And would it be effective outside of petri dishes?

I turned to 720px-US-NLM-PubMed-Logo.svg .gov for answers. Studies testing the anticancer effects of methionine deprivation in mice looked promising. In one study, researchers injected 21 nude mice with Yoshida Sarcoma, a commonly used cancer cell line. One group of mice was fed 8.2g of methionine per kg, while the other group of mice got 0g of methionine per kg.

By day 12, all the mice with methionine in their diet were dead. In contrast, mice fed a methionine-free diet had slower tumor growth and even some regression of their tumors. At day 30, all the animals on the methionine-free diet were still alive, though the whole group died by day 38. Poor mice!

This literature is not the most fun to read. Still, survival time for one methionine-free mouse more than tripled, so they’ve gotta be onto something, right?

Researchers from the M.D. Anderson Cancer Center in Houston cast doubt upon these findings in a 1988 article; they reported that while three of the seven rodent tumor cell lines tested failed to grow in a petri dish without methionine, all 17 of the human tumor cell lines tested were able to grow in the methionine-free petri dishes. I'm over it emojiThe researchers concluded that methionine dependence is less likely to occur in human tumors than rodent tumors.

Just as I was about to dismiss the whole idea of methionine restriction, I found a study that was novel in its use of human (as opposed to rodent) breast, colon and lung tumors. Growth of these human tumors (transplanted as usual into nude mice) was significantly inhibited in the mice fed a methionine-free diet. This demonstrated that at least some types of human cancers require methionine in living (albeit all-too-briefly-living) animals. Maybe this did warrant further exploration.

Fast forward to 2016: scientists still seem stuck on using nude mice to investigate the role of methionine in cancer progression. One such study published this year focused specifically on breast cancer. Mice were injected with immortalized human breast cells and fed either a control diet consisting of 0.086% methionine or a methionine restricted diet with only 0.012% methionine. After 12 weeks, all the mice were euthanized (when will these poor little creatures catch a break?) and examined. Tumors weights in the methionine restricted mice averaged 11.4±4.0 mg compared to a 20.2±6.1 mg tumor weight average in the control mice. That’s a 55% tumor weight reduction for the methionine restricted diet vs. a standard control diet.

I’d be super excited by these results…sticker.crazyhamsterif I were a rodent injected with malignant cells (but not marked for euthanization).

More than 40 years have passed since the initial discovery at the University of California. Where were the human clinical trials? Ridic emojiI did finally dig up a small Phase I clinical trial from among all the mouse and petri dish experiments. This trial had modest objectives and only eight patients with various types of metastatic cancer.  Participants followed a methionine restricted diet for an average of approximately three months, and their plasma methionine levels fell by an average of 58%. The authors concluded that a methionine restricted diet can be safe and tolerable in adults with advanced cancer.

Not much more than that can be learned from a trial with so few participants, but I still felt underwhelmed by the results (or lack thereof). Certainly no miraculous recoveries for any of those eight patients. One patient with prostate cancer had a 25% reduction in serum prostate-specific antigen (PSA) after three months on the diet, and another patient with renal cell cancer experienced “an objective radiographic response.”

Otherwise, the trial didn’t find any notable anticancer effects from methionine restriction, not even in the patient who followed the diet for 38 weeks. Maybe a 58% drop in plasma methionine isn’t enough to cause the tumors to regress? In any case, I doubt I’d manage to be much more strict with my methionine intake than these eight trial participants.

The researchers called for more clinical trials to determine whether methionine restriction could enhance the anticancer activity of chemo and other treatments. Why couldn’t I find any of those follow-up trials?

what Happened emoji

I decided to contact one of the authors, Dr. Epner, to ask him directly why he abandoned this line of research after publishing the Phase I trial results in 2002. I’ll save Dr. Epner’s response and further adventures in methionine research for my next installment.

As for my progress in cooking turmeric dishes, I’ve been sticking with the tried and truly delicious turmeric potato salad.  I made and devoured it three more times since my last post. Maybe I’ll feel more venturesome and try a new recipe this week. Stay tuned!

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The Shocking Truth About Methionine

I’m experimenting with my headlines – apologies if this one seems too click-baity.

Yet the headline is not misleading. In my journey down the proverbial rabbit hole of methionine research, I experienced multiple shocks.

There’s nothing inherently shocking about methionine. It’s one of the nine essential amino acids – building blocks of protein that our bodies cannot make and therefore must come from our diet. Once our digestive system breaks down the proteins that we eat into amino acids, they can be used for energy or as components in proteins that we need for normal growth and repair. Elementary stuff that I learned in Bio 101.

265px-Methionin_-_Methionine.svgCanonical form of methionine

But until a friend sent me an article from Dr. Gregor’s Medical Nutrition Blog, I had no idea that many cancer cells have a metabolic defect – an absolute dependence on methionine.

Researchers at the University of California became aware of this defect in cancer cells back in 1974. They reported that when normal and malignant cancer cells are put in a growth medium that includes methionine, only malignant cells remain in the flask after three weeks. That flask serves as the control in which the crowding out of normal cells by the malignant cells is expected.

In contrast, if the medium contains homocystine (a methionine precursor) but no methionine, the cancer cells die. After just one week, only normal cells remain in the methionine-free flask.

Amazing bitmoji

How had I never heard of this? How do I get that to happen to the cancer cells inside me?

In the article my friend had sent me, Dr. Gregor advises lowering methionine intake through a “predominantly vegan diet.” So I need to go vegan after all? What exactly would it mean to drastically decrease my intake of this one amino acid?

Sorting foods by methionine content in the National Nutrient Database for Standard Reference Release 28 shows that parmesan cheese, eggs, many different types of fish and seafood, as well as beef, lamb, pork, turkey, chicken, ostrich and antelope have the highest amounts of methionine per 100 grams (g) of each food.

Methionine Nutrient Lists 1st 25 USDA

It’s clear that high-protein animal foods are rich in methionine, but sesame flour actually has more methionine (1.66g methionine per 100g of flour) than whale meat (1.35g methionine per 100g of meat).

image by yamachem
image by yamachem

Spirulina (a form of blue-green algae), soy protein isolate and brazil nuts are also up there, with 1.15g, 1.13g and 1.12g of methionine per 100g, respectively. In comparison, chuck eye beef and a hind-shank of lamb have only 1.06g of methionine each per 100g.

Looks like restricting dietary methionine isn’t quite as simple as just following a vegan diet. It would have to be a vegan diet with quite a few additional restrictions.

Skipping to page 201 of the 200+ pages of foods ranked for methionine content by the

Methionine Nutrient Lists last pages USDA

National Nutrient Database for Standard Reference Release 28 reveals that I wouldn’t even have to be strictly vegan. I could successfully follow a virtually methionine-free diet by making duck, turkey and goose fat my staple foods. Along with various hydrogenated vegetable oils and beer.Best Buds emoji

True, many great veggies and fruits have 0.01g of methionine per 100g or less. So, all joking aside, I do believe that I’d have the discipline to follow an ultra-low methionine diet. I could give up cheese, salmon, seeds, nuts, whale and countless other foods in favor of mostly fruits and veggies. Of course, I’d need to supplement with pea protein powder, which is naturally low in methionine.pea-protein-amino-acid-profileWhile there’s still about 0.15g of methionine per serving, that’s a trade off I’d have to make to ensure I’m getting enough of all the other essential and conditionally essential amino acids.

Plus, I’d need to take vitamin B12, vitamin D3, vitamin K2, omega-3 fatty acids, zinc, calcium, iron pills and likely other nutrients that I haven’t even thought of.

The change would be costly and might leave me slightlyHangry bitmojiat times. Despite all that, it would be worth it if the drastic reduction in methionine killed all my cancer cells. But would the same thing that happened in that methionine-free flask happen in my body too? I want to believe emoji

For how long would I have to restrict methionine? Would I be risking my health by keeping methionine intake so minimal?

Surely, scientists must have answered these questions over the 40+ years since the breakthrough discovery was made at the University of California.

In my next post, I’ll dig into this 40+ years of research to uncover more shocking truths.

As for my turmeric cooking adventures, I must report that I haven’t tried making any new turmeric dishes since the last post. However, I have again successfully prepared both the turmeric potatoes and the turmeric stew that I blogged about in my previous postsSide by Side turmeric

That’s two turmeric dishes in one week! I’m especially proud of my kitchen prowess since this second week of cycle 4 on my Xeloda chemo meds has zapped my energy levels. Nothing like the promise of good food to rally me off the couch and to the stove.

 

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Should I Go Vegan to Fight Breast Cancer?

Yes Or No Emoji

I’m researching and writing this series of posts with a bias. For nearly eight years, I’ve eaten a mostly Paleo or Primal diet.

A common misconception about the Paleo diet is that it’s very meat-heavy. That may be true for some Paleo enthusiasts, but the bloggers and podcasters that I follow have always emphasized eating plenty of fruits and veggies, choosing high-quality whole (non-processed or minimally-processed) foods with the highest nutrient density, and self-experimentation to personalize the diet to each individual situation.

Over the past several years, the Paleo diet has begun to morph into a lifestyle, with advocates emphasizing the importance of stress management, moving/staying active, getting enough quality sleep and even maintaining good social connections.

For me, going Paleo wasn’t so much about going gluten-free or loading up on meat as it was about giving up highly processed food that I felt nearly addicted to. EatingIceCreamCupcake

Fruit replaced cookies and bagels got switched out for pumpkin seeds and almonds. Hamburger buns became mushroom buns. That meant that my fruit and vegetable intake skyrocketed, while my meat consumption actually decreased.

I also became aware of the health benefits of choosing wild-caught salmon, grass-fed beef and eggs from pasture-raised chickens. Being so choosy comes at a high cost. As a graduate student and later an AmeriCorps VISTA volunteer, I could only afford to have grass-fed beef or wild-caught salmon as an occasional treat. My main sources of protein were eggs from pastured chickens, sardines and sometimes cheese or yogurt.

I considered my eating habits to be predominantly pescatarian, and started to use the terms nutritarian (or nutrivore? Best terminology TBD) to describe the philosophy behind my dietary choices.

On many occasions my nutritarian aspirations were restricted by cost, cooking skills or taste buds. Still, I thought I was doing pretty well.HealthyLivingEmojiAnd then I was diagnosed with stage 4 breast cancer.

I felt like the universe was playing a joke on me. As a Registered Dietitian, I counseled people on making healthy food and lifestyle choices. How ironic that practicing what I preached failed to protect me.

Who knows, though – maybe I could have avoided cancer if I’d changed my eating habits as a teen. Or maybe something about my Paleo-ish diet did contribute to the cancer’s development. Not enough organic produce? Too much cheese? Too much animal protein? Too much kale?

Numerous studies do show an association between meat intake and cancer. However, in her evidence-based analysis of this link between meat and cancer, Sarah Ballantyne, Ph.D., concludes that: yes meat does

Dr. Ballantyne’s point-by-point examination of the cancer-promoting substances in meat and how they can be neutralized by plant foods, especially cruciferous vegetables, helped me to not be overly swayed by stories like Kris Carr’s.

Kris was diagnosed with a very rare form of cancer (40-80 cases per year in the U.S.) called epithelioid hemangioendothelioma in 2003. She went on to direct the documentary Crazy Sexy Cancer and to author several New York Times best-seller vegan cookbooks.

CrazySexyBook

Kris’s story is, indeed, crazy sexy inspirational. She was able to use a devastating diagnosis of stage 4 cancer as a catalyst for improving her life. Most intriguing of all, her cancer appears to have been stable for over thirteen years and counting! Would I see the same crazy sexy results if I became a vegan like her?too sexy emoji

Another blogger, Dr. Elaine Schattner, offers a medical perspective on how Kris Carr has been able to thrive with cancer for so long. Epithelioid hemangioendothelioma (EH) comes in two forms – one that’s aggressive and another that isn’t. Kris luckily has the latter, non-aggressive form of EH. She’s been able to stay in wait-and-watch mode since receiving her diagnosis, and has never had chemo, radiation or major surgery to treat her cancer.

It’s entirely possible that Kris’s diet has helped to keep her cancer at bay. But Dr. Schattner’s post convinced me that Kris’s current well-being is due in large part to the type of cancer she has rather than any particular diet she might be following.

It’s also impossible to tell whether the vegan aspect of Kris’s diet is necessary. The results she sees could be entirely due to her shift from junk food to whole, minimally-processed food that includes a wide variety of fruits and veggies. Foregoing meat may have nothing to do with her or her followers’ success on the diet.

Or so I thought, until a friend emailed me a link to an article about methionine.

Woahemoji

More (much more) about that in my next post.

For now, I’ll leave you with a pic of the latest turmeric dish made by yours truly, with a bit of assistance from my patient fiance:

SoupwithEdits

Inspired by this post’s topic, I followed the Superfood Veggie Soup recipe from my Turmeric Pinterest board, with some modifications. I didn’t include carrots since I only like them raw, but I upped the garlic to five cloves, threw in some bay leaves and added an extra teaspoon of turmeric. My frozen veggies were okra and mixed mushrooms, and I substituted kale for Nori.

I made the stew for dinner a few nights ago but found it even more delicious when I heated it up for lunch the next day. I couldn’t taste the turmeric so threw in another tablespoon for the whole pot of leftovers. I think it’s just right at two tablespoons of turmeric for the entire pot, though the recipe only calls for two teaspoons.

The stew is all gone now, the turmeric-stained ladle licked clean. I’m thinking of making it again next week. Any suggestions for what veggies I can add to complement the mushrooms, kale, okra, tomatoes, garlic and onions?

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Health Status Update

I have a post in the works about going vegan to combat cancer.  But first, I wanted to share a few developments from last week.

GoodNewsEmoji

I had two appointments on Friday, one with my oncologist and the second with my radiation oncologist. Earlier in the week, I’d had a PET scan and an MRI.

In case you’re not familiar with how a positron emission tomography (PET) scan works, the first step is an IV injection of radioactive glucose. I brought Cryptonomicon to keep me company during the hour of waiting for my body to absorb the glucose.  Then I dozed off in the scanner as it detected any areas where the glucose collected abnormally. Abnormal uptake can indicate cancer cells, but also areas of radiation damage or inflammation.

My oncologist ordered the PET scan after seeing numerous lesions on my bone scan in June. The PET imaging report also revealed multiple bone and spine lesions but noted that they showed a”relatively low level of uptake.” This suggests that the bone mets are stable, at least for now. There was also a bit of activity seen in my lymph nodes and the left breast. All the other organs read as clear or “unremarkable in appearance” with “normal physiologic uptake.” I’ve never been more excited to hear the words “normal” and “unremarkable.”

YeeHawEmoji

The second appointment with my radiation oncologist was even more encouraging. The brain MRI showed that multiple small metastatic lesions seen on the previous scan three months ago were either smaller or “no longer visualized.” The remaining mets were deemed “stable.”

So it’s not an all-clear, no evidence of disease (N.E.D.) situation. But I still feel triumphant in my hanging on, Texas-style. Yee-haw!

Friday also brought the news that I’ve been selected to participate in Living Beyond Breast Cancer‘s Young Advocate Training Program. I bought plane tickets for the September conference and have already started researching food spots in Philadelphia – they have Snap Kitchen too, and it’s less than a mile away from my hotel.

SoExcitedEmojiAmid all the bustle, I didn’t make time to cook a new turmeric dish last week. Binge watching Stranger Things on Netflix didn’t help matters.

Still, I did manage to re-create the Spicy Potato Salad from last week’s post. I simply halved the ingredients since I was only cooking for myself.

I also splurged on a celebratory Turmeric Ginger flavored Apple Cider Vinegar Tonic.20160807_KevitaTonic

So refreshing, and not too sweet. I just wish Whole Foods would drop the price.

TreatYoSelfemoji

Plus, I sprinkled turmeric and black pepper on my Fit Cross burger from Wholly Cow. Next time, I think I’ll use a little less turmeric. Or maybe I’ll even make the patty myself, with the turmeric mixed into the meat. I just don’t know where to find those humongous mushroom buns that Wholly Cow uses.  BurgerWithTurmeric

The week started out with a trip to the ER, but seeing the last Blues on the Green concert of 2016 with good friends helped me to recover, as did Friday’s news. A week that ends in conference travel plans, KeVita’s turmeric ginger tonic, and a grass-fed, mushroom capped burger is a fantastic week in my book (or should I say blog?)!

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I Cooked! With Turmeric!

I’m excited to report that I made my first turmeric dish! I got the recipe from my Pinterest board: The Middle Eastern Spicy Potato Salad from the Mediterranean Dish.

I couldn’t have done it without my wonderfully supportive and patient fiance. Cooking the potatoes was a team effort, and he actually did most of the stove-related work once we got the ingredients together.

CookingHandswithHerbs

It’s quite rare for me to cook with so many ingredients – potatoes, parsley, dill, cilantro, lime, coriander, garlic, olive oil and turmeric, oh my!

I chose the recipe partly because of all those nutrient-packed ingredients, but also because the recipe stated that the salad could be served at room temperature.  I needed a side dish for Family Picnic potluck for my stage 4 breast cancer support group. bitmojiLets Party My go-to for potlucks is typically bagged salad mixed with berries, but the Family Picnic seemed like the perfect opportunity to practice what I’d begun to preach and to meet my weekly goal of cooking at least one turmeric dish besides.

Most of my Pinterest recipes looked too complicated or unlikely to benefit from the long car ride to the Picnic location. The Middle Eastern potato salad recipe stood out because I had many of the ingredients already and the dish didn’t have to be served hot. I modified it only a little, using 9 potatoes instead of the 6 potatoes called for and increasing all the other ingredients by 1.5X.

IMG_20160730turmericpotatoes

The salad was scrumptious, though I might have been the most enthusiastic about it of everyone who tried it. Still, we set out for the potluck with a big bowl of it and returned home with maybe 1/8 of the salad left. I happily finished it off.bitmojiHighFive I might make this potato salad again this week, or maybe I’ll choose a dessert or a soup. I had an unwelcome visit from some stomach bug last night that sent me to the ER. I’m feeling better now, but craving nourishing comfort food. Any suggestions?

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