 What if just one lifestyle change could help you avoid getting cancer? Or diabetes? Or heart disease? Or high blood pressure? This one change could cut your risk of chronic disease and add years to your life. Well, the simple solution to so many of these problems is to eat a healthy diet. In other words, one centered around whole plant foods. Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger. There are lots of things you can do to reduce your risk of getting cancer. Avoid tobacco, maintain a healthy weight, but one of the simplest kinds of cancer prevention is to follow a healthy diet. The vast majority of cancer research is devoted to finding cures rather than finding new ways to prevent disease, and the results of these skewed priorities are plain to see. 2021 is the 50th anniversary of Nixon's declaration of war on cancer, and the death tolls from the most common forms of cancer in the United States have continued unabated. We've been looking at the very nature of cancer in the wrong way. Breast cancer doesn't begin when a lump is first detected. All the common cancers, like lung, colorectal, breast, and prostate, which counts for the majority of deaths, have a long latency period, often 20 years or more. So it's not like you were healthy, and then one day you got cancer. You haven't been healthy. You've had cancer growing in you for decades. Indeed, there's a bizarre misperception that people are healthy until they have actual symptoms of invasive cancer. But the barn in which hay is smoldering before it bursts into flames is not a safe place. What about using diet and nutrition to prevent and treat cancer? OK, but what kind of cancer? There are more than 200 types of cancer, but they all share the same hallmarks. In a series of papers cited more than 40,000 times in the biomedical literature, 10 hallmarks of cancer have been identified. Increased sensitivity to growth factors, evading your body's tumor suppressors, dodging your immune system, being able to grow forever, tumor-promoting inflammation, the ability to invade and spread, and hook up its own blood supply. The accumulation of DNA mutations disarming the self-destruct mechanisms in place and hijacking the cell's metabolism. And yes, of course there are classes of drugs to try to counter each one. Chemotherapy agents designed to target each piece of the cancer puzzle. Now ideally there would be drugs able to target multiple hallmarks at the same time, but that's not how drugs tend to work. And this is one of the major reasons why in the context of cancer research there's so many proponents of investigating plant foods as they can deliver a cocktail of bioactive compounds, bioactive compounds that make target most, if not all, of the hallmarks of cancer. Compounds found in fruits and vegetables, such as berries, greens, and broccoli, shown to be able to target each of the 10 hallmarks of cancer, at least in a Petri dish. Moreover, they fit the characteristics of an ideal chemo-preventive agent. I mean, if you were to design the perfect candidate, you'd want them to be selective for cancerous or pre-cancerous cells while leaving normal cells alone, be side-effect-free, target most types of cancer, be able to be consumed as part of a daily diet, be conveniently available almost everywhere, and be relatively inexpensive to boot, and plants have all these. So no wonder those eating more plant-based and have lower cancer rates. However, it should be understood that we're not talking about taking supplements containing extra extra purified phytochemicals, but rather eating whole plant foods themselves, more of a food system-based approach to targeting the hallmarks of cancer. Foods contain many thousands of substances that lead to vast numbers of possible interactions, yet much of nutritional science has long been directed towards the impact of single dietary components. Yes, this kind of reductionist approach can reveal the role of individual nutrients or foods in the development of disease, but let's think about what the optimal research strategy would be to study the effects of bioactive natural plant compounds on disease prevention. Instead of using isolated phytochemicals in the management of cancer, how about using whole foods? Because sometimes the whole can be greater than the sum of its parts, a concept known as food synergy. Check out this study. The simultaneous inhibition of a series of cancer stages in breast cancer cells using a phytochemical supercoctail, two breast cancer cell lines were treated with six different plant compounds individually, and then all together at the level you might find your bloodstream after eating foods like broccoli, grapes, soybeans, and turmeric. And while the compounds were ineffective individually in combination, they significantly suppressed breast cancer cell proliferation by more than 80% inhibited cancer cell migration and evasion, stopped the cancer cells in their tracts, and eventually killed them all off. The plant compounds did all this without having any deleterious effects on the normal non-cancer cells used as control. No wonder the Foundation of Cancer Prevention, based on an update of the most extensive report on dying cancer ever published, is not pills, but plans. Cut down on alcohol, soda, meat, and processed junk, and center your diet around whole grains, vegetables, fruits, and beans. In our next story, we'd look at whether choosing organic over conventional fruits and vegetables could protect against cancer. In a review updating the evidence on human exposure and toxicity of pesticides, the body of evidence linking pesticide exposure and cancer is said to be so huge that the role of pesticides in cancer development can no longer be doubted. But most of the evidence that shows DNA damage from pesticides is from occupational exposure among farmers and workers in the fields, the pesticide industry itself, or those living in high-spray areas. There is evidence linking non-occupational exposure to pesticides, to DNA damage, in this case single and double-stranded DNA fragmentation in sperm of men with higher levels of pesticides flowing through their bodies. But that was in China, where the average pesticide concentration are as much as four times higher than some other parts of the world. Another way pesticides could potentially facilitate tumor growth is to adverse effects on anti-cancer immunity. NK cells, natural killer cells, are a body's first line of white blood cell defense against cancer cells and virus-infected cells. And pesticides have been shown to induce harmful effects on these defender cells, reducing their ability to kill off tumor cells. For example, if you put a bunch of natural killer cells in a petri dish, along with human leukemia cells without any pesticide, your natural killer cells can clean house and wipe out more than half of the cancer. But if you drip a tiny bit of pesticide on, your NK cells are so disabled that the cancer wins the day. OK, but how much pesticide are we talking? The researchers used the maximum level found in those actively spraying pesticides. Most of us, however, privileged enough not to be forced into such a job. So what about looking at just the residual pesticides left on conventional produce? Is choosing organic for cancer prevention worth the investment? In the United States, more than 90% of the population has detectable pesticides in their urine and blood, regardless of where they work or live. And we know it's from the food we eat, because crossover trials where people are switched between consuming conventionally grown and organic foods show you can turn on and off urinary concentrations of pesticide metabolites like a light switch. But that doesn't necessarily mean the pesticides are harming you. The health consequences of consuming pesticide residues from conventionally grown foods remain unknown. But a recent study did find that those who self-reported the highest frequency of organic food consumption had about a 25% lower risk of getting cancer. And here it is. The first of its kind to evaluate the association between frequency of organic food consumption and cancer risk, controlling for a wide array of other factors. Doesn't it matter that organic consumers are younger? The researchers controlled for that and still found significantly lower cancer risk. OK, but maybe organic consumers get less cancer because they're more affluent or more highly educated or skinny or exercise more or eat less meat or smoke less. Nope, they controlled for all that and still found significantly lower cancer risk in organic consumers. Maybe their diets were different in other ways, though more fruits and vegetables overall or less junk food? Nope, they still found significantly lower cancer risk. They concluded, our results indicate that higher organic food consumption is indeed associated with a reduction in the risk of overall cancer. This is the most sophisticated study of its type to date, but there was an earlier study that was even bigger, and little evidence was found for a decrease in the incidence of all cancers except for perhaps one kind of blood cancer, non-Hodgkin's lymphoma. Here are the data. No difference in cancer overall between those who never choose organic or those who usually or always do with the only significant findings a lower risk of non-Hodgkin lymphoma and an increased risk of breast cancer. Is it possible that women who choose organic food are more conscientious about getting screened for breast cancer and that explains the higher diagnosis rate? We really don't know. Of course, what we care about the most is not just cancer, but so-called all-cause mortality, the risk of dying prematurely period, and higher blood levels of a pesticide known as beta-hexachlorocyclohexane are associated with living a significantly shorter life. How do we cut down on our levels? Well, there was a study done way back when that found that the breast milk of a vegetarian mother was found to have less beta-hexachlorocyclohexane than the milk of her sister, who was also breastfeeding at the time, but included meat in her diet. The vegetarian sister apparently had levels of that pesticide that were lower by about a third compared with her omnivorous sibling. No surprise, since this class of chlorinated pesticides are fat-soluble, so they're found most frequently in foods of animal origin. A more recent study failed to look at beta-hexachlorocyclohexane, but they did find that chlorinated PCBs were associated with increased mortality risk. And again, the toxins were found in the same kinds of food— dairy products, eggs, and animal fats. So no surprise the blood of those eating vegan was found to be significantly less polluted than omnivores, regarding a whole series of PCBs, including those found in the study to be associated with increased mortality. But the vegans did not have lower levels of beta-hexachlorocyclohexane. The bottom line is that if you're worried about the adverse health effects of pesticides and pesticide-type compounds, you may want to lower your intake of animal products. But when it comes to fruits and vegetables, the benefits of consuming conventionally grown produce are likely to outweigh any possible risk from pesticide exposure. So concerns over pesticide risk should not discourage us from stuffing our faces with as many fruits and vegetables as possible. That would give us a huge health benefit, whereas the potential lifelong damage of any pesticides on those same fruits and veggies has been estimated to only cut up a few minutes off a person's life on average, which is nothing compared to the nutritional benefits of eating more fruits and vegetables. We would love it if you could share with us your stories about reinventing your health through evidence-based nutrition. Go to nutritionfacts.org slash testimonials. We may share it on our social media to help inspire others. To see any graphs, charts, graphics, images, or studies mentioned here, please go to the Nutrition Facts podcast landing page. There you'll find all the detailed information you need, plus links to all the sources we cite to each of these topics. My latest two books are How to Survive a Pandemic, Available on e-book, audio book, or actual book, and The How Not to Diet Cookbook, with more than 100 recipes for delicious and nutritious meals. All proceeds I receive from the sales of my books go to charity. NutritionFacts.org is a non-profit science-based public service where you can sign up for free daily updates on the latest in nutrition research via bite-sized videos and articles. Everything on the website is free. There's no ads, no corporate sponsorship. It's strictly non-commercial, not selling anything. I just put it up as a public service as a labor of love as a tribute to my grandmother, whose own life was saved with evidence-based nutrition.