Newsletter Archives > Monthly Health Newsletter: June 2010 Health Newsletter

June 2010 Health Newsletter

Current Articles

» Soy and Breast Cancer
» Mountain Biking Hazardous To Your Spine
» New Research Sheds Light on Chiropractic and Multiple Sclerosis
» House Passes Bill to Expand Chiropractic Care to All Major VA Medical Centers
» Food industry to Obama: We'll Improve Nutrition

Soy and Breast Cancer

There has been considerable investigation of the potential for soy foods to reduce risk of cancer, particularly cancer of the breast. This interest dates back more than two decades and in 1990, participants of a workshop sponsored by the U.S. National Cancer Institute concluded that soybeans contain several chemopreventive agents [1]. The basis for the initial investigation into a potential relationship between soy and breast cancer was based largely on the observation that women in Asia with their high consumption of soybeans had a considerably lower incidence of breast cancer than their western counterparts.

 In the last two decades, epidemiologic research (i.e. research focusing on large populations of persons in a specific geographic area) has verified the suspicion that there exists an inverse relationship between soy consumption and breast cancer incidence [2,3,4]. In other words, the more soy a woman eats the lower her risk of breast cancer.

In recent years, however, the relationship between soy and breast cancer has become controversial, largely due to an attempt to study the effects of isolated soy food chemicals. These chemicals, known as isoflavones, exhibit estrogen-like properties under certain experimental conditions, and may stimulate the growth of existing estrogen-sensitive breast tumors [5]. For the purpose of clarification, controversy has resulted only when researchers began isolating singular chemicals found in soy and using these chemicals individually and at very high concentrations—in other words, like drugs. Author's note: I blame this confusion on the misguided pursuit of western researchers' "magic bullet" mentality. That is, a preoccupation with finding a pill to treat everything that ails humans despite the fact that there has never been found a magic bullet despite enormous money and resources invested to this ill-conceived pursuit. "Ill-conceived" because it ignores the fundamental apothegm that diet and lifestyle are the most important modifiable factors that relate to all disease.

The issue of soy or no soy gets even more confounding when studying the effects--again of singular isoflavones—on women taking tamoxifen as part of breast cancer treatment or prevention. Two of the three soy isoflavones are genistein and daidzein. One study published in 2005 found that genistein was able to negate the positive effect of tamoxifen, while a combination of daidzein and tamoxifen produced increased protection against breast cancer [6]. A study published in 2008 likewise found that genistein can interfere with tamoxifen activity [7]. These two studies refuted the findings of a 2002 publication that showed that genistein increased the effectiveness of tamoxifen [8]. Needles to say, everyone was confused by these contradictory findings and cancer researchers concluded there was sufficient evidence to advise women to refrain from isoflavone supplementation. It is important to reiterate these warnings were for supplementation with isoflavones—not for soy as part of a healthy diet. It must also be noted that in using soy isoflavones as drugs, the levels of genistein and daidzein were at doses 5-20 times that which is normally consumed by humans. Fortunately, a large, population-based cohort study of 5042 female breast cancer survivors in China is providing the clarification sought by many women regarding this important topic.

The Shanghai Breast Cancer Survival Study included women who were diagnosed between 2002 and 2006 and followed-up until 2009. Information on cancer diagnosis and treatment, lifestyle exposures after cancer diagnosis, and disease progression was collected at approximately 6 months after cancer diagnosis and was reassessed at 3 follow-up interviews. I've presented the results as direct quotes from the study followed by my comments:

  • "Soy food consumption after cancer diagnosis, measured as soy protein intake, was inversely associated with mortality and recurrence. The association of soy protein/isoflavone intake with mortality and recurrence appear to follow a linear dose-response pattern until soy protein intake reaches 11 grams a day (or soy isoflavone intake reaches 40 mg a day). After these points, the association appears to level off or even rebound." COMMENT: This reiterates what we had already known, that is, soy as part of a diet decreases the recurrence of breast cancer and death from breast cancer. It also indicates more is not necessarily better. Reasonable amounts of dietary soy for women diagnosed with breast cancer are a good thing.
  • "In our study, we found that soy food intake was associated with improved survival regardless of tamoxifen use, while tamoxifen use was related to improved survival only among women who have low or moderate levels of soy food intake. Tamoxifen was not related to further improvement of survival rates among women who had the highest level of soy food intake. More importantly, women who had the highest level of soy food intake and who did not take tamoxifen had a lower risk of mortality and a lower risk of recurrence rate than women who had the lowest level of soy food intake and used tamoxifen, suggesting that high soy food intake and tamoxifen may have a comparable effect on breast cancer outcome." COMMENT: This puts to rest the issue of whether or not women on tamoxifen should eat soy. They should. In fact, this research suggests that women with breast cancer may be able to use high soy food intake instead of tamoxifen.
  • "In our comprehensive evaluation of soy food consumption and breast cancer outcome using data from a large, population-based cohort study, we found that soy food intake was inversely associated with mortality and recurrence. The inverse association did not appear to vary by menopausal status and was evident for women with ER-positive and ER-negative cancers and early and late-stage cancers." COMMENT: This is big news. Soy helped across the board—early to late stage of the disease, pre- or post-menopausal status, and both receptor positive and negative classes. Until opponents of soy produce contradictory results in human population research, the dangerous advice for women with breast cancer is to avoid soy.
  • "In summary, in this population-based prospective study, we found that soy food intake is safe and were associated with lower mortality and recurrence among breast cancer patients. The association of soy food intake with mortality and recurrence appears to follow a linear dose-response pattern until soy food intake reaches 11 grams a day of soy protein; no additional benefits on mortality and recurrence were observed with higher intakes of soy food."

In conclusion, women should include soy as part of their diets, but be hesitant to use soy isoflavone supplements. This includes women with and without breast cancer, who are both pre- and post-menopausal, who are taking tamoxifen, and those women with breast cancer that is ER-negative or ER-positive. This conclusion is based on the fact that all human research to date has confirmed these recommendations and not one single human trial have refuted it.



  1. Messina M, Barnes S: The role of soy products in reducing risk of cancer. J Natl Cancer Inst 1991, 83:541-546.
  2. Trock BJ, Hilakivi-Clarke L, Clarke R: Meta-analysis of soy intake and breast cancer risk. J Natl Cancer Inst 2006, 98(7):459-71.
  3. Wu AH, Yu MC, Tseng CC, Pike MC: Epidemiology of soy exposures and breast cancer risk. Br J Cancer 2008, 98(1):9-14.
  4. Lee SA, Shu XO, Li H, Yang G, et al: Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women's Health Study. Am J Clin Nutr 2009, 89(6):1920-6.
  5. Messina MJ, Loprinzi CL: Soy for breast cancer survivors: a critical review of the literature. J Nutr 2001, 131:30955-1085.
  6. Constantinou AI, White BE, Tonetti D, et al: The soy isoflavone daidzein improves the capacity of tamoxifen to prevent mammary tumours. Eur J Cancer 2005, 41(4):647-54.
  7. Helferich WG, Andrade JE, Hoagland MS: Phytoestrogens and breast cancer: a complex story. Inflammopharmacology 2008, 16(5):219-26.
  8. Tanos V, Brzezinski A, Drize O, et al: Synergistic inhibitory effects of genistein and tamoxifen on human dysplastic and malignant epithelial breast cells in vitro. Eur J Obstet Gynecol Reprod Biol 2002, 102(2):188-94.

Author: Dr. Nick LeRoy, DC, MS
Source: Shanghai Breast Cancer Survival Study
Copyright: Dr. Nick LeRoy 2010

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Mountain Biking Hazardous To Your Spine
New research indicates the increasingly popular recreational sport of mountain biking may be just as dangerous as other sports like football, hockey, skiing and rugby. Canadian researchers reviewed 107 patients seen at a spinal referral center during a 13-year period who were injured while mountain biking. The majority of those injured were male with the average age of 33. Of those injured, almost two-thirds required surgery and 40 percent sustained spinal cord injuries. Worse yet, of those 40 percent who had spinal cord injury, almost half resulted in complete paralysis. Moreover, at discharge 2 patients remained on a ventilator. Surprisingly, the study also found that helmets didn’t appear to help in reducing spinal injures, although, they protected the head. Thus, while helmets are important in protecting the head and brain, they offer little protection to the cervical spine when riders go over the handle bars or fall from heights and land on their heads. Researchers advise mountain bikers and for that matter all bikers, to use extreme caution when thinking about or performing any tricks or jumps. They also advised to ride with others and to stay together just incase someone becomes injured.

Source: The American Journal of Sports Medicine. May 20, 2010.
Copyright: LLC 2010

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New Research Sheds Light on Chiropractic and Multiple Sclerosis

Recent research reported in the Journal of Pediatric, Maternal & Family Health - Chiropractic revealed improvement in symptoms related to multiple sclerosis in a woman undergoing chiropractic care suggesting that chiropractic may play an important role in managing people with such disorders.

The 51 year old woman reported on in the study also suffered from gastroesophageal reflux disorder (often called GERD), asthma and a number of other problems which were all helped through chiropractic care. The research includes a review of the literature on the role of chiropractic in such disorders.

"Research is revealing that there is a relationship between abnormalities in the spine, the nervous system and brain," stated Dr. Ben Lerner, lead author of the paper. "Researchers from different fields are now showing that trauma, problems in the upper neck and problems with blood flow to and from the brain may be playing a significant role in multiple sclerosis."

Research has shown that in many cases people who have multiple sclerosis have a history of head and/or neck trauma and researchers studying this in chiropractic suggest that this trauma also cause misalignments of the bones in the neck. The trauma along with the misalignments can lead to compression of nerve structures as well as alterations of blood flow leading to the degenerative conditions and other problems associated with multiple sclerosis.

"It makes perfect sense when you think about it" stated Dr. Sheri Lerner, a co-author on the paper. "Our study is one more example of how people with these debilitating conditions can be helped through specific chiropractic adjustments to restore normal spinal and nervous system function."

According to Dr. Matthew McCoy, a chiropractor, public health researcher and editor of the journal that published the study, "Chiropractors have been talking about these links for some time now and I think research in this area will soon reach a critical mass because its not just chiropractors saying this any more. You have researchers in several different fields coming to similar conclusions. The real challenge with these models is going to be showing what works best and chiropractic has a respectable foundation of research in this area" stated McCoy.

In the case reported on in the article the initial application of chiropractic was followed by nutritional advice which included eliminating sugar and grains from the patient's diet. Correction of the spinal and related neurological interference was the first priority however. Abnormal position or movement of the spinal vertebra can develop and this can lead to nerve and vascular interference. It is this interference, called vertebral subluxations, that chiropractors correct.

The woman reported on in the study suffered from a number of health challenges including multiple sclerosis, gastroesophageal reflux disease (GERD), asthma, osteoarthritis, and scoliosis. She also had complaints of neck pain, back pain and jaw pain. She had been under the care of several healthcare professionals prior to presenting to the chiropractic office. These practitioners included the family medical doctor, a neurologist, allergist, rheumatologist, gastrointestinal specialist, cardiologist, and dermatologist. She was taking several medications.

The patient began to report improvement in pain levels throughout her body after just 12 visits, had better mobility and was able to increase her physical activity. Her lung function and posture improved and she was gradually able to discontinue all her medications. Follow-up x-rays revealed an improvement in the crucial curve in her neck.

The authors of the study call for more research on the role of chiropractic care in these types of disorders. 

Author: MSRC
Copyright: MSRC 2010

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House Passes Bill to Expand Chiropractic Care to All Major VA Medical Centers

The U.S. House of Representatives passed H.R. 1017, the "Chiropractic Care Available to All Veterans Act," tonight, putting America's veterans one step closer to gaining access to chiropractic care at all major Department of Veterans Affairs (VA) medical centers. The bill was approved 365:6.  

H.R. 1017 requires the VA to have doctors of chiropractic on staff at no fewer than 75 major VA medical centers before the end of 2011 and for all major VA medical centers to have a doctor of chiropractic on staff before the end of 2013. There are nearly 160 VA treatment facilities nationwide. Currently, the VA provides chiropractic care at 32 treatment facilities across the country. 

The bill comes after a recent VA report, "Analysis of VA Health Care Utilization Among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans," from Feb 2010 which cites "diseases of Musculoskeletal System/Connective System," such as back pain, as the number one ailment of Iraq and Afghanistan veterans accessing VA treatment. 

The American Chiropractic Association (ACA) believes that the inclusion of chiropractic care in the VA health care system would speed the recovery of many of the veterans returning from current operations in Iraq and Afghanistan. Chiropractic care has been proven to be a cost-effective and beneficial treatment option. In fact, a 2010 study published in Clinical Rehabilitation found that spinal manipulation provided better short and long-term functional improvement and more pain relief in follow-up assessments than other physiotherapy interventions. Furthermore, a 2003 study published in the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications.

House VA Committee Chairman Bob Filner (D-CA), a strong supporter of extending chiropractic care benefits to military retirees and active-duty personnel, introduced the legislation. Over the years, Rep. Filner has worked closely with ACA in securing support for a number of pro-chiropractic measures.  Rep. Michael Michaud (D-ME), Ranking Member Steve Buyer (R-IN) and Rep. Jerry Moran (R-KS) also deserve recognition for their support of this legislation.

"For too long, veterans have been denied access to the chiropractic care that they want, need and deserve through the VA," said ACA President Rick McMichael, DC. "I am proud that ACA has worked closely with our congressional allies, such as Rep. Filner, on behalf of our nation's heroes and in support of this important bill."

Prior to congressional intervention over the past decade, no doctors of chiropractic served on the staff of any VA treatment facility. The availability of chiropractic care for eligible veterans was limited to VA "referrals" to doctors of chiropractic serving in private practice outside of the VA system. Such referrals were so rare that chiropractic care was essentially non-existent within the VA system.

"I am especially proud that the member institutions that comprise the Association of Chiropractic Colleges will play a pivotal role in preparing the next generation of doctors of chiropractic to serve our military veterans throughout the United States and overseas," said Frank J. Nicchi, DC, MS, President of the Association of Chiropractic Colleges. "This legislation will assist in making that possible."

In the U.S. Senate, a companion bill (S1204) has been introduced by Sen. Patty Murray (D-WA), who is a member of the Senate VA Committee. This legislation would also expand access to chiropractic care within the VA system.

The American Chiropractic Association, based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients.

Author: American Chiropractic Association
Source: May 24, 2010.
Copyright: American Chiropractic Association 2010

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Food industry to Obama: We'll Improve Nutrition

The U.S. food industry is willing to let the White House take the lead on making foods healthier in schools, but said on Friday it could improve what is sold on store shelves without government intervention.

"The school environment is a special environment where having a government play a role in setting the standards for what's sold makes sense," Scott Faber, a vice president at the Grocery Manufacturers Association, told reporters.

"I think the public marketplace is a different environment," he said.

The Obama administration has launched an initiative, led by first lady Michelle Obama, to combat growing levels of obesity among children. She has urged food makers to work faster to reformulate or repackage food to make it healthier for children.

"They respect our ability to find ways to produce more products that offer consumers more choices including choices with less sodium, less sugar, less fat," said Faber.

The food industry group said its members improved the nutritional value of more than 10,000 products between 2002 and 2006 and plans in May to update that total to include changes through 2009.

A separate initiative called the Healthy Weight Commitment Foundation -- which includes many GMA members -- will announce pledges to improve the health content of its products later this month.

Obesity rates among U.S. children have doubled in the past 20 years, and almost a third of American children are either overweight or obese.

Obesity causes a host of health problems such as heart disease and diabetes and costs the United States an estimated $150 billion each year, according to U.S. federal agencies.

"We've heard from consumers and you can see this in the companies in terms of how they've changed their recipes," said Pamela Bailey, president and chief executive of GMA.

In an effort not to miss the lucrative push toward healthier foods, major food manufacturers have recently changed some popular products.

Kraft Foods, the maker of Oreo cookies and Velveeta cheese, announced it would cut sodium levels in its North American products by about 10 percent over the next two years -- eliminating more than 750 million teaspoons of salt.

PepsiCo, the world's No. 2 soft-drink maker, vowed in March to cut the levels of salt, sugar and saturated fats in its top-selling products by 2020.

Author: Christopher Doering
Source: Reuters. April 10, 2010.
Copyright: Reuters 2010

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