Newsletter Archives > Monthly Health Newsletter: July 2010 Health Newsletter

July 2010 Health Newsletter

Current Articles

» Soy and Breast Cancer
» October is National Chiropractic Health Month, but ACA Asks: Why Weight?
» Glucosamine Doesn’t Appear To Lessen Low Back Pain
» "Mind-body" Therapy Shows Promise For Fibromyalgia

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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October is National Chiropractic Health Month, but ACA Asks: Why Weight?

National Chiropractic Health Month, sponsored by the American Chiropractic Association (ACA), is a nationwide observance held each October. This year's theme—"Why Weight? Get Healthy!"—and activities will focus on how doctors of chiropractic can play an important role in preventing and treating obesity.

More than 60 percent of adults in the United States are either overweight or obese, according to CDC statistics, and obesity is associated with an increased risk of diabetes, hypertension, heart disease, and some types of cancer. However, many people don't know that even modest weight loss, such as 5 to 10 percent of a person's total body weight, could improve blood pressure as well as blood cholesterol and blood sugar levels. That's only 10 to 20 pounds for a person who weighs 200 pounds.

Yet losing weight can be a struggle, and many people wonder where to begin. The answer for some may be in the office of a doctor of chiropractic (DC). Consultation with a DC is particularly important when you consider that the effects of obesity on the musculoskeletal system—osteoarthritis, back pain, neck pain and joint pain—often cause overweight and obese people to avoid physical activity and exercise when they need it most. DCs also counsel their patients on good nutrition and offer dietary and lifestyle advice in addition to expert structural care.

"If you're carrying more weight than the load-bearing structures of your body—spine, legs, etc.—can handle, there's going to be pain, loss of movement and degeneration in the joints," explains James Powell, DC, a member of ACA's Wellness Committee. "Particularly if you're carrying most of your weight in your abdomen, the low back and the spine will need to work harder to hold you upright. This adds extra stress and tension on your muscles, which in turn creates stiffness."

Each year in October, ACA and its members raise public awareness of chiropractic care by observing National Chiropractic Month. Starting this year, the association will celebrate National Chiropractic Health Month in an effort to promote a broader understanding of chiropractic's approach to patient care—as natural, whole-body, patient-centered health care.

"National Chiropractic Health Month is an important opportunity to educate the public on the general health benefits of chiropractic care, which include so much more than simply the expert hands-on care that DCs are so well known for," said ACA President Rick McMichael, DC. "Doctors of Chiropractic focus on changing patients' habits—postural, physical activity, nutritional, etc.—to promote health and wellness, short-term and long-term. Patients are tired of quick fixes that don't produce lasting weight loss and better health; and they are always delighted to discover how doctors of chiropractic promote total health and wellness over a lifetime."

For more information about National Chiropractic Health Month, visit 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: July 6, 2010.
Copyright: American Chiropractic Association 2010

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Glucosamine Doesn’t Appear To Lessen Low Back Pain

With 80 percent of the population experiencing back pain sometime during their life, it would be nice if taking a natural supplement would be the cure. New research shows that supplementing with glucosamine, while potentially beneficial to the joints, doesn’t appear to be the silver bullet for low back pain. When Norwegian researchers randomly gave a group of 250 patients with chronic low back pain either glucosamine or a sugar pill for 6 months, there was little difference in pain outcomes. At both 6 and 12 months, there was no significant difference between those receiving the glucosamine or those receiving the sugar pill. And while glucosamine may still possess other benefits including success in certain cases of knee osteoarthritis, its ability to specifically lessen lower back pain does not appear to be one of them. If you’re suffering from back pain, don’t give up hope. Consult your local licensed doctor of chiropractic today to discover other safe and natural alternatives to reducing and eliminating your back pain.

Source: Reuters. July 7, 2010.
Copyright: LLC 2010

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"Mind-body" Therapy Shows Promise For Fibromyalgia

A form of 'mind-body' therapy that focuses on the role of emotions in physical pain may offer some relief to people with fibromyalgia, a small clinical trial suggests.

The study, of 45 women with fibromyalgia, found that those who learned a technique called "affective self-awareness" were more likely to show a significant reduction in their pain over six months. Overall, 46 percent of the women had a 30-percent or greater reduction in their pain severity, as measured by a standard pain-rating scale.

Fibromyalgia is a syndrome marked by widespread pain -- including discomfort at specific "tender points" in the body -- along with symptoms such as fatigue, irritable bowel and sleep problems. It is estimated to affect up to 5 million U.S. adults, most commonly middle-aged women.

The precise cause of fibromyalgia is unknown -- there are no physical signs, such as inflammation and tissue damage in the painful area -- but some researchers believe the disorder involves problems in how the brain processes pain signals.

Standard treatments include painkillers, antidepressants, cognitive- behavioral therapy and exercise therapy. However, many people with fibromyalgia find that their symptoms -- pain, in particular -- persist despite treatment.

Part of that, according to the researchers on the new study, may be because standard treatments do not specifically address the role psychological stress and emotions can play in triggering people's pain.

That is not to say that the pain people with fibromyalgia feel is "all in their head," stressed Dr. Howard Schubiner, of St. John Health/ Providence Hospital and Medical Centers in Southfield, Michigan.

"The pain is very real," Schubiner said in an interview. But, he explained, pain and emotions are "connected in the brain," and emotional factors may act to trigger "learned nerve pathways" that give rise to pain.

Past studies have found that compared with people without fibromyalgia, those with the disorder have higher rates of stressful life events, such as childhood abuse, marital problems and high levels of job stress. There is also evidence that they are relatively less aware of their own emotions and more reluctant to express their feelings, particularly anger.

For the new study, published in the Journal of General Internal Medicine, Schubiner and his colleagues tested the effects of affective self-awareness -- a technique Schubiner developed and uses in treating certain chronic-pain conditions -- on fibromyalgia.

They randomly assigned 45 women with the condition to either undergo the therapy or go on a wait-list for treatment, serving as a control group. Women in the treatment group each had a one-on-one consultation, then attended three group meetings to learn the affective self-awareness techniques so that they could carry them out on their own.

The therapy involves an educational component where patients learn about the emotion-pain connection. They learn specific techniques -- including mindfulness meditation and "expressive" writing -- for recognizing and dealing with the emotions that may be contributing to their pain. Patients are also encouraged to get back to any exercise or other activities that they have been avoiding due to pain.

Schubiner's team found that six months later, 46 percent of the treatment group had at least a 30-percent reduction in their pain ratings compared with scores at the outset. And 21 percent had a 50-percent or greater reduction.
None of the women in the control group had a comparable improvement.

The study is only the first clinical trial to test affective self-awareness for fibromyalgia, and it had a number of limitations, including its small size. In addition, the control group received no active therapy to serve as a comparison.

That is important because it is possible for patients to benefit from simply receiving attention from a healthcare provider, or being part of small-group sessions with other people suffering from the same condition, for example.

Schubiner also acknowledged that this general "model" for understanding and addressing fibromyalgia pain is controversial.

He said that he and his colleagues have applied for funding to conduct a larger clinical trial comparing affective self-awareness with standard cognitive-behavioral therapy.

Affective self-awareness and cognitive-behavioral therapy have similarities, according to Schubiner. Both, for example, try to show patients that they have the power to improve their own health.

A key difference, Schubiner said, is that affective self-awareness asks people to "directly engage" the emotions that may be helping to drive their symptoms.

Another difference is that, right now, only a small number of healthcare providers practice affective self-awareness, according to Schubiner.

Some components of the technique, such as teachings in mindfulness meditation, are more widely available. But whether those practices in isolation would help fibromyalgia patients' pain is not clear.

Author: Reuters
Source: Journal of General Internal Medicine, online June 8, 2010.
Copyright: Reuters 2010

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