~ Green Tea and Fish Oil: It's Nutrients vs. Disease; UA Aims to Pick a Winner

The Arizona Daily Star, 05-30-05

You have been smoking heavily for many years. All you can do now is pray you don't develop one of the most deadly of all cancers - lung cancer.

But just maybe you also can drink plenty of green tea to delay or even prevent this hideous disease.

What if your problem is a high risk for colon cancer, because you have a precancerous polyp? You can try to ward off full-fledged cancer by eating more fruits and vegetables and less red meat.

But perhaps you can do more to protect yourself - by taking a daily capsule of the trace mineral selenium, maybe along with some vitamin E, to significantly drop your chances of ending up a cancer patient.

Or try this for a frightening scenario: You are pregnant with or just gave birth to your first baby. But instead of joy, you feel depressed, frustrated, maybe unable to even care for yourself or the infant. You don't want to take an antidepressant drug, fearing its effect on the baby.

However, there may be help in a safe and natural nutrient - fish oil capsules with omega-3 fatty acids that may lift your mood and nourish the baby's brain at the same time.

No one knows for certain if any or all of these simple, inexpensive, easy-to-get, easy-to-tolerate dietary agents actually work to fight off or prevent devastating diseases and disorders.

But a slew of scientific studies under way at the University of Arizona Health Sciences Center aims to find out within the next few years.

Considered one of the nation's top research centers in preventive medicine - especially the prevention of cancer - the UA is leading or involved in many of the first or largest studies ever done in this field.

"We are living in a health-conscious environment today. As our population ages, the threat of these chronic diseases grows. People want to take control over their lives, to try to prevent them as long as possible," said Dr. Suzanne Stratton, co-director of cancer prevention and control at the Arizona Cancer Center.

"In the last two decades, we have a lot more information empowering people about how to do that, and they are making real lifestyle changes.

"Bottom line is, people don't want to go to the doctor or end up in the hospital, and they're doing everything they can to stay healthy."

At the same time, Americans are increasingly spooked by popular medical drugs once thought safe now being yanked off the market because they cause heart attacks, strokes, even death.

"I will never take prescription drugs, or even over-the-counter drugs, unless it's a real emergency," said Sheal Cooper, 25, who battled severe postpartum depression after the birth of her first baby.

"I was raised by my parents to avoid being dependent on medicines, so I never have been, and I didn't want to start that cycle because of this problem. I am very concerned about the side effects of these drugs, about what we don't know about them - especially how that may affect a very young child.

"So when I heard there was something natural that might help, that's what I did."

After several weeks on high doses of omega-3 fatty acids - as fish oil capsules - Cooper felt the first relief from the depression and deep frustration she felt during her colicky baby's prolonged crying spells.

"I still had ups and downs, but now I felt I could handle those feelings," she said. "Before, I just wanted to escape. But finally, I wanted to care for my son. It seemed to really help."

Although UA studies and clinical trials are investigating such diverse nutrients as fish oil, vitamins E, D and calcium, lycopene in tomatoes, the Indian spice turmeric, a tree bark extract, and an Indian plant known as winter cherry, by far the main focus is on two dietary agents - green tea and the trace mineral selenium - for the prevention of cancers.

Used medicinally for thousands of years in China and Japan, green tea - derived from steaming green tea leaves - is being hurled against such threats as lung and cervical cancer, also cardiovascular disease, and even obesity in current and future UA studies.

"In many Asian countries, green tea is treated as a kind of holy beverage - they use it for everything, and drink it all the time," said Dr. Iman Hakim, a physician at the UA College of Public Health who heads several of the anti-cancer tea studies.

In epidemiologic and other studies out of these countries, green tea has been shown to have anti-inflammatory effects, antibiotic effects, cardiovascular benefit, and the ability to prevent cell proliferation and oxidation - processes that lead to cancer.

It is even linked to an increase in the body's metabolic rate, and preventing the absorption of fat - which means it may help with weight loss, Hakim said.

"Green tea appears to work in different ways, with different mechanisms, simultaneously in the body," she said.

Hakim wants to find out if it can thwart lung cancer and possibly heart disease in those at high risk for both - smokers:

* Some 200 smokers and former smokers suffering impaired lung function will drink eight cups of green tea, black tea or a placebo tea daily, without knowing which, for six months.

At the beginning and end of the study, they will undergo sophisticated tests of various biomarkers in the lung and cardiovascular systems to determine the extent of damage or repair to DNA, lung function, lipids, also cell growth and cell death - all warning signs of cancer or heart disease.

"Yes, eight cups is a lot of tea to drink, so we give them two teabags in a 12-ounce cup to make it easier," Hakim said. "They either love it or hate it. But the question is - can we get the damage levels down, so we can delay or even prevent these diseases?"

* A group of 200 former heavy smokers will consume either green tea as a beverage, or green tea extract in capsule form, or a placebo in both forms daily for six months. They too will be tested to determine the extent of damage or repair to biomarkers for lung cancer.

This study aims to find out if it is the polyphenol catechins in green tea - believed to be the beneficial ingredient - doing the job, or if other compounds also are involved. The capsules contain only the catechins, while the beverage has all compounds.

Hakim frankly admits she expects positive results.

"In some of the patients who have completed the study, we have seen clinical improvement - increases of 60 to 70 percent in lung function. That's outstanding," she said. "They tell us they can run and exercise more, and they keep asking us what they've been getting.

"But the study is blinded - nobody knows who gets what, and won't until it's over," Hakim said.

Although today's scientific interest in green tea is based on thousands of years of experience with it in ancient and exotic cultures, the focus on selenium started much more recently - in studies done at the UA in the mid-1990s.

Well-known as a powerful antioxidant - able to protect cells from oxidative damage that can trigger the cancer process - the trace mineral was first tested here against common skin cancers in 1996.

Although it proved useless against skin cancer, secondary analyses showed patients who took daily selenium supplements had a 60 percent reduced risk of prostate cancer and about a 50 percent lower risk of colon cancer.

On top of that, an exhaustive British review of 20 years of research of the major antioxidant vitamins - A, C, E and selenium - concluded only selenium showed any promise at preventing gastrointestinal cancers.

And so was launched a whole series of trials at the UA and nationwide testing of selenium in people at high risk for these two cancers - including the largest-ever cancer prevention trial:

* That trial, under way at the UA and 400 sites around the nation, has enrolled some 35,000 healthy men 55 or older, including about 500 in Arizona. They will take either daily selenium capsules, vitamin E, or both, or a placebo for at least five years. The study will be unblinded and analyzed in 2013 to see who developed the fewest prostate cancers.

"Cancer is a long 20- to 30-year process, and we're looking at where best to intervene in that process," Stratton said. "This is the earliest stage. Whether selenium will really pan out in these big numbers, no one knows."

* The UA is leading a five-year test of selenium in some 700 men who have elevated PSA levels - prostate antigens in the blood indicating cancer - but a negative biopsy for cancer.

* And in the latest stage of study, some 164 men diagnosed with slow-growing prostate cancer, and who are being monitored but not treated, will take daily selenium supplements or a placebo.

* Some 1,600 patients at high risk for colon cancer - who have had one or more precancerous polyps removed - will take daily selenium supplements for three to five years to see if it can reduce the rate of polyp recurrence - and thus the risk of colon cancer.

Although selenium is found in foods grown in selenium-rich soils, it is easier to obtain in supplement form. In these studies, doses of 200, 400 and 800 micrograms are being used in the form of organic brewer's yeast or selenized yeast pills.

All of these major vitamin and nutrient studies are federally funded, with multi-year grants from the National Institutes of Health, the National Cancer Institute and the U.S. Department of Defense.

Credited for putting the Arizona Cancer Center on the cancer prevention path years ahead of most medical centers, Dr. David S. Alberts - now the center's director - explained why.

"I've always looked at the entire process of carcinogenesis, from the first tumor cell to full-fledged metastatic cancer, and I've always thought we ought to be moving to the left - to the earlier stages, when we can turn back this process," he said.

"But if you do that, you're working with healthy people and you have to use nontoxic agents. So nutrients are the best place to start."


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