Do Organic Foods Decrease Cancer Risk?

Written by Dr. Steve Chaney on . Posted in Organic foods, Reduce Cancer Risk

Is Eating Organic Worth The Cost?

Author: Dr. Stephen Chaney

 

organic foods decrease cancer riskMillions of Americans choose organic foods whenever possible. However, organic foods are expensive, and some experts claim they are a waste of money. That is why recent headlines claiming that eating organic foods decrease cancer risk have created such a stir. I will look at the study behind the headlines below, but first let me summarize what we do know about organic foods.

I discussed a study comparing organic and conventionally-grown produce in a recent issue, Organic Foods Healthier, of “Health Tips From the Professor”. It was a major study that combined the results from 343 of the best-designed previous studies. The study found that pesticide and herbicide residues were 4-fold lower in organically-raised produce than in conventionally-raised produce. It also found that the polyphenol content of organically-raised produce was slightly higher than in conventionally-raised produce.

Neither of these findings automatically mean that eating organic produce will improve your health. However, there is increasing evidence that pesticide exposure is linked to increased risk of cancer. Thus, it seems logical that eating organic might decrease cancer risk. It is that hypothesis that the current study (J Baudry et al, JAMA Internal Medicine, doi: 10.1001/jamainternmed.2018.4357 ) was designed to test.

 

How Was The Study Designed?

stethoscopeThis study is part of a major French study called NutriNet-Santé that was launched in 2009. The NutriNet-Santé study is web-based study designed to investigate associations between nutrition and health.Volunteers with access to the internet were recruited from the general population. After agreeing to participate in the study, the volunteers were asked to complete a battery of online assessment forms.

The baseline data for the NutriNet-Santé study included age, sex, occupational status, education level, marital status, income, number of children, smoking status, physical activity, and diet. Dietary intake was assessed using three 24-hour dietary recalls collected over a 2-week period. Two of the 24-hour dietary recalls were on weekdays and one was on a weekend.

The dietary recalls were used to create a “score” of diet quality. Without going into detail, diets that favored animal protein, animal fats, sweets, and highly processed foods were considered “poor quality diets.” Diets that favored plant proteins, vegetable oils & and omega-3 fats, fruits, vegetables, and whole grains were considered “good quality diets.”

This portion of the NutriNet-Santé was designed to measure the correlation between organic food consumption and cancer risk. Two months after enrollment in the study, the participants were asked to provide information on the frequency with which they chose the organic version of 16 different types of food. From this information each participant was assigned an “organic food score” ranging from 0 to 32 points.

The participants in this study were also asked to complete a yearly health status questionnaire online. If they reported a cancer diagnosis, they were asked to provide their medical records, and the study physicians contacted the patient’s physician to confirm details of the diagnosis.

A total of 68,946 French adults completed the study (78% female, mean age 44.2 years). They were followed for an average of 4.56 years. During this time period there were 1340 new cancer diagnoses in this population.

 

Do Organic Foods Decrease Cancer Risk?

 

organic foods decrease cancer risk chartThe participants were divided into four groups based on their organic food score. When participants with the highest organic food score were compared to those with the lowest organic food score there was a:

  • 25% reduction in total cancer risk.
  • 86% reduction in non-Hodgkin lymphoma risk. This is not a novel finding. A previous study has also suggested eating organic might reduce the risk of non-Hodgkin lymphoma.
  • 76% reduction in all lymphoma risk.
  • 34% reduction in postmenopausal breast cancer risk.

The authors concluded “A higher frequency of organic food consumption was associated with a reduced risk of cancer. Although the study findings need to be confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer.”

These are the results and conclusions that made the headlines. However, the scientists who designed the study were aware of previous data showing that people who eat organic are also more likely to eat a healthy diet and follow a healthy lifestyle. Thus, their statistical analysis of the data considered all factors that might influence cancer risk. This analysis provided a much more nuanced interpretation of the data. They found that the association between increased organic food consumption and decreased cancer risk:

  • Was significant for women, older adults, individuals with a family history of cancer, individuals who had a poor diet, and former smokers.
  • Was seen for people of all weights but was greatest for individuals who were obese.
  • Was non-significant for men, younger adults, individuals with no family history of cancer, individuals who had a good diet, never-smokers, and current smokers.
  • Was non-significant for other types of cancer.

You are probably wondering “Does this mean organic foods are beneficial for some people, but not for others?” A superficial interpretation of these data might lead to that conclusion, but let’s dig a little deeper.

 

What Does This Study Mean For You?

organic foods decrease cancer risk women ponderingIn interpreting a study of this type, it is important to ask whether enough people will develop cancer during the study for the results to be statistically significant. That depends on 3 factors:

  • The number of people enrolled in the study.
  • The duration of the study.
  • The probability that participants will develop cancer during the duration of the study.

When you look at the whole study population, all three criteria have been met. There were 68,949 participants who were followed for 4.56 years. During that time 1340 of them developed cancer, of which 459 were breast cancer, 47 were non-Hodgkin lymphomas, and 15 were other lymphomas. A higher frequency of organic food consumption was associated with a decreased in the risk of all these cancers, and that decreased risk was statistically significant. This is the main take-home lesson of the study.

However, when you start to break the study down into subgroups, the number of people in each subgroup and the duration of the study become limiting factors. For example:

  • We don’t really know whether eating organic foods are unimportant for men or whether there were too few men in the study for any benefit to be statistically significant.
  • Colon cancer and many other cancers develop gradually over a 10 to 20-year period. We don’t know whether choosing organic foods is unimportant for these cancers or whether 4.56 years is too short a time to show a significant benefit.
  • The same is true for several of the other variables in this study. For example, if you are an older adult, have a family history of cancer, have a bad diet, and/or have smoked in the recent past, your probability of developing cancer over a 4.56-year time period is relatively high. On the other hand, if you are younger, have no family history of cancer, have a good diet, and have never smoked, your probability of developing cancer during that same time period is very low.

So, how do we interpret the data with these subgroups? We could conclude that eating organic foods in unimportant for people who are young, have no family history of cancer, have a good diet, and have never smoked. A more likely interpretation, however, is that people in these groups have such a low risk of cancer that 4.56 years is too short to demonstrate a benefit of organic foods. It might require a 10, 20, or 30-year study to show benefit of organic foods for these people.

Let me close with three important observations:

  • People often say too me: “I can’t afford organic fruits and vegetables, but I am concerned about pesticide exposure. Does that mean I should avoid fruits and vegetables?” The data from this study provide a clear answer. Eating lots of fruits and vegetables is beneficial even if you can’t afford organic.

[I also let them know about “The Dirty Dozen” ( Rank Produce Items By Pesticide Level ). This is a list of the fruits and vegetables most likely to be contaminated with pesticides. If your budget for organic foods is limited, these are the most important fruits and vegetables to spend it on.]

  • I find it ironic that people who consume a poor diet are the ones most likely to experience an immediate benefit from choosing organic foods. This is, of course, the group that is least likely to eat organic.
  • If you smoke, eating organic probably isn’t going to help you much. Your best bet is to stop smoking.

 

The Bottom Line

 

A recent study looked at the association between organic food consumption and cancer risk. When participants who consumed organic foods frequently were compared to those who almost never consumed organic foods there was a:

  • 25% reduction in total cancer risk.
  • 86% reduction in non-Hodgkin lymphoma risk. This is not novel. A previous study has also suggested eating organic might reduce the risk of non-Hodgkin lymphoma.
  • 76% reduction in all lymphoma risk.
  • 34% reduction in postmenopausal breast cancer risk.

The authors concluded “A higher frequency of organic food consumption was associated with a reduced risk of cancer. Although the study findings need to be confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer.”

These are the results and conclusions that you have seen in the headlines. However, the scientists who designed the study were aware of previous data showing that people who eat organic are also more likely to eat a healthy diet and follow a healthy lifestyle. Thus, their statistical analysis of the data considered all factors that might influence cancer risk. This analysis provided a much more nuanced interpretation of the data, which I have discussed in the article above.

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Trackback from your site.

Leave a comment

Recent Videos From Dr. Steve Chaney

READ THE ARTICLE
READ THE ARTICLE

Latest Article

The Truth About Vitamin D

Posted December 11, 2018 by Dr. Steve Chaney

Does Vitamin D Reduce Risk Of Heart Disease & Cancer?

Author: Dr. Stephen Chaney

 

the truth about vitamin dYou have every right to be confused. One day you are told that vitamin D reduces your risk of heart disease and cancer. The next day you are told vitamin D makes has no effect on those diseases. You are told vitamin D is a waste of money. What should you believe?  What is the truth about vitamin D?

In mid-November a major clinical study called VITAL was published. It examined the effect of vitamin D and omega-3s on heart disease and cancer risk. Last week I wrote about the omega-3 portion of the study. This week I will cover the vitamin D portion of the study.

Once again, if you rely on the media for your information on supplementation, you are probably confused. Headlines ranged from “Vitamin D Is Ineffective For Preventing Cancer And Heart Disease to “Vitamin D Lowers Odds Of Cancer Death.” What is the truth?

The problem is that reporters aren’t scientists. They don’t know how to interpret clinical studies. What they report is filtered through their personal biases. That is why I take the time to carefully evaluate the clinical studies, so I can provide you with accurate information. Let me sort through the dueling headlines and give you the truth about vitamin D, cancer, and heart disease.

How Was The Study Designed?

the truth about vitamin d studyThe VITAL study (JE Manson et al, New England Journal of Medicine, DOI: 10.1056/NEJMoa1811403) enrolled 25,871 healthy adults (average age = 67) in the United States. The study participants were 50% female, 50% male, and 20% African American. None of the participants had preexisting cancer or heart disease. The characteristics of the study group were typical of the American population at that age, namely:

  • The average BMI was 28, which means that most of the participants were significantly overweight.
  • 7% of them had diabetes.

Study participants were given questionnaires on enrollment to assess clinical and lifestyle factors including dietary intake. Blood samples were taken from about 65% of the participants to determine 25-hydroxyvitamin D levels (a measure of vitamin D status) at baseline and at the end of the first year. The participants were given either 2,000 IU of vitamin D/day or a placebo and followed for an average of 5.3 years.

There were two important characteristics of the participants in this study that may have influenced the outcome.

  • The average 25-hydroxyvitamin D level of participants at the beginning of the study was 31 ng/ml (78 nmol/L). The NIH considers 20-50 ng/ml (50-125 nmol/L) to be the optimal level of 25-hydroxyvitamin D for most physiological functions. This means that study participants started in the middle of the optimal range with respect to vitamin D status.

[Note: The NIH defines the 20-50 ng/ml range as “adequate.”  However, I know many of my readers like to aim beyond adequate to reach what they consider to be “optimal.”  In the case of vitamin D, that might not be a good idea. The NIH considers anything above 50 ng/ml as associated “with potentially adverse effects.”  For that reason, I will refer to the 20-50 ng/ml range as optimal for this article. I wouldn’t want to encourage my readers to be aiming for above 50 ng/ml.]

  • Only 12.7% of participants had 25-hydroxyvitamin D levels below 20 ng/ml, which the NIH considers to be inadequate. The results with this group were not statistically different from the study participants with optimal vitamin D status, but it is not clear that there were enough people in this subgroup for a statistically valid comparison with participants starting with an optimal vitamin D status.
  • At the end of the first year, 25-hydroxyvitamin D levels in the treatment group increased to 42 ng/ml (105 nmol/L), which is near the upper end of the optimal range. Thus, for most of the participants, the study was evaluating whether there was a benefit of increasing vitamin D status from the middle to the upper end of the optimal range.
  • The study allowed subjects to continue taking supplements that contained up to 800 IU of vitamin D. While the authors tried to correct for this statistically, it is a confounding variable.

Does Vitamin D Reduce The Risk Of Cancer?

 

the truth about vitamin d and cancerYou may remember from last week that omega-3s were more effective for reducing heart disease risk than for reducing cancer risk. What is the truth about vitamin D and cancer risk?   The results are reversed for vitamin D, so I will discuss cancer first.

The study reported that vitamin D supplementation did not reduce a diagnosis of invasive cancer of any type, breast cancer, prostate cancer, or colon cancer during the 5.3-year time-period of this study. This was the result that was reported in the abstract and was what lazy journalists, who never read past the abstract, reported.

However, the rest of the study was more positive. For example, occurrence of invasive cancer of any type was reduced by:

  • 23% in African-Americans.
  • 24% in patients with a healthy body weight.

Several previous studies have suggested that vitamin D may be more effective at preventing cancer in people with a healthy body weight, but the mechanism of this effect is currently unknown.

Most previous studies have not included enough African-Americans to determine whether they respond more favorably to vitamin D supplementation. However, African-Americans have a higher risk of cancer, so this finding deserves follow-up.

In addition, when the study looked at deaths from cancer, the results were very positive. For example:

  • Cancer deaths during the 5.3-year study period were reduced by 17%.
  • The longer vitamin D supplementation was continued the more effective it became at reducing cancer deaths. For example,
  • When the authors excluded cancer deaths occurring during the first year of supplementation, vitamin D reduced cancer deaths by 21%.
  • When the authors excluded cancer deaths occurring during the first two years of supplementation, vitamin D reduced cancer deaths by 25%.

Finally, no side effects were noted in the vitamin D group.

 

Does Vitamin D Reduce The Risk Of Heart Disease?

 

the truth about vitamin d and heart diseaseThe VITAL study also looked at the effect of vitamin D on heart disease risk. What is the truth about vitamin D and heart disease?  The results from this study were uniformly negative. There was no effect of vitamin D supplementation on all major cardiovascular events combined, heart attack, stroke, or death from heart disease. Does that mean vitamin D has no role in reducing heart disease risk? That’s not clear.

The authors had a thought-provoking explanation for why the results were negative for heart disease, but positive for cancer. Remember that the participants in this trial started with a 25-hydroxyvitamin D level of 31 ng/ml and increased it to at least 42 ng/ml with vitamin D supplementation.

The authors stated that previous studies have suggested the 25-hydroxyvitamin D level associated with the lowest risk for heart disease is between 20 and 25 ng/ml. If that is true, most of the participants in this trial were already in the lowest possible risk for heart disease with respect to vitamin D status before the study even started. There would be no reason to expect additional vitamin D to further reduce their risk of heart disease.

In contrast, the authors said that previous studies suggest the 25-hydroxyvitamin D level associated with the lowest risk of cancer deaths is above 30 ng/ml. If that is true, it would explain why vitamin D supplementation in this study was effective at reducing cancer deaths.

However, previous placebo-controlled clinical studies have also been inconclusive with respect to vitamin D and heart disease. My recommendation would be to think of adequate vitamin D status as part of a holistic approach to reducing heart disease – one that includes a heart-healthy diet and a heart-healthy lifestyle – rather than a “magic bullet” that decreases heart disease risk by itself.

As for heart-healthy diets, I discuss the pros and cons of various diets in my book, “Slaying The Food Myths.”  As I discuss in my book, the weight of scientific evidence supports primarily plant-based diets that include omega-3s as heart healthy. As an example, the Mediterranean diet is primarily plant-based and is rich in healthy oils like olive oil and omega-3s. It is associated with reduced risk of both heart disease and cancer.

 

What Is The Truth About Vitamin D?

 

the truth about vitamin d signThere is a lot of confusion around the question of whether vitamin D reduces the risk of cancer. This study strengthened previous observation suggesting that vitamin D supplementation decreases cancer deaths. However, it is also consistent with previous studies that have failed to find an effect of vitamin D on cancer development. How can we understand this apparent discrepancy? The authors provided a logical explanation. They pointed out that:

  • Cancer development takes 20-30 years while this clinical study lasted only 5.3 years. That means that vitamin D supplementation only occurred at the tail end of the cancer development process. In fact, the cancer was already there in most of the patients in the study who developed cancer. It just had not been diagnosed yet. In the words of the authors: “Given the long latency for cancer development, extended follow-up is necessary to fully ascertain potential effects [of vitamin D supplementation].”
  • In contrast, none of the patients had been diagnosed with cancer when they entered the trial. That means that the patients were diagnosed with cancer during the 5.3-year study period. They were receiving extra vitamin D during the entire period of cancer treatment. Thus, the effect of vitamin D on reducing cancer deaths was easier to detect.

What Does This Study Mean For You?

the truth about vitamin d questionsVitamin D Is Likely To Decrease Your Risk Of Dying From Cancer: When you combine the results of this study with what we already know about vitamin D and cancer, the results are clear. Vitamin D appears to reduce your risk of dying from cancer. More importantly, the longer you have been supplementing with vitamin D, the greater your risk reduction is likely to be.

Vitamin D May Decrease Your Risk Of Developing Cancer: Association studies suggest that optimal vitamin D status is associated with decreased cancer risk, especially colon cancer risk. However, the long time for cancer development means that we may never be able to prove this effect through double-blind, placebo-controlled clinical trials.

Holistic Is Best: When you combine the VITAL study results with what we already know about vitamin D and heart disease, it appears that supplementing with vitamin D is unlikely to reduce your risk of developing heart disease unless you are vitamin D deficient. However, a holistic approach that starts with a healthy, primarily plant-based diet and makes sure your vitamin D status is adequate is likely to be effective.

The same is likely true for cancer. While the latest study suggests that vitamin D supplementation reduces your risk of dying from cancer, those vitamin D supplements are likely to be even more effective if you also adopt a healthy diet and lifestyle.

How Much Vitamin D Do You Need? The optimal dose of vitamin D is likely to be different for each of us. One of the things we have learned in recent years is that there are significant differences in the efficiency with which we convert vitamin D from diet and/or sun exposure into the active form of vitamin D in our cells. Fortunately, the blood test for 25-hydroxyvitamin D is readily available and is widely considered to be an excellent measure of our vitamin D status.

I recommend that you have your blood level of 25-hydroxyvitamin D tested on an annual basis. Based on the best currently available data, I recommend you aim for >20 ng/ml (50 nmol/L) if you wish to minimize your risk of heart disease and >30 ng/ml (75 nmol/L) if you wish to minimize your risk of cancer. If you can achieve those levels through diet and a multivitamin supplement, that is great. If not, I would recommend adding a vitamin D supplement until those levels are achieved.

Finally, you shouldn’t think of vitamin D as a magic bullet. If you are a couch potato and eat sodas and junk food, don’t expect vitamin D to protect you from cancer and heart disease. You should think of maintaining adequate 25-hydroxyvitamin D levels as just one component of a holistic approach to healthy, disease-free living.

 

The Bottom Line

 

There is a lot of confusion around the question of whether vitamin D reduces the risk of cancer and heart disease. A major clinical study has just been published that sheds light on these important questions. It reported:

  • Vitamin D did not decrease the risk of developing cancer during the 5.3-year study duration. The authors pointed out that cancer takes 20-30 years to develop, which means their study was probably too short to detect an effect of vitamin D on the risk of developing cancer.
  • Vitamin D did decrease the risk of dying from cancer, and the longer people were supplementing with vitamin D the bigger the protective effect of vitamin D was.
  • Vitamin D did not decrease the risk of heart disease. However, most study participants had a level of 25-hydroxyvitamin D that was optimal for reducing the risk of heart disease at the beginning of the study. There was no reason to expect that extra vitamin D would provide additional benefit.
  • With respect to both cancer and heart disease the best advice is to:
    • Get your 25-hydroxyvitamin D levels tested on an annual basis and supplement, if necessary, to keep your 25-hydroxyvitamin D levels in what the NIH considers to be an adequate range (20-50 ng/ml).
    • We do not have good dose response data for the beneficial effects of vitamin D on heart disease and cancer. However, according to this article, previous studies suggest you may want to am for 25-hydroxyvitamin D levels above 20 ng/ml to reduce the risk of heart disease and above 30 ng/ml to reduce your risk of cancer.
    • Consider vitamin D as just one component of a holistic approach to healthy, disease-free living.

For more details about the interpretation of these studies and what they mean for you, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

UA-43257393-1