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November 2010

Soy and curcumin lower PSA
Mediterranean diet lowers diabetes risk
Meat increases metabolic syndrome
Combined exercise fights diabetes
Vegetables to prevent breast cancer
Red meat raises esophageal cancer

Soy and curcumin lower PSA

Prostate specific antigen (PSA) is a protein produced in the prostate. High serum levels of PSA are associated with prostate cancer as well as inflammation (PSA is also elevated after ejaculation, so men should wait at least one full day after ejaculation before the blood test). Chronic inflammation in the prostate promotes carcinogenesis, so anything that decreases the PSA might be beneficial in prostate cancer prevention.

Researchers in Japan evaluated the effect of a combination of curcumin (a turmeric extract) and soy isoflavones on prostate cancer cells, and then they did a human study. In the lab study, the cells’ production of PSA was markedly decreased by the treatment. The expression of the cell receptors for androgens (male hormones) was also suppressed by the combination.

In the human double-blind study, they included 85 participants, giving half of them daily doses of the combined isoflavones and curcumin and the other half a placebo. They evaluated them six months after the treatment started. In the subjects who started with an elevated PSA, they found a marked decrease in the level of PSA at the end of the study period. (Ide H, et al., Combined inhibitory effects of soy isoflavones and curcumin on the production of prostate-specific antigen. Prostate. 2010 Jul 1;70(10):1127-33.

Mediterranean diet lowers diabetes risk

In Spain, researchers evaluated 418 non-diabetic subjects aged 55-80 years for the effect of dietary intervention on the incidence of diabetes (this was part of a larger study on diet and cardiovascular risk, and all of the subjects had at least three risk factors for heart disease). They were divided into three groups: the control group, given only education on a low-fat diet, or two Mediterranean diets, one offering a free liter of virgin olive oil per week, and the other one ounce of nuts per day.

The diets were not restricted in any way, and they gave no advice on physical activity. They followed the subjects for an average of four years. In both Mediterranean diet groups, the incidence of diabetes was about half of the rate in the control group, independent of any weight changes. This suggests that something in olive oil or nuts helps to reduce the risk, possibly due to anti-inflammatory effects of the unsaturated oils or to other nutrients.

This is not to say that weight loss and exercise are not important parts of diabetes prevention. In the control group, those who did not develop diabetes lost a few pounds and those who become diabetic had gained a few. The Mediterranean diet is high in fiber-rich grains, fresh fruits and vegetables, mono-unsaturated oils, and fish, and low in red meat and dairy products. (Salas-Salvadó J, et al., Reduction in the incidence of type 2-diabetes with the Mediterranean diet: results of the PREDIMED-Reus Nutrition Intervention Randomized Trial. Diabetes Care. 2010 Oct 13. [Epub ahead of print])

I noticed in one report that a registered dietitian said that this dietary advice is good for anyone with diabetes or at risk of diabetes, but this means everyone! People who do not eat healthfully (and maintain a healthy weight) are at risk of diabetes, so there is no reason to restrict the advice to some subgroup of people. On another note, while the Mediterranean diet is superior to the American diet, it is not better than a traditional Asian diet, which is also low in meat and dairy.

Meat increases metabolic syndrome

Some patients at risk of diabetes and heart disease have a condition called metabolic syndrome (MetS), with high blood fats, central obesity, high blood pressure, insulin resistance, and elevated inflammatory markers. Some doctors tell patients to be on a low carbohydrate diet if they have MetS, but this can be misleading. MetS patients (and everyone else, really) should avoid refined carbohydrates, such as sugar and white flour, but diets that include complex carbohydrates, such as whole grains, vegetables and fruits, (including yams, and squashes) can actually help.

The low carbohydrate diets that are commonly recommended are usually high in meat and other animal proteins, but this approach is itself a risk factor for the conditions that we are trying to prevent. A new study shows that meat consumption increases the incidence of metabolic syndrome. (Babio N, et al., Association between red meat consumption and metabolic syndrome in a Mediterranean population at high cardiovascular risk: cross-sectional and 1-year follow-up assessment. Nutr Metab Cardiovasc Dis. 2010 Sep 26. [Epub ahead of print])

After one year, those subjects with the highest meat consumption had nearly triple the rate of development of MetS compared to those with the lowest consumption of meat. They also had a much higher rate of central obesity (eight times higher, although this trend did not quite reach statistical significance). Numerous problems have been associated with red meat consumption (as noted later), and a large body of evidence supports this same conclusion (and now I hope I do not get sued by the meat industry).

Combined exercise fights diabetes

Sugar in the blood is the fuel for cells, and muscle activity, which consumes sugar, is part of the complex process of controlling the level in the blood so it does not get too high. High levels of blood sugar, or glucose, is called hyperglycemia. Glucose comes from foods and is manufactured in the body, and insulin helps transport it into muscle cells (the brain uses glucose as a fuel also, but does not require insulin). Sucrose is a combination of glucose and fructose.

Diabetes is a persistent hyperglycemia that can result in dehydration in the short term and numerous problems in the long term, including vascular disease of the heart, brain, abdominal organs, and legs, and kidney and eye diseases. Type 1 diabetes results from a failure of pancreatic cells to produce insulin. Type 2 diabetes is related to diet and lifestyle, and can usually be controlled by exercise, diet, and a number of dietary supplements.

Exercise helps to control blood sugar by increasing the influx of glucose into the muscles where it is burned for energy. Exercises that help to build muscle increase the utilization of sugar even at rest because of the increased muscle mass, so it seems that a combination of exercises might help to prevent and treat diabetes. This is apparent from some new research from Louisiana. (Church T, et al., Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes; a randomized controlled trial. JAMA.  2010 Nov 24;304(20):2253-2262.)

The study was a controlled trial of 262 sedentary men and women who averaged 56 years old and had type 2 diabetes, with elevated glycohemoglobin levels (or HbA1c, a measure of long term blood sugar levels). They assigned 41 subjects to a non-exercise control group, 73 to resistance training (muscle building), 72 to aerobic exercise, and 76 to combined aerobics and resistance.

After nine months, they found some improvement in HbA1c levels in the two single exercise groups, especially in the aerobic group, but these were not statistically significant. However, in the group that combined aerobic exercise and resistance training, the HbA1c declined significantly. In addition, compared to the control group, all exercise groups lost about one inch in waist circumference. The resistance group lost about three pounds of body fat and the combined exercise group lost about four pounds of fat compared to the control group. Combining exercise with diet and supplements makes it possible to control diabetes in a large majority of type 2 diabetics.

Vegetables to prevent breast cancer

Numerous phytochemicals (plant-derived chemicals) in vegetables and fruits, grains, and legumes provide protection from chronic disease, including cancer. These include flavonoids, anti-inflammatory substances, and antioxidants. In a new report from the Black Women’s Health Study, researchers evaluated fruit and vegetable intake and breast cancer incidence in 51,928 women aged 21 to 69 years at the start of the research. (Boggs DA, et al., Fruit and vegetable intake in relation to risk of breast cancer in the Black Women's Health Study. Am. J. Epidemiol. 2010 Oct 11;172(11):1268-1279.)

The women were followed for 12 years, during which they found 1268 cases of breast cancer. Although previous research by the same group found that a diet high in fruits, vegetables, whole grains, and fish was protective, they wanted to find out whether the protection was specifically from the fruits and vegetables. They found that total fruit and vegetable consumption was not related to overall risk. However, high vegetable consumption was associated with a 42 percent reduction in the risk of estrogen-receptor-negative breast cancers, which are the most aggressive and the most difficult to treat. In addition, cruciferous vegetables (broccoli, cabbage, Brussels sprouts, kale, collards, mustards) lowered the risk of total breast cancer, but this was not quite statistically significant, while carrot intake was significantly related to reduced overall breast cancers.

Red meat raises esophageal cancer

New research shows low serum testosterone levels are associated with increased mortality from heart disease and other causes in spite of the prior misconception that testosterone was harmful to the heart . (Malkin CJ, et al., Low serum testosterone and increased mortality in men with coronary heart disease. Heart. 2010 Oct 19. [Epub ahead of print])

Researchers followed 930 men with heart disease for an average of 7 years. Those with low testosterone had 21 percent mortality, while those with normal levels had only 12 percent mortality. The excess risk was seen even with borderline low testosterone. Replacement with hormones could be beneficial to those with low levels. This can be done with bio-identical hormone in skin cream or sublingual lozenges, or with synthetic injections.

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From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.

Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.