Recently, several studies have been published that seem to indicate that taking flax seed, or flax seed oil, might exacerbate or even cause prostate cancer.
Probably the most damning of these was the dietary study in Uruguay that found that those with the highest intake of ALA (alpha-linolenic acid, an omega-3 fatty acid precursor found at high levels in flax seed) had a 440% increase in their risk of getting prostate cancer compared with those at the lowest level. Therefore, ipso facto, since flax seed has a high concentration of ALA, it should be avoided by anyone who has prostate cancer or is worried about getting prostate cancer.
Needless to say, this has resulted in a flood of warnings on the net – and a flood of questions to my email site. So what is the true story?
As it turns out, it may be a case of flax being declared guilty by being found at the scene of the crime, rather than actually being the criminal. Sort of like saying that policemen may actually cause crime because, statistically, you always find a lot of them at crime scenes.
To understand what I'm talking about, it's worth looking at this from two angles, commonsense and biochemistry. But first, since, as they say, you can't tell the players without a scorecard, here are the players. (Note: this table is primarily for reference as the different fats are mentioned in the newsletter.)
|Saturated fats||Polyunsaturated fats||Monounsaturated fats|
|Omega-6 fatty acids||Omega-3 fatty acids||Omega-9 fatty acids|
|Meat (grain fed)||Linoleic acid: From safflower, sunflower, corn, hemp, soybean, walnut, pumpkin, canola, and sesame oils.||Alpha-linolenic acid (ALA): From flaxseed, canola oil, hempseeds, greens, walnuts and soy, range fed meat, cage free eggs||Olives and avocados|
|Dairy||Arachidonic acid – via synthesis from linoleic acid and consumption of meat||Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA): From fish, marine animals, alga, and from the breakdown of alpha-linolenic acid|
|Hydrogenated oils||Gamma-linolenic acid (GLA): From black current seeds and evening primrose oil.|
|Chocolate, coconut oil, palm oil||DGLA|
It's important to understand that most substances that contain fats or oils, contain more than one kind. Canola oil, for example, contains omega 3s, 6s, and 9s. Meat contains not only saturated fat, but also omega-6s and 3s. What this table shows is the major fat that each food provides.
ALA, the True Story
Commonsense: Omega Fatty Acids
For most of human existence, we have eaten foods containing omega-6 fatty acids (linoleic acid and arachidonic acid) and omega-3 fatty acids (DHA, EPA, and alpha-linolenic acid) in a ratio of about 1:1 to 2:1. Over the last 50 years, however, in the “civilized world” that ratio has changed to 20:1 or 30:1 and in some cases as high as 50:1. Our diets now include huge amounts of highly refined oils that are extracted from plants and used for cooking or in prepared foods. These oils (such as corn oil, safflower oil, cottonseed oil, peanut oil, and soybean oil) are all high in the omega-6s. As a consequence, we have dramatically decreased our intake of omega-3's as found primarily in whole grains, beans and other seeds, and seafood – now getting our omega-3's primarily as the secondary fatty acid in our highly refined bottled oils.
And yet, it is over this exact same 50-year period, as we have moved away from raw seeds and oils such as flax (all high in ALA), that the incidence of prostate cancer has soared. (Just as a side note, the incidence of prostate cancer in Uruguay, the source of the referenced study, has increased by close to 80% in the last 50 years. And, for what it's worth, the Uruguayan diet is comprised largely of meat (a major dietary source of ALA), dairy, and lots of food fried in refined cooking oils such as canola oil (also a major dietary source of ALA) – and virtually no flaxseed or unheated cold-processed flax oil.
Commonsense says that over the last 50 years we've been doing something wrong – as it turns out, probably several things.
- As detailed above, we now get most of our omega-3s from foods that are ever higher in the omega-6 fatty acids, thus accounting for the increasing distortion of the fatty acid balance.
- The oils that we are consuming (even our omega-3s) have been heated to high temperatures in the process of refining them and in the process of cooking. As we will see later, this is particularly devastating.
- We have refined out the beneficial phytochemicals such as the lignans, which are an integral part of the oil complex, and which play a key anticancer role in the body
- Since we rarely eat fresh food anymore, we are also now consuming an ever-larger portion of rancid (oxidized) fats in our diets, which produces a large number of cancer forming free radicals in the body. (Note: The less saturated a fat is, the faster it will go rancid – a particular problem for vegetable oils.)
And yet, if you were to take the studies seriously, and listen to the advice of the medical community, you would be encouraged to keep moving in that same direction – but even more strongly than you are doing so now.
Scientific Studies on Flax Seed
As is typical in the scientific community, there are a number of studies that have come to the exact opposite conclusion concerning flax. For example, a Duke University Medical Center pilot study, published in the July 2001 issue of Urology, suggests that flaxseed, coupled with a low-fat diet, may help men reduce the risk of prostate cancer. The conclusions of the study were that even short-term changes to a high-fiber/flax supplemented diet resulted in prostate cancer cells that didn't divide as quickly as those in people not on the diet. And in men with early-stage cancers, a decrease in PSA levels associated with the cancer was also noted. “I really didn't think we'd have results like we did, because this was a diet and not drug intervention," said Wendy Demark-Wahnefried, associate research professor in the department of surgery at Duke.
Then again, a Korean study found that the ratios of serum omega-3 to omega-6 polyunsaturated acids were highly indicative of prostate cancer, ranging from 0.89 for normal subjects to 0.71 for men with BPH to 0.50 for men with prostate cancer. The men with prostate cancer also had significantly higher levels of omega-6 acids than did the normal men and the men with BPH. The researchers concluded that their work supports the contention that omega-6 polyunsaturated fatty acids have a tumor-promoting effect while omega-3 acids have a protective effect. Clinical Biochemistry, Vol. 32, August 1999, pp. 405-09
Can't see the forest for the trees
So what's going on here? Well, the only way to truly understand what's happening is to take our noses out of the trees and look at the whole forest for a moment.
What happens to ALA in the body?
In a healthy body, a portion of the alpha-linolenic acid we consume is converted into two forms that your body can more readily utilize, DHA and EPA.
- Unfortunately, this process, which is governed by a particular enzyme (delta-6 desaturase), is significantly inhibited (up to 50% or more) by an overabundance of linoleic acid. The enzyme is literally “used up” in the desaturation process involved in getting rid of excess omega-6 fats, as found in sunflower oil and corn oil, etc. Therefore the enzyme is no longer available for converting ALA to it's more usable cousins, DHA and EPA.
- In addition, the delta-6 enzyme is also inhibited by the trans fatty acids found in hydrogenated oils, margarine, shortening, and refined oils – all significant components of the modern diet.
- Delta-6 is further inhibited by high levels of insulin, a problem in large percentages of civilized societies where obesity and diabetes are soaring. In America, two-thirds of the population is now considered overweight.
- And finally, the process of delta 6-desaturation of linoleic and alpha-linolenic acids slows with aging.
Each and every one of these factors can lead to an accumulation of ALA, which is counterproductive. But alleviating that build-up is relatively easy.
- Stop using all plastic fats – that is, all hydrogenated vegetable oils and all super-refined vegetable oils. The high temperatures that these oils are exposed to dramatically changes their structure. This may be the single biggest flaw in the alpha-linolenic studies. No distinction was made between highly refined and cold-pressed oils. They are not the same. They behave very differently in the body.
- Stop cooking with high omega-6 oils, such as safflower, sunflower, and corn oil, and shift to olive oil, coconut oil, avocado oil, and grass-fed organic butter (in moderation). And if you need to use oil for high-temperature frying or sautéing, use small amounts of refined avocado oil or Spectrum Naturals Super Canola oil, which are both heat resistant.
- Shift away from high-glycemic refined-carbohydrates and move to a more Mediterranean style diet to help lower insulin levels.
- And finally, an effective method of counteracting the effect of the slowed desaturation of linoleic acid is to provide the 6-desaturated metabolite, gamma-linolenic acid (GLA) directly. The delta-6 desaturation of linoleic and especially alpha-linolenic acid increases dramatically in the elderly with GLA supplementation. The best source of GLA is black currant seed oil. Another good source is evening primrose oil. One other advantage to GLA supplementation is that much of the GLA is converted to DGLA, which competes with arachidonic acid and prevents the negative inflammatory effects that arachidonic acid otherwise causes in the body.
The Budwig Diet
Okay, no discussion of prostate cancer and flax would be complete without at least mentioning Dr. Johanna Budwig and her flax oil treatment for cancer. I know a lot of doctors will object because there have been no peer-reviewed studies supporting her program. On the other hand, there is voluminous anecdotal evidence in Europe and the United States. And you can argue all you want about the efficacy of the program (I happen to believe that the evidence is compelling that it's beneficial), but the one thing that is inarguable is that there is absolutely no evidence that any of the vast numbers of men who have used her program of high flax oil consumption have suffered increased rates of prostate cancer – absolutely none. The large numbers of men with prostate cancer following her high-intake flax oil program with no negative results stands as the single greatest refutation of the anti-flax discussion.
Very briefly, Dr. Budwig found that flaxseed oil, with its two fatty acid components (alpha-linolenic acid and linoleic acid), was held together by three “high-energy” pi-electron double bonds and is capable of transferring immense amounts of energy resulting from those pi-electrons to every cell in the body. And for those of you who have read, Lessons from the Miracle Doctors, you know that cancer is associated with low energy states in cells. In other words, using the Budwig diet can raise the energy level of cells to a non-cancerous level. In addition, the pi-electrons found in flax promote a much greater assimilation of oxygen in the cells of the body – also a major anticancer factor. The bottom line is that a huge amount of anecdotal evidence strongly indicates that her program works. Far from promoting prostate cancer, consumption of flax oil, may very well play a major role in reversing it. HOWEVER, heating the flaxseed oil, prevents this energy transfer from taking place, so it is absolutely necessary to use cold pressed, unprocessed oil.
The bottom line is that I believe that once you look at all the evidence that exists at this stage of the game, commonsense and scientific included, it becomes apparent that neither flax seed nor alpha-linonenic acid present any health risk. The risk primarily comes from the consumption of bottled oils and salad dressings, that are high in linoleic acid, that are highly refined, and that have been exposed to high levels of heat – that and the consumption of large amounts of grain fed beef.
So what do I do?
- Until I see some studies that account for the factors mentioned in this newsletter (and I do not expect to see such studies), I am continuing to use ground flaxseed. (Also, the concentration of ALA in the seed is so low that it has absolutely no impact on ALA levels in the body. But that said, I would have no problem using flax oil, if I were so inclined; but I prefer the seed because of its beneficial fiber and its higher lignan content.
- I also use fish oil capsules, because the EPA and DHA omega-3 fatty acids are much more readily utilized by the body than ALA. In addition, the EPA and DHA partially replace the omega-6 fats, especially arachidonic acid, in cell membranes. (If you're absolutely panicked by the flax warnings, you can use fish oil instead of flax and receive many of the benefits, but you will have to find another source of fiber, and you absolutely will not get the anticancer and cardiovascular-promoting benefits of the flax lignans.)
- I take a black-currant-seed-oil capsule every day for its high GLA content. (Available in virtually every health food store or on the net).
- I use no hydrogenated or partially hydrogenated oil (just what sneaks in when I go to a restaurant). And I use almost no high omega-6 oil (maybe two to four tablespoons of super canola oil or avocado oil a month for sautéing – and that's cooking for two people).
- I don't eat red meat (personal choice), and limit fish and chicken (for the most part) to less than 4 ounces a day when I do eat it.
- I eat very little dairy. Maybe the equivalent of less than ½ pound of cheese a month. (High dairy consumption is associated with increased levels of prostate cancer.)
- I use a men's progesterone crème to counter the effects of exposure to xenoestrogens, which stimulate the BCL2 gene, thereby allowing prostate cell growth to continue unabated – a major factor in the development of prostate cancer.
- I take red raspberry seed ellagitannin extract to promote prostate cancer cell death for any abnormal cells that may appear.
- And finally, I use an antioxidant formula and testosterone un-binder to inhibit the lipoxygenase enzyme that metabolizes arachidonic acid into 5-HETE, the primary “food” that prostate cancer cells need to survive. Research has repeatedly demonstrated that prostate cancer cells die “massively and rapidly” no more than 1 to 2 hours after the production of 5-HETE has stopped. As it turns out, a number of the ingredients such as green tea, saw palmetto, wild oats, and nettles inhibit the lipoxygenase enzyme.
Does this mean that I will never get prostate cancer? No. Unfortunately, there are no guarantees in health, just odds. I believe that this program significantly improves my odds, and I believe that the new warnings concerning flax do not necessarily do that. I believe that these warnings are based on bad science, studies with so many flaws that the conclusions have to meaning.
But isn't it better to be safe than sorry? Not necessarily. As I said at the beginning of this report, it would be akin to blaming the police for crime because they are always found at the scene of the crime – then coming to the conclusion that "Maybe it's true and maybe it isn't, but just to be safe we probably shouldn't use any police at all, just in case they really are responsible for crime." Ultimately, the biggest problem I have with the "warnings" concerning flax is that not only do they damn a valuable component of a healthy lifestyle based on faulty information, but they let the true killers (highly refined, high omega-6 oils) go free, and, what's more, gently nudge people even further into their arms. On reflection, this may not be a "safe" decision after all; it might be downright unhealthy.
Anyway, I hope that sheds some light on the flaxseed/prostate cancer controversy.
Note: When I think of the natural therapies that have come under false scientific attack over the years, I get angry. And even though, the attacks are later retracted ("Whoops, new research proves it's actually okay."), the taint remains. Exonerated but forever tainted therapies include Chaparral, DMSO, and Senna, to name just a few. And currently on the chopping block are Kava Kava (talk about a bogus attack) and Flax. Anyway, if Jon's information made sense to you, pass it along. Heaven knows, flax could use a few defenders right now.