Cancer Decisions - Free Newsletter -February 14, 2004

THE MOSS REPORTS

We recently received the following letter:

"I always find your newsletters to be not only the most informative and candid assessments available on various cancer treatments, but also an enjoyable and personal journal of your travels, speaking engagements and honors received. You are truly a treasured resources for all those families struggling with cancer."

(Ken Schueler, President and CEO of HKS Patient Advocates.)

It is always a pleasure to hear from readers such as Mr Schueler. Please remember to tell your friends about this newsletter since the main way we grow is through word of mouth. Also remember that we have for sale reports on over 200 different types of cancer. We are also available for phone consultations and for individualized research. Let us know how we can be of service to you.

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PURSUING POMEGRANATES

Andy Warhol predicted that in the future everyone would be famous for 15 minutes. Perhaps, by the same token, every exotic fruit or vegetable will also get its quarter-hour in the sun. That time has clearly arrived for the pomegranate. Recent articles in such otherwise staid publications as Lancet Oncology and the Journal of the National Cancer Institute have asked whether pomegranates could be "nature's power fruit."

Pomegranates have a tough reddish rind and an interior containing many seeds, each enclosed in a juicy, mildly acidic red pulp. They are among the oldest and most fascinating of cultivated plants. A small deciduous bush or tree of the myrtle family, the pomegranate is native to northwestern India but is now widely cultivated for its edible fruit in many parts of the world (Fetrow 1999).

In the last year or so, a California company, Pom Wonderful, has been busily promoting a new line of pomegranate juice blends. Time magazine has enthused over it and new pomegranate-based cocktails have been created. Suddenly this once obscure fruit, which was generally found lurking modestly at the edge of the banana display, is showing up everywhere. I knew the pomegranate had 'arrived' when my local supermarket, never known for left coast trendiness, suddenly greeted me with a large promotional display featuring pomegranate juice. So part of the craze can be ascribed to skilful product placement.

Another source of renewed interest comes, oddly enough, from some religious groups. That is because, in the Bible, God specifically singled out the pomegranate as one of the delights awaiting the Hebrew nation when it reached the promised land (Deut. 8:8). In another Biblical passage, the Israelites, wandering around the desolate Zin Desert, complain that in Egypt at least they had "grain and figs and grapevines and pomegranates" (Numbers 20:5; see also Numbers 13:23 and Joel 1:12) - an early version of the four food groups. Some literal-minded religious groups aspire to emulate the ancient Jews in every respect. As a result of such references, they have rediscovered the pomegranate and embraced it as a "delicious and healthy Bible juice" (Foods of the Bible, 2004).

Some scholars have suggested that in the Book of Genesis it was the pomegranate, not the apple, with which Eve tempted Adam, leading to the expulsion of the pair from the Garden of Eden. Along with citrus and peaches, the pomegranate is also one of the three blessed fruits of Buddhism. In Greek mythology, the goddess Persephone was sentenced to spend half the year in the underworld just for consuming six pomegranate seeds - a backhanded compliment to the fruit's allure (McLaughlin 2003).

The name "pomegranate" comes from botanical Latin, Pomum granatum, meaning "grained apple." The "grains" in question are not grasses but the tightly-packed juicy seeds of the plant. The Romans themselves called pomegranate "Punicum malum," or the Carthaginian apple. (Punic was another term for Carthaginian.) This was because they received their own ample supply via the North African city of Carthage. There are also depictions of pomegranate trees in the House of the Faun in Pompeii (Melillo 1994). Pomegranates figure prominently in other religious and even magical ceremonies. In alchemy, pomegranates, like other red substances, were considered akin to blood, and therefore helpful in promoting longevity (Mahdihassan 1984). With a nod towards the fruit's mythological reputation, Pom Wonderful has been promoting pomegranates as a means of helping you cheat death. One advertisement states, "It's been around for 5,000 years. Drink it and you might be too" (McLaughlin 2003).

So is the pomegranate really something you need to add to your diet? Or can you can safely forego it until, let's say, feijoa, litchi nuts, and cherimoya edge it aside for their own fifteen minutes of fame?

Actually, the pomegranate's health value is well documented, but you have to have a taste for the fruit. I happen to love pomegranates and have eaten them for many years.

There is something about the one-two punch of pure sweetness followed by the slightly acidic tongue-tingling aftertaste that some of us find appealing. But I know of other people who are put off by this unusual combination. It was probably in an effort to mask the bitter half of the pomegranate equation that the marketers at Pom Wonderful ("Wonderful" being itself a variety of the fruit) have added other straight-up-sweet juices to the mix. I picked up an artfully designed bottle of their pomegranate-cherry mix at the food co-op. I enjoyed it but also thought the cherry flavor dominated. Even when I diluted it, the mixture was still too sweet for my palate. I missed the puckering tang of the original.

You can, of course, purchase whole pomegranates when they are in season in the fall. By chewing the seeds you will release the dark red juice. However, extracting edible material from a whole pomegranate in this way can be embarrassing because of all the spitting and slurping involved. It is perhaps something best done in the privacy of one's own home. That is one reason that sipping a pomegranate cocktail has become a socially acceptable substitute for slobbering over a peculiar red fruit in public.

What the Science Shows

Serious research on pomegranates has only been going on for about four years, and is still in a preliminary phase. Much of the research on pomegranates comes from Israel, which, thousands of years after the Bible was written, is still a major producer and exporter of the fruit. In 1999 Israeli scientists began to analyze the contents of various varieties and derivatives of the pomegranate, including fresh and fermented juices and a pressing of seeds. They found "strong antioxidant activity" that was "significantly greater than that of red wine," a major dietary source of the anthocyanin-type of antioxidant (Schubert 1999).

In another test, dried pomegranate seeds were found to have "antiseptic and disinfectant properties" and "potent antimicrobial activities" against test microbes including Bacillus subtilis, and a form of E. coli (De 1999). This is reassuring in our era of alarming new infections and confirms the sound basis of some of the traditional uses of pomegranate in folk medicine, where, for example, it was used as a treatment for diarrhea (Fetrow 1999).

The breakthrough article came in 2000. Israeli scientists, headed by Michael Aviram, DSc, gave pomegranate juice to healthy male volunteers and also to mice that were genetically predisposed to develop heart disease. After just 14 weeks they found "potent antioxidative effects of pomegranate juice" on the oxidation of lipids and on isolated fractions of the "good cholesterol" HDL and the "bad cholesterol" LDL, in both humans and test rodents. In humans, pomegranate juice consumption decreased "bad" LDL activity and increased markers for the "good" HDL by a significant 20 percent. In the mice, the oxidation of LDL (which is thought by some to be a major cause of heart disease) "was reduced by up to 90 percent after pomegranate juice consumption." Finally, pomegranate juice reduced the size of plaque (atherosclerotic lesions) in the arteries of the mice by 44 percent. These are impressive numbers. The same scientists concluded that pomegranate juice had potent anti-heart-disease effects in both healthy humans and in disease-prone mice "that may be attributable to its antioxidative properties" (Aviram 2000).

The following year, the same group showed that consumption of 50 milliliters (a mere 1.7 ounces) per day of pomegranate juice for just two weeks could lower the systolic blood pressure of hypertensive patients by 5 percent. The authors concluded that "pomegranate juice can offer a wide protection against cardiovascular diseases which could be related to its inhibitory effect on oxidative stress…." (Aviram 2001).

Dr. Aviram has been kind enough to share with me a preprint of a forthcoming article. It shows that after one to three years of consuming the same amount of promegranate juice, patients with preexisting cardiovascular disease showed great improvement in many important physiological measurements and pathological signs, compared to a control group. These measurements included carotid artery stenosis (CAS), common carotid intima-media thickness (IMT), blood pressure and LDL oxidation (Aviram 2004). The implications of this are vast, since heart disease remains the number one killer in many countries of the world.

California scientists have found that commercially prepared juices contain more antioxidants than preparations made purely from pressed seeds in the laboratory. That is because the industrial processing of pomegranates also extracts some of the bitter tannins that are present in the fruit's rind. In other words, some of the benefit of the pomegranate is associated with the very compounds that cause its slight bitterness. Commercially produced pomegranate juice contains tannins as well as other compounds, derivatives of anthocyanins and ellagic acid, all of which are associated with antioxidant activity. Scientists in Prof. Lester Packer's laboratory at the University of California, Berkeley, have independently confirmed that pomegranate juice contains at least three major antioxidants (Noda 2002).

Antioxidant activity is frequently measured through the Trolox Equivalent Antioxidant Capacity (TEAC) test. Pomegranate juice has been found to have a TEAC score of 18 to 20, which is an astonishing three times higher than that of red wine or green tea (Gil 2001).

Pomegranates Vs. Cancer

In recent years, scientists have also turned their attention to the relationship between pomegranates and another killer disease, cancer. It has been shown in experimental animals that pomegranate seed oil can prevent the formation of skin cancers by significantly decreasing tumor incidence and the number of lesions. "Overall," these South Dakota scientists wrote, "the results highlight the potential of pomegranate seed oil as a safe and effective chemopreventive agent against skin cancer" (Hora 2003).

Korean scientists have shown that antioxidants from fermented pomegranate juice caused a 47 percent inhibition of cancer formation in mice. They concluded that "clinical trials to further assess chemopreventive and adjuvant therapeutic applications of pomegranate in human breast cancer may be warranted" (Kim 2002).

Potential Dangers?

How safe is pomegranate? There are sometimes allergic reactions to the juice, but these very rare. The rind does contain a high concentration of tannins and these theoretically could be toxic to the liver. Some dried rinds have also been found to contain a carcinogenic substance, aflatoxin B-1 (Selim 1996). Anyone concerned about these issues should avoid eating rinds, especially dried rinds, which are sometimes imported for medicinal purposes.

There is also an odd association of pomegranate with esophageal cancer, a disease that is prevalent in northern Iran. Pregnant women in that area consume a local food called "majum" or "majoweh," which contains a mixture of sour pomegranate seeds, black pepper, dried raisins and garlic. There is some suspicion that "majum" is responsible for the increased esophageal cancer rate in that area. Rather than being chemically carcinogenic, however, it appears that, if anything, this harsh and scratchy mixture causes physical trauma to the esophagus, which then predisposes these individuals to cancer (Fetrow 1999).

In general, though, commercial pomegranate juice seems very safe. However, one distressing feature of these and other commercial fruits and juices is the danger posed by pesticide residues. In California, over 82,000 pounds of pesticide were sprayed on 57,000 acres of pomegranate trees in 2001 alone, according to the Pesticide Action Network (PAN). At PAN's website there is a detailed breakdown of such pesticide use including information concerning those sprays that are suspected of causing cancer (PAN 2003).

My own suggestion is to buy and drink organic pomegranate juice. It is not cheap and you may be surprised to pay over $7.00 for a 32-ounce bottle of juice. But since patients in Dr. Aviram's study consumed less than two ounces per day to attain major health benefits, the daily cost is actually around 50 cents
.

My top choice is Lakewood or some other reputable producer of organic juices. If interested, you can purchase a supply of their pomegranate juice online and have it delivered to your door by
clicking here.

For those who don't like the taste of pomegranates, or prefer to get their antioxidants in a supplement capsule, Solaray offers standardized extracts of the fruit, which you can access by
clicking here.

My book, Antioxidants Against Cancer, contains a full discussion of why and how foods containing antioxidants can be useful in the fight against cancer, heart disease and other illnesses. (It also has the most complete discussion I know of concerning the interaction of antioxidants and chemotherapy/radiation.) You can buy it by clicking here.

--Ralph W. Moss, Ph.D.

References:

Aviram M, Dornfeld L, Rosenblat M, et al. Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am J Clin Nutr. 2000 May;71(5):1062-76.

Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis. 2001 Sep;158(1):195-8.

Aviram M, Rosenbalt M, Gaitini D, et al. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis (CAS) reduces common carotid intima-media thickness (IMT), blood pressure and LDL oxidation. Clinical Nutrition (2004, in press).

Fetrow CW and Avila JR. Professional's Handbook of Complementary & Alternative Medicines. Springhouse, PA: Springhouse Corp., 1999, pp. 518-520.

Foods of the Bible. Retrieved February 8, 2004 from http://www.logia.net/products/pomegranate_juice.html

Gil MI, Tomas-Barberan FA, Hess-Pierce B, Holcroft DM, Kader AA. Antioxidant activity of pomegranate juice and its relationship with phenolic composition and processing. J Agric Food Chem. 2000 Oct;48(10):4581-9.

Hora JJ, Maydew ER, Lansky EP, Dwivedi C. Chemopreventive effects of pomegranate seed oil on skin tumor development in CD1 mice. J Med Food. 2003 Fall;6(3):157-61.

Kim ND, Mehta R, Yu W, et al.Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer. Breast Cancer Res Treat. 2002 Feb;71(3):203-17.

Mahdihassan S. Outline of the beginnings of alchemy and its antecedents. Am J Chin Med. 1984 Summer;12(1-4):32-42.

McLaughlin, Lisa. Pomegranate Power. Time, December 1, 2003. Retrieved February 9, 2004 from http://www.pomwonderful.com/

Melillo L. Diuretic plants in the paintings of Pompeii. Am J Nephrol. 1994;14(4-6):423-5.

Noda Y, Kaneyuki T, Mori A, Packer L. Antioxidant activities of pomegranate fruit extract and its anthocyanidins: delphinidin, cyanidin, and pelargonidin. J Agric Food Chem. 2002 Jan 2;50(1):166-71.

Pesticide Action Network report on pomegranates. Retrieved February 8, 2004 from http://www.pesticideinfo.org/DS.jsp?sk=6015#TopChems

Schubert SY, Lansky EP, Neeman I. Antioxidant and eicosanoid enzyme inhibition properties of pomegranate seed oil and fermented juice flavonoids. J Ethnopharmacol. 1999 Jul;66(1):11-7.

Selim MI. Aflatoxin B-1 in common Egyptian foods. J AOAC Int 1996;79:1124-1129.

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IMPORTANT DISCLAIMER

The news and other items in this newsletter are intended for informational purposes only. Nothing in this newsletter is intended to be a substitute for professional medical advice.