about a health problem you've been trying to reverse?

Maybe high blood pressure, diabetes, or heart disease.

Well, there's nothing I like better than bringing you the information

that will help you do just that.

Welcome to the Nutrition Facts Podcast.

I'm your host, Dr. Michael Greger.

There are a variety of unique health issues that women face

that affect their quality of life.

And today we start with one way to treat

one of the most debilitating diseases that women face: endometriosis.

Endometriosis is a major cause of disability

and compromised quality of life among women — a chronic disease

which is under-diagnosed, under- reported, under-researched.

For patients it can be a nightmare of misinformation, myths, taboos,

lack of diagnosis, and problematic hit-and-miss treatments,

overlaid by a painful, chronic, stubborn disease.

Pain is what best characterizes the disease,

pain, painful intercourse, heavy irregular periods and infertility.

About one in a dozen young women suffer,

and it accounts for about half the cases of pelvic pain and infertility.

It's caused by what's called retrograde menstruation.

Instead of the blood going down, it goes up into the abdominal cavity,

where bleeding tissue of the uterine lining can implant onto other organs.

You can have the lesions surgically removed,

but the recurrence rate within five years is as high as 50%.

Now, endometriosis is an estrogen-dependent disease,

so might the anti-estrogenic effects of the phytoestrogens

in flaxseeds and soy foods help, as they appear to in breast cancer?

I couldn't find studies on flax, but soy food consumption may indeed

reduce the risk of endometriosis,

but I couldn't find any studies on treating the disease with soy.

There's another food, though, associated

with decreased breast cancer risk: seaweed.

Seaweeds have special types of fiber and phytonutrients

not found among land plants, so it's not like choosing

to get your beta-carotene from a carrot versus a sweet potato.

If you want these unique seaweed components,

some of which may have anti-cancer properties,

we need to find a way to incorporate sea vegetables into our diets —

anti-cancer properties such as anti-estrogen effects.

Japanese women have among the lowest rates of breast,

endometrial, and ovarian cancers.

They have longer menstrual cycles and lower estrogen levels

circulating in their blood and that may help account

for their low risk of estrogen-dependent cancers.

We assumed this was their soy intake, but the seaweed might be helping as well.

You can drip seaweed broth on human ovary cells that make estrogen

and see estrogen levels drop, because it's either

inhibiting production or facilitating breakdown of estrogen,

and may even block estrogen receptors,

lowering the activity of the estrogen you do produce.

This is in a Petri dish, though, but it happens in women as well.

They estimate that an effective estrogen-lowering dose of seaweed

for an average American woman might be around 5 grams a day,

but no one has apparently tried testing it on cancer patients yet,

but it has been tried on endometriosis.

Three women with abnormal cycles— two of which with endometriosis—

volunteered to add a tiny amount of dried powdered bladderwrack,

a common seaweed, to their daily diet.

It effectively lengthened their cycles and reduced the duration of their periods.

And not just by a little. Check out subject number 1.

A 30-year history of irregular periods, averaging every 16 days,

but adding just a quarter teaspoon of this seaweed powder a day

added 10 days onto her cycle, up to 26 days,

and a half teaspoon a day brought her up to like 31,

nearly doubling the length of her cycle.

And they all experienced marked reductions in blood flow

and a decreased duration of menstruation.

Poor subject number 1 was having periods every 16 days

that lasted 9 days long. Can you imagine?

After 30 years of this kind of craziness, just a half teaspoon of seaweed a day

and she was having periods just once a month and only lasting about 4 days.

And most importantly, in the two women suffering from endometriosis,

they reported substantial alleviation of their pain.

How is that possible? Look at their drop in estrogen levels.

A 75% drop after just a quarter teaspoon of seaweed powder a day,

85% after a half teaspoon.

Now obviously with just a couple women, no control group,

we have to do bigger better studies.

But look when this study was published: more than a decade ago

and not a single such study has been published since.

Does the research world just not care about women?

Millions of women are suffering with these conditions.

Who's going to fund it, though?

That much seaweed costs less than 5 pennies,

so a larger study may never be done.

But with no downsides, I would suggest endometriosis sufferers give it a try.

In our next story,

we look at how oxidized cholesterol found in eggs,

processed meat, and parmesan cheese

can have cancer-fueling estrogenic effects on human breast cancer.

In 1908, the presence of cholesterol crystals was noted

in the proliferating areas of cancers, suggesting that perhaps cholesterol,

in some way, was associated with the regulation of cancer proliferation.

A century later we now recognize the accumulation of cholesterol

as a general feature of cancer tissue,

and recent evidence suggests that cholesterol

may indeed play critical roles in the progression of cancers,

including breast, prostate, and colorectal cancers.

Perhaps that could explain why egg consumption was associated

with increased breast cancer risk.

And indeed, a systematic review of the evidence suggests

that dietary cholesterol intake increases risk of breast cancer,

and the more cholesterol you eat, the higher the risk appears to go.

But why?

One thought is that the prolonged ingestion of a cholesterol-enriched diet

induces a chronic auto- inflammatory response,

and we know that chronic inflammation can lead

to the initiation, promotion, and progression of tumor development.

It's true that sprinkling some cholesterol on white blood cells

in a test tube can trigger the release of inflammatory compounds,

and LDL cholesterol can induce breast cancer proliferation and invasion.

But again that's in vitro, where you can show that like breast cancer cells

can migrate nearly twice as far within a day in a petri dish

in the presence of LDL cholesterol.

But what about in people?

Well, the level of LDL cholesterol in the blood of women

diagnosed with breast cancer does appear to be

a predictive factor of tumor progression.

About two years after surgery/chemo/radiation,

not one of the women in the lowest third of LDL cholesterol levels

had a cancer recurrence.

The same could not be said for women with higher cholesterol.

We know cholesterol can cause inflammation in our artery walls.

Maybe it's also playing an effect on breast cancer initiation and progression?

They speculate that the high cholesterol levels may have a cancer-fueling effect.

And indeed, women with breast cancer

who happen to be taking cholesterol-lowering statin drugs

appear to live about 40% longer before the cancer comes back.

But the data isn't good enough to ensure the drug benefits outweigh the risks,

though lowering cholesterol with diet one may be able to get

the best of both worlds.

But what does that have to do with dietary cholesterol?

Sure, animal studies show that if you feed mice cholesterol

you can accelerate their cancers, but extrapolation to humans

is difficult as dietary cholesterol has limited effects

on blood cholesterol levels in humans.

Thus, dietary cholesterol might just be indicative of a lifestyle

prone to health-related problems, including cancer.

Maybe people are just more likely to chase bacon and eggs down

with a cigarette compared to oatmeal?

It's hard to imagine how dietary cholesterol alone

could promote cancer development.

But that all changed recently with the discovery that 27-Hydroxycholesterol,

a metabolite of cholesterol, can function as an estrogen

and increase the proliferation of most breast cancer cells.

Ah, so it's not the cholesterol itself, but what it turns into in the body.

Scientists have long struggled to understand why women

with heart disease risk factors are more likely to develop breast cancer.

Now, perhaps we know.

The discovery that the most abundant oxidized cholesterol metabolite

in our bloodstream can have estrogenic effects

may explain the link between high cholesterol and the development

and progression of breast cancer and prostate cancer.

Yes, 27-Hydroxycholesterol also stimulates the proliferation

of prostate cancer cells, boosting growth by about 50 percent.

I've explored before the role oxycholesterols may play

in mediating pro-oxidative and pro-inflammatory processes

in degenerative diseases such as Alzheimer's and heart disease,

but now it looks like oxidized cholesterol can play a role

in all three stages of tumor development as well:

initiation, promotion, and then the progression of the cancer.

Not just promoting the growth of breast cancer cells,

but also inducing their invasion and migration,

potentially facilitating breast cancer metastasis

through suppressing anti-cancer immunity,

and then inducing angiogenesis:

helping breast tumors hook up their blood supply.

This is all supported by several lines of evidence

that point to a pathologic role for this cholesterol metabolite.

Yeah, you can feed mice cholesterol,

their oxysterol levels go up and their tumors accelerate.

It also appears to dramatically hasten the spread, or metastasis,

of breast tumors to other organs.

But turning to human breast tissue samples,

they found that more aggressive tumors have higher levels

of the enzyme that converts cholesterol into 27-HC.

In breast cancer patients with estrogen receptor-positive tumors, the 27

Hydroxycholesterol content in their breast tissue is increased overall,

and especially within the tumor itself,

so much so that circulating oxysterol levels

in the blood may one day be used as a prognostic factor.

And breast cancer patients with low tumor levels of the enzyme that breaks down

27-HC did not live as long as women who can detoxify it better.

The bottom line is that some estrogen- driven breast tumors may rely

on 27-HC to grow when estrogen isn't available.

And that may explain a second breast cancer mystery.

Over 80% of breast cancers start out responding to estrogen,

and so what we do is use hormone blockers,

either aromatase inhibitors to stop the formation of estrogen in the first place,

or tamoxifen to block its action.

Despite the efficacy of these drugs, many patients relapse with resistant tumors.

And that's where oxidized cholesterol can come in.

27-HC can fuel breast cancer growth without estrogen,

which could explain why sometimes these estrogen blockers don't work.

And finally, 27-HC may explain why breast cancer patients

with higher vitamin D levels appear to live longer.

Vitamin D supplementation decreases 27-HC levels in the blood.

The best way, though, may be to just lower overall cholesterol.

Lower cholesterol, and you lower oxidized cholesterol.

So discovering this role of cholesterol is actually really good news,

since cholesterol is a highly amenable risk factor,

either by lifestyle, dietary, or pharmacologic interventions.

The implications of these findings, according to the principal investigator,

is that lowering cholesterol with dietary changes or drugs

could reduce a women's breast cancer risk or slow tumor growth.

Finally, when it comes to uterine fibroids,

is soy helpful, harmful, or harmless?

About 1 in 4 women will eventually suffer from fibroids,

most commonly manifesting as excessively

heavy periods and pain or pressure.

Why might you feel pressure?

Because you may be carrying around 26 pounds

of tumors in your uterus.

Fibroids are the most common reason women get hysterectomies—

having their uterus removed completely,

a major surgery associated with disability and death,

but all surgery carries risk.

The chances of dying within a month of surgery

may only be about 1 in 1200,

which makes it among our safest surgeries,

safer than getting your gallbladder removed, for example.

But, of course, you lose the ability to bear children,

and costs billions of dollars a year.

Yet, despite the high prevalence,

significant pain and suffering, and huge economic impact,

relatively little is understood about the cause

and disease process that lead to fibroid tumors.