Is White Rice a Yellow-Light or Red-Light Food?

Arsenic is not just considered to be a carcinogen; it’s also designated as a “nonthreshold carcinogen, meaning that any dose, no matter how small, carries some cancer risk”—so there really isn’t a “safe” level of exposure. Given that, it may be reasonable to “use the conservative ALARA” approach, reducing exposure As Low As Reasonably Achievable.

I have a low bar for recommending people avoid foods that aren’t particularly health-promoting in the first place. Remember when that acrylamide story broke, about the chemical found concentrated in french fries and potato chips? (See my video Acrylamide in French Fries for more.) My take was pretty simple: Look, we’re not sure how bad this acrylamide stuff is, but we’re talking about french fries and potato chips, which are not healthy anyway. So, I had no problem provisionally bumping them from my list of yellow-light foods into my red-light list, from “minimize consumption” to “ideally avoid on a day-to-day basis.”

One could apply the same logic here. Junk foods made out of brown rice syrup, rice milk, and white rice are not just processed foods, but also arsenic-contaminated processed foods, so they may belong in the red zone as red-light foods we should avoid. What about something like whole brown rice? That is more difficult, because there are pros to help outweigh the cons. I discuss this in my video Is White Rice a Yellow-Light or Red-Light Food?, where you can see a graphical depiction of my traffic light food system at 0:49.

The rice industry argues that the “many health benefits of rice consumption outweigh any potential risk,” which is the same sentiment you hear coming out of Japan about the arsenic-contaminated seaweed hijiki: Yes, “the cancer risk posed by hijiki consumption exceeds this acceptable [cancer risk] level by a factor of 10,” an order of magnitude, but the Japanese Ministry of Health stresses the “possible health benefits,” such as lots of fiber and minerals, as if hijiki was the only weed in the sea. Why not choose any of the other seaweeds and get all the benefits without the arsenic? So, when the rice industry says the “many health benefits of rice consumption outweigh any potential risk,” it’s as if brown rice was the only whole grain on the planet. Can’t you get the whole grain benefits without the risks by eating oatmeal, barley, or quinoa instead? Or, is there some unique benefit to rice, such that we really should try to keep brown rice in our diet?

Consumer Reports recommended moving rice to the yellow-light zone—in other words, don’t necessarily avoid it completely, but moderate your intake. The rice industry, in a fact sheet entitled “The Consumer Reports Article is Flawed,” criticized Consumer Reports for warning people about the arsenic levels in rice, saying “[t]here is a body of scientific evidence that establishes…the nutritional benefits of rice consumption; any assessment of the arsenic levels in rice that fails to take this information into account is inherently flawed and very misleading.” The rice industry cites two pieces of evidence. First, it asserts that rice-consuming cultures tend to be healthier, but is that because of, or despite, their white rice consumption? And what about the fact that rice-eating Americans tend to be healthier? Perhaps, but they also tend to eat significantly less saturated fat. So, once again, how do we know whether it’s because of—or despite—the white rice?

The rice industry could have cited the study I discuss at 3:12 in my video that showed that brown rice intake of two or more servings a week was associated with a lower risk of diabetes, but presumably, the reason it didn’t is because intake of white rice is associated with an increased risk of diabetes, and white rice represents 95 percent of the U.S. rice industry. Switching out a third of a serving of white rice a day for brown rice might lower diabetes risk by 16 percent, but switching out that same white rice for whole grains in general, like oats or barley, might work even better! So, other grains have about ten times less arsenic and are associated with even lower disease risk. No wonder the rice industry doesn’t cite this study.

It does cite the Adventist studies, though, and some in vitro data. For example, in a petri dish, as you can see at 4:05 in my video, there are rice phytonutrients that, at greater and greater doses, can inhibit the growth of colon cancer cells while apparently leaving normal colon cells alone, which is exciting. And, indeed, those who happened to eat those phytonutrients in the form of brown rice once or more a week between colonoscopies had a 40 percent lower risk of developing polyps. (The consumption of green leafy vegetables, dried fruit, and beans were also associated with lower polyp incidence.) But, the only reason we care about the development of polyps is that polyps can turn into cancer. But, there had never been studies on brown rice consumption and cancer…until now, which I discuss in my video Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.

For those unfamiliar with my traffic light system, I talk about it in my book trailer. Check out How Not to Die: An Animated Summary.

Almost there! This is the corresponding article to the 12th in my 13-video series on arsenic in the food supply. If you missed any of the first 11 videos, see:

Ready for the finale? See Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.

And you may be interested in Benefits of Turmeric for Arsenic Exposure.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

What Explains the Egg-Cancer Connection

The reason egg consumption is associated with elevated cancer risk may be the TMAO, considered the “smoking gun” of microbiome-disease interactions.

“We are walking communities comprised not only of a Homo sapiens host, but also of trillions of symbiotic commensal microorganisms within the gut and on every other surface of our bodies.” There are more bacterial cells in our gut than there are human cells in our entire body. In fact, only about 10 percent of the DNA in our body is human. The rest is in our microbiome, the microbes with whom we share with the “walking community” we call our body. What do they do?

Our gut bacteria microbiota “serve as a filter for our largest environmental exposure—what we eat”—and, “technically speaking, food is a foreign object that we take into our bodies” by the pound every day. The “microbial community within each of us significantly influences how we experience a meal…Hence, our metabolism and absorption of food occurs through” this filter of bacteria.

However, as you can see at 1:22 in my video How Our Gut Bacteria Can Use Eggs to Accelerate Cancer, if we eat a lot of meat, including poultry and fish, milk, cheese, and eggs, we can foster the growth of bacteria that convert the choline and carnitine in those foods into trimethylamine (TMA), which can be oxidized into TMAO and wreak havoc on our arteries, increasing our risk of heart attack, stroke, and death.

We’ve known about this “troublesome” transformation from choline into trimethylamine for more than 40 years, but that was way before we learned about the heart disease connection. Why were researchers concerned back then? Because these methylamines might form nitrosamines, which have “marked carcinogenic activity”—cancer-causing activity. So where is choline found in our diet? Mostly from meat, eggs, dairy, and refined grains. The link between meat and cancer probably wouldn’t surprise anyone. In fact, just due to the industrial pollutants, like PCBs, children probably shouldn’t eat more than about five servings a month of meats like beef, pork, or chicken combined. But, what about cancer and eggs?

Studies going back to the 1970s hinted at a correlation between eggs and colon cancer, as you can see at 2:45 in my video. That was based just on so-called ecological data, though, showing that countries eating more eggs tended to have higher cancer rates, but that could be due to a million factors. It needed to be put to the test.

This testing started in the 80s, and, by the 1990s, 15 studies had been published, of which 10 suggested “a direct association” between egg consumption and colorectal cancer, “whereas five found no association.” By 2014, dozens more studies had been published, confirming that eggs may indeed be playing a role in the development of colon cancer, though no relationship was discovered between egg consumption and the development of precancerous polyps, which “suggested that egg consumption might be involved in the promotional” stage of cancer growth—accelerating cancer growth—rather than initiating the cancer in the first place.

This brings us to 2015. Perhaps it’s the TMAO made from the choline in meat and eggs that’s promoting cancer growth. Indeed, in the Women’s Health Initiative study, women with the highest TMAO levels in their blood had approximately three times greater risk of rectal cancer, suggesting that TMAO levels “may serve as a potential predictor of increased colorectal cancer risk.”

As you can see at 4:17 in my video, though there may be more evidence for elevated breast cancer risk with egg consumption than prostate cancer risk, the only other study to date on TMAO and cancer looked at prostate cancer and did indeed find a higher risk.

“Diet has long been considered a primary factor in health; however, with the microbiome revolution of the past decade, we have begun to understand how diet can” affect the back and forth between us and the rest of us inside, and the whole TMAO story is “a smoking gun” in gut bacteria-disease interactions.

Since choline and carnitine are the primary sources of TMAO production, the logical intervention strategy might be to reduce meat, dairy, and egg consumption. And, if we eat plant-based for long enough, we can actually change our gut microbial communities such that we may not be able to make TMAO even if we try.

“The theory of ‘you are what you eat’ finally is supported by scientific evidence.” We may not have to eat healthy for long, though. Soon, Big Pharma hopes, “we may yet ‘drug the microbiome’…as a way of promoting cardiovascular health.”

What did the egg industry do in response to this information? Distort the scientific record. See my video Egg Industry Response to Choline and TMAO.

This is not the first time the egg industry has been caught in the act. See, for example:

For background on TMAO see my original coverage in Carnitine, Choline, Cancer, and Cholesterol: The TMAO Connection and then find out How to Reduce Your TMAO Levels. Also, see: Flashback Friday: How to Reduce Your TMAO Levels.

This is all part of the microbiome revolution in medicine, the underappreciated role our gut flora play in our health. For more, see: 

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Using Green Tea to Help Prevent Cancer and Treat Cancer

Tea consumption is associated with a reduced risk of heart disease, stroke, and premature death in general, with each additional cup of green tea a day associated with a 4-percent lower mortality risk. So, perhaps “drinking several cups of tea daily can keep the doctor away,” as well as the mortician—but what about cancer?

As I discuss in my video Can Green Tea Help Prevent Cancer, there is “growing evidence from laboratory, epidemiologic [population], and human intervention studies that tea can exert beneficial disease-preventive effects” and, further, may actually “slow cancer progression.” Let’s review some of that evidence.

Not only do those who drink a lot of tea appear to live longer than those who drink less, as you can see at 0:49 in my video, drinking lots of tea may also delay the onset of cancer. At 0:56 in my video, you can see a table titled “Average age at cancer onset and daily green tea consumption.” The green tea intake is measured in Japanese tea cups, which only contain a half a cup, so the highest category in the table is actually greater than or equal to five full cups of tea, not ten as it appears in the table. Women who did get cancer appeared to get it seven years later if they had been drinking lots of tea compared to those who had consumed less. Men, however, had a three-year delay in cancer onset if they had consumed more than five full cups of green tea daily, the difference potentially “due to higher tobacco consumption by males.”

Green tea may be able to interfere with each of the stages of cancer formation: the initiation of the first cancer cell, promotion into a tumor, and then subsequent progression and spread, as you can see at 1:24 in my video. Cancer is often initiated when a free radical oxidizes our DNA, causing a mutation, but, as you can see at 1:44 in my video, we can get a nice “spike of antioxidant power” of our bloodstream within 40 minutes of drinking green tea. “This increase may, in turn, lower oxidative damage to DNA and so decrease risk of cancer.”

Furthermore, in terms of genoprotective effects—that is, protecting our genes—pre-existing oxidation-induced DNA damage was lower after drinking green tea, suggesting consumption can boost DNA repair as well. We didn’t know for certain, however…until now.

There is a DNA-repair enzyme in our body called OGG1. As you can see at 2:15 in my video, within one hour of drinking a single cup of green tea, we can boost OGG1’s activity, and after a week of tea drinking, we can boost it even higher. So, “regular intake of green tea has additional benefits in the prevention and/or repair of DNA damage.” In fact, tea is so DNA-protective it can be used for sperm storage for fresh samples until they can be properly refrigerated.

What’s more, tea is so anti-inflammatory it can be used for pain control as a mouthwash after wisdom tooth surgery, as you can see at 2:41 in my video. In terms of controlling cancer growth, at a dose of green tea compounds that would make it into our organs after drinking six cups of tea, it can cause cancer cells to commit suicide—apoptosis (programmed cell death)—while leaving normal cells alone. There are a number of chemotherapy agents that can kill cancer through brute force, but that can make normal cells vulnerable, too. So, “[g]reen tea appears to be potentially an ideal agent for [cancer] prevention”: little or no adverse side-effects, efficacious for multiple cancers at achievable dose levels, and able to be taken orally. We have a sense of how it works—how it stops cancer cells from growing and causing them to kill off themselves—and it’s cheap and has a history of safe, acceptable use. But, all of this was based on in-vitro studies in a test tube. “It needs to be evaluated in human trials,” concluded the researchers. Indeed, what happens when we give green tea to people with cancer? Does it help?

Tea consumption may reduce the risk of getting oral cancer. Not only may the consumption of tea boost the antioxidant power of our bloodstream within minutes and decrease the amount of free-radical DNA damage throughout our systems over time, but it can also increase the antioxidant power of our saliva and decrease the DNA damage within the inner cheek cells of smokers, though not as much as stopping smoking all together. You can see several graphs and tables showing these findings in the first 35 seconds of my video Can Green Tea Help Treat Cancer?.

Might this help precancerous oral lesions from turning into cancerous oral lesions? More than 100,000 people develop oral cancer annually worldwide, with a five-year overall survival rate of less than the flip of a coin. Oral cancer frequently arises from precancerous lesions in the mouth, each having a few percent chance of turning cancerous every year. Can green tea help?

Fifty-nine patients with precancerous oral lesions were randomized into either a tea group, in which capsules of powdered tea extract were given and their lesions were painted with green tea powder, or a control group, who essentially got sugar pills and their lesions painted with nothing but glycerin. As you can see at 1:23 in my video, within six months, lesions in 11 out of the 29 in the tea group shrunk, compared to only 3 of 30 in the placebo group. “The results indicate that tea treatment can improve the clinical manifestations of the oral lesions.”

The most important question, though, is whether the tea treatment prevented the lesions from turning cancerous. Because the trial only lasted a few months, the researchers couldn’t tell. When they scraped some cells off of the lesions, however, there was a significant drop in DNA-damaged cells within three months in the treatment groups, suggesting that things were going in the right direction, as you can see at 1:46 in my video. Ideally, we’d have a longer study to see if they ended up with less cancer and one that just used swallowed tea components, since most people don’t finger-paint with tea in their mouths. And, we got just that.

As you can see at 2:15 in my video, there were the same extraordinary clinical results with some precancerous lesions shrinking away. What’s more, the study lasted long enough to see if fewer people actually got cancer. The answer? There was just as much new cancer in the green tea group as the placebo group. So, the tea treatment resulted in a higher response rate, as the lesions looked better, but there was no improvement in cancer-free survival.

These studies were done on mostly smokers and former smokers. What about lung cancer? As you can see at 2:46 in my video, population studies suggest tea may be protective, but let’s put it to the test. Seventeen patients with advanced lung cancer were given up to the equivalent of 30 cups of green tea a day, but “[n]o objective responses were seen.” In a study of 49 cancer patients, 21 of whom had lung cancer, the subjects received between 4 and 25 cups worth of green tea compounds a day. Once again, no benefits were found. The only benefit green tea may be able to offer lung cancer patients is to help lessen the burns from the radiation treatments when applied on the skin. Indeed, green tea compresses may be able to shorten the duration of the burns, as you can see at 3:21 in my video.

The protective effects of green tea applied topically were also seen in precancerous cervical lesions, where the twice-a-day direct application of a green tea ointment showed a beneficial response in nearly three-quarters of the patients, compared to only about 10 percent in the untreated control group, which is consistent with the benefits of green tea compounds on cervical cancer cells in a petri dish. When women were given green tea extract pills to take, however, they didn’t seem to help.

I talked about the potential benefit of green tea wraps for skin cancer in Treating Gorlin Syndrome with Green Tea, but is there any other cancer where green tea can come into direct contact? Yes. Colon cancer, which grows from the inner surface of the colon that comes into contact with food and drink. As you can see at 4:13 in my video, in the colon, tea compounds are fermented by our good gut bacteria into compounds like 3,4DHPA, which appears to wipe out colon cancer cells, while leaving normal colon cells relatively intact in vitro. So one hundred thirty-six patients with a history of polyps were randomized to get green tea extract pills or not. Now, this study was done in Japan, where drinking green tea is commonplace, so, effectively, this was comparing those who drank three cups of green tea a day to subjects who drank four daily cups. A year later on colonoscopy, the added-green tea group had only half the polyp recurrence and the polyps that did grow were 25 percent smaller. With such exciting findings, why hasn’t a larger follow-up study been done? Perhaps due to the difficulty “in raising funds” for the study, “because green tea is a beverage but not a pharmaceutical.”

There is good news. Thanks to a major cancer charity in Germany, researchers are currently recruiting for the largest green tea cancer trial to date, in which more than 2,000 patients will be randomized. I look forward to presenting the results to you when they come in.

What about prostate cancer? See my videos Preventing Prostate Cancer with Green Tea and Treating Prostate Cancer with Green Tea.

You may also be interested in these somewhat older videos:

How interesting was that about wisdom teeth? Green tea can also be used as an anti-cavity mouth rinse, which I discuss in my video What’s the Best Mouthwash?.

Is Caffeinated Tea Dehydrating? Watch the video to find out.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: