This report discusses the therapeutic actions, current research available, practical consumption advice and cautions and contraindications for the four foods chosen, which are likely to have the greatest therapeutic impact on the specific conditions stated in each case study. Pomegranate Juice is chosen to prevent prostate cancer. Kiwifruit is chosen to treat constipation and in turn treat haemorrhoids and varicose veins. Blueberries are chosen to prevent dementia. Turmeric is chosen to prevent a recurrence of ulcerative colitis.
Prevention and treatment through dietary intervention is both practical and easily accepted by patients (Malik & Muktar 2005, p1). Foods such as pomegranate, kiwifruit, blueberries and turmeric have antitumor, laxative, antioxidant and anti-inflammatory therapeutic actions respectively.
Malik & Muktar (2005) state that the pomegranate fruit has been shown to possess strong antioxidant, anti-inflammatory and antitumor properties. The antioxidant activity of pomegranate fruit is shown to be higher than that of red wine and green tea. (Malik & Muktar 2005, p1)
The study by Albrecht et al. (2004) demonstrated significant antitumor activity in vivo and in vitro against prostate cancer of pomegranate-derived materials.
The four components, ellagic acid, caffeic acid, luteolin and punicic acid, of the pomegranate fruit were tested in vitro in a study by Lansky et al. (2005) as potential inhibitors of human PC-3 prostate cancer cells. Individually, the chemicals significantly inhibited invasion, but when combined in equal amounts at the same gross dosage (4 μ g/ml), the inhibition observed was increased.
Wang & Martins-Green (2014) investigated the effects of pomegranate juice on prostate cancer progression in a clinical trial. Patients were treated with approximately 250 ml of pomegranate juice daily until disease progression. The trial showed that the patients’ prostate specific antigen doubling time increased from 15 months to 54 months and that cell proliferation was suppressed. Apoptosis in the cancer cell line LNCaP also increased.
It is recommended therefore, to drink 250 ml of pomegranate juice daily to reduce the risk of prostate cancer.
The treatment was well tolerated and no serious side effects were observed during the clinical trial (Wang & Martins-Green 2014). Wang & Martins-Green (2014) also noted that no patients developed secondary malignant growths away from the primary cancer site during the trial period.
Case Study 2: Treatment of Constipation, Haemorrhoids and Varicose Veins
Bosaeus (2004) found that an increase in fibre in the diet will generally increase the weight of the stool, however, the degree to which it increases in weight, varies with the source of fibre.
Burkitt & Graham-Stewart (1975) present evidence that haemorrhoids are caused by straining when constipated and that constipation is a result of low fibre diets.
Burkitt (1972) concluded that a low fibre diet resulted in strained bowel movements and that communities who suffer constipation also had a high incidence of varicose veins and vice versa.
Chan et al. (2007) chose kiwifruit as the source of dietary fibre in a study aimed at assessing whether an increase in dietary fibre could improve constipation. The compound actinidin found in kiwifruit is suggested as having a laxative effect as well as the fibre content of the kiwifruit (Chan et al 2007). Chan et al (2007) found sufferers of chronic constipation experienced an improvement in the number of complete spontaneous bowel movements per week, an improvement in symptoms of constipation and a reduction in colonic transit time. There was also an improvement in rectal sensation which had not been shown in other similar studies where bran was the source of fibre (Chan et al 2007).
The treatment protocol used by Chan et al (2007) consisted of patients eating two green kiwifruits per day. They ate one in the morning after breakfast and the other after dinner. They ate the whole fruit minus the skin.
It is therefore recommended that a patient with chronic constipation, who, as a result is suffering from haemorrhoids and varicose veins, should consume 2 kiwifruits per day as described by Chang et al (2007). Chang et al (2007) also notes that the kiwifruit should be of optimum ripeness and freshness. Kiwifruit is generally palatable making patient compliance high.
No side effects, including diarrhoea, were reported in either group of the study by Chang et al (2007). Chang et al (2007) also notes that although the fibre in kiwifruit is insoluble, there were no reports of intolerance including gas or bloating by any of the patients.
Joseph et al (2003) found that diet may overcome genetic dispositions to Alzheimer disease. Blueberries contain anthocyanins, polyphenolic compounds which are shown to have antioxidant and anti-inflammatory properties (Krikorian et al. 2010). Krikorian et al. (2010) states that anthocyanins are linked with increased neuronal brain signalling, improved memory function and can lessen neural degeneration.
In a study on rats by Joseph et al (1999) blueberry supplementation showed greater results than strawberry, spinach or the control group. The group supplemented with blueberry were the only group to show a reversal in motor behavioural deficits.
A review by McCormack and McFadden (2013, p.8) looked at pterostilbene which is the primary antioxidant component of blueberries. Pterostilbene is structurally similar to resveratrol found in red wine but shows greater bioavailability (McCormack & McFadden 2013). McCormack and McFadden (2013) reviewed both in vitro and in vivo studies and found that pterostilbene demonstrated both preventative and therapeutic benefits in neurological disease due to its antioxidant activity. The cerebellum, cortex and hippocampal regions of the rats supplemented with blueberry showed substantial expression of compounds derived from blueberries in brain tissues areas related to learning and memory (Andres-Lacueva et al. 2005). This suggests that the compounds cross the blood brain barrier and can alter central nervous system signals (McCormack & McFadden 2013).
Daily consumption of wild blueberry juice in a small study by Krikorian et al. (2010) of adults with early memory changes showed improved cognition and memory. Devore et al. (2012) found that women who ate approximately half a cup of berries per week slowed their cognitive decline by about 1.5 to 2.5 years. It is therefore recommended to include at least half a cup of blueberries in the diet each week to reduce the risk of developing dementia.
Copp et al. (2009) demonstrated antioxidant supplementation alters the delivery of oxygen in rats. Copp et al. (2009) concluded that rats that were given excessive amounts of blueberries exhibited impaired muscle function. Copp et al. (2009) pointed out that antioxidants remove hydrogen peroxide and other vasodilators. Patients with heart conditions should therefore use blueberry supplementation with caution (Copp et al. 2009).
Human trials of curcumin, a phytochemical found in turmeric, suggest that curcumin is effective and safe when treating clients in remission of ulcerative colitis (Hanai et al. 2006).
Baliga et al. (2012) reviewed clinical studies which showed that treatment with curcumin along with conventional drugs was effective, tolerated well and considered to be safe in maintaining remission and to prevent relapse of ulcerative colitis.
Curcumin is almost insoluble in water but remains stable in the acidic environment in the stomach (Julie & Jurenka 2009, p. 142).
Animal studies showed that a dose of 50mg/kg of curcumin for 10 days prior to inducing colitis resulted in reduced mucosal injury (Julie & Jurenka 2009, p. 144). Julie & Jurenka (2009) attribute the improvement in symptoms to the anti-inflammatory and antioxidant properties of curcumin.
The University of Maryland Medical Centre (2015) advises that turmeric is available in capsules, fluid extract and tincture forms. If incorporating into the daily diet, 1- 3 grams of the dried and powdered root may be added to dishes per day.
Piperine, found in black pepper was shown to increase the bioavailability of curcumin in humans by 2,000% with no adverse effects (Prasad, Tyagi & Aggarwal, 2014).
Hutchins-Wolfbrandt & Mistry (2011) recommend consuming curcumin in a spice blend containing turmeric and black pepper or to consume a turmeric milk which includes sugar or honey to make it more palatable.
Curcumin appears to be safe for doses up to 8 grams per day however some evidence suggests that curcumin may inhibit chemotherapy drugs (Julie & Jurenka 2009, p.151) and therefore caution should be advised for patients undergoing chemotherapy.
Available research shows the efficacy of pomegranate juice in the prevention of prostate cancer, kiwifruit in the treatment of constipation and hence haemorrhoids and varicose veins, blueberries in the prevention of dementia and turmeric in the maintenance of ulcerative colitis in remission. Practical consumption advice should result in high patient compliance. Although nutritional treatment strategies are generally considered safe, cautions outlined in each case study should be considered.
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