Yearly Archives: 2011 - Page 25

Happy Mother’s Day! with Hot Chocolate

Posted by on May 8, 2011 25 comments

Our best wishes to all Moms!

We thought we’d post something kids and moms can enjoy together: hot chocolate.

Hot Chocolate

We recommend some combination of whole milk or heavy cream, dark chocolate, and coconut milk or coconut oil.

We like ours thick so we used cream and coconut oil. (Shou-Ching suggests mixing some coffee with the cream — for Mom only! (Paul suggests some Irish whiskey.)) We used 72% chocolate, which is sweet but not too sweet.

We mixed about 100 g chocolate with a heaping tablespoon (~2 tbsp) coconut oil and 1 cup cream. Melt the chocolate with the oil in a sauce pan:

Then add the cream or milk and stir until well mixed:

Whipped Cream

It wouldn’t be hot chocolate without whipped cream on top. We use 1 cup heavy whipping cream and 1 tbsp rice syrup as a sweetener.

We do the preparation in the same plastic container we’ll use to store the extra whipped cream – less cleanup that way:

Whip the cream, then add the rice syrup and whip some more:

Serve

Transfer everything to a mug and top with cinnamon or nutmeg:

Happy Mother’s Day everyone!

Around the Web; Say Hey Kid edition

Posted by on May 7, 2011 17 comments

Here’s what caught my eye this week:

[1] First, thank you to Mark Sisson: Our thanks to Mark Sisson and Mark’s Daily Apple for listing us among his “18 Underrated Blogs You Should Be Reading”. We’re in excellent company because all 18 are great blogs. Many of the blogs are fairly new, which demonstrates how rapidly the Paleosphere is growing. Mark is in many ways the leader of the Paleo movement (deservedly so), so we’re honored and proud to be recommended by him.

[2] For aural amusement: I love the way Dinah Washington sings this song.

[3] Interesting posts this week: Speaking of Mark, he somehow produces high-quality interesting posts every day. This week I was intrigued to learn that Australian aborigines were engaging in eel farming on a massive scale as early as 6,000 BC.

Melissa McEwen commented on “Venus-gate”.  Also in Paleolithic commentary, anthropologist Julien Riel-Salvatore gives an update on the finding that Neanderthals cooked starches by boiling in water or moist baking. Quick summary: at Shanidar, Iraq, they cooked date palms, wild barley and legumes; at Spy, Belgium, they cooked water lily corms, sorghum, and five other starchy plant species.

Chris Masterjohn had a fascinating post: “When Fat Burns In the Flame of Lean Muscle Mass — Better Put That Butter Either on Steak or Potatoes”. I left some thoughts in a comment there.

In his post welcoming Mark’s Daily Apple readers, Chris mentioned us among his top referrers. We’re delighted to have passed readers along, but disappointed that we rate so highly – it means others aren’t linking to him enough!

Emily Deans writes on who’s vulnerable to stress and why.

The Scientist tells us that oxidative stress in birds produces timidity as well as shortened lifespan.

Greg Laden of Science Blogs addresses the claim that Paleolithic peoples didn’t live long. In fact, it appears that life expectancy of girls was well into the 50s; as in all premodern societies, the greatest mortality was at childbirth and infancy.

The New York Times joins Ray Peat, Matt Stone, and others in discussing possible benefits of fructose at low doses. It turns out that after intense exercise or fasting has depleted glycogen, glycogen is replenished most rapidly by a mix of 2 parts glucose to 1 part fructose. Precisely the ratio in bananas! Perhaps bananas are the best breakfast.

The New York Times also reported on a study which found the lowest mortality with intake of more than 6 grams of sodium per day. That’s about 2 teaspoons of salt.

In yet a third New York Times report, we learn that removal of the tonsils causes obesity. Of course, the tonsils have an immune function, obesity is a disease, and pathogens cause disease. But that’s not the explanation doctors are proposing:

One of several theories is that enlarged tonsils cause difficulty swallowing, prompting a child to eat less. Once the tonsils are removed, appetite returns.

For lovers of baked goods, Chef Rachel Albert, the Healthy Cooking Coach, has a 99% Perfect Health Diet compliant (save for a bit of legume-derived xanthum or guar gum) recipe for Rosemary-Garlic Popovers.

[4] That plush toy looks real:

[5] Venus-gate revisited: Those odd-shaped Paleolithic figurines? Maybe they were a result of the Gravettian liposuction industry.

Gina Kolata (“With Liposuction, the Belly Finds What the Thighs Lose”) reports that liposuction doesn’t produce lasting weight loss. When liposuction is used to remove fat from one part of the body, the fat comes back elsewhere:

It took a year, but it all returned. But it did not reappear in the women’s thighs. Instead, Dr. Robert H. Eckel said, “it was redistributed upstairs,” mostly in the upper abdomen, but also around the shoulders and triceps of the arms.

[6] How to lose weight fast: Stephan Guyenet continues his must-read series on links between the brain’s reward system and obesity with a post on “How to Make a Rat Obese” and “How to Make an Obese Human Lean”. Secret to the latter? Stock your refrigerator like this:

I wonder if this refrigerator would work as well:

[7] Seth Roberts has another long-term weight loss chart: This time the Shangri-La Diet comes out the best.

The Shangri-La Diet fits in with Stephan’s ideas, but makes a radical claim: that although eating tasteless calories causes weight loss, it’s not necessary that the whole diet be tasteless – only one spoonful a day is enough!

Seth’s ideas are incorporated into our weight loss recommendations indirectly. Our recommendation (Perfect Health Diet: Weight Loss Version, Feb 1, 2011) is to eat normal dietary levels of carbs and protein, reducing fat intake a bit but eating the usual Perfect Health Diet foods – but to eat intermittently with a daily 16-hour fast. During the fast, meet any hunger with a spoonful of coconut oil, Shangri-La Diet style.

[8] Bravo: Our view of obesity was superbly summarized by Stabby on Mark’s Daily Apple forum, and then reduced to a pithy aphorism by NourishedEm:

Stabby: Perfect Health Diet strives for…well…perfection in health and what follows from that? Better body composition.… [O]besity is a disease of metabolic syndrome, and eating a healthy diet can help in reversing it. The general mindset of someone trying to lose weight is that they would like as much of it gone as quickly as possible, but as always with everything it is the sustainability of things that ultimately matters. When we make health numero uno we put ourselves on the best possible path for the future.

NourishedEm: You don’t need to lose weight to get healthy, you need to get healthy to lose weight.

[9] I love this photo: The Hadza of Tanzania:

From National Geographic via Conditioning Research.

[10] Willie Mays turns 80 today: Here’s his famous catch:

[11] As if we needed more reason to avoid prostate exams: Biopsies are causing dangerous infections:

Studies emerging during the past year have uncovered that a small, yet growing percentage of those undergoing routine needle biopsy tests are becoming critically ill and dying from bacterial infections…. Nine out of 10,000 men whose tests were negative died within a month, researchers in Toronto reported in the Journal of Urology in March last year….

When he looked at hospital admissions among patients whose biopsy was negative for cancer, Nam discovered the chance of being hospitalized within a month of the procedure had increased fourfold in less than a decade, reaching 4.1 percent in 2005 from 1 percent in 1996, according to the Journal of Urology report.

When Nam searched for the cause of the hospitalizations, he found 72 percent had an infection-related diagnosis.

[12] Post of the week: In a week with some great competition, anthropologist Peter Frost of Evo and Proud wins the prize with a really interesting post on Candida infections. He presents evidence that a few substrains of Candida, which thrive in the mouth and vagina, have evolved an ability to infect the brain and induce a preference for sexual activity in “non-Euclidean” geometries. Startling if true. Of course, it’s only a matter of time before many pathogens evolve these abilities.

[13] Shou-Ching’s Photo-Art: This week’s installment – click to enlarge:

[14] But do the computers have health insurance?: Scientists afflict computers with schizophrenia to better understand the human brain:

Computer networks that can’t forget fast enough can show symptoms of a kind of virtual schizophrenia, giving researchers further clues to the inner workings of schizophrenic brains, researchers at The University of Texas at Austin and Yale University have found.

Pouring corn oil and sugar into the computer also impairs it, giving further clues to the origin of mental illness.

[15] Not the weekly video: The ultimate dog tease:

Via Bix.

[16] Video of the week: The Coral Triangle is a huge area centered on the Indonesian archipelago. The Bajau are a people who not only maintain Paleolithic lifeways – they live much their lives at sea. The Bajau are often hard of hearing due to intentionally puncturing their eardrums to facilitate diving. This video is mainly about conservation, but I thought the parts about the Bajau were most interesting:

People of the Coral Triangle from James Morgan Photography on Vimeo.

The conservation part touches upon a topic that came up in the comments last week, in which Peter argued that to save fisheries we need a system of oceanic property rights. Someone in the film (at 10:25) makes the same point in different words:

In order to enact a really sustainable and meaningful conservation program for the Coral Triangle region, we need to empower groups such as the Bajau to look after and curate their own environment.

Video via Barry Ritholtz.

Pictures from the Paleolithic

Posted by on May 5, 2011 38 comments

After two weeks of science-heavy posts, I thought I’d do something light: a picture show.

Paleolithic Body Shapes

It’s often said that Paleolithic men were large-boned and very muscular. For instance:

The limb bones of the early Upper Palaeolithic Gravettian people are not only large but also have massive muscle attachments.

This is true of some Paleolithic skeletons, including Neanderthals and Eastern Gravettians, but it is far from generally true. (Gravettian is the name for a European toolkit used between about 28,000 and 22,000 BC.)

In fact, the Paleolithic population that expanded through Europe in the Upper Paleolithic was notably tall and slender. Here is a Gravettian skeleton from Grottes des Enfants 4 in Grimaldi, Italy [1]:

Note the narrow hips, narrow rib cage, and slender bones. The body shape is not dissimilar to some tall, slender East African populations today.

Of course, you can be small-boned and slender and strong. Still, it’s likely this population fought with poison-tipped throwing weapons like the atlatl, not with spears like the Neanderthals, and consequently needed much less strength. Also, they were fishermen and horticulturists, not big game hunters; their nitrogen isotope ratios prove that much of their protein came from fish.

What about obesity? Don Matesz had an interesting post this week, in which he argued that the Venus of Willendorf proves that Paleolithic Europeans were familiar with the shape of obese women:

Source: Wikipedia.

Indeed, it appears that post-menopausal weight gain may have been a problem on Paleolithic diets. As were sagging breasts:

Source: Wikipedia.

Paleolithic Art

The Gravettians were major producers of cave art. A few years ago, Friedrich Blowhard of 2blowhards.com did a great review of a book by anthropologist J. David Lewis-Williams, The Mind in the Cave: Consciousness and the Origins of Art, which sought to explain the origins of Paleolithic cave art.

Lewis-William’s idea is that is that the art was the product of shamanistic religious rituals involving hallucinations. The art was placed in the darkest and most inaccessible corners of caves because those were the best places to have a private hallucination.

Here is the Mammoth from Rouffignac:

To be sure, some of the cave art was in more accessible locations. Here is the Hall of the Bulls at Lascaux:

One thing I learned from Friedrich’s review is that animals were often painted as if they were floating in air – either lacking hooves, or with the bottoms of the hooves visible. Here is a bison at Altamira:

If Paleolithic art was created in an hallucinogenic state, it might explain The Sorcerer from Les Trois Freres:

Paintings of humans were rare until the latest stages of the Upper Paleolithic. Via DonsMaps.com, here are some Paleolithic Frenchmen from La Marche, Vienne, France about 12,000 BC:

Paleolithic artists did sometimes represent the fish that made up so much of their diet. Here is a Paleolithic salmon:

Here is a sculpture of a bird:

Conclusion

I’m happy to appropriate their diet, and I admire their art, but I must say, I’m quite pleased to be living now rather than then.

And now — that duck is making me hungry. It must be time for dinner!

References

[1] Holt & Formicola (2008) “Hunters of the Ice Age: The Biology of Upper Paleolithic People,” Yearbook of Physical Anthropology 51:70–99.

DHA and Angiogenesis: The Bottom Line

Posted by on May 4, 2011 72 comments

So I thought I’d finish up the series on DHA and angiogenesis by discussing 2 issues:

1.      First, an assertion: The pathway by which oxidized DHA drives angiogenesis may be really important for human health.

2.      Second, the $64,000 question: Is there evidence that high levels of dietary DHA promotes diseases of pathological angiogenesis? What about other dietary factors bearing on DHA oxidation?

Significance of the Oxidized DHA Link to Angiogenesis

The papers discussed in Friday’s post about a major angiogenesis pathway stimulated by oxidized DHA (Omega-3s, Angiogenesis and Cancer: Part II, April 29, 2011) may not seem important to many readers. But to cancer researchers and pharmaceutical companies, this is blockbuster work.

A tumor is, in the words of Hal Dvorak, “a wound that never heals.” [1] To support growth, cancers invoke the wound healing process – especially, creation of new blood vessels, or angiogenesis. But the tumor prevents the wound healing process from completing. If it ever did complete, then the tumor itself would be healed. It would cease to grow and become benign.

It’s been recognized for decades that an ability to block angiogenesis would effectively constitute a cure for cancer. The William Li video explains why: nearly everyone gets microscopic tumors that never develop the ability to induce angiogenesis. Life-threatening cancer is the result of tumors that can induce angiogenesis. No angiogenesis, and no one would die of cancer.

But existing anti-angiogenic cancer therapies have produced disappointing results. Avastin, an anti-angiogenic drug targeting VEGF (vascular endothelial growth factor), has been estimated to extend colon cancer patient lifespan by only 6 weeks.  (Nevertheless, Avastin generated $7.3 billion in revenue last year. Imagine how much money there would be in an anti-angiogenic therapy that worked!)

The work I discussed last Friday suggests a reason for that failure. Recall these pictures:

If only the VEGF pathway is blocked (upper right), there is almost as much angiogenesis and wound healing as in a normal wound (upper left). But when both the VEGF and TLR-2 angiogenic pathways are blocked (lower right), there is no wound healing.

If these are the operative pathways in cancer also, then blocking the TLR-2 angiogenesis pathway might be the key to cancer therapy.

But cancer is not the only disease of pathological angiogenesis. Others include:

  • Age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity – three common causes of blindness.
  • Atherosclerosis, which often features angiogenic vessels in thickened arterial walls.
  • Vascular malformations and tumors.
  • Obesity. Adipose tissue utilizes angiogenic pathways, and angiogenesis inhibition prevents the deposition of fat.
  • Rosacea, psoriasis, and some other skin conditions.
  • Endometriosis, uterine fibroids, and some other causes of female infertility.
  • Rheumatoid arthritis.
  • Crohn’s disease.
  • Preeclampsia.

It may be that the TLR-2 pathway is key to these diseases as well, and that a treatment that inhibits this pathway can cure or improve all of these diseases.

Add up the size of these markets and a pharmaceutical company executive would swoon.

Luckily, we’re not pharmaceutical company executives. But we can still get excited over possibilities to improve these diseases through diet and anti-microbial medicine.

Infections as Contributing Causes of These Diseases

TLR-2 is stimulated by other things besides oxidized DHA. In particular, TLR-2 is an immune molecule which is stimulated by pathogen proteins. As Wikipedia notes:

TLR-2 recognizes many bacterial, fungal, viral, and certain endogenous substances.

This tells us that many pathogens may stimulate angiogenesis through the TLR-2 pathway. As a result, anti-microbial medicines might help treat some diseases of pathological angiogenesis.

Some antibiotics, including doxycycline and minocycline, are known to exercise anti-angiogenic effects independent of the antibiotic effects. [2]

Diet-Induced Angiogenesis

Many foods affect angiogenesis. In fact, cancer studies have identified dozens of plant foods, from garlic to tomatoes to leeks, that possess anti-angiogenic properties.

However, foods can also promote angiogenesis. Let’s stick to the oxidized DHA pathway and see if there’s evidence that foods drive it.

You’ll recall the recipe was:

DHA + oxidative stress + retinyl protein = TLR-2 driven angiogenesis

If this pathway is important in human disease, then we should expect diseases of angiogenesis to be worsened by adding the ingredients on the left.

Specifically, cancer, AMD, rosacea, and so forth should be worsened by high doses of DHA, high doses of vitamin A, and low doses of antioxidant minerals like zinc or selenium.

Is there any evidence for that pattern?

Cancer Studies

First, let me give my bottom line on the Brasky study that kicked off this series. High tissue levels of DHA were associated with increased risk of high-grade prostate cancer, and the oxidized DHA angiogenesis pathway provides a mechanism for this association. What’s not clear is why tissue DHA levels were high. EPA levels were also elevated in the high-grade prostate cancers, but not by nearly as much as DHA levels. EPA and DHA appear together in fish and fish oil, so this suggests that fish consumption contributed to but was not the primary cause of the elevated tissue DHA. The drug finasteride greatly raised risk of high-grade prostate cancer, but the paper did not break down the DHA-cancer association between the finasteride and placebo arms. The most likely explanation, in my view, is that finasteride increases conversion of EPA to DHA and creates artificially high tissue DHA levels. The high DHA levels combined with oxidative stress drive cancer through the TLR-2 angiogenesis pathway.

A clever but unlikely alternative explanation was suggested by Peter at Hyperlipid: perhaps extra dietary fish oil raises testosterone levels. Prostate cancer is a hormone-dependent cancer and can be promoted by testosterone, just as breast cancer is promoted by estrogen. Possible supporting evidence comes from a paper showing an inverse association between metabolic syndrome / diabetes and prostate cancer. The trouble with this idea is that (a) this effect should have been strongest in the low-grade cancers, since diabetes reduced the incidence of low-grade cancers, but in the Brasky study DHA had no association with low-grade cancers, (b) fish oil lowers testosterone levels in rats, (c) in the Brasky study high-grade prostate cancers were strongly associated with obesity and the obese generally have low testosterone levels, and (d) surprisingly, high-grade prostate cancers are associated with low testosterone, not high. So one could argue that fish oil might promote high-grade prostate cancer by lowering testosterone!

A unified explanation along this line would be: Finasteride raises DHA levels, and DHA lowers testosterone. Low testosterone reduces incidence of low-grade prostate cancers but makes it much more likely they will progress to high-grade. Thus, finasteride reduces prostate cancer incidence but increases high-grade prostate cancer incidence and overall prostate cancer mortality. Fits all the facts. Could be.

My bottom line: the Brasky study is weak evidence for anything, but it does raise a whiff of evidence that high dietary fish oil intake might encourage a transition from low-grade to high-grade cancer.

What about other ingredients in the recipe? Does increasing retinyl levels raise cancer risk?

Retinyl palmitate (vitamin A) has been tested in clinical trials for its effect on cancer risk. The trials had to be cut short when it was found that vitamin A increased cancer mortality:

The Carotene and Retinol Efficacy Trial (CARET) was a multicenter randomized, double-blind placebo-controlled chemoprevention trial testing whether daily supplementation with 30 mg β-carotene + 25,000 IU retinyl palmitate would reduce lung cancer risk among 18,314 heavy smokers, former heavy smokers and asbestos-exposed workers. The intervention ended 21 months early in January, 1996 when interim analysis found evidence that the supplements increased the risk of lung cancer and total mortality in this high-risk population by 28% and 17%, respectively (10). [3]

After the study ended participants were tracked for years afterward. Those who had received vitamin A during the trial, but especially those in the vitamin A arm who took additional supplements (mainly multivitamins which are rich in A, but possibly also fish oil), had more high-grade prostate cancers:

As a proportion of the total prostate cancer cases, more men who were randomized to the active arm developed high-grade prostate cancer (Gleason 7-10) than in the placebo arm (44.6% vs. 40.1%, respectively)….

For aggressive prostate cancer, men in the CARET intervention arm who used additional supplements had a relative risk for aggressive prostate cancer (Gleason >or=7 or stage III/IV) of 1.52 (95% CI, 1.03-2.24; P < 0.05), relative to all others. [3]

Interestingly, in the placebo arm taking multivitamins and other supplements reduced cancer risk.

Other studies have found similar results.

Men with higher retinol concentrations at baseline were more likely to develop prostate cancer (quintile 5 vs. quintile 1 hazard ratio = 1.19, 95% confidence interval: 1.03, 1.36; P(trend) = 0.009). The results were similar for aggressive disease. Joint categorization based on baseline and 3-year retinol levels showed that men who were in the highest quintile at both time points had the greatest increased risk (baseline/3-year quintile 5/quintile 5 vs. quintile 1/quintile 1 hazard ratio = 1.31, 95% confidence interval: 1.08, 1.59). In this largest study to date of vitamin A status and subsequent risk of prostate cancer, higher serum retinol was associated with elevated risk, with sustained high exposure conferring the greatest risk. [4]

Carotenoids, which can generally be converted to vitamin A, are also associated with higher cancer risk. There is one exception – lycopene:

Lycopene was inversely associated with prostate cancer risk (comparing highest with lowest quartiles, odds ratio (OR) = 0.65, 95% confidence interval (CI): 0.36, 1.15; test for trend, p = 0.09), particularly for aggressive disease (comparing extreme quartiles, OR = 0.37, 95% CI: 0.15, 0.94; test for trend, p = 0.04). Other carotenoids were positively associated with risk. [5]

What’s special about lycopene? Wikipedia explains:

Lycopene may be the most powerful carotenoid quencher of singlet oxygen,[18] being 100 times more efficient in test tube studies of singlet-oxygen quenching action than vitamin E … The absence of the beta-ionone ring structure for lycopene increases its antioxidant action….

Lycopene is not modified to vitamin A in the body …

So lycopene does not increase retinyl levels, but does act as an extraordinarily powerful antioxidant, thus reducing oxidative stress! If you wanted a good food for stopping the DHA – angiogenesis pathway, you’ve found it: tomatoes.

Hmmm, tomatoes go well with salmon …

That gets us to the third part of the recipe, oxidative stress. If oxidized DHA drives angiogenesis, then antioxidants should be preventative for these diseases.

The evidence here is rather mixed, because with the exception of the negative effects of vitamin A, most antioxidants seem to have little effect on cancer. Nevertheless, I’ll give some studies. Selenium is a antioxidant mineral due to its role in glutathione peroxidase:

Serum selenium was inversely associated with risk of prostate cancer (comparing highest to lowest quartiles, OR = 0.71, 95% CI 0.39-1.28; p for trend = 0.11), with similar patterns seen in both blacks and whites. [6]

Zinc is an antioxidant due to its role in zinc-copper superoxide dismutase. Prostate cancer is associated with low tissue levels of zinc. [7, 8] High dietary intake of zinc is associated with lower rates of prostate cancer. [9]

N-acetylcysteine is an antioxidant supplement that is a precursor to glutathione. N-acetylcysteine has been shown to prevent angiogenesis and has been proposed as a likely cancer preventative, but this is as yet untested. [10]

Other Diseases of Angiogenesis

I’ll skip those for now, other than to note that fish oil is a well-known trigger of rosacea. Is it possible that the mechanism is via TLR-2 activation by oxidized DHA?

Conclusion

At the moment there’s some puffs of smoke but no fire. Observational studies weakly link high DHA, high vitamin A, and low antioxidant status to diseases of angiogenesis such as cancer.

This pattern would be consistent with the idea that the natural pathway used in wound healing to trigger angiogenesis – DHA oxidation and combination with retinyl protein to trigger TLR-2 pathways – is also important for cancer progression.

It suggests a strategy of reduced fish oil and vitamin A consumption and increased intake of certain antioxidants (such as lycopene, zinc, selenium, or NAC) may be helpful against cancer.

However, this idea needs testing. No study in animal cancer models has tested this dietary combination.

Given the many proven benefits of moderate amounts of fish oil, I don’t see a reason yet to alter our recommendation that healthy people should eat a pound of fish per week. That said, I do think very high intakes of fish or fish oil are ill advised. And I’m intrigued by the idea that dietary changes may have the potential to play a powerful role in recovery from diseases of angiogenesis such as cancer.

References

[1] Dvorak HF. Tumors: wounds that do not heal. Similarities between tumor stroma generation and wound healing. N Engl J Med. 1986 Dec 25;315(26):1650-9. http://pmid.us/3537791.

[2] Yao JS et al. Comparison of doxycycline and minocycline in the inhibition of VEGF-induced smooth muscle cell migration. Neurochem Int. 2007 Feb;50(3):524-30. http://pmid.us/17145119.

[3] Neuhouser ML et al. Dietary supplement use and prostate cancer risk in the Carotene and Retinol Efficacy Trial. Cancer Epidemiol Biomarkers Prev. 2009 Aug;18(8):2202-6. http://pmid.us/19661078.

[4] Mondul AM et al. Serum retinol and risk of prostate cancer. Am J Epidemiol. 2011 Apr 1;173(7):813-21. http://pmid.us/21389041.

[5] Vogt TM et al. Serum lycopene, other serum carotenoids, and risk of prostate cancer in US Blacks and Whites. Am J Epidemiol. 2002 Jun 1;155(11):1023-32. http://pmid.us/12034581.

[6] Vogt TM et al. Serum selenium and risk of prostate cancer in U.S. blacks and whites. Int J Cancer. 2003 Feb 20;103(5):664-70. http://pmid.us/12494476.

[7] Sarafanov AG et al. Prostate cancer outcome and tissue levels of metal ions. Prostate. 2011 Jan 26. doi: 10.1002/pros.21339. [Epub ahead of print] http://pmid.us/21271612.

[8] Costello LC, Franklin RB. Zinc is decreased in prostate cancer: an established relationship of prostate cancer! J Biol Inorg Chem. 2011 Jan;16(1):3-8. http://pmid.us/21140181.

[9] Epstein MM et al. Dietary zinc and prostate cancer survival in a Swedish cohort. Am J Clin Nutr. 2011 Mar;93(3):586-93. http://pmid.us/21228268.

[10] Noonan DM et al. Angiogenesis and cancer prevention: a vision. Recent Results Cancer Res. 2007;174:219-24. http://pmid.us/17302199.