Lifestyle changes do matter

Some of us may find the constant reminder that one should eat healthily, exercise regularly and maintain a normal BMI annoying. The attitude is born out of either a sense of denial or belief: denying that the ill effects of having an unhealthy lifestyle will ever affect one’s health or believing that destiny and not lifestyle will determine if one gets seriously ill or not. Perhaps a recent report from the University of California might make these individuals reconsider.

Researchers studied changes in the prostate gene expression in men, with low-grade prostate cancer, who underwent intensive lifestyle and nutrition intervention over a period of 3 months (PAS 2008; 105: 8369 – 8374). Thirty one men with low-grade prostate cancer, who declined immediate surgery, hormonal therapy or radiation, participated in the study. They agreed to a comprehensive lifestyle change instead. A prostate biopsy was performed prior to initiation of the lifestyle change programme. The 3 month lifestyle modification comprised of a 3-day intensive residential retreat followed by weekly outpatient follow-up by a study nurse. The modifications included a low fat (10% of calories from fat), whole foods, plant-based diet; stress management 60 minutes / day (gentle yoga-based stretching, breathing, meditation, imagery and progressive relaxation), moderate aerobic exercise (walking 30 minutes / day for 6 days / week) and a one hour group support session per week. The diet was supplemented with soy (one daily serving of tofu plus 58 gm of a fortified soy protein powdered beverage), fish oil (3 gm daily), vitamin E (100 units daily) selenium (200 mg daily) and vitamin C (2 gm daily). Another prostate biopsy was performed at the end of the 3 months intervention. The gene expression from the normal prostate tissue obtained before and after the lifestyle changes was compared. At the end of 3 months, they found 48 genes up-regulated and 453 genes down-regulated (simplistically, up-regulation means switched on and down-regulation means switched off) in the prostate tissue. The pathways under the control of these genes were found to be involved in tumorigenesis (formation of tumours). For example, they found a set of down-regulated RAS family oncogenes (RAN, RAB14 and RAB8A). In the prostate, RAN may function as an androgen receptor coactivator and its expression is increased in tumour tissues. (Androgen stimulates prostate cancer to grow and oestrogen can suppress prostate cancer growth. Hence, one of the treatments for prostate cancer is to castrate the patient and remove testosterone, an androgen, from circulation. This manoeuvre will then deprive the prostate cancer its driving force, thus, slowing its growth.)

While this study involves only a small number of patients, if its findings are shown to be true in subsequent larger studies, it will make us sit up and take note. We can no longer blame it all on fate or parents for passing on ‘bad’ genes. In the meantime will you continue with your unhealthy lifestyle habits or might you, just to be on the safe side, adopt a more healthy lifestyle?