Hi Marilyn,

I have followed this thread with interest and I certainly agree with the
feedback you have gotten from William and Philip. I believe that your
interest in whole grains is an outgrowth of its advertised value in reducing
the risk of colorectal cancers. That may not be the best reason for eating
anything derived from grains.

Dietary studies in humans are notoriously difficult to design for accurate
and meaningful results. Rarely can a single variable be isolated and
manipulated in ways that result in specific, measurable outcomes. Most human
dietary studies are conducted based on patients recollections over rather
lengthy periods. Some are conducted based on patients being given
nutritional instruction, then the patient is asked at follow-up about their
compliance. Other studies estimate the proportional consumption of soluble
fiber in their diet. One study that was cited on a television commercial
touted the value of oats for preventing colorectal cancers. The relationship
they were touting had just barely made it to statistical significance.
Variations in dietary practices, aside from the food being studied,
variations in the subject's perceptions of the food in question, and a host
of other factors make such studies very difficult. I'm also concerned about
how large a role the researcher's bias is playing when the approaches become
too innovative.  Despite some impressively creative approaches to studying
human diet, I have read only a few such research reports that I would trust
very far. 

The few exceptions identify a single food or food group and it is totally
eliminated or extensively manipulated. A gluten-free diet is often used. A
dairy-free diet offers another approach. Each of the ketogenic diets offers
yet another such intervention. When individuals comply with such diets they
are making a dramatic change that may induce a measurable, meaningful
result. Despite the usual absence of control groups these studies, and their
many other weaknessses, I consider these diets in to be a much better source
of data. 

There are some studies of this sort that show reductions in a variety of
tumor types following institution of a gluten-free diet,, and some studies
that show tumor size reduction following compliance with a gluten-free diet
or a ketogenic diet. These latter are, I think, particularly instructive. 

I realize that your concern is prevention so you may be wondering why I
would look so favourably at tumor size reduction. My reasoning is that if an
intervention can cause tumor reduction, then it should serve as a useful
tool for prevention. 

There are reports in the _Lancet_ (1) and the _Journal of Clinical
Gastroenterol_(2,3). They report a total remission of malignancy in celiac
patients following a gluten-free diet. One report then recants the original
diagnosis, and identifies the correct diagnosis as lymphadenopathy. 

Further, in a 1977 report, in _Nutrition and Cancer_ (4), from Stanford
University, *all* the children suffering from radiation and chemotherapy
damage to the small bowel recovered fully from their chronic enteritis, and
suffered *no* relapse of either the bowel obstruction or the disease. The
treatment they were given was a gluten-free, dairy-free, low fat, low
residue diet. 

Others have reported the use of a ketogenic diet to reduce tumor size and
cause disease remission in two patients (5,6).  

There are many reasons to question any of these studies. As a person with
celiac disease, I am strictly compliant with a gluten-free diet and the only
dairy I eat is butter. I believe that my risk of malignancy is reduced
because of my diet. However, if I ever do get cancer of any kind, I plan to
follow a ketogenic diet unless something else comes along in the interim
that offers ne an even better prospect.  


1. Holmes, et. al. "Malignancy in coeliac disease - effect of a gluten free
diet" Gut 1989; 30: 333-338

2. de Boer et. al. "Disappearance of Mesenteric Lymphadenopathy with
Gluten-Free diet in Celiac Sprue" J. Clin. Gastroenterol 1993; 16(4):317-319

3. Wink A, et. al. "Disappearance of Mesenteric Lymphadenopathy with
Gluten-Free Deit in Celiac Sprue" _J. Clin. Gastroenterol_1993; 16(4):
317-319
 
4. Donaldson SS, "Effect of Nutrition as Related to Radiation and
Chemotherapy"  _Nutrition and Cancer_ Winick ed. 1977; Wiley & Sons,  New
York, 137153

5. Nebeling LC, Lerner E.  Implementing a ketogenic diet based on
medium-chain triglyceride oil in pediatric patients with cancer. J Am Diet
Assoc. 1995 Jun;95(6):693-7. 

6.  Nebeling LC, Miraldi F, Shurin SB, Lerner E. Effects of a ketogenic diet
on tumor metabolism and nutritional status in pediatric oncology patients:
two case reports. J Am Coll Nutr. 1995 Apr;14(2):202-8. 


You also mentioned a controversy regarding the nutritional value of
phytates. I would encourage you to look more closely at that issue. The harm
caused by phytates is that they bind to minerals in a way that does not
allow their absorption through the intestinal wall. We waste them in feces.
How would anti-oxidants in phytates reach beyond the intestinal lumen to
provide any health benefits? How would they provide benefits within the
lumen? 
 


Best Wishes,
Ron Hoggan