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Breast Cancer and Iron

November 23, 2009 Written by JP       [Font too small?]

One of the top news stories of this past week involved a proposed change in the current breast cancer screening protocol. Mammograms have been generally recommended for all women 40 years and up. However, new guidelines announced by the U.S. Preventive Services Task Force now suggest that routine testing begin a decade later, at age 50. At the moment there is a passionate debate about whether or not this recommendation and others, such as only having a mammogram every two years instead of one, would result in equivalent or improved health outcomes in older women. But controversy is no stranger to the field of breast cancer research. The topic of breast cancer prevention is perhaps the hottest issue in this category. Some experts are confident that dietary and lifestyle factors can, in fact, impact the odds of a women developing breast malignancies. Other researchers subscribe primarily to the notion of “genetic destiny”. In their minds, whether you get cancer or not is a essentially a roll of the dice. If you happen to have a family history of breast cancer, the dice are loaded against you.

A relatively new piece in the breast cancer prevention puzzle is beginning to come to light. A study just published in the Journal of Clinical Biochemistry and Nutrition is the latest to point out an apparent link between elevated iron levels and an increased risk of breast cancer (BC). Korean researchers examined the iron status of 121 women with BC and compared those findings with those of 149 healthy volunteers. Iron concentrations were determined via blood tests and food frequency questionnaires. The scientists discovered that – a) healthy females consumed lesser quantities of non-heme (“plant-based” iron) and total iron; b) blood levels of iron were dramatically elevated in the participants who were diagnosed with BC; and c) a marker of oxidative stress known as malondialdehyde (MDA) was also significantly higher in the BC patients. The researchers decided to measure MDA levels because excess iron is known to generate “reactive oxygen species” (pro-oxidants) which may damage healthy tissue and ultimately contribute to aberrant cellular changes. The authors of the study remarked as follows: “These results suggest that serum iron overload may be a breast cancer risk factor possibly due to increased oxidative stress”. (1)

Two observational studies conducted at the Oregon Health and Sciences University and the National Cancer Institute have also recently taken notice of the association between iron and breast malignancies. The Oregon-based scientists specifically looked for such a connection in two densely populated countries – China and United States. They noted that the modern Chinese diet is quickly following the lead of current US dietary trends. This way of eating is sometimes referred to as the “standard American diet” or “SAD”. Perhaps because of this dietary shift, many Chinese are now being diagnosed with iron overload. In the past, it was much more common for them to have an iron deficiency. The details of the study are as follows:

  • Iron concentrations and dietary journals were employed to assess the iron status of 248 Chinese breast cancer patients, 346 women with “fibrocystic breast changes” and 1,040 healthy volunteers.
  • Higher levels of ferritin (a measure of serum iron status) were present in the women with “nonproliferative fibrocystic changes”.
  • “Similar, but weaker, trends were observed for proliferative changes and for breast cancer”. (2)

The research from the National Cancer Institute evaluated iron intake in a much larger group of middle-aged and senior women. Links to other forms of cancer such as colorectal, lung and ovarian cancer were also examined in this trial. Of the 52,158 women participating in the study, a total of 1,205 had invasive breast cancer. Food frequency questionnaires were used to determine the iron consumption of all the participants. It was determined that higher dietary iron intake contributed a 25% greater risk of BC. In fact, the researchers found iron to be the only dietary factor tested for that showed a “linear trend” in relation to breast cancer occurrence. (3)

A paper presented in the August 2008 edition of the journal The Lancet Oncology proposes an underlying mechanism by which iron overload may be influencing BC risk. The author of that study suggests that breast cancer rates increase after menopause because this a time when women no longer menstruate. The regular loss of blood, via a woman’s monthly cycle, helps to reduce iron concentrations. Excess iron is left unregulated in older women and may then contribute to increased oxidative stress which could promote breast cancer. What’s more, London based researchers have even determined that certain minerals, such as iron, tend to concentrate more heavily in sensitive tissues that are “correlated with areas of cancer cells”, such as the breasts. (4,5)

This brings up the unique possibility of utilizing blood tests to rule out iron overload. The words “blood test” are paramount here. There are alternative tests that measure iron concentrations in human hair. However, these tests do not appear to be useful in measuring iron status relating to breast cancer. In fact, a recent hair analysis study in women with breast cancer found that they generally exhibited low levels of iron. (6)

Pre and Postmenopausal Changes That May Influence Breast Cancer
Source: Lancet Oncol. 2008 August; 9(8): 803–807. (link)

There are several effective ways to lower iron while at the same protecting against breast cancer. The first and most highly recommend avenue is regular exercise. A study from April 2008 found that frequent physical activity can significantly lower serum iron levels without increasing the likelihood of anemia or iron deficiency. An earlier trial conducted exclusively on female military personnel during various stages of physical training found that they consistently “experience diminished iron status following training”. Some researchers go as far as recommending that “recreational athletes should be screened for iron deficiency without anemia” because of the profound effect that physical exertion can play on iron stores. This leads to a rather provocative question: Is a reduction in iron levels part of the reason why female exercisers tend to exhibit lower breast cancer rates? (7,8,9,10,11,12)

Another excellent way to naturally reduce serum iron is by donating blood. Modern research indicates that giving blood on a regular basis not only reduces iron concentrations but may also decrease oxidative stress. Once again, the theory behind this observation takes us back to the “iron as a pro-oxidant” theory. But there may also be another explanation. A trial from 2005 draws a link between frequent blood donations and increased insulin sensitivity. Poor blood sugar control and insulin resistance are considered other risk factors associated with BC incidence. (13,14,15)

A third option worth considering can be accomplished via diet and/or supplementation. A substance known as phytic acid or IP-6, which is primarily contained in fiber-rich foods, is known to lower iron in the body and counter the associated free radical damage and inflammation induced by the mineral. IP6 in an isolated/supplemental form has even been shown to directly kill breast cancer cells and inhibit their spread while leaving healthy cells intact. In addition, preliminary research indicates that IP6 may be a suitable complementary therapy that can be used along with conventional breast cancer options such as adriamycin and tamoxifen. (16,17,18)

I’m not in any way trying to paint iron as some sort of dietary villain. It is after all an essential mineral that we cannot live without. A lack of iron can bring about a host of unwanted side-effects including brittle nails, fatigue, hair loss, headaches, irregular heartbeat, poor circulation and immune function and restless leg syndrome. I think the take home message here is to consider having your iron levels tested – especially if you have reason to believe you’re at an increased risk for breast cancer. Experts don’t always agree about whether breast cancer prevention is possible. But there’s no disputing that prevention is preferable to treatment. Only time will tell whether this iron-breast cancer link will one day become an established and modifiable risk factor in the prevention and treatment of BC. Until then, you have the option of considering this information and using it proactively. Having enough iron in your system is vital but there’s simply no need nor benefit to having an overload.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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9 Comments & Updates to “Breast Cancer and Iron”

  1. Nina K. Says:

    Morning JP :-)

    i think, the more the chinese women adapt to a “sad” the less they consume green tea, green tea is a chelator and catches free iron in the blood. so high consumption decreases iron. another fact may be that they live more modern, what means they became lazier and move less, exercise less. and last of course nutrition style is changing.

    in europe they did similar studies. here younger women (in the reproductive age, premenopausal) tend to have very less iron in blood because of poor nutrition (white bread, white noodles, cakes, etc….), they have a lot of deficiencies (vitamin d, e, calcium, magnesium and iron).

    in this chinese study – im not shure that the iron is the devil, because a poor diet is always followed by an high oxidative load. iron could be one piece of the puzzle.

    some researcher discuss the fact that different sorts of viruses have an great and underestimatet impact in the genesis of cancer. so maybe thats the bridge to iron: viruses need lots of iron to feel good and proliferate fast.

    i hope that the variable iron is only a confounding variable because i love the low carb (and higher meat and fish intake) lifestyle :-)

    Greetings from the “other side”
    Nina K.

  2. JP Says:

    Thanks, Nina!

    Sorry for the delay in my reply. This is the first time I’ve been back online since posting this past blog!

    I think your points are excellent – as usual! :) My personal opinion is that iron is much like LDL cholesterol. It’s perfectly fine (and essential) under normal circumstances. The trouble occurs when they become oxidized. In which case, excess amounts are more problematic.

    I think the key is to get enough dietary (and occasionally, supplemental) iron AND to make sure to also include plenty of antioxidants into our daily routine. Just my two cents worth! :)

    Be well!

    JP

  3. liverock Says:

    I recently emailed Bill Sardi, who has done a lot of research on IP6,asking whether it would chelate other heavy metals beside iron. He sent me the following study:

    An in vitro study of wheat bran binding capacity for Hg (mercury), Cd (cadmium), and Pb (copper).
    Ou S, Gao K, Li Y.
    Research Center of Food Science and Technology, Jinan University, Guangzhou 510632, People’s Republic of China.

    Water-soluble dietary fiber (WSDF), water-insoluble dietary fiber (WIDF) from wheat bran, and the carboxymethylated product of WIDF (CIDF), all having low contents of protein, ash, and phytic acid (IP6), were evaluated for their scavenging capacity for three heavy metals, Hg, Cd, and Pb.

    The results showed that WIDF had higher BC(max) (maximum amount of bound heavy metal ions) and BC(min) values (minimum concentration of heavy metal ions below which the ions cannot be bound by dietary fibers) than WSDF at two pH conditions (pH 2.0 and 7.0).

    Carboxymethylation of WIDF improved its binding capacity for heavy metals (increase in BC(max) and decrease in BC(min)). The pH value significantly affected the binding capacity for heavy metals; BC(max) sharply increased and BC(min) sharply decreased for each heavy metal ion for all of the dietary fibers when the pH was raised from 2.0 to 7.0. The binding capacity of dietary fibers for heavy metals was slightly affected by amino acids, calcium, iron, and zinc but significantly affected by copper.

    Colon fermentation released part of the heavy metal ions from dietary fibers. From the results it can be concluded that dietary fibers from wheat bran can effectively bind all three tested metal ions to prevent the body from being affected by their toxicity.

  4. JP Says:

    Thanks, Liverock! That’s yet another reason to consider supplementing with phytic acid and eating a fiber rich diet.

    I like Bill quite a lot. His IP6 and resveratrol articles are truly excellent. I hope he’ll resume publishing new work in one form or another in the near future.

    Be well!

    JP

  5. liverock Says:

    Bill Sardi is still writing a mixture of nutritional and politicol articles at http://www.lewrockwell.com/sardi/sardi-arch.html

  6. JP Says:

    Thanks, Liverock! :)

    Be well!

    JP

  7. V. Shapoval Says:

    H. F. !
    You cannot explain numerous bad phenomena into any tumor cells without words: crystallization AND ferromagnetism.

  8. JP Says:

    Updated 06/17/16:

    http://www.degruyter.com/view/j/jbcpp.ahead-of-print/jbcpp-2015-0111/jbcpp-2015-0111.xml

    J Basic Clin Physiol Pharmacol. 2016 Apr 18.

    One more health benefit of blood donation: reduces acute-phase reactants, oxidants and increases antioxidant capacity.

    BACKGROUND: One of the most important problems in finding blood donors is the inadequacy of volunteer number. To overcome this problem, one of the solutions we suggest is innovating new health benefits of blood donation. The aim of the present study is to investigate the effects of blood donation on oxidative status markers and acute-phase reactants.

    METHODS: A total of 96 healthy volunteers were recruited into the study. Blood samples were withdrawn 5 min before and 24 h after the blood donation. Serum nitric oxide, malondialdehyde levels, and activity of superoxide dismutase and myeloperoxidase were measured spectrophotometrically. Serum levels of high-sensitive C-reactive protein and pentraxin-3 as acute-phase reactants were measured by enzyme-linked immunosorbent assay kits.

    RESULTS: We found statistically significant lower pentraxin-3 and high-sensitive C-reactive protein levels and higher superoxide dismutase activity and nitric oxide level 24 h after blood donation in serum of blood donor when compared with before blood donation.

    CONCLUSIONS: These findings suggest that blood donation affected oxidative status and acute-phase reactants in donors. Blood donation removes oxidants and decreases oxidative stress by elevating antioxidant enzyme such as superoxide dismutase. This is one more health benefit or reason why we should donate blood. Further large-scale studies should evaluate this mechanism and compare the same effect of wet cupping therapy.

    Be well!

    JP

  9. JP Says:

    Updated 10/19/16:

    http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=12592&path%5B%5D=39892

    Oncotarget. 2016 Oct 12.

    Dietary iron intake and breast cancer risk: modulation by an antioxidant supplementation.

    Experimental results suggested that iron-induced lipid peroxidation may explain the direct associations observed between red/processed meat intakes and colorectal and breast cancer risk. However, epidemiological evidence is lacking. Thus, we investigated the association between dietary iron intake and breast cancer risk, and its potential modulation by an antioxidant supplementation and lipid intake. This prospective study included 4646 women from the SU.VI.MAX trial (daily low-dose antioxidants vs. placebo). 188 incident breast cancers were diagnosed (median follow-up=12.6y). Dietary iron intake was assessed using repeated 24h dietary records. Multivariable Cox proportional hazards models were computed. Dietary iron intake was associated with an increased breast cancer risk (HRT3vs.T1=1.67 (1.02-2.71), P-trend=0.04). This association was observed in the placebo group (HRT3vs.T1=2.80 (1.42-5.54), P-trend=0.003), but not in the antioxidant-supplemented group (P-trend=0.7, P-interaction=0.1). Besides, in the placebo group, the increased breast cancer risk associated with dietary iron intake was more specifically observed in women with higher lipid intake (P-trend=0.046). These findings suggest that dietary iron intake may be associated with an increased breast cancer risk, especially in women who did not received antioxidants during the trial and who consumed more lipids. This supports the experimental results suggesting that breast cancer risk may be increased by iron-induced lipid peroxidation.

    Be well!

    JP

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