#187: Prevent Prostate Cancer with These Four Foods- Dr. Benny Gavi and Maya Eylon
Dr. Benny Gavi and Maya Eylon
What do cruciferous vegetables, tomatoes, soy, and green tea all have in common?
According to hundreds of scientific studies, they all can drastically reduce the risk of prostate cancer in men.
Here are a few facts:
Prostate cancer is the 2nd leading cause of cancer in men
One in eight men will be diagnosed with prostate cancer at some point in their life
Sadly, one in 40 will succumb to this disease
However, much like heart disease and many other lifestyle diseases, this cancer can mostly be prevented, and today's guests lay out the extensive research and practical solutions in their book, Preventing Prostate Cancer: Reduce Your Risk with Simple, Proactive Choices
Dr. Benny Gavi, Clinical Assistant Professor of Medicine at Stanford University, teamed up with researcher Maya Eylon to compile more than one hundred recent, reliable, and relevant international studies on the effects of diet on prostate health.
As you probably guessed, all signs point to a whole-food, plant-based diet, combined with exercise and screenings, as your best defense against prostate cancer.
Today, we discuss some of their research, along with outlining the biggest cancer-fighting foods to consume on a regular basis.
16:00 Cruciferous Veggies - super fighters for our bodies
20:25 Tomatoes and Lycopene
23:20 Healthy Soy Consumption
27:28 Green Tea
They also share research on foods you should avoid, including meat, dairy, and eggs in excess.
This book is a powerful tool to empower men (and those of you who love those men) to make healthy, lifestyle changes that can save thousands of lives.
Episode Resources
Order Preventing Prostate Cancer: Reduce Your Risk with Simple, Proactive Choices
Email Maya: maya@interactivewellness.com
Email Dr. Gavi: drgavi@interactivewellness.com
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Full YouTube Transcript
Rip Esselstyn:
We know that you have choices, and I am so proud of all of you for choosing to eat PLANTSTRONG, whole food, plant-based. It is where it's at. There's some pretty powerful new research that shows that a keto like diet may be associated with a higher risk of heart disease. And this is based on an average of 11.8 years of follow up. And this is after adjustment for other risk factors for heart disease, such as diabetes, high blood pressure, obesity, and smoking. And the discovery is that people on a low carbohydrate, high fat diet had more than two times higher risk of having several major cardiovascular events such as blockages in the arteries that needed to be opened with stenting procedures, heart attacks, stroke, and peripheral arterial disease. So again, thank you for your choice. I also know that you have lots of choices when it comes to what you subscribe to, and I want to thank you for subscribing and choosing PLANTSTRONG podcast.
Now, another choice that you might be considering is whether or not to attend a PLANTSTRONG retreat. And I am here to tell you that spending a week immersed in the lifestyle surrounded by learning and laughter and incredible food is one of the greatest gifts that you can give yourself. We have a few spots left this spring from April 16th to 21st in gorgeous Black Mountain, North Carolina. And we are excited to announce our fall dates in Sedona, Arizona, that will be October 9th to the 14th. Both of these retreats will help you enhance or elevate your journey to eat more plants, and you'll be surrounded by our world-class team of physicians and behavioral experts to help you unlock your best path forward. Now, side note, we also offer CME and CEU credits for physicians, nurses, and other healthcare providers as part of the registration fee. To check out either of these events, simply go to plantstrongfoods.com, and then click on More. I hope to see you in Black Mountain or Sedona, Arizona in 2023.
Dr. Benny Gavi:
About 10 years ago, I went into a private practice focusing on health and primary care, and I had patients who had prostate issues and concerns about prostate cancers. And so I started doing some reading about nutrition and prostate cancer. And I was surprised by just the amount of data that was out there, the amount of information, the amount of high quality studies that suggested that nutrition can markedly reduce the risk of prostate cancer. And I was asking myself, how is it that I was trained at Harvard and worked there for many years? I teach at Stanford and I have not really been familiar with the depth, breadth, and power of the data. And I said to myself, someone needs to write this book. Someone needs to tell this story. Someone needs to bring the studies in a simple way so that people can read the studies and make their own decision.
Rip Esselstyn:
I'm Rip Esselstyn and welcome to the PLANTSTRONG podcast. The mission at PLANTSTRONG is to further the advancement of all things within the plant-based movement. We advocate for the scientifically proven benefits of plant-based living and envision a world that universally understands, promotes, and prescribes plants as a solution to empowering your health, enhancing your performance, restoring the environment, and becoming better guardians to the animals we share this planet with. We welcome you wherever you are on your PLANTSTRONG journey, and I hope that you enjoy this show. A few facts to start this week's show, one in eight men will be diagnosed with prostate cancer at some point in their life, and one in 40 will succumb to this disease.
Much like cardiovascular disease and many other lifestyle diseases, prostate cancer can mostly be prevented. And my guest today lay out the extensive research and practical solutions that can help you ward off prostate cancer, which is the second leading cause of cancer in men. Dr. Benny Gavi, Clinical Assistant Professor of Medicine at Stanford University has teamed up with researcher Maya Eylon to compile more than 100 recent, reliable, and relevant international studies on the effects of diet on prostate cancer. What did they discover? No surprise here, and I'm sure that you guessed it, especially if you're a fan of this show, a whole food, PLANTSTRONG diet combined with exercise and screenings are your best defense against prostate cancer.
Today, we discussed some of their favorite studies along with the biggest cancer fighting foods to consume on a consistent basis. We also discussed various screening and exercise recommendations that they discovered when parsing through all the research. And all of these are powerful tools in the toolbox to empower men and those of you who love those men to make healthy lifestyle changes that can save thousands of lives. Benny Gavi, you are a graduate of Harvard Medical School and you're currently a Clinical Assistant Professor of Medicine at Stanford. Is that correct?
Dr. Benny Gavi:
That is correct.
Rip Esselstyn:
Beautiful, beautiful. And then Maya Eylon, how do you pronounce your last name?
Maya Eylon:
Eylon. You were close.
Rip Esselstyn:
Maya Eylon. You are a second year medical student and a clinical researcher. And how in the world did you guys come together to create this wonderful dynamic duo trying to teach all the men out there in the world about how to prevent prostate cancer in this new book, right, Preventing Prostate Cancer, which is fabulous. Fabulous. Every male should have it on their bookshelves.
Maya Eylon:
Thank you.
Dr. Benny Gavi:
Yeah. So the story begins probably about 10 years ago. I work at Stanford as a teacher. About 10 years ago I went into a private practice focusing on health and primary care, and I had patients who had prostate issues and concerns about prostate cancers. And so I started doing some reading about nutrition and prostate cancer. And I was surprised by just the amount of data that was out there, the amount of information, the amount of high quality studies that suggested that nutrition can markedly reduce the risk of prostate cancer. And I was asking myself, how is it that I was trained at Harvard and worked there for many years? I teach at Stanford and I have not really been familiar with the depth, breadth, and power of the data. And I said to myself, someone needs to write this book. Someone needs to tell this story. Someone needs to bring the studies in a simple way so that people can read the studies and make their own decision.
And frankly be being a teacher, hospitalist based doctor, office based doctor, I just didn't have the time. And then Maya's mom and I work in the office together. She's a medical assistant, and I met Maya, who is really bright, really smart, and I said, "I've had this project for two or three years sitting on my desk. I'm very emotionally committed to it. I just can't find the time to really write the book and put it together. Will you help me?" And I was fortunate that she said, "Yes," and I'll let you take it from there, Maya.
Maya Eylon:
Yeah. No, it was the perfect situation. We both happened to find each other at a perfect time. And in life I was applying to medical school, and Dr. Gavi had this incredible passion, and it was just the timing fit perfectly, and it was his passion. And I put in the work and we read hundreds of articles. We skimmed the entire area of research in this work, and we're both passionate about the same thing at the same time. Very fortuitous.
Rip Esselstyn:
So the data currently lets us know, and you guys have this in the book, and so I'm just reciting this, that one out of eight men will come down with prostate cancer. One out of 40 will die from prostate cancer. It's the second most frequent cancer in men, and it's the fifth leading cause of cancer deaths in men. These are staggering numbers. And you guys, in your book say that prostate cancer, for the most part is preventable. And so are you blowing smoke or is this the truth?
Dr. Benny Gavi:
It's the truth. And let me start out with some of the most basic or fundamental studies, which I think are the twin studies, the genetic twin studies when several pretty large trials looking at tens of thousands of genetically identical twins. And when you look at these studies, only about half of the men get prostate cancer. And these are genetically identical people, and so from a genetic point of view, it's at most 50%. And probably 50% is an overestimate because probably genetic twins probably eat similarly because they were raised in similar homes. And so that probably is an overestimate of the genetic contribution.
So the genetic contribution to prostate cancer is low. At most, in one study it was 42%. In another large study it was 57%. And so it's not in our genes. So if it's not in our genes, what is it? Could be chance. But there's also a lot of data lifestyle. And not only is it we know about lifestyle for prostate cancer, we know also a lot about lifestyle for heart disease and many other forms of cancer. So prostate cancer, it's not an outlier. It's really what we're learning from a lot of chronic diseases, that lifestyle have a very important impact.
Rip Esselstyn:
Right. Maya, anything you don't want to add on to that?
Maya Eylon:
Yeah. I feel like when people hear the word cancer, there's a lot of fear surrounding that. Most of it is from the unknown and the thought that cancer is out of our control. But like Dr. Gavi was saying, these twin studies have indicated that more of your risk for prostate cancer might actually be within your control than you realize. So you've got these twin studies, you've got studies on ethnicity, you've got studies on diagnostic technology. All of these studies are indicating that those aren't the primary causes of prostate cancer incidents. So like Dr. Gavi was saying, what is, and then there are countless studies that look further into lifestyle being your diet, your exercise patterns, your routine checkups, all of these things and their impact on your incidents. And there is so much more of the story that has not really been talked about yet.
Dr. Benny Gavi:
One thing that I think is really important, in medical school, at Harvard Medical School, I wasn't taught that health begins in the kitchen, not in the doctor's office, and maybe the gym, but mostly in the kitchen. And I think that's something that we're learning as doctors and we need to pass it on to our patients.
Rip Esselstyn:
Yeah. No, I think that the kitchen trumps everything. Absolutely everything. It's interesting because I will turn 60 this year in 2023, and it's interesting how many of my friends are complaining about all these things from frequent urination, difficulty going to the bathroom, bifurcation of the stream when you're urinating, all these things, some of which I would imagine are just a function of as you age, the prostate typically enlarges. But also, I mean, I've heard a quote that all men, if you live long enough, will get prostate cancer. Now, I don't know if that's accurate or not, but it's just interesting to me that the prostate just keeps on getting a little bit bigger and bigger. It's kind of obnoxious.
Maya Eylon:
Right. That is something so many men don't really talk about with prostate cancer, with benign prosthetic hyperplasia, many of the conditions surrounding the prostate, the symptoms that manifest are not really discussed and are so prevalent and really do impact life. And that's one of the things we wanted to illuminate with our book.
Dr. Benny Gavi:
We used to think, and maybe we still do think that atherosclerosis is inevitable, that heart attacks are inevitable. I think many people probably still believe that. And we know that to a large degree, coronary artery disease could be prevented with a very proactive lifestyle. And so I think we have to be careful about what we think is inevitable, because then it just becomes something that we just live out if we don't make the changes. And so I do think that prostate cancer is common, but it could be reduced. I think also dealing with the effects of prostate cancer in somebody's in their 50s or 60s is different than dealing it with their 80s or 90s. I think loss of sexual function in somebody's 50s is a lot more difficult, loss of bladder function. I think people have expectations for what their life will be like in their 50s and 60s, and when those expectations are not met, that could lead to difficulties and often difficulties that men may not share with other people.
Rip Esselstyn:
Right. Well, I want you to know that you have a very sympathetic audience here, because all the listeners, I would imagine most listeners of the PLANTSTRONG podcast are familiar with my father's work at the Cleveland Clinic showing that you can prevent and reverse heart disease. He started doing this research in 1984. So the fact that you can do this with the prostate cancer is I think something that everybody in listening is like, "Yes, I absolutely can get my head around this." So let's go through some of the things that we can do with our lifestyle to help give us the best chance of preventing that prostate cancer so we can be in that 50 or greater percentage range in preventing it. So in the book you talk about, it's chapter number two, vegetables and cruciferous vegetables. Go ahead, swing away on that.
Maya Eylon:
I can start us off on cruciferous vegetables. So some of you may be unfamiliar with the term cruciferous vegetables. So I'm just going to really briefly, that includes broccoli, cauliflower, Brussels sprouts, cabbage, kale, turnips, and so many more vegetables. And these are little super fighters for our body. So cruciferous vegetables and vegetables in general have a lot of powerful anti-cancer properties that come in the form of phytochemicals. Phytochemicals are plant products, compounds that our bodies can't make. So we have to get in our diet and they have basically anti-cancer properties. And that's just one small way that we try to explain why cruciferous vegetables are so good for us. But I think it's just when you see the impact of eating the whole vegetable, not just those specific compounds, you really see how much of a difference it can make. So we found that cruciferous vegetables can help reduce prostate cancer risk significantly by over 50% if eaten in high quantities and in a regular basis.
Rip Esselstyn:
What's your definition of high quantities?
Maya Eylon:
Yeah. So the American Cancer Society recommends two and a half cups of vegetables a day, but I think adding vegetables to your diet is a gradual process. It's a process that you have to incorporate into your life in a way that works for you. I try to stick with the American Cancer Society recommendation personally, but it's really whatever works with your lifestyle.
Rip Esselstyn:
Benny, what about you? Did you have any cruciferous vegetables for breakfast this morning?
Dr. Benny Gavi:
I actually did. Well, usually we have them with dinner, and then when my kids don't finish them, then I'll put them in the refrigerator and throw them in my smoothie in the morning. And then, sometimes I'll have an egg white omelet with them, which is what I did today. I don't have a lot of egg whites, but sometimes I'll do that. And that was this morning. But many days of the week, breakfast will be vegetables.
Rip Esselstyn:
And what's interesting to me is that, you guys mentioned in the book how less than 10% of Americans are consuming two and a half cups of vegetables a day.
Maya Eylon:
And that's even less in certain states. It just depends on the states you're looking at.
Rip Esselstyn:
Yeah, yeah. So I mean, that doesn't bode well, right? For us, giving ourselves the best chance to help prevent prostate cancer if we're not eating fruits and specifically vegetables and cruciferous vegetables. Okay. Anything else you want to say about vegetables and cruciferous vegetables, or you want to move on?
Dr. Benny Gavi:
I would say as a practicing doctor, one of the things that I try to help people is with behavioral change. I think many people know what we should do more of. I think it's just hard to do it. And I think two things, one is we want to retain pleasure, and so we really want people to cook delicious food with their broccoli or delicious cauliflower or broccoli sprouts. So we don't want to take pleasure away. But I also want to reassure people that our sense of taste and pleasure and what we're used to can adapt over time. And there may be a time where maybe you're used to having a certain breakfast and it's a sense of pleasure. We're a lot more open to change than sometimes we give ourselves credit. And our sense of pleasure can change a lot more than we give ourself credit.
Rip Esselstyn:
I couldn't agree with you more. And I'm like, no one that I know comes out of the womb liking alcohol, smoking cigarettes, the taste of coffee. These are all learned behaviors, right? And so I think the same could be true, especially when you know how beneficial it is for vegetables and cruciferous vegetables and the like. Exactly. All right. So let's talk about, you say tomato, I say tomato, tomatoes and lycopene, and why this is such a dynamic help in preventing prostate cancer.
Maya Eylon:
Yeah. So tomatoes are wonderful. It's actually, I think the second most consumed vegetable by people in the U.S. mostly because of tomato sauce. And again, like we were saying for cruciferous vegetables, you've got those good, good phytochemicals, specifically lycopene, which is really an antioxidant warrior. But I was saying for cruciferous vegetables as well, we don't want to just narrow in on the lycopene because tomatoes also have folate and potassium, and a bunch of vitamins that make them so powerful. And one of my favorite studies in this chapter is one that compares like a lycopene extract and the effects that has on people who consume it versus the whole tomato, and the protective effects of the entire tomato. And you can't compare when you eat a whole plant, a whole food the way it comes, it just does have such a powerful anti-cancer, anti-prostate cancer property, and lycopene might be one of the reasons for that.
Rip Esselstyn:
And isn't that so interesting, because many people are trying to take a shortcut, I just want to take the pill or the supplement, and it's not nearly as effective as the symphony that you're going to get in the whole food. Dr. Benny, what about tomatoes versus tomatoes and broccoli? Is there a difference? Because I saw in the book that there's a difference when you combine the tomatoes with some other maybe cruciferous vegetables.
Dr. Benny Gavi:
Yes. I mean, I think they work better in combination. I mean, I think back to the symphony, I think back to the diversity of foods and healthy chemicals that we want in our body. Diversity is great. I think we don't want people to consume only one food group.
Rip Esselstyn:
Yeah.
Maya Eylon:
You don't go to a band to just listen to the guitarist. You want to hear the piano and you want to hear the singer, and that is really what we see with vegetables when you combine the broccoli and the tomato. I think I remember the study you're referencing, they looked at just tomatoes, just broccoli, and then people will eat both. Yeah. And I mean, there's a stepwise increase in the powerful impact that they have together.
Dr. Benny Gavi:
Yeah. And there's this synergy with, and this has been stated by numerous people, but there's this visual synergy when you look at a salad and the multiple colors, you look at the plate of a multiple colors, there's a visual synergy between what is visually appealing and what is healthy to us.
Rip Esselstyn:
Speaking of powerful, you guys are fans of soy and the isoflavones, and there's a lot of, I think mixed messages around soy. A lot of people are scared, but you're like, "Hey man, we're fans of soy." So let's try and put people's fears to rest, okay?
Dr. Benny Gavi:
Let me speak to that a little bit around. People have concerns about soy and cancer, particularly about soy and breast cancer. And one of the reasons is that soy, the molecular structure of soy has some similarities to the molecular structure of estrogen. And so people are concerned that soy may function like estrogen. There have been studies of soy consumption in women who have had breast cancer. So the highest risk group you can imagine. And in those groups, people who consume soy do as well as people who don't consume and sometimes even better. And so soy consumption in women who have recovered from breast cancer does not cause more issues, and that's the highest risk group.
So I think that should reassure people who have concerns about the estrogen effect of soy, that there's really not much of an issue. And also when soy is in a food, there's only so much soy you could eat in a day, and again, it's part of a diverse diet. I think we wouldn't recommend people take cups of soy extracts or soy pills. I think that that would not be a good thing. But soy is a component of a healthy diet, and people who do that, they have healthier outcomes, they live longer, they have less cancers. That's just what the data shows.
Rip Esselstyn:
Yeah. Yeah. So let me ask you this. So Maya, I try and stay away from the soy protein isolates and concentrates. Because I've heard that it can rate jack up the insulin-like growth factor number one, which promotes tumors and cancers. What soy foods do you recommend or steer people towards?
Maya Eylon:
Yeah. It's a great question. Yeah. And I think the answer to your question really is the heart of our book. We wanted the data to lead people to their own conclusions. So we present the data as it is, and the data shows that avoiding those concentrates of supplements and focusing on the whole product. So like edamame, the beans as they come, or tofu as it comes, those are really healthy and effective ways of eating soy that are both protective and really good for you.
Rip Esselstyn:
Yeah. The other night I had tempeh in my stir-fry, which I really loved. Occasionally we have miso, which is made from soybeans. What I found interesting, Dr. Benny, was that in the studies that you guys referenced in this chapter, there was no benefit with those with advanced prostate cancer. But earlier on a great deal.
Maya Eylon:
I think I remember if Dr. Gavi doesn't mind, because I actually, I remember this study specifically. So there's like an alteration in the chemistry of your cells, the way that your cells present, basically their little receptors for soy molecules when you progress from early stages of prostate cancer to later stages of prostate cancer. So a healthy cell and early stage prostate cancer cells will express a little receptor on it for the protective factors in soy. And then later in prostate cancer, the cell stops expressing those cells. So you're not going to be able to have that same benefit as you would have earlier or in a healthier cell, if that makes sense.
Rip Esselstyn:
Yep. Absolutely. So Dr. Benny, so you had a smoothie this morning. Have you had any green tea yet today?
Dr. Benny Gavi:
Not yet. That will be probably around midday, early afternoon.
Rip Esselstyn:
Okay. So you have an old chapter on the world's healthiest drink, which you guys say is green tea. I'm not surprised, but I didn't know it was the healthiest thing on the planet. So what is it about green tea?
Dr. Benny Gavi:
Well, I think one way to think about it is that it's a plant, right? So we're drinking a plant extract. So in the way that we're eating plants, we're getting all those phytochemicals and all of those antioxidants and anti-inflammatory molecules. Here we're drinking an extract of a plant, and there's a lot of antioxidants and anti-inflammatory chemicals that just do a lot of really good. And I think more importantly in observational studies, people seem to be healthier and having better outcomes. And I like my green tea a little flavored. So I'll buy a pomegranate flavored green tea, or there's one other, just different flavors that they'll put in them. Sometimes a little blueberries, so you get a little antioxidant from the blueberry or the pomegranate, and then it gives it a little bit more flavor. Sometimes they'll drink straight up green tea as well, but I like it with a little flavoring.
Rip Esselstyn:
Right, right. Maya, have you had any green tea yet today?
Maya Eylon:
Not yet, but again, it's my dinner drink. That's a really easy way. Dr. Gavi in the past has described it as a salad and a drink, and I really love that. It's such an easy way to get a nutritious benefit.
Rip Esselstyn:
Yeah.
Dr. Benny Gavi:
There is little caffeine in green tea, and so I probably don't consume it beyond three or 4:00 PM, but Maya's a medical student [laughter] younger, so she's probably fine with it. But once she crossed into the 50s, the caffeine affects you more at nighttime for sleep.
Rip Esselstyn:
Yeah. Well, you guys, one of the things that really, shocked isn't the right word, but I just was like, wow, this is powerful, was you referenced in this chapter how it prevented 90% of prostate cancer incidents in the experimental group versus the control group. And those are some serious, serious outcomes right there.
Dr. Benny Gavi:
Those are serious outcomes. And also the researchers, these are serious researchers. These are not people who are casually reporting what they observed or what they observed in their family members or their friends. These are serious researchers published in serious journals. And one of my themes for this book early on was to let the researchers speak the data. And for us to get out of the way. This isn't one of those books where, "Oh, this is what I did and this is how much better I feel," this is really, and yeah, that's what the data shows, and we want that to come clear. And as you know, with the help of Maya, this book is really just full of a lot of really powerful studies like that.
Rip Esselstyn:
Oh, it's incredible. All the different studies that you've referenced in this. Super excellent job. So let's move on from green tea. I'm going to have a cup as soon as we're done with this. But let's talk about foods that you guys recommend people shy away from or avoid because they can increase your chance of getting prostate. And I'd love for you to start with eggs, which you have a egg white omelet this morning, maybe, but eggs and how, it sounds like eggs are not the healthiest foot forward.
Maya Eylon:
Sure. Yeah. So again, like Dr. Gavi was saying about letting the data speak for itself, we did include a few, I think it was three specifically, three studies that are at the forefront of discovering why eggs might not be as healthy for us as we thought they were. But mostly it focuses on eggs in excess. So a lot of the food groups that we talk about in this chapter are excessive amounts of this food and why that could be potentially dangerous. And finding moderation in life is always important. And Dr. Gavi and I would never recommend cutting a food group completely out of your diet, but finding ways to limit or to replace these foods with other potentially more healthy foods and eggs are one of those.
Rip Esselstyn:
So when you say, because what I read was that eggs actually will increase your chance of prostate, getting prostate cancer by 89%, right? So what is the upper limit where if you go over that it increases your chances? Are you saying you could have an egg a day?
Maya Eylon:
Yeah, I think it was looking at people who had two and a half eggs a day.
Dr. Benny Gavi:
A week.
Maya Eylon:
Oh, okay. Yeah. Right. So it was looking at maybe a small, well, might seem like a small amount, and yeah, that's what they found. They found that it really did have a strong correlation.
Rip Esselstyn:
And is that the whole egg? Is that the white and the yolk? What do you think?
Maya Eylon:
That's correct.
Dr. Benny Gavi:
It's the whole egg. There is a suggestion that it may be a protein called choline. Yes. Which is in the egg yolk. And so that's why I think the egg white may be healthier. But before we did this research for the book, I had a lot more eggs. I loved eggs, and now I'll probably limit it to maybe two or three egg whites a week for me, and no egg yolk, for the most part, I mean. But just to be clear, I mean, we're human. We're going to try things. People offer us things. Social occasions, sometimes my kids will not finish their sandwich and I'll finish it for them and they're having an egg sandwich. And so we have to be realistic that we live in a life. But I think that with the eggs, there was also one study that was neutral.
And so I would say that food studies are hard to do. I would say that when it comes to eggs, because we get a lot of questions about eggs, I think, are eggs good or bad? It depends a little bit what you were going to eat if you weren't going to eat the eggs. If people are going to have pancakes and syrup, then maybe eggs are better because at least it's not so much carbohydrates and sugar and people have this, they feel tired after a big carb meal. So it depends a little bit what you're going to eat if you don't eat the eggs. But there is certainly better. There's an opportunity for plants. There's an opportunity, I think that many days I'll eat for breakfast, whole grain toast with maybe some heirloom tomatoes and a little olive oil, or some avocado, or even avocado and I'll do a cucumber on top of the avocado on the whole grain toast. I think that we could do better.
The eggs, again, my kids actually eat a fair bit of eggs because they want to eat pancakes and syrup, and I get them to eat the eggs. I'm not going to eat avocado toast. And so I guess it's okay. We do the best that we can, depending where we are in life. I think maybe a bigger message is eggs are a little bit of a mixed picture, but we could do better.
Rip Esselstyn:
Yeah. Well, let me just, we at PLANTSTRONG like to say there's only two things wrong with the egg, and that's the yolk and the white. Okay? And I could go on and on about why we're not a fan of eggs. So just know that on this podcast, we're not a fan of moderation. We like extremes. We like people that are taking the kale by the stock and cutting out the offending food groups. Because the most precious gift that we have on this planet is our health. I truly believe that. Let's move on to dairy. What about dairy? Low fat versus whole?
Maya Eylon:
Yeah. So there's a linear connection as you go into higher fat dairies and the risk for prostate cancer increasing. So the whole milks, the whole fat dairies, those are associated with not only increased rates of prostate cancer, but increased rates of lethal forms of prostate cancer. And then as you go down towards the low fat dairy options, there is some connection or studies have found no connection. So based on those studies, the researchers who did them recommended leaning towards the low fat dairy options, or if you can, dairy alternatives. I know I really love almond milk, also a big fan of soy milk. And that works really well.
Rip Esselstyn:
Yeah. Yeah. It's interesting, again, in this chapter when I was reading it, I saw that one of the issues with dairy is you get all this calcium, which oh, we think we need all this calcium. But the calcium actually can block the vitamin D absorption, which will then stop the protection of the prostate cells and help contribute to it turning into cancer. So it's funny how everything is so interconnected and interwoven. This is why, to me, again, I am such a fan of plants because I feel plants just mother nature had it right. And protein, for example, the protein you're getting from plants, it's like the Goldilocks version of protein. It truly is. Whereas meat is the next thing that you recommend that people avoid. Meat is just, is like got this junky sulfurous form of protein that wreaks havoc. So let's now go to meat. And what did you guys find in your research with meat?
Dr. Benny Gavi:
Well, I mean, it's a carcinogen for one. Need I say more, but Maya let you get into a little bit of the details around that.
Maya Eylon:
Yeah, I'd love to. So the International Agency for Research on Cancer, which is a division of the World Health Organization, has independently classified red and processed meats as carcinogens and independent predictors of prostate cancer.
Rip Esselstyn:
Wow.
Maya Eylon:
Yeah. I mean, that speaks for itself. It's a pretty strong statement. So we start that section of the chapter with that just to let that message sink in. And then there's also a ton of studies that just show as countries consumption of meat increases, you also see their rates of prostate cancer in the entire country increase as well again in a linear fashion. And that correlation is really powerful.
Rip Esselstyn:
I'm using this word a lot today. But it's also interesting. My father, when he gives his talk on preventing and reversing heart disease, he talks about how in the whole nation of Japan in 1956, there were 18 autopsy proven or cases of death by prostate cancer. I mean, 18 in the whole nation of Japan. Now it's right up the same as ours. And back then they were predominantly a vegetarian culture. So I think that's a pretty powerful stat as well.
Maya Eylon:
Right. You can look at some parts of Asia and they're going to have 50 times less incidents of prostate cancer than we do. And one of the studies actually references that possibly their primary source of protein being tofu as opposed to meat, could be a contributor, could be a protective factor.
Rip Esselstyn:
Yeah. Yeah. All right. Let's move on to obesity, BMI, and exercise. You guys have a whole chapter on this and how this can help or hinder our chances of getting prostate cancer. Who wants to start it off with obesity, BMI, and exercise?
Dr. Benny Gavi:
Well, let me start off by setting the foundation that obesity is correlated with so many diseases, so many cancers, diabetes, which by itself is a risk factor for cancer. And so the impact on prostate is consistent with so many other cancers where obesity is a risk factor. And so obviously reducing that will markedly reduce people's risk of prostate cancer, other cancer, heart disease, and improve the quality of their life. In terms of exercise, there's some really cool studies that I want Maya to speak about because I know she enjoys speaking about them. But again, it's good for the prostate and what's good about a lot of these things they recommend, there are so many good for other parts of your health, mood, sleep, so many other parts of our health. But I'll let Maya talk a little bit more about the exercise and prostate cancer.
Rip Esselstyn:
Yeah.
Maya Eylon:
Dr. Gavi knows this is my favorite study that I read probably out of 300- I think it's in chapter one that it's not that one, but that's a good one as well.
Rip Esselstyn:
Yeah. Yeah.
Maya Eylon:
Yeah. We read maybe three or 400 articles, and this one always stands out to me. But basically, researchers looked at a group of men and they compared their blood's ability to fight prostate cancer cells before and after a single hour of exercise, just one single hour. And just after one hour, their blood was able to fight prostate cancer cells 31% more effectively. And if that's not powerful, I don't know what is, because what can two hours do? What can a week do? And you really just have to start somewhere and already it'll make a difference.
Rip Esselstyn:
So what's your recommendation as far as exercise each day for people? 20 minutes, what do you like?
Maya Eylon:
So the American Cancer Society recommends 150 minutes a week, which goes down to 20 minutes a day.
Dr. Benny Gavi:
Right. I think we also have to acknowledge where people are starting from. We are a pretty sedentary society, so if we told people an hour a day, people are like, "Whoa, that's not realistic." But humans evolved to move not to sit, and 20 minutes a day is probably really low in terms of the benefit that we can get. I don't know where it plateaus, is it one hour a day? One and a half hour a day? It's probably more than 20 minutes. I think we probably would get significant more benefit. Looking at other studies and other outcomes, I think 30 minutes to an hour a day would be a really good of some kind of movement if people can do that.
Rip Esselstyn:
Have you guys had any exercise today?
Maya Eylon:
Yeah, I love to start my morning with some yoga. The best way. I have a big window in my room, so I get to see the sunrise with it.
Rip Esselstyn:
Nice. Nice. How about you, Benny?
Dr. Benny Gavi:
Not yet. For me, it's usually in the mornings. I'm getting the kids off to school and all of that. And so it's going to be when I get home around 5:00 or 5:30.
Rip Esselstyn:
What do you like to do?
Dr. Benny Gavi:
Well, I like to exercise with, I have a stationary bicycle, jogging, swimming, and then I'll do workouts with my wife, actually. And the nice thing about that is we sort of commit to each other because invariably there's always other competing things to do, but if you make a commitment with another person, I'm more likely to keep it.
Rip Esselstyn:
Yeah. Absolutely. All right. Let's go to screenings. Okay. Screening for prostate cancer. I can tell you guys, as I said, I'm almost 60 years old, and other than the bend over and the digital rectal exam, I've never done anything else. And I'm wondering if, for other men that are in my boat, what do you recommend?
Dr. Benny Gavi:
Well, a conversation with your primary care doctor, and the one common option that people can have is the blood test called a PSA.
Rip Esselstyn:
Yeah.
Dr. Benny Gavi:
And it's a blood test that could be checked once a year, once every two years. But it is helpful and has been shown to be helpful in detecting prostate cancer. I think that it's helpful in the absolute amount in that the higher the number, the greater the chance there is a prostate cancer. I think it's even more helpful to actually trend it over time and to see what the trajectory of changes in terms of diagnosing prostate cancer. And if the PSA is elevated or there is some concern, there has been the development of prostate MRIs and the imaging has gotten better. And so that's an additional piece of information where you could look at the prostate. Obviously there's also biopsies, those are pretty painful and difficult and have some risks. And so those are reserved for higher risk situations.
But I think it's traditionally been a blood test. In some people it's an MRI or an ultrasound not as good as an MRI. The digital rectal examination is also an option. I don't think it's as good as the blood test, certainly not as good as an MRI because when a doctor does that exam, they're really only feeling a part of the gland that's protruding into the rectum area. So you're really getting a very small feel of the gland. But if there's a nodule, if the gland feels abnormal, that could also be another indication, obviously also symptoms. So having a conversations about a dramatic change in the pattern of urination. Also, if there's any kind of pain burning, any kind of blood or anything like that, that should also prompt an evaluation.
Rip Esselstyn:
Yeah. Yeah. I would hope any blood in the urine would prompt a visit to your physician.
Maya Eylon:
Yeah, screening is a very individual process. There are certain risk factors for prostate cancer that might indicate that you should be screening earlier or perhaps that you don't want to screen. And that's definitely a decision Dr. Gavi and I both recommend the individual have with their physician.
Dr. Benny Gavi:
The PSA test have an interesting history. Initially it was commonly used, and then people thought that perhaps there was an overdiagnosis of prostate cancer that wasn't meaningful. And then the United States Preventative Task Force, approximately 2012, recommended that doctors no longer do the PSA. And then, that was reversed in about 2016 or 2018. They went back and said, "You know what? We're seeing more prostate cancers now." And so maybe that 2012 decision was premature. And so then the recommendations were put back on the dashboard. But I think the adoption of that has been heterogeneous because of that 2012 recommendation.
Rip Esselstyn:
So Benny, this is something that you, putting this book together that you've wanted to do, you didn't really have the time, you recruited Maya, you two went into it. How long did it take you guys to write this book and go through all the research studies?
Dr. Benny Gavi:
Well, I probably was accumulating studies for about a year or two. But again, doing it 5% of my time, keeping my eyes and ears open, attending conferences on lifestyle medicine, which I do as part of my general education conferences where your dad was a speaker. I got to hear him speak five, six years ago. But then Maya and I worked in, I think it's about a year, Maya.
Maya Eylon:
Yeah. Maybe almost two.
Dr. Benny Gavi:
Maya is pretty efficient, hard worker. One to two years.
Maya Eylon:
Yeah.
Dr. Benny Gavi:
And so Maya, you were working on this book before you were in medical school, correct?
Maya Eylon:
Right. Yeah.
Rip Esselstyn:
Yeah. So how has medical school been for you having done all this research? Is there any point in time when you're like, "You know what? Let me tell you guys a little something about what I know."
Maya Eylon:
Yeah. So one of the ways that we study in medical school is in groups where we tackle patient cases together. And we had one on prostate cancer, and I definitely led the charge on that one.
Rip Esselstyn:
I bet they must have been so incredibly impressed. You alluded to this, Benny, earlier, but I want to ask each of you individually. So since doing this research, since writing this book, and I should state that, and Benny, tell me if you agree with this statement that what men should do here for their prostates by association women should do for their breasts and their whole bodies, correct?
Dr. Benny Gavi:
Well, I don't want to overgeneralize. I think there are studies around breast cancer, for example, alcohol and breast cancer for women is a risk factor. And that didn't come across in our studies. Maybe nobody did the study. I don't know. So it's not the same, it's not identical, but I think that it's safe to say that what we recommend in our book for prostate cancer probably, generally speaking, impacts most cancers.
Rip Esselstyn:
Right, right. Okay. Fair enough. I also remember reading in chapter one under, Can You Prevent Prostate Cancer? You guys have the three circles. One's Diet, one is Exercise, and then the last one's Remember. And then under Remember, you have alcohol and you have smoking, and how important it is to, I think maybe limit or refrain from those. So how has writing this book and the information that you've gleaned, how has that reframed the way you guys now eat and maybe your family eats, Benny. And Maya, I don't know if you're single or married, but the way you and your boyfriend or partner eat and live.
Dr. Benny Gavi:
I guess I'll go first, but I wouldn't recognize what I eat compared to five years ago. I mean, it's markedly a different diet. Breakfast, lunch, dinner, snacks it's completely different. And the pleasure is the same or more, and I feel a lot better.
Rip Esselstyn:
And how about your wife and your kids? Are they on board? They don't have a choice?
Dr. Benny Gavi:
The kids are on board. They don't know they're on board just because that's what we eat. And my wife, she's happy to make the change. I mean, she's feels really positive about it. Yeah.
Rip Esselstyn:
Fantastic. Great. Thank you. How about you, Maya?
Maya Eylon:
Yeah. No, I think I'm someone who loves to know. I like to have the information and when I make a decision, I like to make it with conviction. And after doing this book, I mean, the data is overwhelming. The story that's told is very powerful and it's very direct. There's a direct cause and effect that we can see. And now I definitely eat with more conviction than I did before.
Rip Esselstyn:
Yeah.
Dr. Benny Gavi:
One thing just to add, in the last month or so, I've been playing with the air fryer and tofu. And they're really, the tofu comes out great little crunchy cubes and the kids dipping in sauces, and we're just having fun, enjoying the food. And so I'm a big fan of keeping fun and pleasure as part of the important ingredients in making this happen.
Rip Esselstyn:
Yes. Here. Here. So where, if people want more information on preventing prostate cancer, in addition to getting this book, where can they get the book and where, do you guys have a website or anything like that you can tell people to go to?
Maya Eylon:
Google the book. It's sold on all places that sell books, and we'd also be happy to provide our email addresses. If people want to reach out and ask questions. We have this information and way more, and we'd be happy to share it.
Rip Esselstyn:
Wonderful. Wonderful. Maya, are you in Michigan right now?
Maya Eylon:
Yes.
Rip Esselstyn:
Okay. And Dr. Benny, you're in Stanford?
Dr. Benny Gavi:
Yes. Northern California.
Rip Esselstyn:
Yeah. Yeah. Well, you guys, I just want to say on behalf of myself and the PLANTSTRONG podcast, thank you for all your work in bringing this book out to the world. I think it's going to really help many, many men prevent prostate cancer and appreciate you bringing this passion project to life. Thank you so much.
Maya Eylon:
Thank you so much. Thank you for having us.
Dr. Benny Gavi:
Thank you. And thank you for being the vehicle to help get this message out, because without people like you, we wouldn't get the message out as effectively. So thank you very much.
Rip Esselstyn:
Oh yeah, my pleasure. All right, you guys. Give me some PLANTSTRONG fist bumps right here. Boom. All right. Prevent prostate cancer.
Dr. Benny Gavi:
Yes. Wonderful.
Rip Esselstyn:
The book Preventing Prostate Cancer is available now, and there's a link in the show notes if you're interested in learning more or purchasing the book. Well, also, be sure to add their contact information if you have more questions. Remember, you can reduce your risk of prostate cancer with practical PLANTSTRONG solutions. Have a great week, and as always, keep it PLANTSTRONG. Thank you for listening to the PLANTSTRONG podcast. You can support the show by taking a quick minute to follow us wherever you listen to your favorite podcast. Leaving us a positive review and sharing the show with your network is another great way to help us reach as many people as possible with the exciting news about plants.
Thank you in advance for your support. It means everything. The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin, and Wade Clark. This season is dedicated to all of those courageous, true seekers who weren't afraid to look through the lens with clear vision and hold firm to a higher truth. Most notably my parents, Dr. Caldwell Esselstyn Jr. and Ann Crile Esselstyn. Thanks for listening.
