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CHAPTER 3

Eat This

“Hey honey, can you run over to aisle five and grab a jar of flavonoids? You’ll see it next to all the polyphenols . . .” Though your ability to track down such cancer-kicking, life-giving antioxidants isn’t this obvious, I am about to make your life easier by showing you where to find the best food-based nutrients to support your breasts and body. I think you’ll love that they’re not found in obscure, disgusting, or pricey foods. They’re yummy, affordable, and located in every grocery store around the world.

When eating food, as opposed to supplements, we don’t consume individual nutrients, like swallowing a spoonful of one essential amino acid. We eat meals and snacks with combinations of ingredients inside a variety of foods. Therefore, an obvious difficulty arises when trying to arrive at a definitive, “Yes, consuming 5 milligrams of this decreases breast cancer risk by 50 percent.” Nonetheless, trends do emerge when one examines the body of literature related to this topic, so let’s be trendy, shall we?

THE MIGHTY PHYTOCHEMICAL (A.K.A. PHYTONUTRIENT)

The key to using food to protect yourself from breast cancer is to understand that food holds the power to alter the following factors inside of you: estrogen levels, growth factors, new blood vessel formation (angiogenesis), inflammation, and immune system function.

Each of these factors affects what we call a tumor’s microenvironment—the fluids and cells that bathe, support, and fuel potential cancers . . . or seek and destroy them. You choose. When your microenvironment cries out, “Pro-cancer!” cancer cells can form and multiply. I want you to regularly ingest foods that make your breast microenvironment unpleasant to tumors by shouting out, “Anticancer!” The ones that do so the loudest come naturally packed with phytochemicals. Phytochemicals are plant-derived molecules (phyto means “plant” in Greek) known to possess profound anticancer and anti-inflammatory properties that directly target the very processes that cancer cells use to develop a tumor.

Imagine a normal cell happily humming along when, unexpectedly, in a matter of days, what was normal becomes mutated by factors like the sun’s UV rays, cigarette smoke, or carcinogenic foods. This mutated cell transforms into a cancer seed. Whether or not that seed takes root and blooms into a full-blown cancer capable of destroying your life depends on the microenvironment—the soil in which cancer seeds either flourish or fail. In 1974, the National Institutes of Health (NIH) funded a study that showed that breast cancers implanted into female rats shed tumor cells into the bloodstream at dizzying rates. From one cubic centimeter of breast cancer—the size of a peanut M&M or sugar cube—cancers will shed 3.2 million malignant cells into the bloodstream every twenty-four hours.¹ Kind of makes you catch your breath, doesn’t it? How, then, doesn’t every cancer story have a fatal ending? The majority of these cells are rapidly cleared from the blood by a functional immune system, and if breast cells do arrive in a foreign land like the liver, they usually stop dividing and perish—unless they find that soil conducive to growth.

How do we engineer soil that stops cancer seeds from sprouting? In the most comprehensive study of human nutrition ever conducted in the history of science, the China Study, the authors observed that nutrition is infinitely more important in controlling cancer growth (the soil) than the dose of the initiating carcinogen (the seed maker).² In other words, healthy cells can wear nutritional armor that protects against mutations when they get exposed to bad things, so they don’t become seeds. Furthermore, even if some cells mutate into malignant seeds, by maintaining an anticancer microenvironment, seeds wither away. But in a pro-cancer body, that mutated cell multiplies and divides over and over again, as weeks turn to years, becoming decades of growth without the body’s ability to control these cells the way it controls normal aging cells. Eventually, that little zombie creates its own blood supply to bring itself even more of the nutrients it needs to now rapidly progress into a cancerous mass that you suddenly feel in your breast, making you gasp and say, “What? That was not there yesterday.”

Let me introduce you to some of the powerful plant compounds that block carcinogenic action—like sulforaphane and indole-3-carbinol (broccoli, kale), genistein (soy), diallyl sulphide (garlic), and ellagic acid (berries, walnuts)—and can save your life. Plants preceded humans on this earth, and they developed some awesome weaponry to protect themselves against adversaries like the sun’s UV rays, microorganisms, and insects.³ So we are going to pay serious attention to them, just as scientists have for many years. Plants behave like little pharmacies, auto-dispensing molecules that kill off bacteria, viruses, and fungi before these attackers kill them. Let me ask you this: If you were to eat plants, would their protective powers extend to you as a human? Of course they would! Folk medicine isn’t folklore. The medicinal gifts of the Amazonian jungle provide the basis for countless medications sold by pharmaceutical companies.⁴

A number of natural chemicals known to actively block the birth and growth of cancer cells (carcinogenesis) have been isolated from fruits and vegetables. When cancer seeds do form, these same phytochemicals enable or disable the soil’s microenvironment everywhere in your body—in the breast, yes, but also in the liver and lung and bone and brain—in all the places where breast cancer likes to travel. Phytonutrients include curcumin (turmeric), epigallocatechin gallate (EGCG, in green tea), resveratrol (grapes, wine), omega-3 fatty acids (flaxseeds, avocado), procyanidins (berries), genistein (soy), lycopene (tomatoes), anthocyanidins (apples), and limonene (oranges). Research reveals that phytochemicals exude serious anticarcinogenesis powers by⁵

• providing antioxidant activity and scavenging free radicals, which stop harmful things we consume and encounter (i.e., carcinogens) from becoming cancer cells in our bodies

• preventing DNA damage

• repairing broken DNA

• destroying harmful cells in our body

• tempering the growth rate of cancer cells

• inhibiting new blood supply to tumor cells (anti-angiogenesis)

• stimulating the immune system

• regulating hormone metabolism

• reducing inflammation

• supplying antibacterial and antiviral effects

THE ACCLAIMED ANTIOXIDANT

The most famous phytochemicals behave as antioxidants, such as vitamins C and E, beta-carotene, and lycopene. But what are antioxidants, and what do they do? Don’t worry, this won’t become a biochemistry lesson, but you need to understand the battlefield we call oxidative stress. Free radicals are bad oxygen molecules, acting like a dog without a bone. Because they need an electron to make themselves stable and happy, they steal it from any cell next to them, and this now makes the adjacent cell unhappy, so it steals from its neighbor, and so on and so on. What-oh-what can stop all the oxidative madness? Antioxidants can halt this cascade of free radical formation and ravaging cell damage. A kind-hearted, life-giving molecule, the antioxidant says to the oxidant, “Hey dog, take my electron. I’m super stable even without that bone. You need it, and I don’t.”

Free radicals are actually necessary to some degree in that they help us breathe (useful, I would say); they combat infection and can actually kill the cancer cells they help cause (ironic, but also useful); and they start the inflammatory response to injury so that your body can repair itself (that’s nice).⁶ But if more “bad” hangs around than there is “good” to stop it, then oxidative stress results, and when this imbalance persists day after day, year after year, your body’s cells and DNA get too beat up. Sickness results. Basically, whichever organs these free radicals injure the most frequently determines what diseases you’ll get. If it’s your blood vessels, hello heart disease. If it’s your muscles, you’re chronically fatigued or have fibromyalgia. If it’s your brain, I forgot what happens—oh wait, dementia and Alzheimer’s. If it’s your gut, bowels get irritable. If there’s excessive free radical damage in your breast tissue, well . . . Eliminate oxidative stress, and you just might live forever.

The role of antioxidants in tempering oxidative stress only scratches the surface of the anticancer abilities of phytonutrients, as evidenced by antioxidant activity being just the first of our ten bullet points above. If you really want to defeat cancer, then eat like you mean it.

I have something to share that will transform your eating forever. Every meal creates damaging free radicals in an effort to digest food; that is, oxidative stress rules what’s called the postprandial—after a meal—state. In fact, harmful oxidation is so high with the standard American diet (a.k.a. SAD) that most people go to bed every night with fewer antioxidants than when they woke up. How can you reverse this? Well, a study gave people a standard breakfast and measured their oxidized LDL cholesterol levels hourly.⁷ Cholesterol tracked up and up, and by noon, the participants were in a hyperoxidized state, ready to chow down their next SAD meal. What happened when people ate the same meals with one change: they added a cup of strawberries? All it took was one cup of antioxidant-packed strawberries with that same breakfast, and oxidative stress levels returned to baseline by noon! I hope your eyes just widened and nearly popped out of your head. Imagine if the meal weren’t pancakes and bacon, or steak and eggs plus that strawberry cup, but rather, steel cut oatmeal plus berries? Wow—then you would be building up health instead of staying neutral. The take home point: eat antioxidants with every meal (not just a cup of blueberries in the morning, and you’re done for the day). Every meal creates an oxidation battle—fight back with antioxidant-rich plant-based foods every time you lift fork to mouth.

The Mediterranean diet (MedDiet) comes up often as a healthy way to eat, and not surprisingly, it makes phytonutrients a priority, emphasizing fruits, vegetables, whole grains, olive oil, fish, and red wine in moderation. The MedDiet theoretically creates a microenvironment that cancers should consider hostile . . . so what happens when you put it to the test? Recently, nineteen studies unanimously showed strong benefits of the MedDiet to reduce the risk of total mortality from all the illnesses we fear: heart attacks, strokes, cognitive decline, and cancer.⁸ Could the MedDiet be the reason why breast cancer rates have been lower in Mediterranean countries (such as Spain, Italy, Greece) than in the United States, and northern and central European countries (such as Scotland, England, Denmark)?⁹ In a multicenter study from Spain, adherence to a MedDiet decreased the occurrence of all breast tumor subtypes, but most notably, the aggressive triple-negative breast cancers (TNBC) dropped by 68 percent.¹⁰ A Dutch study of over 62,000 women tracked for twenty years showed a 40 percent drop in TNBC on the MedDiet.¹¹ Finally, a ten-country European study followed a whopping 330,000 women for eleven years and found 20 percent less TNBC with a MedDiet.¹² Well, I’d say the MedDiet passed the longevity test with flying (antioxidant-rich) colors.

THE PERFECT PLATE

So what does a plate loaded with antioxidants and other cancer-fighting nutrients look like? The ideal meal is largely plant-based with an abundance of fresh fruits and vegetables, healthy fats, whole grains, legumes, occasional fish or lean meats (or not, as we later discuss), with a cup of green tea—and sometimes wine—on the side.

Your plate at any given meal should be 70 percent full of fresh fruits, vegetables, and leafy greens (kale, spinach, collards), and 30 percent packed with whole grains and protein (legumes and soy). Don’t fear starchy veggies like sweet potatoes and butternut squash; go for a deep-colored rainbow of foods, since the color contains the phytonutrients (chlorophyll makes a mean green; carotenoids create yellow and orange; flavonoids equal blue, red, and cream). For example, red jasmine rice extract reduced the migration and invasion of human breast cancer cells in a petri dish; the same thing happened with bran extract from brown rice dripped onto breast cancer cells. But white rice extract did nothing; what’s more, black rice extract fed to mice with human breast cancer grafts (I know, science can be cruel) clearly suppressed tumor growth and angiogenesis.¹³ So be colorful. And FYI, sprouting, soaking, and fermenting whole grains forms a more digestible carbohydrate.

A typical meal for me follows the 70/30 rule. I’ll eat a huge salad with a thick, delicious whole grain base across half the bottom and legumes on the other. I pile kale, arugula, and broccoli sprouts atop this layer, and then I vary what gets thrown on next among about five to ten different foods that suit my mood: raw broccoli (always), cherry tomatoes, artichoke hearts, sweet yellow peppers, fresh blueberries, avocado, a heap of hummus, and pumpkin seeds. My dressing involves a blend of apple cider vinegar, crushed garlic, ground pepper, and herbs. But honestly, if this concept is new to you, and you need a little Thousand Island or creamy ranch to enjoy it, go ahead. I’m so psyched that your plate has all those antioxidants, you won this meal’s oxidative stress battle already.

MY IDEAL MEAL, DECODED . . .

We all know our fruits and vegetables, and we even have a number of go-to faves, but when I got started eating a whole food, plant-based diet and wanted to find hearty replacements for my butter, eggs, and salmon fillet, I ran into quite a few delicious discoveries. So may I introduce to you . . .

• Healthy fats: Avocados, nuts (walnuts, pecans, pistachios, cashews, macadamia, almonds), seeds (ground flax, chia, sunflower, sesame), nut and seed butters (almond, cashew, sunflower), olives, tofu, edamame, at least 70 percent cacao dark chocolate, extra virgin olive oil, organic expeller-pressed canola oil.

• 100 percent whole grains: Whole wheat and whole grain bread and pasta, brown/wild/black/red rice, whole oats, quinoa, freekeh, farro, popcorn, whole rye, whole barley, buckwheat, whole wheat couscous, bulgur, amaranth, sorghum, teff.

• Legumes: Beans (kidney, garbanzo, lima, fava, mung, black, soy), peas (green, snow, snap, split, black-eyed), special nuts (peanuts, soy nuts), and lentils (brown, green, red, black, yellow).

RELATIVE WHAAA?

Before we chase a rainbow of healthy foods, we need a stat course in statistics. I want you to understand two important terms, relative risk and absolute risk, so you have a way of digesting the numbers I use to explain how your diet and lifestyle choices impact cancer risk.

Relative risk compares the chance of getting a particular disease when people are exposed to a certain factor with the chance of people getting the disease who are not exposed to the same factor. The easiest analogy is smoking and lung cancer; no one will be surprised to hear that the relative risk for those who smoke is way higher than for those who don’t. So now, let’s talk breast cancer and compare not eating enough fiber to chowing down plenty of fiber. Fact: if you don’t eat at least 30 grams of fiber per day, your breast cancer risk goes up 50 percent. This means you have a 50 percent increase in breast cancer relative to the high-fiber consumer. But what you really want to know is how this affects absolute risk. Absolute risk takes you out of the one context of fiber and puts you back into the context of all women, including your fiber factor. The numbers show that women have a 1 in 8 risk of developing breast cancer by the time they reach age eighty, so how does “50 percent” alter this risk in a low-fiber consumer? Well, 50 percent of 1 is 0.5. So a 50 percent increase in relative risk takes your absolute risk from 1 in 8 to 1.5 in 8.

Indulge me as I share two more interesting ways to assimilate this statistical information. First, the other person in our example—the fiber lover—had 50 percent less breast cancer, yes? Again, 50 percent of 1 is 0.5, but this time a decrease in relative risk takes absolute risk from 1 in 8 to 0.5 in 8. As we dive into all that I have learned and plan to show you, we will use these powerful additions and subtractions to our lifetime risk of breast cancer to try to optimize health. Second, risks may come and go, especially if we step up our anticancer game and change our behavior. Sometimes it’s reassuring if you look at your absolute risk over a shorter period of time than an entire lifespan. For example, if you are currently forty-two years old, it turns out that your absolute risk of developing breast cancer this year is 1 in 680.¹⁴ If you don’t consume lots of bran cereals and fiber-rich fruit, your risk becomes 1.5 in 680—see, a “50 percent increase” barely moved your absolute risk at the age of 42.

When you read about a risk factor, and it says you are 300 percent more likely to have breast cancer because you drank something, remember to relate it to absolute risk. A 300 percent increase means a forty-two-year-old with a 1 in 680 chance without the drink of something now has a 4 in 680 chance. I doubt you’d take those odds to Vegas. So nobody panic, but remember that eventually all the little trees of relative risk (all the daily choices about each food or habit) add up to a forest, which determines the health of your breasts.

KNOW YOUR PHYTOS

As difficult as it may be to pinpoint a single nutrient and confirm its cancer-fighting capacity, scientists have identified tens of thousands of phytochemicals and continue to study their complex functions. So far, these nutrients appear to be little masterminds at playing the anticancer game. The exquisite and truly unknowable power packed into foods like broccoli and berries, and then the complex cascade of events that follow from your stomach to the insides of your every cell . . . it’s dazzling. If the starring role of that movie goes to a Big Mac, it’s more horrifying than dazzling, but that’s the next chapter.

The following cast of characters represents the A-listers, the most fabulous phytonutrients in town, and they should make daily appearances in the story of your life. Start including these foods in your grocery cart today.¹⁵

THESE PHYTONUTRIENTS	ARE FOUND IN THESE FOODS	AND THIS IS WHY YOU CARE
Isothiocyanates, indoles, carotenoids, flavonoids	All cruciferous vegetables: broccoli, cauliflower, leafy greens (kale, spinach, bok choy, collard greens, watercress, arugula), brussels sprouts, cabbage, radishes, rutabaga, turnips	• Reduce breast cancer risk • Decrease inflammation • Neutralize carcinogens • Slow cancer cell growth • Stimulate cancer cell suicide • Limit free radical damage • Preserve memory • Lower heart disease
Flavonoids, lignans, phenolic acids, phytic acid, protease inhibitors, saponins	100 percent whole grains: brown rice, wild rice, whole oats, quinoa, whole rye, whole barley, whole wheat pasta, popcorn, buckwheat, whole wheat couscous, millet, bulgur, freekeh, amaranth, sorghum, teff	• Reduce breast cancer risk • Slow cancer cell growth • Lower heart disease
Ellagitannins, flavonoids (anthocyanins, catechins, kaempferol, quercetin), pterostilbene, resveratrol	Blackberries, blueberries, raspberries, strawberries, grapes, wine	• Reduce breast cancer risk • Decrease inflammation • Slow cancer cell growth • Stimulate cancer cell suicide • Limit free radical damage
Carotenoids: beta-carotene, lycopene	Tomatoes	• Reduce breast cancer risk • Slow cancer cell growth • Stimulate cancer cell suicide • Limit free radical damage
Carotenoids: alpha-carotene, lutein, beta-carotene, zeaxanthin, beta-cryptoxanthin	Everything orange: winter squash (butternut, acorn, pumpkin, spaghetti), carrots, sweet potatoes, apricots, cantaloupe, mango	• Reduce breast cancer risk • Neutralize carcinogens • Slow cancer cell growth • Stimulate cancer cell suicide • Limit free radical damage
Allium compounds (allicin, allyl sulfides), flavonoids	Garlic, onions, leeks, shallots, chives, scallions	• Reduce breast cancer risk • Neutralize carcinogens • Slow cancer cell growth • Lower heart disease
Isoflavones (daidzein, genistein, glycitein), phenolic acids, protein kinase inhibitors, sphingolipids	Soy: tempeh, miso, nattō, soybeans, edamame, soy milk, tofu	• Reduce breast cancer risk • Slow cancer cell growth • Reduce hot flashes • Lessen breast pain
Lignans	Ground flaxseed	• Reduce breast cancer risk • Decrease inflammation • Slow cancer cell growth
Inositol, flavonoids, lignans, polyphenols, protease inhibitors, saponins, sterols, triterpenoids	Beans (kidney, pinto, black, white, green, garbanzo), peas (green, snow, snap, split, black-eyed)	• Reduce breast cancer risk • Decrease inflammation • Slow cancer cell growth • Stimulate cancer cell suicide • Lower cholesterol
Flavonoids (beta-carotene, naringenin, lycopene), carotenoids, limonoids	Citrus fruits: grapefruit, orange, tangerine, clementine, tangelo, lemon, lime	• Reduce breast cancer risk • Slow cancer cell growth • Stimulate cancer cell suicide • Limit free radical damage • Protect vision • Lower heart disease
Flavones, isoflavones, polyphenols, L-ergothioneine	Mushrooms: shiitake, oyster, portabella, maitake, crimini, white button	• Reduce breast cancer risk • Decrease inflammation • Boost immune function • Slow cancer cell growth
Ellagitannins, flavonoids, phenolic acids, phytosterols	Walnuts	• Reduce breast cancer risk • Neutralize carcinogens • Slow cancer cell growth • Stimulate cancer cell suicide • Limit free radical damage
Flavonoids (anthocyanins—red apples, epicatechin, quercetin), triterpenoids	Apples	• Reduce breast cancer risk • Slow cancer cell growth
Caffeine, flavonoids (epigallocatechin gallate—non-herbal tea)	Tea: green, matcha, hibiscus, black, white, rooibos, chai, chamomile	• Reduce breast cancer risk • Neutralize carcinogens • Slow cancer cell growth • Stimulate cancer cell suicide • Limit free radical damage
Caffeine, diterpenes, phenolic acids (chlorogenic acid, quinic acid)	Coffee	• Reduce breast cancer risk • Decrease inflammation • Neutralize carcinogens • Slow cancer cell growth • Stimulate cancer cell suicide • Lower heart disease

In 2009, researchers used data from surveys that capture what Americans eat on a daily basis (the National Health and Nutrition Examination Surveys, NHANES), as well as data about nutrient content from the United States Department of Agriculture (USDA) and other published literature to estimate “the phytonutrient gap”—that is, how far we fall short of the recommended five to thirteen fruit and vegetable servings a day.¹⁶ They grouped our phytonutrient A-listers above into one of five color categories depending on the primary pigment of the foods in which they are found. Based on this report, here’s your fun and informative breakdown of the rainbow we eat (or don’t eat, as the case turns out):

• Green: 69 percent fall short (kiwi, honeydew melon, broccoli, kale, spinach, avocado, peas)

• Red: 78 percent fall short (apples, grapefruit, raspberries, tomatoes, beets, kidney beans)

• White: 86 percent fall short (pears, cauliflower, chickpeas, garlic, onions, mushrooms)

• Purple/blue: 88 percent fall short (plums, grapes, blueberries, eggplant, turnips)

• Yellow/orange: 79 percent fall short (banana, pineapple, peach, lemon, carrots, yams)

Yowza—a phytonutrient gap exists in 8 out of 10 Americans. Ideally, you should consume ten servings of fruits and vegetables daily (this quantity averages about five cups). While we could debate the exact balance of servings per color, a simple goal should be to eat two servings from each color each day. Choose the richest, most vibrantly colored foods whenever possible, since color generally reflects phytonutrient content.

THE TEN BREAST SUPERFOODS

Ready for the ten most powerful superfoods that just might stop breast cancer cold in its tracks?

#1: Cruciferous Vegetables and Leafy Greens

These include broccoli, cauliflower, cabbage, brussels sprouts, turnips, radish, watercress, kale, arugula, collards, bok choy, and Swiss chard. The high isothiocyanate exposure from cruciferous vegetables may be the primary reason for breast cancer reduction.¹⁷ In order to get the most bang for your broc, eat it lightly steamed or raw, and chew it thoroughly to break down the cell walls, which then allows the molecules to mix together, creating (yes, it was not there before) sulforaphane, the superstar of all isothiocyanates. Sulforaphanes display ridiculous talent when it comes to seeking out and destroying potential breast cancer cells.¹⁸ And broccoli sprouts contain one hundred times the sulforaphane of broccoli. If that weren’t enough, greens also provide indole-3-carbinols, which exit excess estrogen out the urinary door.¹⁹ A study following nearly 52,000 African American women for twelve years analyzed food consumption and found that cruciferous veggies cut breast cancer by 41 percent among premenopausal ladies consuming more than six servings a week.²⁰

#2: Dietary Fiber

Think whole grains, beans, and veggies. Estrogen feeds and fuels 80 percent of all breast cancers. Unfortunately, most women don’t know this fact, or that estrogen can be suppressed with a targeted diet. Fiber crushes cancer’s dreams when it binds estrogen and toxins in your gastrointestinal tract (you poop them out!), improves insulin sensitivity, and releases a litany of antioxidant vitamins and anticancer compounds.²¹ High vegetable intake even quells the more aggressive estrogen-negative tumors.²² Strive to consume more than 30 grams of fiber per day to decrease breast cancer risk by as much as 50 percent.²³ Even just 20 grams gives you a 15 percent cancer reduction.²⁴

What does 30 grams look like? It’s three to five servings a day of high fiber foods, such as the following:

• one cup of boiled split peas, lentils, black beans (15 grams), lima beans (13 grams), baked beans (10 grams), green peas (9 grams)

• one avocado (13.5 grams)

• one half cup of passion fruit (12 grams)

• one medium artichoke (10.3 grams)

• one cup of raspberries (8 grams)

• one cup whole wheat spaghetti (6.3 grams) or pearled barley (6 grams)

• one medium pear (5.5 grams)

• three-quarters cup bran flakes (5.5 grams)

• one cup of broccoli (5 grams)

How many American adults fail to consume enough daily fiber? Ninety-seven percent.²⁵ You and I will be in the 3 percent. Long live legumes (and us)!

#3: Berries

In decreasing order of antioxidant/free radical scavenging power, please meet and greet the wild blueberry, cranberry, blackberry, raspberry, strawberry, and cherry. Compounds like ellagic acid, anthocyanidins, and proanthocyanidins interfere with cancer cell signals, encourage cancer cell suicide (apoptosis), and inhibit angiogenesis.²⁶ Frozen berries more rapidly release these polyphenol heavyweights than fresh berries, but either fresh or frozen, throw them into oatmeal, smoothies, and salads—nobody’s looking, go ahead and just pop them straight into your mouth. I also love the Indian gooseberry, which has 124 times the antioxidant power of a blueberry, and works synergistically within the body to extinguish oxidative damage from free radicals.²⁷ You can use it in the powdered form, amla, as I do in my Antioxidant Smoothie recipe at the end of this chapter.

#4: Apples

Can an apple a day keep breast cancer away? Seems so! The flavonols and catechins in all apple peels and the anthocyanins in red apples work against every metabolic pathway cancers try to take, at least in animal models.²⁸ Daily apple eaters (not pie, people) have 24 percent less breast cancer than those eating fewer apples.²⁹ Extracts from the peel stop cancer cells in the lab ten times more effectively than from the flesh of the same apples, so eat them whole or blended, but not juiced.³⁰

#5: Tomatoes

One of the carotenoids, lycopene, colors tomatoes bright red and is most concentrated in the skin. As a powerful antioxidant, lycopene exhibits anti-inflammatory and anti-angiogenesis abilities, both plausible reasons for the reported decrease in breast cancer among women with high tomato intake.³¹ Unlike most phytochemicals, which are best consumed in their raw state, heating tomatoes for fifteen minutes increases the lycopene bioavailability by 300 percent.³² They are fat-soluble, so bump up absorption even more by sautéing or roasting them in a touch of olive oil.

#6: Mushrooms

Mushrooms aren’t technically fruits, vegetables, or even plants—they’re fungi, but they’re also delicious and nutritious. Who would’ve guessed that fancy mushrooms like portobello, chanterelle, and oyster have fewer flavones and isoflavones than the little ol’ white button?³³ True, the buttons carry the highest estrogen-blocking abilities of all these mushrooms and inhibit an enzyme, aromatase, which normally converts precursors of estrogen to its cancer-causing active form. A daily intake of 10 grams or more—the equivalent of half a button mushroom—dropped breast cancer rates in Chinese women by 64 percent compared with age-matched “no mushroom” eaters, and by 89 percent when they sipped a halfcup of green tea to boot.³⁴ Studies credit polysaccharides in medicinal mushrooms with stimulating immune response pathways and exhibiting direct antitumor ninja skills.³⁵

#7: Garlic, Onions, Leeks, Shallots, Chives, Scallions

Crush, chop, or chew them, but these immunity-boosting bulbs need to be fresh to unleash the antiproliferative and antioxidant protection of the phytochemical allicin.³⁶ A French study showed an astounding 75 percent drop in breast cancer with eleven to twelve weekly servings of the allium vegetables such as garlic and onions.³⁷ Vampires were also reported missing.

#8: Turmeric and Spices

Could curcumin, the most active ingredient in the pungent yellow herb turmeric be the reason breast cancer rates in India are five times less than in Westernized countries? Curcumin decreases estrogen, induces cancer cell apoptosis, suppresses inflammation (COX-2 inhibition), and inhibits free radicals.³⁸ In fact, human blood samples were exposed to free radicals in a lab one week, and when this exposure was repeated on fresh samples from the same people the following week, they sustained half the oxidative DNA damage. What changed in one week? The study subjects merely consumed one daily pinch of turmeric.³⁹ Piperine, found in black pepper, increases the bioavailability of curcumin from barely detectable to 2,000 percent higher.⁴⁰ Mixing 1/4 teaspoon of turmeric powder or a quarter inch fresh turmeric root with 1/4 teaspoon of black pepper and one tablespoon of fat like ground flaxseeds helps with absorption and avoids elimination by the liver—and makes a great topping for salad, rice, or vegetable dishes. While straight curcumin is powerful, it shows less cancer inhibition than turmeric when the two go head-to-head against breast cancer cells in a petri dish, so you may as well reap all the benefit you can from turning things ochre yellow (like I did the inside of my blender) and choose turmeric.⁴¹ Avoid turmeric if you have gallstones; it stimulates gallbladder contraction, which can lead to a painful gallbladder attack.⁴²

Spices contribute far more than color and flavor to food; they beneficially affect inflammation, free radical formation and cancer cell proliferation, apoptosis, angiogenesis, and immune function.⁴³ So while we’re feeling spicy, let me also suggest anticancer cooking with clove (second only to that gooseberry in antioxidant potency), ginger, paprika, cumin, cinnamon, sage, rosemary, oregano, thyme, and anything else inside the box below that you think adds zest and zing.⁴⁴ Incidentally, cassia cinnamon contains much more of the blood thinner, coumarin, than does Ceylon cinnamon; coumarin can also be toxic to the liver at doses of 1 teaspoon a day, so favor Ceylon if you consume cinnamon regularly.⁴⁵

HEY, HERB, LET’S SPICE IT UP

A pinch of this and a dash of that can transform bland and boring into “Yummy yummy, seconds, please!” Over 180 spice-derived phytonutrients have been explored for their health benefits, so the most impressive of these deserve some shelf space, please.⁴⁶ If salt and pepper is your idea of a spice rack, try incorporating these breast-friendly herbs and spices into your cooking and experience the flavorful taste of cancer fighting:

• allspice

• barberries

• basil

• bay leaves

• black pepper

• caraway

• cardamom

• chili pepper

• chili powder

• chives

• cilantro

• cinnamon (Ceylon)

• clove

• coriander

• cumin

• curry powder

• dill

• fennel

• fenugreek

• garlic

• ginger

• horseradish

• kokum

• leeks

• lemongrass

• marjoram

• mint

• mustard powder

• onions

• oregano

• nutmeg

• paprika

• parsley

• rosemary

• sage

• saffron

• scallions

• shallots

• thyme

• turmeric / turmeric

root

#9: Seaweed

Seaweed reduces the estrogen burden in the body by promoting urinary excretion and altering the gut bacteria.⁴⁷ A Korean study showed that daily consumption of gim (like a sheet of nori, the sushi wrap) drops breast cancer by over 50 percent.⁴⁸ Common seaweeds include nori, wakame, arame, mekabu, kombu, dulse, Irish moss, and spirulina. Try snacking on sheets of nori instead of chips, or roll up veggies and colored rice in a nori wrap. Throw a teaspoon of powdered spirulina into a smoothie or salad dressing, or shake seaweed flakes (found online or in Asian markets) instead of salt onto any meal.

#10: Cacao

Packed with flavonoids and procyanidins, cacao powder (not Dutch-processed) can be added to berry smoothies to satisfy a sweet tooth.⁴⁹ Consuming 1.5 ounces (40 grams) of more than 70 percent cacao solid dark chocolate gets an anticancer thumbs up, as it delivers antioxidants more than it does cocoa fat and sugar.⁵⁰

THERE’S SOMETHING SPECIAL ABOUT SOY—NO, REALLY

It’s time to set the record straight on this healing ingredient because it gets an unfair bad rap. Soy contains isoflavones, some of which act as phytoestrogens (plant-based estrogen-like compounds), and estrogen fuels most breast cancers, so I’ll bet somebody somewhere told you, “Say no to soy!” and you spit that miso soup right out of your mouth. Most physicians believe this to be unchartered territory, so they err on the side of caution and advise you to avoid all phytoestrogens. I guess they haven’t seen the evidence, so let me show you.

First of all, we have two totally different estrogen receptors (ER) in our bodies: ER-alpha and ER-beta. When estrogen from any source stimulates these receptors, the cells respond according to their programmed function. In the breast, ER-alpha sends signals to cancer cells to multiply and divide, whereas ER-beta actually exerts an antiestrogen effect. It turns out our natural estrogens love ER-alpha (yes, the ones implicated in cancer); but soy phytoestrogens, like genistein, bind 1,600 percent more to ER-beta than alpha.⁵¹ When bound to its ER-beta throne, soy actually blocks estrogen from sitting in the alpha chair. And if soy should land in ER-alpha, it has about one-tenth to one-hundredth of the signaling capacity of real estrogen, so soy essentially occupies but inactivates ER-alpha receptors.⁵² On top of that, soy stops the conversion of other steroids into estrogen.⁵³ Okay, if that’s true, then people who consume soy should drop their circulating estrogen, right? Right. A group of premenopausal women in Texas drank three twelve-ounce cups of soy milk a day for one month. Depending on where they were in their menstrual cycles, blood levels of estrogen dropped between 30 to 80 percent in all of them, and estrogen levels stayed lower than baseline for another two to three months.⁵⁴ Wow, so soy really does slow down estrogen production.

With less estrogen from a few daily servings of soy, should we then expect to see less breast cancer forming? Yes. One study examined the dietary intake of over 73,000 Chinese women and concluded that consuming soy during childhood, adolescence, and adult life protects against breast cancer, especially when consumed in youth.⁵⁵ Early soy intake (more than 1.5 times per week, not much) during childhood reduced adult-onset breast cancer by 58 percent in a study of Asian women in California and Hawaii, so tell your daughters to soy it up.⁵⁶ Even among Korean BRCA gene mutation carriers, largely considered to be at the mercy of their DNA breaks, a reduction in breast cancer up to 43 percent was noted in high soy consumers.⁵⁷

Okay, so far soy blocks estrogen effects on ER-alpha; it lowers estrogen levels in the blood; it protects against making breast cancer; but . . . what if you already had an estrogen-driven cancer, and now you’re on a drug that blocks estrogen’s actions in your body, like tamoxifen? Will the isoflavones in soy interfere with these drugs? Until 2009, we weren’t sure. In the Life After Cancer Epidemiology Study, 1,954 multiethnic survivors on tamoxifen (estrogen-driven cancers) were followed over six years; those eating the most tofu and soy milk products had a 60 percent reduction in breast cancer recurrence compared to women ingesting low soy amounts.⁵⁸ Isoflavones not only deal favorably with estrogen, they exhibit antiproliferative, antioxidant, anti-angiogenesis, and anti-inflammatory properties such that soy even keeps estrogen-negative tumors at bay.⁵⁹ The largest soy study to date in breast cancer patients followed over 6,200 multiethnic women from the United States and Canada for 9.4 years.⁶⁰ For those consuming merely 0.5 to 1.0 servings of soy a week, researchers observed a 21 percent decrease in all-cause mortality compared to lower soy consumption; this increased to 51 percent for estrogen-negative cancers, and 32 percent for those estrogen-positive cancer patients not taking antiestrogen therapy. Another study with over 5,000 breast cancer patients found a 29 percent decrease in death and a 32 percent drop in recurrence for high soy consumers, independent of receptor status.⁶¹ Even just one cup of soy milk a day provides enough phytoestrogens to reduce recurrence by 25 percent.⁶² So soy consumption after breast cancer is safe and protective.

Soy does not increase breast cancer but in fact decreases the occurrence, recurrence, and death rates in every single study exploring this matter since 2009.⁶³ What’s a safe soy to consume? Choose soy products specifically labeled USDA organic, 100 percent organic, or non-GMO. Although 94 percent of soy comes from genetically modified organisms (GMOs), non-GMO products shouldn’t be hard to find; most GMO-soy is fed to livestock and not you (unless you eat the livestock).⁶⁴ Soy is a “complete protein,” meaning it contains all of the essential amino acids necessary for biological function. Strive to consume two to three servings of soy food every day; whole food soy far outranks processed, and fermented whole soy products like tempeh, miso, tamari (a fermented soy sauce), and nattō are the best. The natural fermentation process accomplishes two things: it lessens gas and bloating with good-for-your-gut probiotics, and it converts soy’s powerful isoflavones into their most active form, making this superfood even more super. Tofu, soybeans (edamame), roasted soybeans, and soy milk are great ready-to-consume options. Avoid soy milk made from soy protein or soy isolate; you want to see whole organic soybeans written as the first ingredient on your milk label. Processed soy products lose some of the nutritional value found in whole foods but provide great substitutes for meat, sauces, cheese, eggs, yogurt, and milk.

ESSENTIALS: VITAMINS, MINERALS, AND A LITTLE SUPPLEMENTAL INFO

If your cells could write an editorial, “A Day in the Life of a Body,” they’d gush about how they hold in high esteem around thirty different essential vitamins and minerals that they cannot produce on their own. Cells use these raw materials to perform hundreds of life-sustaining functions. Your cells would say that consuming whole foods, and not supplements or pills like a single vitamin, exposes them to at least 25,000 phytochemicals, the complexities of which we only poorly understand. These bioactive food constituents can work individually, like what you get from a supplement, but I don’t want you to miss out on all the additive and synergistic ways this vast community of chemicals comes together to thwart disease development. For instance, sure, vitamin C is an antioxidant, but eating a whole orange unlocks other weapons, like limonene, which accumulates inside breast cells where it can protect against the onset of cancer.⁶⁵ Your chewable vitamin C didn’t know about limonene-flavored chemo! With rare exceptions—noted in the B₁₂, folate, and vitamin D sections below—balanced eating remains the safest and most efficient way to get adequate amounts of the vitamins and minerals you need. Here are the biggies:

Vitamin A: Fenretinide (200 milligrams per day), an analogue of vitamin A, promises a 35 percent reduction in recurrent or new breast cancers in premenopausal women.⁶⁶ It’s found in carrots, sweet potatoes, kale, spinach, broccoli, and yellow squash.

Beta-carotene: An eleven-study meta-analysis showed an 18 percent breast benefit from beta-carotene.⁶⁷ It becomes vitamin A in your body, so add apricots, cantaloupe, and sweet red peppers to our vitamin A-rich foods listed above.

Vitamin B6: Vitamin B₆ confers a 30 percent reduction.⁶⁸ Eat avocado, pinto beans, molasses, sunflower seeds, sesame seeds, and pistachios; if you consume meat, you can find B₆ in tuna, chicken, and turkey breast.

Vitamin B12: B₁₂ exerts a 64 percent breast advantage in premenopausal women.⁶⁹ Find it in shellfish, fish, meat, poultry, liver, dairy, eggs, fortified cereals. For vegans and adults under age sixty-five who do not consume adequate amounts of the stated B₁₂ sources, take cyanocobalamin (not methylcobalamin) 2,500 mcg weekly supplements,⁷⁰ and for those at or over sixty-five, ingest cyanocobalamin 1,000 micrograms a day.⁷¹

Folic Acid (Folate): Folate works alongside B₆ and B₁₂ to engineer glutathione, the most powerful of all intracellular antioxidants, which detoxifies and eliminates carcinogens.⁷² You’ll find folate in foods like peas, beans, nuts, spinach, collard greens, asparagus, and fortified whole wheat sources. In the Nurses’ Health Study, high levels of serum folate led to 27 percent less breast cancer.⁷³ Among those in this study averaging one glass or more of alcohol a day, the drinkers who consumed the most folate from food or supplements plummeted their cancer risk by 89 percent compared to drinkers who had low folate. You see, alcohol inhibits the conversion of folate into its helpful DNA-repairing form called methylfolate. Therefore, moderate drinkers (one or more drinks a day) should consider taking methylfolate (not folic acid), 800 micrograms once a day—or stop drinking so much.

Vitamin C: When you think vitamin C, you may think orange juice, yet citrus fruits—oranges, tangerines, grapefruits, lemons, and limes—bestow a modest 10 percent reduction in breast cancer.⁷⁴ When you add other vitamin C sources (and therefore multiple phytonutrients), like carrots, sweet potatoes, greens, and broccoli, you amp up the protection to 31 percent.⁷⁵

Vitamin D: The sunshine vitamin deserves the spotlight it’s stolen. At proper doses, vitamin D exerts protective effects: more than 800 IU (International Units) per day confers a 34 percent decrease in breast cancer among postmenopausal women.⁷⁶ Bump it to 50 percent protection with dietary doses of 2,000 IU a day combined with approximately 3,000 IU synthesized in your skin after twelve minutes of daily sunlight exposure without sunblock.⁷⁷ Excellent vitamin D sources include fortified milk and soy milk, fortified tofu and cereals, UV-exposed mushrooms (stick them in the sun for two days), sardines, salmon, and the very best source: you + sunshine.

If you live anywhere in the world north of 40 degrees latitude (New York, Barcelona, Rome, Toronto, Budapest, Zurich, Vienna, Munich, Paris) or south of 40 degrees latitude (Queenstown, Sydney, Cape Town, Buenos Aires), if you are over sixty years old, or if you have darker skin and spend less than thirty minutes a day in the sun, you need a vitamin D boost. Take 4,000 IU daily during winter months when the sun doesn’t shine.⁷⁸ The latest research suggests that you reduce cancer the most with a serum level of 40 to 80 nanograms per milliliter, which often requires 5,000 IU or more, so at your next doctor visit, get your vitamin D blood level checked and ask your physician to optimize your supplement strategy if you need one.⁷⁹

Calcium: Dietary calcium, 1,250 milligrams per day, reduces breast cancer by 20 to 50 percent, and up to 74 percent for premenopausal women,⁸⁰ probably by decreasing fat-induced cell proliferation, neutralizing fatty acids, and binding mutagenic bile acids.⁸¹ You’ll find it in kale, broccoli, all dark leafy greens, yogurt, cheese, milk, soybeans, fortified cereals, and grains.

Long-Chain Omega-3 Alpha-Linolenic Acid (ALA): For those who do not consume fish, you might not generate enough long-chain ALA from your intake of short-chain ALA (see the next section on fats). Be sure you get enough of this essential fatty acid for optimal brain health, and supplement with either omega-3 fish oils or with fish-free yeast- or algae-derived long-chain ALA, 250 milligrams daily.⁸²

SPEAKING OF FATS . . .

Fat used to be a dirty word, remember? We thought that if you don’t eat fat, you won’t be fat. Turns out that if you don’t eat fat, you will be dead. Fat efficiently stores energy, supplies energy, and regulates body temperature; fat surrounds your nerves, brain tissue, and eyeballs like teacups in bubble wrap; fat transports vitamins, makes steroids, supports cell growth and function, and keeps your skin from looking like a sharpei.⁸³ But do you know the difference between friendly fat and foe fat? Let’s talk friendly fats here.

What’s the healthiest fat? An unsaturated fat. These contain polyunsaturated fatty acids known as PUFAs, or as I like to say, “PUFA! There goes a cancer cell.” PUFAs are liquid at room temperature. They are essential, which means your body can’t make them, and you can only find them in food. You need them if you plan to do things like move your muscles or stop bleeding when you’re cut. You find omega-3 PUFAs, also called alpha-Linolenic acid (ALA), in flaxseed, walnuts, canola oil, unhydrogenated soybean oil, and oily fish like salmon, herring, sardines, and mackerel.

Beneficial fats also include monounsaturated fatty acid or MUFA, as in “MUFA! More Fa me!” (I’m hoping my goofy mnemonics help you with label reading, which we discuss soon.) Find MUFAs in oils like olive, canola, sesame, walnut, peanut, almond, flaxseed, borage, and high-oleic safflower or sunflower oils; whole food sources include avocados, olives, almonds, cashews, pecans, macadamias, and nut butters. By the way, oils can contain blends of different PUFAs and MUFAs and saturated fat, so they can be in three places at once.

Pick the purest unsaturated fats, and minimally consume or eliminate saturated fats from sources like meat, chicken, oil (avoid safflower, sunflower, hydrogenated soybean, corn, coconut, and palm oils, further discussed in chapter 4), butter, and cheese. A number of studies confirm the benefits of MUFAs and omega-3 PUFAs.⁸⁴ In the largest study to look into the fat-cancer connection, European researchers followed 337,327 women in ten countries over eleven years.⁸⁵ They found that women who ate the most saturated fat were about 30 percent more likely to develop breast cancer.

Remember when Mama told you to eat your vegetables? Mama’s always right. Emerging evidence confirms that eating more vegetable fat (PUFA, MUFA) and nuts at ten to fifteen years old significantly decreases postmenopausal breast cancer many years later.⁸⁶ The Nurses’ Health Study II showed a 42 percent reduction for increased vegetable fat consumption during high school years.⁸⁷

For more insight into a friendly fat’s power, consider flaxseeds (a MUFA). They offer the most concentrated source of omega-3 fat on the planet, and over one hundred times the lignan phytonutrient content of most other foods.⁸⁸ Lignans exhibit all kinds of anti–breast cancer virtues related to lowering estrogen and stopping cancer cell growth.⁸⁹ In one study, forty-five women got a breast biopsy that showed precancerous cells. This put them at high risk. They simply ate one teaspoon of ground flaxseed a day for a year, and then repeated the biopsy. Precancerous cell changes reverted to normal in 32 percent, and a biomarker for cell division called Ki-67 went down in 80 percent of the women.⁹⁰ Toss a spoonful of ground flaxseed onto your salad at lunch today (whole flaxseeds go straight out the other end), or blend into a smoothie as I do. If there’s only one thing you change after reading this chapter, may it be in the form of one to two tablespoons of ground flaxseeds daily. True that.

Not All Oil Is Evil: Extra Virgin Olive Oil

Just like wine, the quality of olives varies from region to region, and the processing of olives leads to different qualities of oil. Extra virgin olive oil (EVOO) ranks supreme, for the sole reason that it contains the highest oil levels of cancer-kicking antioxidants: phenols, polyphenols, and lignans. It also gets bragging rights about its high squalene content, a molecule that inhibits the ras oncogene.⁹¹ The phytonutrient oleocanthal swims abundantly in this golden oil and bears a striking chemical similarity to ibuprofen, which decreases inflammation in your body.⁹² Besides taking away inflammation, EVOO also regulates insulin secretion and lowers blood-sugar levels, which really annoys cancer cells (remember the microenvironment?).⁹³

Most studies investigating whether EVOO exerts protective effects against breast cancer conclude YES in all caps.⁹⁴ In the only prospective randomized trial (the best type) looking at the MedDiet, 4,152 women (no personal cancer history) aged sixty to eighty were randomly allocated to a MedDiet supplemented with EVOO, a MedDiet with mixed nuts, or a control diet (advised to reduce dietary fat).⁹⁵ At 4.8 years follow-up, thirty-five breast cancers developed (eight in the oil group, ten in the nuts group, seventeen in the control group). The MedDiet plus EVOO group was 68 percent less likely to have breast cancer than the control. There’s one oil-slick caveat to all this I must mention: as an isolated, concentrated nutrient entirely stripped of its vitamins, minerals, fibers, and other phytochemicals, EVOO becomes simply fat without the power and function it once had back in its oval olive days. Always prioritize whole foods, as they are best for the breast.

Don’t cook with EVOO, because you will destroy all its awesomeness; use organic canola, or try broth, vinegar, or water to keep food from sticking while you cook. Store your oil away from light to keep from degrading nutrients, and replace open olive oil every three months. Use in salad dressings, sauces, pesto, smoothies, drizzle onto already cooked foods, and substitute it for butter or margarine. And trust me, not all fat makes you fat; in fact, extra virgin olive oil consumption aids in weight loss.⁹⁶

READY TO WASH IT ALL DOWN?

Let’s start this off with a pop quiz. What’s the most common beverage enjoyed by centenarians, a.k.a. people over one hundred years old? Water, grapefruit juice, tea, or red wine?

If you guessed tea, you’re a smart crumpet.⁹⁷ And when it comes to breast health, your beverages of choice should include tea, coffee, and the ever-clear winner, water.

Tea’s Not Teasing

To me, tea is liquid gold. You derive a number of health benefits from all types of tea—green, black, white, oolong, and pu’er—so enjoy your favorite, but know that herbal tea does not come from the powerful tea plant, Camellia sinensis. As such, herbal tea lacks tea catechin flavonoids like the antiooxidant epigallocatechin gallate (EGCG), but it still gets a high-five for antioxidant activity.⁹⁸ When it comes to the breast, green surpasses all other tea. Three cups of green tea a day can reduce risk of breast cancer by as much as 50 percent!⁹⁹

Researchers go gaga over green tea. Over 500 Asian American women in Los Angeles County with breast cancer were compared to 594 without cancer. Women who drank less than 85.7 milliliters (one-third cup) of green tea daily were 29 percent less likely to have breast cancer, and those who drank more than 85.7 milliliters (one-third cup) were 47 percent less likely to have breast cancer, as compared to women who did not drink green tea at all.¹⁰⁰ A meta-analysis combining seven studies of cancer incidence between green tea drinkers and nondrinkers echoes these findings.¹⁰¹ Then there’s the question of cancer recurrence: can green tea decrease the chances of cancer coming back again? A striking study showed that Japanese women with stage I breast cancer who drank more than three cups of green tea a day were 57 percent less likely to recur, and stage II cancer patients were 31 percent less likely to recur than women in both groups who drank less green tea.¹⁰²

The brewing of black and oolong teas destroys catechins like EGCG, so gulp down the green variety when combating risk of breast cancer.¹⁰³ If you’re not a huge fan of green tea, I still want you to reap the rewards from it, so just plug your nose and chug down three cups or add it to a smoothie (I put matcha—green tea powder—in mine and consume the entire leaf). Three cups of green tea equals the caffeine content of one cup of coffee; although decaffeinated green tea has one-third the antioxidants of caffeinated, drinking some tea is better than none, even if you prefer decaf. In high to low polyphenol concentration, brewed hot green tea far outweighs instant preparations, iced, and ready-to-drink green teas.¹⁰⁴ Tea aficionados will tell you that tea bags literally contain the bottom of the tea barrel, the lowest quality tea known as fannings or dust. It all boils down to freshness, flavor, and cost, but nowadays you can also find whole leaves in a tea bag. To see what all the fuss is about with loose-leaf tea, place one teaspoon of green tea leaves in a cup, pour in four ounces of hot water, cover and steep for three minutes, then pour through a kitchen strainer into your mug. Whether you dunk and dash, or steep then strain, you will receive that precious EGCG either way you brew it. Always add a squeeze of lemon, since citrus quintuples the antioxidant absorption of your green tea.¹⁰⁵