What role does diet and baby powder play in the development of fibroids and ovarian cancer?
If you randomly select a group of women and ultrasound their uterus, most of them have fibroid tumors by age 50—and by most, I mean more than 80 percent of black women and nearly 70 percent of white women. As you can see at 0:23 in my video Talcum Powder and Fibroids, half of the white women in study already had fibroids by their early 40s, while half of the African-American women had them even early, by their mid-30s.
After getting over the shock of how widespread fibroids are, the next question becomes, Why the racial disparity? Is it “diet, stress, [or] environmental exposures”? Perhaps the reason could offer a clue as to what causes fibroids. For example, African Americans tend to have lower intakes of fruits and vegetables, and fruits and vegetables appear protective against fibroids. (Citrus are particularly protective, though apparently not just citrus juice, as found in the Black Women’s Health Study.)
It’s interesting that if you measure the levels of beta-carotene in fresh surgical tissue samples of uterine fibroids and adjacent normal uterine tissue obtained during hysterectomies, you find significantly lower concentrations in the fibroids. In fact, as you can see at 1:23 in my video, beta-carotene was not even detectable in half the fibroid specimens, and the same was found in cancer: Most cancerous tissues tested had undetectable levels of beta carotene, compared to the normal tissue right next to the tumor. Could it be that decreased levels of beta-carotene somehow play a role in causing these conditions? Sounds like a bit of a stretch, but you don’t know until…you put it to the test.
There had never been a randomized controlled clinical trial of fruits and vegetables for fibroids, until… never. Researchers did do a randomized controlled trial of kind-of-a-fruit-and–vegetable-at-the-same-time studying tomatoes for the prevention of fibroids, but they studied fibroids in Japanese quail—as in the birds. That doesn’t really help me help my human, non-quail patients.
The action of lycopene, the red pigment in tomatoes, “in an animal model may not accurately represent lycopene action in humans.” And, indeed, the Harvard Nurse’s study found no apparent link between lycopene consumption and fibroids, as you can see at 2:27 in my video. So, yes, fruits and green vegetables at least may have a protective effect, but we won’t know for sure until they’re properly put to the test.
Vitamin D level is another possible factor as to why African Americans disproportionately suffer from fibroids, since women with darker skin are more likely to be deficient in the vitamin. As many as 80 percent of black women may have inadequate levels of vitamin D, compared to only one in five white women.
Vitamin D does inhibit fibroid cell proliferation, at least in a petri dish, and it may be able to shrink tumors in your pet rat, but what about in people? A population study did find that women with “sufficient vitamin D” levels in their blood had about one-third lower odds of fibroids, consistent with the finding that women who report lots of sun exposure also appear to be protected, but until there’s an interventional trial where women are randomized to vitamin D or a placebo, we won’t know for sure if vitamin D plays a role in fibroid prevention or treatment.
African-American women are also more likely to sprinkle baby powder on their genitals, which may not only double the odds of fibroids, but may also increase the risk of ovarian cancer, the deadliest gynecological cancer. Internal memos show Johnson & Johnson knew about the cancer risk, but still decided to target African Americans. In an advertisement depicting an African-American family that you can see at 4:04 in my video, Johnson & Johnson said, “Think of us as a lifetime friend of the family”—perhaps a lifetime cut short by its baby powder. At least that’s what a jury found in 2017 when it awarded a woman $110 million in damages, and that was on top of the $200 million in verdicts from 2016, with thousands of lawsuits pending after internal memos revealed that, decades ago, Johnson & Johnson’s own contracted toxicologists were warning the company there are multiple studies showing a cancer link. “Anyone who denies this risks that the talc industry will be perceived by the public like it perceives the cigarette industry: denying the obvious in the face of all evidence to the contrary.”
- Fruits and vegetables appear to be protective against fibroids, and African Americans tend to have lower intakes of these plant foods.
- Fibroids are widespread amongst women, with more than 80 percent of Black women and nearly 70 percent of White women having fibroid tumors by age 50, as determined by uterine ultrasound, and African-American women seeming to get them at an earlier age.
- When measuring levels of beta-carotene, significantly lower concentrations are typically found in fibroids and cancerous tissues.
- A randomized controlled clinical trial of fruits and vegetables for fibroids has never been conducted, so, although we know fruits and green vegetables appear to be protective, we cannot know for certain until put to the test in an interventional trial.
- African Americans may suffer disproportionately from fibroids due to inadequate levels of vitamin D.
- Sprinkling baby powder on genitals may not only double the odds of fibroids, but also increase ovarian cancer risk, and African American women are more likely to do this than White women.
- Johnson & Johnson was aware of the cancer risk but, according to internal memos, still chose to target African Americans in its baby powder ad campaigns.
- Juries have awarded hundreds of millions of dollars in damages in verdicts from lawsuits filed against the company, with thousands more suits pending.
When I started this article’s corresponding video, I profiled the effects of diet and supplements of fibroid tumors, but then I got dragged off on that horrifying ovarian cancer tangent—and I’m so glad I did. What a story! No wonder corporations are working hard to pass tort reform to limit the amount of damages they have to pay for their negligence or malfeasance. If you remember, it was a series of landmark court cases that also dragged damning internal tobacco industry communications into the light. For a bit on that story see:
Michael Greger, M.D.
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