Porn Addiction: The Reality

Hello and happy reading,

Today we have a fan requested review on the effects internet pornography can have on our health and behaviour. Internet pornography is highly addictive, toxic and the effects are under-appreciated in today's society. Furthermore by the end of this you will understand not just the addictive capacity of pornography but the negative side-effects associated with engagement.

Firstly, how internet pornography (porn) has become such a common and significant part of our lives must be established. Here are some facts (published 2010) that underline this obsession, 12% of websites on the internet are pornographic, 2.5 billion e-mails per day contain pornographic content, a quarter of all search engine requests are porn related, just over a third of all internet downloads are pornographic [1]. Clearly, we are consumed by porn; the internet has made high-speed porn easier to access but the reason for engaging has never changed, it stems from archaic mechanisms in the human brain responsible for pleasure. Pleasure is produced deep within the brain, so deep that locked-in patients (patient is aware but cannot move or verbally communicate as a result of complete paralysis of all voluntary muscles except the eyes) and even patients suffering from severe hydranencephaly (Fig 1.0) can still experience and express pleasure [2]. As a result we are slaves to our hedonistic ways. Orgasms and sexual arousal produce the highest rates of pleasure by producing the greatest amount of dopamine; dopamine is the brains reward chemical [3]. Porn creates a method of experiencing these extreme high's without the energy or time expenditure required to gain a real mate. Moreover, the use of porn plays into the hands of the 'Coolidge effect.' The Coolidge effect refers to a phenomenon in mammals (typically associated with rats), whereby sexual interest is renewed upon the introduction of a novel mate    attributed    to    increased    dopamine   release   in   response   to   the   induction  of  a   new

Figure 1.0 visual display of lack of 
cortex as a result of  hydranencephaly.

mate [4]. This response is not limited to rats and is present in humans [5], resultantly, habituated porn users commonly multi-tab to experience multiple (2D) mates in one sexual experience meaning high levels dopamine can be maintained. Getting more pleasure for less expense sounds like a good deal but this ancient hard-wiring of the human brain is not designed to experience such extreme pleasures frequently.

How porn addiction works

Excess chronic consumption of drugs (artificial pleasures), junk foods, or porn (natural pleasures) can override our natural satiation processes by creating chronic dopamine surges resulting in the production and accumulation of Delta-FosB (binge mechanism). Delta-FosB functions as a sustained 'molecular switch' capable converting acute responses to stable adaptations contributing to long-term addiction [6]. i.e Delta-FosB is your binge mechanism firing signals to 'get it while the getting's good;' this was invaluable when the arrival of your next mate was unknown but nowadays makes porn addiction very easy. Following this comes synapse alterations amounting to long-term potantiation (LTP) and long-term depression (LTD). LTP is the strengthening of synapses whereas, LTD is the weakening of them [7,8]. By engaging in porn LTP deepens the wiring between your reward circuit and pornographic cues. This process results in sensitization (hyper-reactivity [of pleasure circuit] only in response to specific cues associated with the addiction) [9]. LTP also strengthens corresponding glutamate pathways (also a producer of the 'get it now' signal) meaning that dopamine is not the only pathway to these extreme pleasures and cravings. However, chronic 'dopamine highs' mean that protective mechanisms activate reducing the sensitivity to dopamine (reduction in D2 receptors and baseline dopamine levels), this leads to desensitization (numbed pleasure-response to all other pleasures) [10]. Desensitization means the subject cannot experience the pleasures we all strive for, unless they activate the sensitized pathway that can only be activated by engaging in the same activity (porn) that brought about and further deepens both the sensitization and desensitization. As bad as this sounds there is a third neurological adaption associated with addiction and this is associated with abnormal activity in the anterior cingulate cortex (decision making) and orbital frontal cortex (emotional attachment) sectors of the brain. This can explain the significant importance attached and the sometimes astonishing active urge to seek out the pleasure. This lack of conscious intervention is known as hypofrontality indicating the cortex is no longer in control of the mid-brain [11].

Internet Porn: The good, the bad, and the ugly

As you can see addiction is most definitely something to avoid. However porn addiction is a reality. 'Addiction' carries serious connotations in the 21st century, so strong that you may have already dismissed this arguing that you do not experience desensitization or hypofrontality and therefore don't need to worry. Before you get defensive simply consider the multi-tabbing previously mentioned, This is escalation, this process was not required when the subject originally engaged in porn. This escalation illustrates the need for higher dopamine releases than originally. Also, try giving it up for 30 days, see if at any point you find yourself thinking about it or trying to justify watching it 'hard day' or 'helps me get to sleep.' It is only a percentage that are susceptible to serious addiction but there is no way of knowing if anyone is in that percentage Regardless it is pertinent to understand the effects porn can have even we you are mildly or not at all addicted.

The neurological changes that take place as a product of addiction is certainly serious and the slippery slope needs to be acknowledged however this is one impact porn has. Sociological and psychological changes also take place which can lead to some disturbing correlations. For example, Paolucci et al., [12] conducted a meta-analysis including 46 studies and a population sample of 12, 323 subjects assessing the effects of pornography exposure on human behaviour. This paper identifies a clear, significant link between porn exposure and negative human behaviours such as increased risk of sexual deviance (i.e non-normative sexual behaviours, excessive and ritualistic masturbation), sexual perpetration (i.e aggressive and sexual hostility), negative intimate relationships (i.e perceptions of dominance, stereotyping, and viewing persons as sexual objects),

and accepting rape myths (i.e believing women are to blame for rape, rapists are normal). This makes sense given that porn portrays women as objects wanting to have sex with everything, never getting pregnant and wishing to please a man in any possible way and men as perpetual soulless erections, expressing zero empathy for any partner they are with or may already have. Social learning theory and the imitation model suggest that by seeing these characters for, cumulatively, long periods of time similar attitudes may be justified in real life [12]. Porn has also been significantly linked to loneliness [13], and closely associated with early-age erectile dysfunction [14]. However, Short et al., [15] identified a lack of consistency with previous studies, particularly with the definition of pornography, suggesting subjects may have used subjective definitions of porn in the same study creating dichotomy in article results. Articles have highlighted negative and positives of porn, the negatives being impairments in interpersonal, financial, and occupational functioning, emotional problems, and sexual dissatisfaction and the positives being relieving stress, decreasing boredom, feeling supported, and increasing sexual knowledge [15]. It could be speculated that stress, support and boredom would be better controlled with an effective interpersonal functioning that porn directly shatters. There are additional dynamics to the negative effects of porn that are beyond the scope of this article. Watson & Welch, [16] assess the effects of porn from multiple perspective (advertising, impact of sexually-orientated businesses, empirical research results, correlation study results, media studies, experience of clinical psychologists, and anecdotal evidence) deducing that porn effects the surrounding areas it is produced in, the people who watch it, the people who make it and the people who are influenced by those who watch it (i.e. 99.9% of everyone). I highly reccommend giving this article a look, easy to locate specific sections and easy to read (Click Here). If you don't fancy reading Ran Gavrieli gives a spectacular talk covering important aspects of porn and other components not covered in this post in a capturing, and inspiring talk. 100% make time to watch this.

Conclusion

The evidence for porn addiction is strong, some people are heavily addicted, whereas, the majority are addicted to a degree that doesn't cause dissipation of normal everyday life pleasures. This does not mean there is no damage. Furthermore, these neurological changes are but one shade of deterioration, the effects of porn can span throughout your life. Consider the alterations porn may have had on your behaviour, sexual desires and perceptions of loved ones. Watch the video linked above and have a read through the linked article, see what your mind tells you. Make your decision.

Your very own health nut,

Chris

Main sources

[1] The United Families International Blog (2010) 14 shocking pornography statistics [Internet]. USA, The United Families International Blog. Available from: http://unitedfamiliesinternational.wordpress.com/2010/06/02/14-shocking-pornography-statistics/ [Accessed 23 September, 2014].

[2] Aleman, B. & Merker, B. (2014). Consciousness without cortex: a hydranencephaly family survey. Acta Paediatrica [Epub ahead of print].

[3] Krüger, T.H., Hartmann, U, & Schedlowski, M. (2005) Prolactinergic and dopaminergicmechanisms underlying sexual arousal and orgasm in humans. World Journal of Urology, 23(2): pp130-138.

[4] Fiorino, D.F., Coury, A. & Phillips, A.G. (1997) Dynamic changes in nucleus accumbens dopamine efflux during the coolidge effect in male rats. The Journal of Neuroscience, 17(2): pp4849-4855.

[5] Wilson, J., Kuehn, R. & Beach, F.A. (1963) Modifications in the Sexual Behavior of Male Rats Produced by Changing the Stimulus Female, Journal of Comparative and Physiological Psychology 56: pp636–644.

[6] Nestler, E.J., Barrot, M. & Self, D.W. (????) ΔFosB: A sustained molecular switch for addiction. Proceedings of the National Achademy of Sciences of the United States of America, 98(20): pp11042-11046.

[7] Ohno, T., Hasegawa, T., Tsuruoka, T., Terabe, K., Gimzewski, J.K. & Aono, M. (2011) Short-term plasticity and long-term potentiation mimicked in single inorganic synapses. Nature Materials, 10: pp591-595

[8] Thomas, M.J., Beurrier, C., Bonci, A. & Malenka, R.C. (2001) Long-term depression in the nucleus accumbens: A neural correlate of behavioural sensitization to cocaine. Nature Neuroscience, 4(12): pp1217-1223.

[9] Vanderschuren, L.J. & Pierce, R.C. (2010) Sensitization processes in drug addiction. Current Topics in Behavioral Neurosciences, 3: pp179-195.

[10] Kim, S.H., Baik, S.H., Park, C.S., Kim, S.J., Choi, S.W. & Kim, S.E. (2011) Reduced striatal dopamine D2 receptors in people with Internet addiction. Neuroreport, 11;22(8): pp407-411.

[11] Kalivas, P.W. & O'Brien, C. (2008) Drug addiction as a pathology of staged neuroplasticity. Neuropsychopharmacology, 33(1): pp166-180.

[12] Paolucci, E.O., Genuis, M. & Violato, C. (2000) A meta-analysis of the published research on the effects of pornography. The Changing Family and Child Development, pp48-59.

[13] Yoder, V.C., Virden III, T.B., & Amin, K. (2005) Internet Pornography and Loneliness: An Association? Sexual Addiction and Compulsivity, 12(1): pp19-44. 

[14] Robinson, M. & Wilson, G. (2013) Porn-Induced Sexual Dysfunction: A Growing Problem. Psychology Today, Jan. 31,

[15] Short, M.B., Black, L., Smith, A.H., Welterneck, C.T. & Wells, D.E (2012) A review of internet pornography use research: Methodology and content from the past 10 years. Cyberpsychology, Behaviour, and Social Networking, 15(1): pp13-23.

[16] Watson, B. & Welch, S.R (2000) Just harmless fun? Understanding the impact of pornography [Internet]. USA, Enough is Enough. Available from: http://www.protectkids.com/effects/justharmlessfun.pdf [Accessed: 21 September, 2014].

Self-esteem Vs self-compassion (Part 1)

Welcome to this 2-part episode of the 21st century health nuts,

This will be a two-part release, this post (part-1) will look at the current social and psychological paradigm of self-esteem, its pitfalls, and look deeper into the sociological impacts governed by and contributing to the issues. The following post (part-2) will define, analyse and critically assess the viability of self-compassion as an alternative in our world as it stands. So let's get started...

Self-esteem and the consequences

For the past decade the primary measure of psychological health has been self-esteem [1]. Self-esteem is defined as a global evaluation of your own worth, you ask, 'How good am I?' and you respond 'Hmm pretty poor to be honest' or 'I'm the best thing going!' Recently however, researchers have begun to criticize self-esteem, to ask the question 'How good am I?' must relate to some predetermined standard of what good is, alongside the requirement for social comparison, 'I am better/worse than that person.' This inevitably results in self-evaluation in relation to the performance of others. Social comparison is never a good idea, if you truly are worse than somebody it is detrimental to motivation and happiness (feel of less value), and if you truly are better than them motivation begins to slide and happiness along with it (as a result of complacency and  lack  of  future

goals) [2]. Nowadays, social media sites (such as facebook) make social comparison almost unavoidable, even provoking jealous, envy, or pity with a specific type of status. Furthermore, these standards are typically defined by the media, for example body image has never been a bigger issue than it is now [3] men and women alike are having to compete with the most sexually desirable celebrities to be considered worthy of attraction and affection. It cannot be disputed that low levels of self-esteem is linked with negative psychological mind states such as stress, depression, anxiety, sadness, and suicidal ideation [1]. However, it is less clear that high self-esteem is the panacea suggested. As well as being highly resistant to change [4], if changed to high self-esteem some negative corollaries are associated. For example, Damon [5] and Seligman [6] argue that an over-emphasis on evaluation can result in narcissism, self-absorption, self-centredness, and a lack of concern for others. Which makes sense, how do you present yourself in best light compared to others? You observe the worst traits of those surrounding you. Or as a child lacking the psychological skills to manipulate reality you physically assert superiority (bullying). Supporting this high self-esteem is also correlated to increased prejudice [1,7] and the use of aggression and violence to thwart any person or persons threatening the ego [8].

To be called mediocre or average is nothing short of an insult in the 21st century, we are not content unless we are above average. Obviously we cannot all be above average and so we allow ourselves to inflate our perception of ourselves; enter narcissism (exaggerated view of one's own value, craving for admiration, and selfishness). Recently, our facebook page released a narcissism personality index (NPI) test to see how narcissistic we all are, the reason for this is that narcissism is on the increase, and has been for over 30 years. A study by Twenge & Foster [9] re-assessed the results of three meta-analysis' of contradicting views on narcissism and controlled for the significant effect of different campus' as data collection and comparison points concluding that, between 1982-2009, NPI scores significantly increased a) in a nationwide meta-analysis, b) within campus in large samples from a southern University. It is a perfectly acceptable position to hold that the degree of narcissism in USA college students has not increased at all, but a cultural development has resulted in students being more honest, resulting in increasing NPI scores. However, strong evidence supports the notion that narcissistic behaviour is  increasing;  number  of  unique  names  given  to newborns is increasing [9],

more popular songs include narcissistic and individualistic lyrics [10], high school students express unrealistically high expectations for success [11], and the number of plastic surgery cases is increasing [12]. Additionally, a clinical report [13] employed structured clinical interviews as opposed to self-reported means of data collection deducing that  in a national representative population of 34,653 Americans (2004-2005) 3.2% of subjects aged over 65 had experienced narcissistic personality disorder (NPD), whereas 5.6% aged 45-64, 7.1% aged 30-44, and 9.4% aged 20-29. If there was no newborn cohort then the older subjects with many more years of experience should display a greater percentage of NPD encounters. Narcissism is a serious social and psychological problem, people high in this trait fail to help others unless there is immediate recognition to themselves for doing so. They often trample others in an effort to rise to the top where they believe they belong and are commonly unhappy with the world not recognising their superiority. Narcissists typically display low empathy traits, empathy refers to the ability and tendency to view the world from points of view other than your own, to share in others' joy and sorrow and to care about their well-being. And so with this increase in NPI scores and NPD experiences illustrating the cultural effect of self-esteem it can concluded that the aforementioned negative effects of self-esteem (such as self-absorption, self-centredness, lack of concern for others, increased prejudice, bullying, violence and aggression in defense of own ego) are also unnecessarily existing in our current environment.

Other factors contributing to the 'me' society

Nevertheless, self-esteem only correlates .25 to narcissism and so there must be other cultural changes that have caused increases in self-absorbed personality traits. Interestingly, a decline in children's free-play time with other children has been documented [14,15]. Free-play is linked with increased empathy, the ability to get along with others, the capacity to problem solve and deal effectively with fear and anger (thus effectively safeguard against anxiety and depression) [14]. It has even been recognized that mental disorders in young Americans has steadily increased between 1938 - 2007 [16]. The study concludes by stating that like all individual characteristics psychopathological symptoms are determined by a number of factors, genetics offer much more explanation that an individuals family environment as a predictor of neuroticism. However large changes in the Minnesota multiphasic personality inventory (MMPI) scores demonstrate that there are also strong cultural influence on psychiatric symptoms. That is, an environmental influence outside of the individual family. Over time, culture has increasingly shifted towards an environment in which more and more young people experience poor mental health and psychopathology, possibly due to an increased focus on money, appearance, and status rather than on community and close relationships. Moreover, free-play is by definition voluntary and so when engaging child X must accept the perspective and wishes of child Y, otherwise child Y will leave. A harsh punishment for a mammalian infant hardwired for communication and growth. And so child X must now try harder to accommodate for child Y, this cycle is perpetually improving the communication and intra- and inter-personal skills of the subjects. Furthermore, children are raised in an extremely competitive environment where winning at any cost is the only option. We have never been more closely linked to celebrities, this proximity to celebrity status has furthered the drive for fame and success, this alongside the life lesson that others are solely obstacles to be beaten or tools to be manipulated to get to the next goal results in an individualistic and self-absorbed society. Of course in this type of society we are going to lack empathy, prejudice those from other background to reinforce the solidity of our origins. And why would we give up our time to help others if it won't fit onto our CV? If not then why bother?

Finally, if all of the points made do not get you questioning whether self-esteem is the best paradigm for yourself and this culture, consider that self-esteem is contingent on success, if we fail our global value must decrease unless everyone else in the world failed too.  How do we remove ourselves from this perpetual battle to perceive ourselves as better than all the rest? 

Conclusion

As you can see there are many flaws with the current aim of promoting , achieving, and maintaining high self-esteem. The benefits of self-esteem come hand in hand with negative psychological traits that are so common we consider them socially desirable. Self-compassion is a contemporary model that offers the benefits of self-esteem without the pitfalls of egotistical isolation upon failure. Many argue that compassion is not only 'fluffy' but a surefire road to passivity, complacency, and being exploited. I sincerely hope that your inquisitive and open-minded nature will encourage you to read the coming post and decide for yourself whether or not self-compassion is non-sense or the pathway to an improved life.

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Main sources

[1] Neff, K. (2003) Self-compassion: An alternative conceptualization of a healthy attitude towards oneself. Self and Identity, 2: pp85-101.

[2] Hill, K.L. (2001) Frameworks for sport psychologists: enhancing sport performance. Human Kinetics.

[3] Albertson, E.R., Neff, K.D. & Dill-Shackleford, K.E (2014) Self-compassion and body dissatisfaction in women: A randomized controlled trial of a brief meditation intervention. Mindfulness, 1-11.

[4] Swann, W.B. (1996). Self-traps: The elusive quest for higher self-esteem. New York: Freeman.

[5] Damon, W. (1995). Greater expectations: Overcoming the culture of indulgence in America’s homes and schools. New York: Free Press.

[6] Seligman, M.E. (1995). The optimistic child. Boston: Houghton Mifflin.

[7] Aberson, C.L., Healy, M., & Romero, V. (2000). Ingroup bias and self-esteem: A meta-analysis. Personality & Social Psychology Review, 4(2): pp157–173.

[8] Baumeister, R.F., Smart, L., & Boden, J.M. (1996). Relation of threatened egotism to violence and aggression: The dark side of high self-esteem. Psychological Review, 103(1): pp5–33.

[9] Twenge, J.M. & Foster, J.D. (2010) Birth cohort increases in narcissistic personality traits among American college students, 1982–2009. Social Psychological and Personality Science, 1(1): pp96-106.

[10] DeWall, C. N., Pond, R. S., Campbell, W. K., & Twenge, J. M. (2009). Tuning in to psychological change: Linguistic markers of selfishness, loneliness, anger, anti-social behavior, and misery increase over time in popular U.S. song lyrics. Unpublished manuscript.

[11] Reynolds, J., Stewart, M., MacDonald, R., & Sischo, L. (2006). Have adolescents become too ambitious? High school seniors’ educational and occupational plans, 1976 to 2000. Social Problems, 53(2): pp186-206.

[12] Twenge, J.M., & Campbell, W.K. (2009). The narcissism epidemic: Living in the age of entitlement. New York: Free Press.

[13] Stinson, F.S., Dawson, D.A., Goldstein, R.B., Chou, S.P., Huang, B., Smith, S.M., Ruan, W.J., Pulay, A.J., Saha, T.D., Pickering, R.P. Grant, B.F. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69(7): pp1033-1045.

[14] Connolly, J.A., & Doyle, A. (1984). Relation of social fantasy play to social competence in preschoolers. Developmental Psychology, 20(5): pp797–806.

[15] Burns, S.M., & Brainerd, C.J. (1979). Effects of constructive and dramatic play on perspective taking in very young children. Developmental Psychology, 15(5): pp512–521.

[16] Twenge, J.M., Gentile, B., DeWall, C.N., Ma, D., Lacefield, K. & Schurtz, D.R. (2010). Birth cohort increases in psychopathology among young Americans, 1938-2007: A cross-temporal meta-analysis of the MMPI. In press, Clinical Psychology Review 30(2): pp145-154.

Redefining the 21st Century Health Nut

Good afternoon readers!!

This series contains critical reviews of contemporary fads, trends and in some cases myths surrounding the 21st century health industry. Just as important as these scientific analyses this series also proposes philosophical and thought provoking ideas to grapple with the ideologies and infrastructure supporting the current system.

The definition of a '21st century Health Nut' has already been given in the original post of this series 'The 21st Century Health Nuts.' However, I feel this definition falls short of what needs to be conveyed. The definition as it currently stands is 'typically (but not necessarily) relatively young and is obsessed with the prolonging of life through healthy habits, whether this include diet, exercise, mindfulness the health nut covers a wide range of people.' However, after the publication of 'Is the health industry exploiting your desire to live forever?' it became apparent that we are all obsessed with prolonging our lives, it is this innate and sub-conscious 'will to immortality' that creates an existential struggle whilst projecting ourselves into the future. The defining characteristic in the previous definition is the methods by which a person attempts to extend their life; 'healthy habits, whether this include diet, exercise, mindfulness'. Yet, this is a crude method of measurement as the subtlety and sensitivity is near non-existent. Either the subject does partake in one of these methods or the subject does not. As with all things in life a parsimonious model (approach) should be selected over competing models including more assumption (Occam's razor), but this does not justify dramatic reduction excluding vital components. So what are these vital components that contribute to a 21st century health nut? (In no particular order)

Life extension

A health nut wishes and actively seeks out methods of extending the life of themselves and others around them. After all, isn't this why we decide to eat healthy, do exercise and persevere through hardship? However, this quality alone encompasses life as a whole, not just humans. The snake who strikes to defend himself is doing just this, the virus who alters the immediate environment to increase survival percentage cannot be classed as a health nut. The previous defining factor of method as previously mentioned holds no subtlety and so we must look elsewhere to create a holistic definition of a health nut.

Acquirement of knowledge

Knowledge is the engine behind a health nut, without knowledge the subjects survival is less promising than the virus and s/he is more gullible to false information resulting in hapless and inept venture at life extension. It is this procedure of seeking out information that begins to add a certain dynamic to the health nut definition. However, the source of information must be considered and therefore it is the quality of information that highlights a key trait, that is that information is gathered from multiple, high quality sources. Although, this offers no clarity on the processing of information, and could result in  blindly submitting to the conclusions of others. Hence the requirement for 'critique of knowledge.'

Critique of knowledge

There are a myriad of benefits to be had by constantly critiquing the world around you, such as increased self-confidence, motivation, understanding, and rationality. By critiquing information a person separates themselves from subjects being told what to eat and how to train to one capable of wholly understanding what is being suggested and generating their own perspective and fully-informed decision.

Spirituality

Spirituality is vital to the healthy existence of humans, on an individual and global level. Gaia theory suggests that the Earth is a single organism that we partake in. Healthy spirituality can not only aid in the attempt of 'life extension' but also creates harmony and congruence between yourself and your surroundings. In the 21st century it is all too easy to spend your time in your head dwelling in the past or projecting into the future, the now is forgotten (a soon-coming post will look deeper into the need for living in the now and spirituality). After all, the previous components have resulted in you gathering and assessing knowledge to generate your own perspective and lead yourself to the healthy life you dream of. How can this be completed without a true understanding of yourself, your world, and what it is exactly you want, not what you should want.

To Conclude

The absolute grey-ness of the world is difficult to encapsulate with the use of our limited vocabulary but these key components of a successful health nut definitely provide the scaffolding for future definitions to be framed and people to get a grasp of. These traits are not exclusive to the health aspect of your life, to take and appropriately apply certain or all of these will lead to an improved understanding of yourself fostering a better perception and expression of politics, science, literature and even your social life. The capacity for these vital components to spread throughout our lives accentuates our personal responsibility to arm ourselves with correct information and resist the temptation to believe and submit to the large corporations that send messages down the pipelines to get us to partake in the newest method of improving your life (and typically spending money). As suggested in 'The 21st Century Health Nuts' the exponential increase information exposure has resulted in our need to evolve. This revolution is personal and internal before it can become anything greater. And so take it upon yourself to question what you are told, think before you act and spend time getting to grips with yourself and what your goals are, not the goals you are expected to have.

Your very own health nut,

Chris

If you liked this, catch up with previous posts below or select an interest in the 'What would you like to read about' tab on the right

Juice +: Critical review of fruit and vegetable concentrates

Welcome,

This is a fan requested post on juice plus (juice +), the potential health benefits fruit and veg (F+V) and whether or not these encapsulated concentrates offer what they say. WARNING: science involved! But who doesn't like a bit of that?

We have all been told to 'eat your greens' or make sure you get your 'five a day' or even the age old 'an apple a day keeps the doctor away'. These have been used for centuries and are still around, surely this points to the possibility that F+V are good for you. To save the suspense, they are! Unbelievably vital to prolonging a healthy life and preventing illness. Increased F+V consumption is associated with reduced risk of many chronic diseases [1,2]. So what is it that makes F+V so good?

What is so good about fruit and veg?

F+V contain vast amounts of antioxidants. These are agents that prevent oxidizing atoms (oxygen-containing free-radical cells) from causing oxidative stress (oxidizing things). This is extremely important to your health as these free-radical cells are highly unstable, charged and cause oxidative stress within cells. They can take or donate electrons at will causing unprecedented damage to cells, proteins, lipids, and even DNA. This DNA damage is a common origin of cancerous cells. This oxidative damage to lipids, proteins and DNA is linked to a number of chronic diseases [7]. It is impossible for us to avoid free-radical damage because our systems are far from perfect (some argue this is the primary cause for ageing) however the serious damage occurs when free-radical numbers accumulate beyond what is manageable by the antioxidants. Therefore, the war between free-radical cells and antioxidants looks best for you with the most antioxidants on the field. Antioxidants are predominantly available in vitamin E, vitamin C, and beta-carotene; so getting these in your diet is vital.

F+V contain folate or folic acid (a B vitamin) that has been inversely correlated with homocysteine levels. elevated levels of homocysteine is very dangerous and is linked to increased independent risk of cardiovascular disease [3]. Additionally, homocysteine levels are a predictor of all-cause mortality in adults [4] essentially stating that with increased homocysteine levels you are at a higher risk of death. Consequently, a higher folate status (and therefore lower homocysteine status) is something that everybody should strive for.

The list of positives from F+V does go on and on however journal articles primarily focus on physiological markers such as oxidative stress, antioxidant levels, folate status and homocysteine levels. As a result, this review will focus on these health markers to remain concise.

The sad truth

So if I tell you that F+V consumption can increase antioxidant levels (therefore neutralizing more free-radical cells) as well as increase folate status (therefore decreasing homocysteine levels) you would go eat them right? Maybe, but the chances are it would not last, this is a result of a statistical phenomena stating any extreme scores will regress towards the norm (reversion to mediocrity) and unfortunately for you and everybody else the norm is not looking too good. 50% of households were found to consume less than the recommended daily intake of F+V in the following countries: Germany, Belgium, Greece, Hungary, Republic of Ireland, Luxembourg, Norway, Poland, Spain, UK (year 2000) [5]. And it's not like the government is not trying to show the light to the public. Despite a USA national campaign for increased F+V consumption from 1991 - 2002 Americans' F+V consumption level did not significantly increase by 2002, only 32% of adults met their daily recommended intake [6].

At this point it is pertinent to bring in juice + and other F+V powder concentrates as these products present the potential to make greater F+V consumption easier and cheaper for the masses.

What do the journals have to say?

The study of juice + and other F+V concentrate capsules is not new to the science scene. Almost 20 years ago, in 1996, it was established that the antioxidant quality in juice + did not significantly differ compared to fresh F+V. This implies that in vitro assays measuring antioxidant potential, one capsule (1g) is equivalent to ~10g of F+V [8]. In 2004, 59 subjects were assessed (aged 40-60) over 14 weeks consuming a placebo or a F+V supplement. Significant increases in beta-carotene, vitamin C and E, selenium (antioxidants), and folate were observed after active supplementation [9]. Over a shorter period (6-weeks) supplementation  resulted in increased antioxidants, vitamin A and C in addition to reduced homocysteine count [10]. 60 Japanese subjects of mixed age, gender and smoking status demonstrated significantly increased beta-carotene (528%), folate (174.3%) and decreased homcysteine levels (-19.9%) while decreasing disease risk and oxidative stress after 28 days of consuming F+V concentrate. Additionally, it was noted that smokers and non-smokers responded similarly suggesting F+V concentrate supplements may assist in relieving disease risk brought about by smoking; even if cessation of smoking is preferably advised [11]. This is supported by Housten et al., [12], Novembrino et al., [13], and Bamonti et al., [14] who found in 2007, 2011, and 2013, respectively, that consumption of F+V capsules resulted in improved pulmonary and cardiovascular parameters, decreased blood pressure, total and LDL cholesterol, oxidative stress, homocysteine levels and increased artery compliance, folate status, beta-carotene, and important antioxidants. Daily ingestion of moderate amounts of juice concentration has also been shown to reduce the immediate adverse artery flow effects of high-fatty meals [15]. I will conclude this section with the main points of a 2011 systematic review assessing previous journal utilising F+V concentrates as clinical interventions. Overall the majority of studies demonstrate F+V capsules have a high bioavailability and as such are capable of improving serum concentrations of folate and major antioxidant vitamins (C+E) and carotenoids. The majority of studies also indicated a potential for F+V capsules to decrease inflammatory biomarkers and improve immune function in addition to decreasing oxidation of lipids, proteins and DNA. [16] ‘While these supplements are not meant to replace a healthy and well balanced diet rich in fruits and vegetables, they may provide a useful means by which individuals can improve intake of FV bioactives.’ [16].

There are always two sides to a story, and the other side of this story is short and under-researched but demands acknowledgement. A 2010 paper in the American journal of medicine reporting a 51-year old woman with endometrial cancer developed liver problems that dissipated 4-weeks subsequent to the cessation of juice + consumption [17]. It is speculated that juice + caused this liver inflammation. Some cancer treatments (chemotherapy) produce free-radical cells to fight the disease, it could be a possibility that the increase in antioxidants prevented the cancer treatments from working effectively. However, such speculation exists far beyond the scope of this blog. This case highlights the necessity for subjects suffering from illness to consult their doctor before taking to alternative treatments as some side-effects may be unknown at present. Nevertheless, this is the only case of liver inflammation associated with F+V concentrates to date, most people report mild (upset stomach to begin with; fairly typical of supplements) or no side-effects.

Conclusion

Are the final products bio-available? Do the F+V concentrates offer health benefits similar to fresh F+V? Are their any side-effects or dangerous drawbacks? 

From the current literature it can be posited that F+V concentrates offer similar nutritional benefits to F+V consumption. The bio-availability is high and it can therefore be speculated that the nutritional value of the original F+V is not significantly reduced or damaged . There is a report of a dangerous side-effect however these are exiguous. Howbeit, a close eye must be kept on up-to-date research to ensure what you are putting in your body is a good idea. With the evidence presented before you what conclusions do you draw? Would you feel good taking these capsules? I know what my answer is, but that is not really any use to you now is it? It does seems that whether male, female, European, American, smoker or non-smoker, you can benefit from this product. I cannot reinforce enough that you must consult your doctor if you have any pre-existing conditions. It feels good to publish this preventing my literature from descending into yet another controversial, fear promoting, and ultimately life-paralyzing blog. As for those sites and countless TV programmes...fear fosters in ideas not fully understood, spend time to wrestle with and understand the details of ideas. Knowledge will one day replace fear and ignorance but you must take it upon yourself to start the revolution.

I cannot thank you enough for reading and promoting this site,

your very own health nut,

Chris

Main sources:

[1] Hung, H.C., Joshipura, K.J., Jiang, R. Hu, F.B., Hunter, D., Smith-Warner, S.A., Colditz, G.A., Rosner, B., Spiegelman, D. & Willet, W.C. (2004) Fruit and vegetable intake and risk of major chronic disease. Journal of the National Cancer Institute, 96(21): pp1577-1584.

[2] Block, G., Patterson, B. & Subar, A. (1992) Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. Nutrition and Cancer, 18(1): pp1-29.

[3] Herrmann, W. (2001) The importance of hyperhomocysteinemia as a risk factor for diseases: an overview. Clinical Chemistry and Laboratory Medicine: CLM/FESCC, 39(8): pp666-674.

[4] Herrmann, W. & Knapp, J.P. (2002) Hyperhomocysteinemia: a new risk factor for degenerative diseases. Clinical Laboratory, 48(9-10): pp471-481.

[5] Naska, A., Vasdekis, V.G., Trichopoulou, A., Friel, S., Leonhauser, I.U., Moreiras, O., Nelson, M., Remaut, A.M., Schmitt, A., Sekula, W., Trygg, K.U. & Zajkas, G. (2000) Fruit and vegetable availability among ten European countries: how does it compare with the `five-a-day' recommendation? The British Journal of Nutrition, 84(8): pp549-556.

[6] Casagrande, S.S., Wang, Y., Anderson, C. & Gary, T.L. (2007) Have Americans increased their fruit and vegetable intake? The trends between 1988 and 2002. American Journal of Preventative Medicine, 32(4): pp257-263.

[7] Halliwell, B. (2007) Oxidative stress and cancer: have we moved forward? The Biochemical Journal, 401(1): pp1-11.

[8] Chambers, S,J., Lambert, N., Plumb, G.W. & Williamson, G. (1996) Evaluation of the antioxidant properties of a methanolic extract from ‘Juice Plus fruit’ and ‘Juice Plus vegetable’ (dietary supplements). Food Chemistry, 57(2): pp271-274.

[9] Kiefer, L., Lawrence, C., Wise, J., Bieger, W., Bayer, P., Rathmanner, T., Kunze, M. & ieder, A. (2004) Supplementation with mixed fruit and vegetable juice concentrates increased serum antioxidants and folate in healthy adults. Journal of the American College of Nutrition, 23(3): pp205-211.

[10] Samman, S., Sivarajah, G., Man, J.C., Ahmad, Z.I., Petocz, P. & Caterson, I.D. (2003) A mixed fruit and vegetable concentrate increases plasma antioxidant vitamins and folate and lowers plasma homocysteine in men. The Journal of Nutrition, 133(7): pp188-193.

[11] Kawashima, A., Madarame, T., Koike, H., Komatsu, Y. & Wise, J.A. (2007) Four week supplementation with mixed fruit and vegetable juice concentrates increased protective serum antioxidants and folate and decreased plasma homocysteine in Japanese subjects. Asian Pacific Journal of Clinical Nutrition, 16(3): pp411-421.

[12] Houston, M.C., Cooil, B., Olafsson, B.J. & Raggi, P. (2007) Juice powder concentrate and systemic blood pressure, progression of coronary artery calcium and antioxidant status in hypertensive subjects: a pilot study. Evidence-Based Complimentary and Alternative Medicine: eCAM, 4(4): pp455-462.

[13] Novembrino, C., Cighetti, G., De Giuseppe, R., Vigna, L., De Liso, F., Pellegatta, M., Gregori, D., Maiaavacca, R. & Bamonti, F. (2011) Effects of encapsulated fruit and vegetable juice powder concentrates on oxidative status in heavy smokers. Journal of the American College of Nutrition, 30(1): pp49-56.

[14] Bamonti, F., Pellegatta, M., Novembrino, C., Vigna, L., De Giuseppe, R., De Liso, F., Gregori, D., Noce, C.D., Patrini, L., Schiraldi, G., Bonara, P., Calvelli, L., Maiavacca, R. & Cighetti, G. (2013) An encapsulated juice powder concentrate improves markers of pulmonary function and cardiovascular risk factors in heavy smokers. Journal of the American College of Nutrition, 32(1): pp18-25.

[15] Plotknick, G., Corretti, M.C., Vogel, R.A., Hesslink, R. & Wise, J.A. (2003) Effect of supplemental phytonutrients on impairment of the flow-mediated brachial artery vasoactivity after a single high-fat meal. Journal of the American College of Cardiology, 41(10): pp1744-1749.

[16] Esfhani, A., Wong, J.M., Truan, J., Villa, C.R., Mirrahimi, A., Srichaikul, K. & Kendall, C.W. (2011) Health effects of mixed fruit and vegetable concentrates: a systematic review of the clinical interventions. Journal of the American College of Nutrition, 30(5): pp285-294.

[17] Naing, A., Aaron, J. & Kurzrock, R. (2010) Juice plus or toxicity plus. The American Journal of Medicine, 123(1): e1-e2.

Is the health industry exploiting your desire to live forever?

Hello my Health Nut,

I hope you have enjoyed the recent posts including plenty of science, I have enjoyed creating them. This post however will take a more philosophical look at our 21st century era and how the marketing schemes may be taking advantage of a natural, innate assumption, that we will live forever. Allow me to elaborate. 

Mankind has accomplished many things since the first monkey stood up. We have built, we have destroyed, we have shared, we have stolen, we have been given the ability to talk, express and interpret emotions to name but a few. Unfortunately immortality has not been given to us.....that has not stopped us from trying now has it? I recently read a book called 'Immortality: The Quest To Live Forever and How It Drives Civilisation' by Stephen Cave [1]. Besides being a highly  recommended read, this book contained interesting ideas, one of which i feel I feel is highly adaptable and applicable to the 21st century health industry. But before I can make this claim I must lay some context and to do that I have to use a lot of ideas used in Cave's book so consider sections ('Will to immortality'; 'Immortality paradox'; 'Engineering immortality') a Cave's work.

Will to immortality

Cave identifies four main narratives to achieving immortality: staying alive (live as long as possible through health and medicine), resurrection (resurrection of the same body after death), soul (spirit or independent component of you that supersedes your existence), and legacy (to live through your reputation or biological legacy). These methods can be noted as far back as the ancient Egyptians (medicine, mummification, the ka, and belief in living through reputation) and yet still remain in some form in today's world. Consequently, it must be considered that the drive to achieve immortality - will to immortality - is intrinsic and innate.

Although it sounds relatively mystical and even far-fetched in today's scientifically focused world nothing could be more biologically enhancing than a will to persist into the future. Of course this is not simply applicable to humans, mother nature will unapologetically remove the genes of the apathetic mouse who has no desire to project himself into the future, no hiding from the snake or the owl, simply existing (not for very long). Richard Dawkin's states 'we are survival machines, but ‘we’ does not mean just people. It embraces all animals, plants, bacteria, and viruses.' This will to immortality is the very reason we exist, our ancestors had the strongest will to project themselves into the future and survive. Therefore it is in us all.

Immortality paradox

The separating factor between humans and the virus, bacteria and mice is the capacity of our highly sophisticated brains to generate great awareness of ourselves, and time. As a result we are cursed with the all too horrifying knowledge that one day, like all living things, we will die. Fact. The paradoxical aspect of this statement comes when you try to imagine being dead, go ahead and give it ago (morbid I know)..... some of you may have imagined yourself dying, others a funeral and others a limbo of nothingness. But was it nothingness? I mean after all you are still seeing from a perspective, and so you are still present as an observer right? How can you not exist if you are still around seeing things? The truth of the matter is you can't imagine not existing. Cave and Freud present this problem in eloquent quotes I wouldn't dare take credit for:

'Imagining your own death, our powerful imaginative faculties malfunction: it is not possible for the one doing the imagining to actively imagine the absence of the one doing the imagining' Stephen Cave [1]

'It is indeed impossible to imagine our own death; and whenever we attempt to do so we can perceive that we are in fact still present as spectators’ Sigmund Freud  [2]

That what we can imagine we can accept, stick a folk in a toaster you get electrocuted is easy to imagine and therefore accept as a possibility. But you cannot imagine your own non-existence and therefore we have trouble accepting this possibility, we are subconsciously convinced of our own immortality, this thought has no time limit, and as a result we believe we are somehow apart of the very fabric of the universe, forever. 'All men think all men mortal, but themselves' Edward Young

Engineering immortality

As previously mentioned Cave posits four main immortality narratives, this post will focus on 'staying alive' as the relevance is clear and it is not the purpose of this post to question your beliefs (unless they concern health in anyway shape or form). 'Engineering immortality' is a method of striving to lengthen lives by identifying problems, breaking them down and solving the issues one by one. The possibility that these problems may kill us is what makes them so problematic. in the 21st century new heights have been achieved by dividing and sub-dividing problems to generate new forms of communication, accommodation, travel, medicine, and healthy habits. Breaking down the unmanageable problem of death into the utterly manageable smaller problems generating a to-do list including do cardio, eat healthy, engage in meditation or yoga. We are developing ever finer solutions to solve ever finer problems, Cave states the most comprehensive of the surviving ancient Egyptian papyruses recognises 700 afflictions and remedies, the WHO recognises over 12,000 diseases and counting.

Where you come in

This means the constant release of new activities, hobbies, chores and general habits to include in our lives. But we can't complain as healthy living has certainly extended our life-span, the overall average life-span of a male/female born in 2010) was ~90/88 years, whereas just 100 years ago being born in 1910 reduced your average predicted lifespan to ~56. Furthermore, our life expectancy is only predicted to increase (Figure 1).

Figure 1. Line graph showing cohort expectation of life in relation to year of birth with expected life expectancy for years up to 2050 [3].

But as our media has become more intricately interlaced in our personal lives distribution of the newest to-do activities has never been easier. And so, in the 21st Century we are perpetually bombarded with posts, blogs and friends online suggestions on how to live our lives. However this distribution is not the problem. The problem comes from our innate will to immortality taking over our rational thoughts and wanting to believe the latest fad/work-out programme or healthy diet will extend our lives. Although this may be true for some discoveries there is a point (I believe we are quickly approaching, if not already there) when we health nuts become all too gullible. When the the minority of health industry cease to produce and market products in our best interest. This is not to say all products and strategies nowadays are wrong, far from it. But what does need to change is the trust we associate with something in a pill, or displayed on a screen.

And so 21st Century health nut blog is forged, with the belief that the critical analysis of empirical evidence holds the truth. The next time you get a suggestion on twitter or facebook or one of your friends, listen to what they have to say, consider the source and find out for yourself if it is worth your time. And if you have no time to complete the research? Do not worry my health nut, simply get in contact with this series, we will find out for you soon enough.

Your very own health nut,

Chris 

As always if you found this interesting why not look through the topics on the right hand side? Join the Facebook and Twitter pages to keep up to date with this series

Main sources:

[1] Cave, S (2010) Immortality: the quest to live forever and how it drives civilization. London: UK. Biteback.

[2] Freud, S. (1915b). Zeitgemässes über Krieg und Tod. Imago, 4: 1-21; GW, 8, 324-355; Thoughts for the times on war and death. SE, 14: 273-300

[3] http://www.ons.gov.uk/ons/dcp171776_253938.pdf

Soursop: Cancer killing fruit

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Hello welcome reader,

This post is based on soursop and the claimed cancer killing capacities that this fruit possesses. The context to this post is result of a social media post I recently saw shared by a friend, a post you have most likely seen yourself (figure 1).

Figure 1. Example of part of social media post on soursop.

This post states (not suggests) that soursop is a 'cancer killer 10,000 times stronger that chemo.' I have never heard of soursop until 2 weeks ago, and so all these questions began eating at my mind, what is soursop? How does it kill cancer? Is it more effective than chemo-therapy? Is this too good to be true? If it is true then why the hell have I not heard of it? I must admit, the fact that the very first sentence reads 'share this information first and read afterwards' is less than encouraging, I entered this research expecting to find a run of the mill hoax attempting to take advantage of people at their most vulnerable. I was to find studies confirming this post sooner than those refuting it...

What is soursop?

Soursop is known by many names, (wikipedia has a nice list, but they are irrelevant to this post) soursop and graviola are the most common. Soursop is the fruit of the Annona muricata, a tree member to the Annonaceae family. Ingredients within Soursop have been recognised as variously cytotoxic, pesticidal, antimalarial, antiparasitic, antimicrobial, and anti-tumoral [7]. The fruit can be seen in figure 2.

What is cancer?

There are more than 200 different types of cancer, each with individual treatments, symptoms and causes (for more statistics and facts on cancer visit cancer research UK [1]). Due to the increased attention towards early detection and  prevention of cancer a number of cancer type (stomach, colon, breast) cases have fallen dramatically over the last 18 years. However cancers such as pancreatic, ovary, and leukemia have remained [2]. In normal cell activity, millions and millions of cells in your body are produced, serve their function, die, and are replaced. Damage to cell DNA (through any number of causes) can result in mutation causing the cell to uncontrollably divide and not under go apoptosis (programmed cell death), creating a cancerous tumor. Due to this rapid cellular division greater energy (or ATP) is required, for example breast cancer cells can metabolize 17 times more glucose than a non-cancerous cell [3,4]. This is significant as it creates a distinguishing characterstic between cancerous and non-cancerous cell, the cancerous cell is dependent on more ATP. Some cancerous cells develop a resistance to common chemo-therapy agents (adriamycin, vincristine, and taxol) as well as multitude of other anti-cancerous agents (these cells resistant to multiple drugs are termed multi-drug resistant cells; or MDR cells). This resistance is attributed to additional intra-cellular 'pumps' that remove the anti-cancerous agents before they can accumulate to lethal doses [6].

How it Works

The active ingredients in soursop is a phytochemical called Annonaceous acetogenins  (ACG's). Chemically, ACG's are derivatives of long-chain fatty acids. Biologically, they express potent bioactivities through the depletion of ATP levels via inhibiting the complex 1 of mitochondria and        Figure 2: Soursop (Graviola)

inhibiting NADH oxidase of plasma membrane of tumor cells [5], it sounds complex, essentially ACG's starve the tumor cells of ATP, resulting in apoptosis. ACG's have been shown to thwart MDR cancerous cells at an equal or lower dose of that required for typical cancerous cells [2]. This could be a result of the additional ATP required for the 'pumps' clearing the MDR cells of anti-cancerous agents. Highlighting a correlation between the toxicity of ACG's and cells ATP requirement. The spectacular thing is that given the correct dosage ACG's have been observed to discriminate between cancerous and non-cancerous cells [2,5,6,7,8]. Meaning healthy cells are not effected. This is currently attributed to oxidase activity (inhibited by ACG's) being over-expressed in cancerous cell lining [7]. For example, a highly relevant study [8] isolated five compounds from within the soursop seed observing that one (cis-annonacin-10-one) was selectively toxic to colon cancerous cells in which the compound was 10,000 times more effective than adriamycin (chemo-therapy agent). And so the post (figure 1) does holds some truth, the exaggeration of this isolated compound having an effect on one type of cancer cell when compared to only one chemotherapy agent is however unwarranted and potentially dangerous particularly when further research unearths concerning facts about ACG's. But questions are raised , why are we not aware of this product? And who is conducting large scale human testing? 

Controversy

The post (figure 1) states that this product and knowledge is being withheld from us because 'some big corporation want to make back their money spent on years of research by trying to make a synthetic version of it for sale.' In argument to this it must be acknowledged that many of our drugs and health supplements are derivative of a natural source, nevertheless millions of pounds are made everyday. One post made an aggressive but relevant comment saying that pharmaceuticals refuse to cure cancer because they will lose a huge commodity. However, Soursop products are available for purchase, 120 Graviola vegicaps containing fruit and seed powder can be purchased  for £19.99 [9]. Furthermore, Tesco's sell Guanabana (soursop) juice, 1L for £1.49 [10]. And so soursop is not being kept from the market at all. Even so this area is currently lacking studies employing large human samples to confirm the cancer killing effects of the ACG's in soursop fruit. 

And I think I know why...

The Wolf in sheep's clothing 

Soursop contains neurodegenerative toxins. Alkaloids within soursop are toxic to mesencephalic dopaminergic neurons (literally meaning ‘mid-brain dopamine-related neurons’) and thus could contribute to neurodegenerative processes [11,14]. In addition to these alkaloids the Annonaceae family contain potent  mitochondrial complex 1 inhibitors extremely toxic to dopaminergic and other mesencephalic (mid-brain) neurons, I am of course referring to ACG's. Specifically annonacin (accounting for ~70% of all ACG's in soursop extract [12]). As previously mentioned these ACG's (and therefore) annonacin are fatty-acid derivatives, as a result of this lipophilic profile annonacin can pass through cell membranes spreading through the brain causing neuron death not limited to dopaminergic neurons [11]. The damage that this neuronal death can cause may have already been researched, it is a well studied phenomenon that Guadeloupe has extraordinarily inflated numbers of atypical Parkinson's disease. These atypical cases represent two-thirds of all Parkinsonism cases on this island, compared to the 5% reported in European countries [13]. A study included 265 Parkinsonism patients referred to a hospital in Guadeloupe identifying that 100 of these patients displayed unclassifiable Parkinsonism, this same study deduced that the regular consumption of Annonaceae fruits containing neurotoxins (alkaloids and ACG's) which induce dopaminergic neuron loss in animals could be a probable cause [15]. Further supporting evidence can be found in Lannuzel et al. [16] where 70% of Parkinson's disease patients displayed atypical forms of levodopa (main drug used to treat parkinsonism) unresponsive Parkinsonism. A comparison of the 30% (typical) to the 70% (atypical) revealed that the latter consumed significantly more fruit, infusions or decoction of leaves from plants of the annonaceae familiy, specifically Annona muricata (soursop). Figure 3 demonstrate the catastrophic effects annanocin can have on the striatum (part of the fore brain) in rats

Figure 3. Histological alterations visualized by Bodian silver impregnation in the striatum of annonacin-treated rats. Enlarged, dystrophic nuclie can be observed in the annonacin-treated but not in the control case [16].

In 2008 epidemiological data suggested a close association between atypical Parkinsonism and regular consumption of soursop, identifying annanocin as a probable etiological factor. Consistent with this view annanocin-treated rats (similar to that in [16] and figure 3) reproduced brain lesions representative of the human disease [13,17]. This certainly does spell concern for the soursop product such as Tesco's guanabana 1L and the Graviola vegicaps recommending consumption of 3-6 capsules per day [9,10]. To put this in perspective a study quantified the amount of annanocin within an average soursop (15mg) and a can of soursop nectar (36mg), clarifying the toxicity by stating the ingestion of one soursop a day for a year would by estimates accumulate the same relative volume of annanocin that caused brain lesions in rats [12]. What about one a week? Or one a month? Continuous low doses of annanocin have been shown to irreversibly commit neurons to death [11]. However this statement is derived from a non-human based study where annanocin treatment lasted 24-hours. Therefore further study is required before any kind of supported recommendation can be made. I shall close this section with the closing statements of a study [16]; the consumption of annonaceae in Guadeloupe and other tropical areas constitutes a serious public health problem, further investigation is therefore urgently needed.

Conclusions

It is clear that more testing needs to be completed before an absolute truth can be attained concerning soursop and its potential benefits. It also becomes clear why large scale human studies are non-existent, until the toxins can be dealt with scientists and pharmaceuticals alike will refrain administering a substance to subjects in studies that is so closely associated with atypical Parkinsonism. From a health perspective I will and recommend you stay well away, at least until the neurotixic agents are better understood or even manageable. Regarding the cancer killing capacity of this fruit, it is most definitely promising and future research may hold prospects of an ACG based cure/preventative but right now, it comes at too steep a price.  As a cancer cure? If the unspeakable diagnosis is in my fate I know what I would do. But that is irrelevant, with the evidence before you what do you think?

Your very own health nut,

Chris

Main sources:

[1] http://www.cancerresearchuk.org/cancer-info/cancerstats/keyfacts/Allcancerscombined/?script=true

[2] McLaughlin, J.L. (2008) Paw Paw and Cancer: Annonaceous Acetogenins from Discovery to Commercial Products. Journal of Natural Products, 71(7): pp1311-1320. 

[3] Papa, V., Pezzino, V., Constantino, A., Belfiore, A., Giuffrida, D., Frittitta, L. Vannelli, G.B., Brand, R., Goldfine, I.D. & Vigneri, R. (1990) Elevated insulin receptor content in human breast cancer. The Journal of Clinical Investigation, 86(5): pp1503-1510.

[4] Cullen, K.J., Yee, D., Sly, W.S., Perdue, J., Hampton, B., Lippman, M.F. & Rosen, N. (1990) Insulin-like growth factor receptor expression and function in human breast cancer. Cancer Research, 50(1): pp48-53.

[5] Alali, F.Q., Liu, X.X. & McLaughlin, J.L. (1999) Annonaceous acetogenins: recent progress. Journal of Natural Products, 62(3): pp504-540.

[6] Oberlies, N.H., Jones, J.L., Corbett, T.H., Fotopoulos, S.S. & McLaughlin, J.L. (1995) Tumor cell growth by several Annonaceous acetogenins in an in vitro diffusion assay. Cancer Letters, 96(1): pp55-62.

[7] Morre, D.J., Cabo, R.D., Farley, C., Oberlies, N.H. & McLaughlin, J.L. (1995) Mode of action of bullatacin, a potent antitumor acetogenin: inhibition of NADH oxidase activity of HELA and HL-60, but not liver, plasma membranes. Life Sciences, 56(5): pp343-348.

[8] Rieser, M.J., Gu, Z.M., Fang, X.P., Zeng, L., Wood, K.V. & McLaughlin, J.L. (1996) Five novel mono-tetrahydrofuran ring acetogenins from the seeds of Annona muricata. Journal of Natural Products, 59(2): pp100-108.

[9] https://www.thefinchleyclinic.com/shop/graviola-120-vegicaps-p-710.html?gclid=CjwKEAjwgYKfBRDvgJeylem9xDUSJACjeQ7A0d82kPuBeD4uC4fv30U0YvpcYHcxtRMQojXrtNQ68xoCNrbw_wcB&utm_campaign=google_merchant&utm_medium=product_search&utm_source=google_merchant&osCsid=d35ba03be3357a95e3cc7f4f1d9f232f

[10] http://www.tesco.com/groceries/Product/Details/?id=256735746

[11] Lannuzel, A., Michel, P.P., Hoglinger, G.U, Champy, P., Jousset, A., Medja, F., Lombes, A., Darios, F., Gleye, C., Laurens,  A., Hocquemiller, R., Hirsch, E.C. & Ruberg, M. (2003) The mitochondrial complex I inhibitor annonacin is toxic to mesencephalic dopaminergic neurons by impairment of energy metabolism. Neuroscience, 121(2): pp287-296.

[12] Champy, P., Melot, A., Guerineau Eng, V., Gleye, C., Fall, D., Hoglinger, G.U., Ruberg, M., Lannuzel, A., Laprevote, O., Laurens, A. & Hocquemiller, R. (2005) Quantification of Acetogenins in
Annona muricata Linked to Atypical Parkinsonism in Guadeloupe. Movement Disorders, 20(12): pp1629-1633.

[13] Lannuzel, A., Ruberg, M. & Michel, P.P. (2008) Atypical parkinsonism in the Caribbean island of Guadeloupe: etiological role of the mitochondrial complex I inhibitor annonacin. Movement Disorders, 23(15): pp2122-2128.

[14] http://www.mskcc.org/cancer-care/herb/graviola

[15] Caparrao-Lefebvre, D. & Lees, A.J. (2005) Atypical unclassifiable parkinsonism on Guadeloupe: an environmental toxic hypothesis. Movement Disorders, Suppl 12:S114-118.

[16] Lannuzel, A., Hoglinger, G.U., Champy, P., Michel, P.P., Hirsch, E.C. & Ruberg, M. (2006) Is atypical parkinsonism in the Caribbean caused by the consumption of Annonacae? Journal of Neural Transmission. Supplementum, Suppl (70): pp153-157.

[17] Champy, P., Hoglinger, G.U., Feger, J., Gleye, C., Hocquemiller, R., Laurens, A., Guerineau, V., Laprevote, O., Medja, F., Lombes, A., Michel, P.P., Lannuzel, A., Hirsch, E.C. & Ruberg, M. (2004) Annonacin, a lipophilic inhibitor of mitochondrial complex I, induces nigral and striatal neurodegeneration in rats: possible relevance for atypical parkinsonism in Guadeloupe. Journal of Neurochemistry, 88(1): pp63-69.