Lifestyle Works

By Michael Greger M.D. FACLM on November 12, 2021

In a recent study, pomegranate pills appeared useless in the treatment for prostate cancer. And, the same disappointing results with a “pomegranate beverage”—but that was just a “pomegranate extract” as well. So, maybe the “pomegranate itself cannot be blamed for the ineffectiveness seen in the study…but rather the low dose of the pomegranate active principles in the extract.” But what is the active principle? Extracts will boast about the level of ellagic acid—”definitely…one of the more potent of the phytochemicals found in pomegranate. However, it is not as strong as the pomegranate itself.”

What they mean is that the components may act synergistically; the whole may be greater than the sum of its parts. When human prostate cancer cells were placed in a petri dish, churning away at 100% growth, and then drip on this pomegranate fraction and the cancer growth rate is cut 30%. But, this other fraction appeared useless. So, if you add them both together, what do you think would happen? 30% suppression plus zero suppression equals 70% suppression! That’s synergy, where 1 + 1 is greater than 2.

So, “any attempt to characterize the…power of a medicinal food by standardizing a single chemical is missing the entire point of plant-based medicine.” So, the standardized extracts “represents a cynical, money-driven attempt to replace the power of the pomegranate with the power of ellagic acid.” But, “the pomegranate needs no such tricks or enhancements.” It’s powerful as is. So, why don’t they just try the fruit out on cancer patients?

Because you can’t stuff a pomegranate in a pill. So, you can’t compare it to an indistinguishable sugar-pill placebo. Drugs are easy to study; people don’t know if they’re taking the active drug or the placebo. But they tend to notice if they’re eating a pomegranate or not. So, if you gave a bunch of cancer patients some pomegranates to eat, and the cancer slowed down, you wouldn’t know if it was the pomegranates or just the placebo effect. Of course, the patients wouldn’t care—if they got better, who cares? But to change medical practice, we want to know if the fruit is actually something special. I suppose you could create some kind of pomegranate smoothie versus some fake smoothie, but that sounds logistically difficult. So, researchers tried powdering it. 199 men with prostate cancer either got a placebo or a tablet, three times a day, containing 100mg of whole powdered pomegranate. Now, this was the whole fruit, just with the water taken out. But even so, how much can you fit in a tablet? Comes out to be about six pomegranate seeds’ worth a day. That’s about 1/100 of a pomegranate a day!

Since they could fit so little in a pill, they tried to maximize their chances of beating back the cancer using diversity. If you have two groups of people eating approximately the same amount of fruits and vegetables, but one group ate a relatively low biological diversity diet, where they ate tons of really healthy foods, but just less variety than smaller servings of a high-diversity diet, which group would win in terms of protecting their DNA from free radical damage? The high-diversity group. This suggests that “smaller amounts of many phytochemicals may have a greater potential to exert beneficial effects than larger amounts of fewer phytochemicals.”

Same result for inflammation. Greater variety in fruit and vegetable intake is associated with lower inflammation, even if you eat the same number of servings. Same with improving cognitive function. “Greater variety in fruit and vegetable intake was associated with a better mental status executive function, attention, and memory function in some cases—even after adjustment for total quantity.”

So, if you have two people eating the same number of servings of healthy foods, the one eating a greater variety may do better. So, the researchers didn’t just put in some pomegranate powder, they added some powdered broccoli too, and some powdered turmeric, and some powdered green tea concentrate. So, a fruit, a vegetable, spice and leaf, but tiny amounts—that’s like one floret of broccoli a day, less than an eighth-teaspoon a day of turmeric, and about one-sixth of a tea bag worth of green tea. All great plants, but could such tiny amounts actually affect the progression of cancer?

Yes. In the group of men with early-stage prostate cancer trying to avoid surgery, the PSA levels rose in the placebo group; rose nearly 50%—indicating the cancer continued to flourish, whereas in the pomegranate/broccoli/turmeric/green tea Food Supplement group, the PSAs didn’t rise at all. And, in those with more advanced disease—already had surgery or radiation, and trying to avoid chemo—a 70% greater rise in the placebo group. That was enough to significantly delay some of the more toxic treatment. So, significant short-term, favorable effects—see, they only had enough money to run the study for six months, because it was a non-commercial endeavor, funded by charity. This wasn’t some supplement company—in fact, there was no supplement until the investigators dreamed it up from scratch.

Of course, now there’s a supplement, given the study’s extraordinary results, but the only reason the researchers put the foods in pill form was to match it with a placebo. In my mind, what this study should tell cancer patients is to eat curried broccoli with fruit for dessert, and sip some green tea. A completely plant-based diet may even shrink the tumor, not just slow it down. But there’s no reason we can’t do both, a plant-based diet chock-full of especially powerful plants.

Recipe of the Month

Pomegranate Salad

Salad Dressing
2c     cooked quinoa, cooled
1c     pomegranate seeds
¼c    chopped pecans
1      large avocado sliced
2c     shredded kale or spinach
¼ c   fresh basil
1     lemon, juiced
1T   olive oil
1T   honey
2     cloves of garlic, crushed
¼t   salt


Salad: Combine all ingredients in a bowl.
Dressing: Whisk together all ingredients in a small bowl.
Pour dressing over  salad, mix well and serve immediately.
Yield: 4-5  servings