Phosphorus is an interesting micronutrient that many of us know little about, except perhaps from chemistry lessons at school. Perhaps you remember its ability to burst into flames spontaneously when it comes into contact with air? We need some phosphorus in our diets, to: Produce DNA and RNA, the components of our genes Build new cells to grow and repair ourselves Produce energy, as ATP (adenosine triphosphate) To build and maintain healthy bones, in combination with calcium, as calcium hydroxyapatite. However, as with so many dietary components, there is a sweet spot for phosphorus. Below that, our bodies don’t function well. Above it, it can cause health problems. The optimum intake for healthy adults is somewhere between 580 mg and 700 mg per day. Sources of dietary phosphorus In a healthy diet, most of our phosphorus comes from proteins. Animal proteins have the most, including seafood, meats, eggs, yoghurt, cheese and milk (from both cows and soy). Our bodies absorb between 50 and 85% of the phosphorus from these. Whereas we absorb between 30 and 50% of the phosphorus in vegetable proteins, such as beans, nuts, grains and vegetables. However, we also get a lot of phosphorus, mainly as phosphates, from processed foods. These include processed meat, like bacon, ham, sausages, meat pies and corned beef. Processed cheeses also contain high levels of it, as do instant noodles, cakes and packaged pasta and sauces. And carbonated drinks, including cola, although relatively low in phosphorus, are easy to drink in large quantities. The food industry uses phosphate additives to preserve colour and moisture, and to stabilise and enhance frozen foods. The industry’s use of phosphates, and the amount of them, is constantly rising as more food products come onto the market. To add to the problem, our bodies absorb them at rates of 90 to 95% (1). The health effects of too much phosphorus The most worrying effect of consuming too much phosphorus is that there is research showing that it increases your cancer risk (2, 3,4). It isn’t just one type of cancer either. It appears to increase the risk of breast, lung, skin, prostate, and bladder cancers (2,3,4). For example, the Study of Women’s Health Across the Nation (SWAN) looked at the phosphorus intake of 3,302 women in America. They found that women who consumed over 1800 mg of phosphorus each day had a 2.3 fold increase in their risk of breast cancer (2). To put that in real terms, on average, there is a 13% chance that an American woman will develop breast cancer. That is a 1 in 8 chance (5). The women identified in the study had increased that to 30%. That means almost 1 in 3 of them is likely to develop breast cancer. Phosphorus doesn’t just increase the risk of cancers starting. It encourages their growth, stimulates the growth of blood vessels to supply the tumour with nutrients, and raises the likelihood of metastasis too (3). Besides increasing cancer risk, high blood phosphorus levels cause premature aging, kidney dysfunction, and arteriosclerosis (hardening of the arteries) (4). It also draws on calcium in the bones to remove it, weakening the bones and raising the risk of osteoporosis and fractures (6). How can you get the balance right? Since you need a certain amount of phosphorus for good health, what is the best way to ensure you don’t have too much of it and cause health risks? Eating a Mediterranean diet  is a good start, because that limits the amount of animal protein that you eat and boosts plant-based protein instead. Since animal protein has more bioavailable phosphorus, that will reduce the amount you absorb. When/if you eat meat of any sort, limit yourself to up to 125 g (about 4 ounces) per meal. Avoid dairy and soy milks, which are high in phosphorus. Three cups of fat-free milk contain 700 mg of phosphorus, which is close to the upper safe limit before you eat anything. Try making nut or seed mylks instead. It’s easy to do if you have a blender. My favourite is hemp mylk. It’s high in protein and omega 3s and very easy to make because it doesn’t need straining. Blend 60 ml (1/4 cup) of hemp seeds, about 400 ml of filtered water , a little monk fruit sweetener  and some vanilla extract. It makes 2 cups of creamy, tasty and very satisfying mylk. Avoid packaged foods, if possible, as many of them contain phosphate additives. At least check the ingredients lists for phosphoric acid or any chemicals ending in phosphate. This applies particularly to snack foods, which use phosphates to improve flavour (6). Watch out for breakfast cereals and refrigerated or frozen meals, which are often high in phosphates too (6). Try to find those that don’t by studying the ingredients list. Don’t drink colas. Although they contain relatively small amounts of phosphorus, it’s easy to drink a lot of them. They are high in phosphoric acid and your body will absorb 90-100% of it. Better options are tea, green tea, herbal teas, coffee or flavoured water. If you must drink sodas, low sugar lemonade, diet versions of ginger ale, root beer, orange soda, Sprite® and 7Up® don’t contain phosphorus (6). Fast foods are high in phosphate additives too, so are best avoided (6). And many restaurant meals contain them too (6). Look at these as ‘sometimes’ foods. Conclusion Phosphorus, while necessary for a healthy life, carries health risks if eaten to excess. Use the suggestions above to manage that risk and stay healthy. If you need more guidance on how to avoid developing cancer, reducing the risk of recurrence or helping you through cancer treatment, check out my book . It has a huge amount of information on diet and lifestyle factors, as well as herbs and supplements. To find all the online sites where it’s available, click the button below. References Queensland Health. Renal phosphate. Queensland Health. November 2022. Accessed April 14, 2025. https://www.health.qld.gov.au/__data/assets/pdf_file/0025/152098/renal_phosphate.pdf . Brown R, Bigelow P, Dubin J, Mielke J. High dietary phosphorus is associated with increased breast cancer risk in a U.S. cohort of middle-aged women. Nutrients . 2023;15(17):3735. doi:10.3390/nu15173735 Brown RB, Razzaque MS. Phosphate toxicity and tumorigenesis. Biochimica et Biophysica Acta (BBA) - Reviews on Cancer . 2018;1869(2):303-309. doi:10.1016/j.bbcan.2018.04.007 Venturelli S, Leischner C, Helling T, Renner O, Burkard M, Marongiu L. Minerals and cancer: Overview of the possible diagnostic value. Cancers . 2022;14(5):1256. doi:10.3390/cancers14051256 American Cancer Society. Breast cancer statistics: How common is breast cancer? Breast Cancer Statistics | How Common Is Breast Cancer? | American Cancer Society. 2025. Accessed April 15, 2025. https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html . Gal NJ, Headrick L, Bennett K, Dahl WJ. Chronic kidney disease: Phosphorus and your diet. EDIS . 2021;2016(1):4. doi:10.32473/edis-fs273-2015

What are synbiotics? They are a combination of probiotics, live microorganisms that have beneficial effects on us, and prebiotics, soluble fibre that we can't digest that feeds the microorganisms in our gut. They work together synergistically to improve our gut health. How poor gut health raises cancer risk Some strains of microbes benefit us, whilst others contribute to poor health. When the numbers of 'good' and 'bad' bacteria are out of balance, a condition known as dysbiosis, it causes inflammation in the body. This inflammation contributes to the cell conditions which cause a range of cancers to start: breast, colon, gastric, pancreatic, oesophageal, laryngeal and gallbladder (1). Inflammation begins in the gut, where pro-inflammatory cytokines (messengers) produced by the 'bad' bacteria damage the lining of the gut. The junctions between the cells of the gut are supposed to be very strong to prevent the leakage of undigested food, toxins, bacteria and their metabolites (lipopolysaccharides or LPS) from the contents of the gut. The inflammation damages the junctions and permits that leakage, allowing these harmful substances to enter the bloodstream, where they set up even more inflammation (2). One metabolite produced by certain bacteria, which are connected with consumption of large quantities of meat, is directly linked to changes in intestinal cells that can lead to colon cancer (2). Other bacteria can convert bile acids, which are involved in fat digestion, into secondary bile acids. They are associated with several types of cancer (2). The ratio of primary to secondary bile acids can influence the composition of gut bacteria, which can affect the immune system, which is critical for the body's surveillance that prevents cancers from starting (2). When you cook processed meat at high temperatures, some gut bacteria can convert the nitrites and amines in the meat to nitrosamines. Nitrosamines can damage DNA and are known causes of respiratory, bladder, liver, oesophageal and stomach cancers (2). With gastric and oesophageal cancers, the problem often starts with an infection by Helicobacter pylori. H. pylori is present in about 50% of humans (3). But other microbes are involved in cancer development, as not everyone with H. pylori  infection develops cancer in the stomach and oesophagus. Research shows that gastric cancer patients have a higher prevalence of H. pylori, as well as certain bacteria that cause inflammation, but eradicating H. pylori   reduces gastric cancer risk (3), so it seems to be a case of symbiosis that adversely affects us. Similar shifts in the composition of oral bacteria are associated with pancreatic cancer, where the researchers suggested they could be used as biomarkers to detect it. Interestingly, oesophageal cancers showed a reduction in the same bacteria (3). The success of the HPV vaccine in reducing cervical cancer shows how eradicating the HPV virus is effective (2). However, again, not everyone who has the HPV virus develops cervical cancer. It needs oestrogen to develop. Intestinal microbes affect the amount of circulating oestrogen, so one study suggested that there might be a link to gut health in the development of cervical cancer (3). Circulating oestrogen also increases the risk of breast cancer, so it's reasonable to assume that gut health plays a part there too (3). HPV, along with H. pylori , seems to be linked with laryngeal cancer too. One study found increases in several strains of bacteria in laryngeal cancer tissue that they believe stimulate the inflammation that's involved in the cancer developing (3). The research into synbiotics and cancer support Using synbiotics helps the production of short-chain fatty acids (SCFAs) in the colon. These include butyrate, acetate and propionate. Butyrate, in particular, has anti-cancer and anti-inflammatory properties. SCFAs help to maintain the strength of the intestinal barrier, preventing leaks and stimulate the production of mucus, which protects the intestinal lining (4). SCFAs also help the immune system, which is so important to prevent cancers from starting, and protect the liver, the nervous system and the heart. They also have a role to play in weight management and preventing diabetes (4). A randomised controlled trial (RCT) explored the effects of vitamin D and synbiotics in 76 breast cancer patients with their neoadjuvant treatment regime before surgery. Although the combination didn't result in eradication of the (non-metastatic) tumours, there was a significant reduction in their inflammatory markers, more than vitamin D and synbiotics individually. This suggested that the vitamin D and synbiotics together had protected patients against the highly inflammatory effects of chemo (5). Fatigue is a major issue for cancer patients. A systematic review studied the evidence for probiotics and synbiotics in managing cancer-related fatigue. Two of the trials they studied showed that probiotics helped colon cancer-related fatigue. The other trial they identified revealed that synbiotics helped breast cancer patients manage their fatigue significantly better (6). When colon cancer patients undergo surgery, they are very vulnerable to infection. Researchers tested the effects of synbiotics prior to patients undergoing colon cancer surgery. The synbiotic group had lower infection rates, shorter time of antibiotic use, lower inflammatory markers, and shorter hospital stays (7). How to increase synbiotic intake You can buy ready-made synbiotic capsules and one study suggested that this was more effective than taking probiotics and prebiotics separately. But people respond to fibre in different ways: some experience unpleasant digestive issues with certain types. As always, I believe it's preferable to use diet to supplement if you can, and there are foods that can provide synbiotics. Kefir If you can tolerate lactose, kefir is an excellent source of synbiotics. It is a fermented milk drink that contains a variety of helpful bacteria and yeasts, and the lactose in it is a prebiotic. It is associated with a reduced cancer risk. No clinical trials have evaluated it yet, but in laboratory testing it killed glioblastoma cells. Kefir extracts were effective against chronic myelogenous leukaemia and colon cancer cells. Kefir also improved the effectiveness of doxorubicin against drug-resistant colorectal cancer cells (2). Kimchi If you enjoy spicy foods, kimchi is a traditional Korean dish made from fermented cabbage and/or Daikon radish. A study found that Koreans who ate a traditional diet, as opposed to a Western diet, had lower rates of colorectal cancers (8). An animal study showed that it prevented colon cancer by upregulating tumour-suppression and antioxidant actions and downregulating inflammation (2). In laboratory studies, it had anti-cancer effects against pancreatic and liver cancer cells (2). Kimchi is fairly easy to make at home, and there are plenty of recipes online if you want suggestions. In Korea, every family has their favourite recipe, so keep looking until you find one that resonates with your tastes. If you buy it, look for refrigerated brands. Miso Fermented soybeans, salt, and a special yeast are used to make miso, which is a traditional Japanese food. It has a delicate umami flavour. Miso contains a novel probiotic called Zygosaccharomyces sapae , which has anti-inflammatory properties. Consuming miso gives your immune system a boost (2). A population study in Japan found that regular consumption of miso soup protected women from breast cancer, and the effect was highest in post-menopausal women (2). They also discovered that it reduced gastric cancer mortality significantly (2). In an animal study, adding miso to their diets reduced colon cancer risk (2). Tempeh Tempeh is a traditional Indonesian delicacy made from fermented soybeans. It has a chunky texture and tastes nutty. Tempeh can inhibit angiogenesis, slowing cancer growth and metastasis, induce apoptosis in cancer cells, and is antioxidant (2). Laboratory tests confirmed it can inhibit the growth of breast and colon cancer cells (2). Rats fed tempeh had lower levels of a certain bacterium that increases the risk of colon cancer (2). Fermented pickled vegetables Cucumbers and other vegetables fermented in brine also contain probiotic strains and the soluble fibre in the vegetables provides prebiotics. These pickles contain substances that can have an anti-cancer effect, potentially preventing cancer cells from growing. They are effective at protecting against colorectal cancers (2). You can ferment your own vegetables at home. Pickles made by adding vinegar don't have the same effects. If you choose to buy pickled vegetables, pick those in refrigerated cabinets rather than shelf-stable varieties. They pasteurize shelf-stable pickles to extend shelf life, killing the microbes you want to preserve. Sauerkraut Sauerkraut is a German dish made from fermented cabbage, very similar to kimchi but not spicy. It contains high levels of vitamin C and glucosinolates, which are known anti-cancer substances. Cancer patients who eat sauerkraut have lower rates of cell mutation (2). Its effects in the gut suggest that it has an immune-boosting effect. Women who eat sauerkraut have lower rates of breast cancer (2). Other synbiotic foods Sourdough bread and unsweetened plain yoghurt, staples of the Mediterranean diet , also contain synbiotics. Alternatively, you can take a probiotic capsule and eat prebiotic foods, which are those high in soluble fibre. These include: Beans: black, lima and kidney Vegetables: Brussels sprouts, sweet potatoes, broccoli, turnips, carrots Fruits: avocados, pears, figs, nectarines, apricots, apples, guavas Nuts and seeds: flaxseeds, sunflower seeds, hazelnuts Grains: oats, barley. Are synbiotics safe for a dairy-free diet? Many people on a dairy-free diet avoid probiotics because they assume that Lactobacillus spp.  contain milk in some form. Their name doesn't come from the fact they contain milk, but because many species of them grow well in milk products, where they use lactose (milk sugar) to form lactic acid (9). One Lactobacillus species, L. rhamnosus GG , is used to treat  cow's milk allergy in children (10). It is a species that cannot use lactose or casein as its source of energy, but produces lactic acid using other sugars. As you have read above, probiotics grow in many foods besides dairy foods, and you can make your own synbiotics, such as yoghurt and cheese, by using non-dairy milks (11). Are synbiotics safe for immunocompromised people? Patients undergoing cancer treatment often suffer from a condition known as neutropaenia, which is defined as very low levels of neutrophils. Neutrophils are one of the most prolific immune cells and serve as the first defence against infections. They develop in the bone marrow, which is very vulnerable during cancer treatments. This means that cancer patients are often very susceptible to infections. For many years, doctors have been reluctant to allow their cancer patients to take probiotics in case their compromised gut allowed bacteria to enter the bloodstream and cause infection. Recently, research has found that, far from being dangerous, it prevents infections. In one, admittedly small, study on patients undergoing intensive chemo and a stem cell transplant, they received synbiotics together with enteral nutrition. Enteral nutrition is feeding via the digestive system, as opposed to via a vein. The synbiotic group had much shorter periods of diarrhoea, their appetites returned more quickly, and there were no infection problems (12). Another trial on oesophageal cancer patients undergoing chemo prior to surgery had similar results. They concluded it prevented infections (13). A further study compared synbiotics with prophylactic antibiotics, and concluded that the synbiotics were more effective (14). Conclusion I recommend the use of synbiotic foods and supplements to help protect you against cancers starting and to support you during and after treatment. The digestive system gets badly damaged during cancer treatments, and they are a wonderful way to help it recover. You can find much more dietary and lifestyle advice on cancer prevention and treatment support in my book, Naturally Supporting Cancer Treatment . If you would like to buy a copy, click on the Buy the Book button below. References Sheflin AM, Whitney AK, Weir TL. Cancer-promoting effects of microbial dysbiosis. Current Oncology Reports . 2014;16(10). doi:10.1007/s11912-014-0406-0 Rowaiye A, Ibeanu GC, Bur D, Nnadi S, Mgbeke OE, Morikwe U. Gut microbiota alteration - cancer relationships and synbiotic roles in cancer therapies. The Microbe . 2024;4:100096. doi:10.1016/j.microb.2024.100096 Brown LM. Helicobacter pylori: Epidemiology and routes of transmission. Epidemiologic Reviews . 2000;22(2):283-297. doi:10.1093/oxfordjournals.epirev.a018040 Xiong R-G, Zhou D-D, Wu S-X, et al. Health benefits and side effects of short-chain fatty acids. Foods . 2022;11(18):2863. doi:10.3390/foods11182863 Tirgar A, Rezaei M, Ehsani M, et al. Exploring the synergistic effects of vitamin D and synbiotics on cytokines profile, and treatment response in breast cancer: A pilot randomized clinical trial. Scientific Reports . 2024;14(1). doi:10.1038/s41598-024-72172-x Belloni S, Caruso R, Giacon C, et al. Microbiome-modifiers for cancer-related fatigue management: A systematic review. Seminars in Oncology Nursing . 2024;40(2):151619. doi:10.1016/j.soncn.2024.151619 Polakowski CB, Kato M, Preti VB, Schieferdecker ME, Ligocki Campos AC. Impact of the preoperative use of synbiotics in colorectal cancer patients: A prospective, randomized, double-blind, placebo-controlled study. Nutrition . 2018;58:40-46. doi:10.1016/j.nut.2018.06.004 Park Y, Lee J, Oh JH, Shin A, Kim J. Dietary patterns and colorectal cancer risk in a Korean population. Medicine . 2016;95(25):e3759. doi:10.1097/md.0000000000003759 Garilli B, Southard C, Wojcik S. Lactobacillus acidophilus. University of Rochester Medical Center. 2025. Accessed March 18, 2025. https://www.urmc.rochester.edu/encyclopedia/content . Tan W, Zhou Z, Li W, Lu H, Qiu Z. Lactobacillus rhamnosus GG for cow's milk allergy in children: A systematic review and meta-analysis. Frontiers in Pediatrics . 2021;9:727127. doi:10.3389/fped.2021.727127 Szparaga A, Tabor S, Kocira S, et al. Survivability of probiotic bacteria in model systems of non-fermented and fermented coconut and hemp milks. Sustainability . 2019;11(21):6093. doi:10.3390/su11216093 Mizutani Y, Kawamoto S, Takahashi M, et al. Efficacy and safety of synbiotics in patients undergoing autologous hematopoietic stem cell transplantation: A prospective, randomized, double-blind, placebo-controlled pilot study . Published online September 23, 2022. doi:10.21203/rs.3.rs-2071083/v1 Fukaya M, Yokoyama Y, Usui H, et al. Impact of synbiotics treatment on bacteremia induced during neoadjuvant chemotherapy for esophageal cancer: A randomised controlled trial. Clinical Nutrition . 2021;40(12):5781-5791. doi:10.1016/j.clnu.2021.10.004 Motoori M, Sugimura K, Tanaka K, et al. Comparison of synbiotics combined with enteral nutrition and prophylactic antibiotics as supportive care in patients with esophageal cancer undergoing neoadjuvant chemotherapy: A multicenter randomized study. Clinical Nutrition . 2022;41(5):1112-1121. doi:10.1016/j.clnu.2022.03.023

What is Yoga? Yoga is an ancient practice that blends movement, breath control, and meditation to enhance physical and mental well-being. Originating in India over 5,000 years ago, yoga has developed into various forms, from gentle, restorative postures to more dynamic flows. In India, it can be a spiritual practice, but in the West it is more of a physical and mental exercise. For cancer patients, yoga offers a holistic approach to recovery by easing treatment side effects, reducing stress, and promoting emotional resilience. Yoga Can Relieve Cancer Fatigue Cancer-related fatigue is a common and debilitating symptom, often persisting long after treatment ends. Research suggests that yoga can significantly reduce fatigue by improving circulation, boosting energy levels, and fostering deep relaxation. A systematic review of 34 controlled studies showed that there was an improvement in fatigue, although the effects varied. The longer the study, the greater the effects (1). A study in The Journal of Clinical Oncology  found that breast cancer survivors practicing yoga experienced a 57% reduction in fatigue compared to non-practitioners (2). Gentle yoga poses help combat lethargy by encouraging movement without overexertion, making it ideal for individuals with limited energy. Controlled breathing techniques (pranayama) enhance oxygen intake, supporting overall vitality. Benefits of Yoga on Sleep Struggling with sleep? Cancer patients frequently experience insomnia because of stress, pain, and side effects of treatment. Yoga can help regulate sleep patterns and improve rest quality. After 4-8 weeks of yoga, research found that yoga significantly improved sleep quality (1). Restorative yoga and guided relaxation techniques encourage the body to enter a parasympathetic state (rest-and-digest mode), promoting deeper sleep. Gentle bedtime yoga routines, such as Child's Pose or Legs-Up-The-Wall, can help signal the body that it's time to wind down. Effects of Yoga on Anxiety and Depression A cancer diagnosis brings emotional challenges, often leading to anxiety and depression. Yoga provides a safe space to process emotions and cultivate inner peace. A systematic review published in Psycho-Oncology  revealed that yoga interventions significantly reduced anxiety and depression in cancer patients (3). Slow, mindful breathing decreases cortisol levels, the hormone responsible for stress. Meditation and guided visualisation techniques in yoga enhance emotional resilience and foster a sense of control over one's well-being. Relieve Stress with Yoga Chronic stress weakens the immune system and exacerbates symptoms of illness. Fortunately, yoga offers an effective way to manage stress through relaxation and mindfulness. A study in Complementary Therapies in Clinical Practice  found that yoga significantly reduced perceived stress in breast cancer patients (4). Yoga activates the parasympathetic nervous system, promoting relaxation and reducing tension. Simple breathing exercises, such as alternate nostril breathing, can help manage stress in moments of overwhelm. Improve Quality of Life with Yoga Yoga isn't just about physical movement—it's a practice that supports emotional, mental, and social well-being. A study in Breast Cancer  found that breast cancer patients who practised yoga reported higher social, emotional and functional well-being (5). Yoga fosters a sense of community, particularly in group classes tailored for cancer patients. Practicing gratitude and mindfulness through yoga can help shift focus from illness to healing. Pain Relief from Yoga Pain, whether from cancer itself or its treatments, can be debilitating. Yoga provides natural pain relief by improving flexibility, reducing inflammation, and altering pain perception. A study in Trends in Cancer Research  showed that patients with chronic pain who practiced yoga experienced significant reductions in pain intensity and frequency (6). Gentle stretching relieves tension, while mindful breathing techniques help manage pain perception. Poses like Cat-Cow, Seated Forward Bend, and Reclined Butterfly promote relaxation and reduce physical discomfort. Yoga Improves Muscle Strength Cancer treatments such as chemotherapy and radiation often lead to muscle weakness and reduced mobility. Yoga helps rebuild strength and improve overall physical function. Research in Cancer showed that cancer survivors engaging in yoga-based programs had improved strength and flexibility (7). Strengthening poses, such as Warrior II and Chair Pose, help maintain muscle mass. Adaptive yoga ensures that even those with physical limitations can take part safely. Other Cancer Treatment Side Effects Reduced using Yoga The best-known side effects of chemo are nausea and vomiting. They can be debilitating, so it is heartening to find several studies that show you can reduce them by practising yoga (1). Several studies reported in Cancer found that issues with memory, commonly known as 'chemo brain', improved after using yoga (7). Cancer  also found several studies that suggested that yoga programs helped reduce lymphoedema (7). Conclusion There are a few different yoga types to consider. If you would like some guidance on choosing the best type for you, you will find it in my book, Naturally Supporting Cancer Treatment . Discover the various online stores that stock it by clicking on the Buy Now button below. Yoga offers a wide range of benefits for cancer patients, from reducing fatigue, stress and side effects to improving sleep and physical strength. Whether through gentle stretching, mindful breathing, or meditation, yoga provides a holistic path to healing and recovery. If you or a loved one is navigating cancer, consider incorporating yoga as part of a comprehensive wellness plan—it may just be the support your body and mind need. References  Niu N, Huang R, Zhao J, Zeng Y. Health benefits of Yoga for Cancer Survivors: An updated systematic review and meta-analysis. Asia-Pacific Journal of Oncology Nursing . 2024;11(3):100316. doi:10.1016/j.apjon.2023.100316 Kiecolt-Glaser JK, Bennett JM, Andridge R, et al. Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: A randomized controlled trial. Journal of Clinical Oncology . 2014;32(10):1040-1049. doi:10.1200/jco.2013.51.8860 Gonzalez M, Pascoe MC, Yang G, et al. Yoga for depression and anxiety symptoms in people with cancer: A systematic review and meta‐analysis. Psycho-Oncology . 2021;30(8):1196-1208. doi:10.1002/pon.5671 Ding X, Zhao F, Zhu M, et al. A systematic review and meta-analysis of interventions to reduce perceived stress in breast cancer patients. Complementary Therapies in Clinical Practice . 2024;54:101803. doi:10.1016/j.ctcp.2023.101803 Hsueh E-J, Loh E-W, Lin JJ-A, Tam K-W. Effects of yoga on improving quality of life in patients with breast cancer: A meta-analysis of randomized controlled trials. Breast Cancer . 2021;28(2):264-276. doi:10.1007/s12282-020-01209-6 Agarwal RP, Mafek AA. Integrating yoga into cancer pain management: A review of the research evidence. Trends in Cancer Research . 2016;11:157-170. Danhauer SC, Addington EL, Cohen L, et al. Yoga for symptom management in oncology: A review of the evidence base and future directions for Research. Cancer . 2019;125(12):1979-1989. doi:10.1002/cncr.31979

Rice bran arabinoxylan compound (RBAC) is gaining attention in the world of integrative oncology for its potential to support cancer patients. With mounting evidence suggesting its beneficial effects, RBAC might be a game-changer in cancer care. This article explores what RBAC is, its mechanisms of action, and its potential roles in improving treatment outcomes and quality of life for cancer patients. What is rice bran arabinoxylan? Rice bran arabinoxylan is a bioactive compound derived from rice bran. The processing typically involves fermentation with enzymes such as those from shiitake mushrooms ( Lentinula edodes ), which enhances its bioavailability and efficacy. The resulting compound is rich in polysaccharides and hemicellulose, which show immunomodulatory and anticancer properties in preclinical and clinical studies. What are RBAC’s effects? RBAC has a range of biological activities that make it a promising adjunct in cancer care. Its mechanisms include enhancing immune function, promoting cancer cell death, reducing oxidative stress, inhibiting tumour growth and metastasis, and improving the effects of conventional therapies like chemotherapy and radiotherapy. Acts as an immune restorative One of the most well-documented effects of RBAC is its ability to enhance immune function. Cancer often suppresses the immune system, weakening the body’s natural defences. Research shows that RBAC: Stimulates the activity, but not the number, of natural killer (NK) cells, which play a critical role in targeting and destroying cancer cells. Enhances the function of macrophages and T-cells, improving overall immune surveillance. Increases cytokine production, boosting the body’s ability to fight cancer and infections. (1) Promotes apoptosis Apoptosis, or programmed cell death, is a natural mechanism that eliminates damaged or abnormal cells. Many cancer cells evade this process, allowing uncontrolled growth. Researchers have found that RBAC can: Induce apoptosis in various cancer cell lines. Enhance the expression of pro-apoptotic proteins like Bax while inhibiting anti-apoptotic proteins like Bcl-2. (1) Acts as an antioxidant As cancer cells grow, they produce high levels of Reactive Oxygen Species, which cause oxidative stress and deplete the body’s natural antioxidants. This harms the surrounding tissues. Cancer cells can adapt and thrive under oxidative stress, which contributes to tumour growth and progression. RBAC’s antioxidant properties help to: Neutralise free radicals, reducing DNA damage and mutation risk. Protect healthy cells from oxidative damage during cancer treatment. Lower inflammation, which is often associated with cancer progression. (1) Stops cancer progression Studies have shown that RBAC inhibits tumour growth and reduces the spread of cancer. Its anti-proliferative effects include suppressing the proliferation of cancer cells by inhibiting key signalling pathways. Although the actual mechanism is unclear, one small human study has found that treatment with RBAC reduced the number of circulating cancer cells, which play a major role in metastasis (1). Improves chemo effects RBAC can enhance the effectiveness of chemotherapy by: Increasing the sensitivity of cancer cells to chemotherapeutic agents. One study showed that the effects of RBAC and chemo drugs together were greater than either achieved alone. Boosting immune responses that complement the cytotoxic effects of chemotherapy. Reducing tumour resistance to drugs, a major challenge in cancer treatment. (1) Protects against chemo side effects Chemotherapy often comes with significant side effects, including immune suppression, weight loss, fatigue, and gastrointestinal distress. RBAC helps to mitigate these issues by: Supporting immune recovery. Reducing weight loss and improving body weight recovery. Reducing inflammation and oxidative damage. Alleviating fatigue and improving overall energy levels. Reducing gastrointestinal side effects. In one study on breast cancer patients, in the group treated with RBAC, only 28% lost their hair compared with 100% of the control group. (1) Improves radiotherapy effects and reduces side effects Radiotherapy is another cornerstone of cancer treatment, but it can damage healthy tissue. RBAC has shown promise in: Enhancing the radiosensitivity of cancer cells, making radiotherapy more effective. Protecting normal cells from radiation-induced damage. Reducing side effects like fatigue, skin reactions, and gastrointestinal discomfort, and so improving quality of life. (1) Improves effects of other natural therapies RBAC, in combination with other natural therapies, can amplify their effects. For instance: It works in synergy with herbal remedies known for their anticancer properties, such as curcumin and mistletoe extract. In combination with oncothermia, the application of low-radio frequency heat to tumours, RBAC improved the efficacy of it against chronic fatigue syndrome (CFS). (1) Safety considerations RBAC is safe and well-tolerated, with only mild adverse effects reported in clinical trials, which included nausea and irritable bowel symptoms (2). However, individuals with blood cancers should be cautious about its use. Overstimulation of the immune system may pose risks in conditions such as leukaemia or lymphoma, which involve immune cell proliferation. Therefore, patients with these types of cancers should consult their oncologist or a healthcare provider before using RBAC. There may be interactions with immunosuppressive therapies, and you should avoid RBAC if you are currently taking these (3). Similarly, those with autoimmune conditions like lupus, rheumatoid arthritis and multiple sclerosis should avoid it, in case it exacerbates their condition (3). Other safety considerations include: Potential allergies to rice or mushroom products. There is limited safety data for pregnant or breastfeeding individuals. As with any supplement, I strongly recommend that you consult a qualified natural health practitioner who will liaise with your oncologist to ensure RBAC is appropriate for your specific condition and treatment plan. Dosages used in clinical trials are typically 1 gram daily for up to 12 months (3). Conclusion Rice bran arabinoxylan compound represents a promising natural adjunct for cancer patients, offering multiple benefits, from immune support to enhanced treatment efficacy and improved quality of life. Its one drawback is its cost: it is not a cheap supplement. However, current evidence suggests that RBAC can be a valuable part of an integrative approach to cancer care. There are many other supplements and herbs that can be helpful in the fight against cancer. I have covered the main ones in my book, Naturally Supporting Cancer Treatment . You can find links to all the online stores that stock it, both in paperback and ebook formats, by clicking here .         References Ooi SL, Micalos PS, Kim J, Pak SC. Rice Bran Arabinoxylan compound as a natural product for cancer treatment – an evidence-based assessment of the effects and mechanisms. Pharmaceutical Biology . 2024;62(1):367-393. doi:10.1080/13880209.2024.2349042 Natural Medicines Database. Rice Bran Arabinoxylan Compound Professional Monograph. NatMed Pro. February 17, 2021. Accessed January 13, 2025. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=271#dosing . WebMD. Rice Bran Arabinoxylan compound: Overview, uses, side effects, precautions, interactions, dosing and reviews. WebMD. Accessed January 13, 2025. https://www.webmd.com/vitamins/ai/ingredientmono-271/rice-bran-arabinoxylan-compound .

Cancer can be an incredibly challenging journey, both physically and emotionally. For those fighting this disease, it's essential to focus on holistic wellness to support the body and mind throughout the treatment process. Holistic wellness looks at the whole person, addressing the physical, emotional, and spiritual aspects of health. Here are some tips to help cancer fighters maintain their well-being: Nutrition: Eating a healthy and balanced diet is crucial for cancer fighters. Focus on incorporating plenty of fruits, vegetables, whole grains, and lean proteins into your meals. Drink plenty of water and limit processed foods and sugary drinks. Mindfulness and Meditation: Practicing mindfulness and meditation can help reduce stress and anxiety, which are common among cancer fighters. Take a few minutes each day to sit quietly, focus on your breath, and center your thoughts. Exercise: Staying active during cancer treatment can help improve energy levels, reduce side effects, and boost overall well-being. Aim for gentle activities like walking, yoga, or swimming, and listen to your body to avoid overexertion. Sleep: Getting enough rest is essential for the body to heal and repair itself. Create a calming bedtime routine, limit screen time before bed, and create a comfortable sleep environment to promote a good night's sleep. Support System: Surround yourself with a strong support system of friends, family, and healthcare professionals who can provide emotional support and help when needed. Don't be afraid to ask for help when you need it. Alternative Therapies: Explore complementary therapies like acupuncture, massage, or aromatherapy to help manage symptoms and improve quality of life during treatment. Herbs and Supplements: This can be a minefield unless you know what works for which cancers, what contraindications exist for them, the side effects, and the interactions. You can find out all these things in my book, Naturally Supporting Cancer Treatment , which also covers all the other tips here in a lot more detail. Stay Informed: Educate yourself about your type of cancer, treatment options, and potential side effects. Being informed can help you make empowered decisions about your healthcare. Stay Positive: Maintaining a positive outlook can be challenging, but it can make a big difference in how you experience your journey. Find things that bring you joy and focus on gratitude and hope. Remember, everyone's cancer journey is unique, so it's essential to find what works best for you. By focusing on holistic wellness and taking care of your body, mind, and spirit, you can support your overall well-being as you navigate through treatment.

Cancer can be a daunting journey for individuals and their loved ones. The physical and emotional toll that it takes can be overwhelming. However, there is a growing movement towards holistic healing for cancer survivors, recognising that traditional medical treatments are not the only answer. Holistic healing looks at the individual as a whole — mind, body, and spirit — and aims to address all aspects of health and well-being. A qualified naturopath, Jenny Graves runs one business that is at the forefront of empowering cancer survivors through holistic healing. With a passion for supporting individuals who have faced or are facing cancer, Jenny Graves offers unique wellness content tailored for cancer survivors. Holistic healing for cancer survivors goes beyond just treating the physical symptoms of the disease. It includes addressing mental and emotional well-being, managing stress, improving sleep quality, and enhancing overall quality of life. By incorporating techniques such as nutrition, herbal medicine, mindfulness practices, and lifestyle changes, holistic healing aims to boost the body's natural ability to heal and thrive. One key aspect of holistic healing for cancer survivors is empowering them to take an active role in their health and well-being. By providing them with the knowledge, tools, and support they need, individuals are better equipped to make informed decisions about their health and treatment options. This sense of empowerment can have a profound impact on their overall recovery and quality of life. Jenny Graves's business also offers a book on holistic healing for cancer survivors, providing them with additional resources and support on their healing journey. By combining traditional medical treatments with holistic approaches, cancer survivors can experience a more comprehensive and integrated approach to their recovery. Empowering cancer survivors through holistic healing is not just about addressing the physical symptoms of the disease. It is about nurturing the mind, body, and spirit, and supporting individuals in reclaiming their health and well-being. Jenny Graves and her business are shining examples of the power of holistic healing in transforming the lives of cancer survivors.

Cancer is a challenging and overwhelming diagnosis that can turn someone's world upside down. The journey to recovery often involves a combination of conventional treatments such as chemotherapy, radiation, and surgery. However, many individuals are now turning to naturopathic approaches to support their cancer recovery alongside traditional medical interventions. Naturopathy is a form of complementary medicine that focuses on a holistic approach to healthcare, emphasizing the body's innate ability to heal itself. Naturopathic practitioners believe in treating the root cause of illness rather than just easing symptoms, and this philosophy can be particularly beneficial for those navigating the complexities of cancer treatment and recovery. One key aspect of naturopathic support for cancer recovery is focusing on strengthening the immune system. Cancer and its conventional treatments can take a toll on the immune system, leaving individuals vulnerable to infections and other complications. Naturopathic approaches such as dietary changes, nutritional supplements, and herbal remedies can help to support and boost the immune system, promoting overall health and well-being. Another important element of naturopathic support for cancer recovery is managing side effects of treatment. Many conventional cancer treatments come with a host of side effects, from nausea and fatigue to neuropathy and hair loss. Naturopathic practitioners can offer natural remedies and therapies to help ease these side effects and improve quality of life during treatment. Besides immune support and symptom management, naturopathic approaches to cancer recovery often include stress reduction techniques, such as meditation, acupuncture, and massage therapy. These holistic modalities can help to reduce anxiety, improve sleep, and enhance overall mental and emotional well-being throughout the cancer journey. It's important to note that naturopathic approaches should never be a substitute for conventional cancer treatment. Instead, collaborate with the healthcare team to integrate it into a comprehensive care plan. By combining the best of both conventional and naturopathic medicine, individuals can enhance their chances of recovery and promote long-term health and vitality. In conclusion, naturopathic approaches can play a valuable role in supporting cancer recovery by strengthening the immune system, managing side effects, and promoting overall well-being. By working with a qualified naturopathic practitioner and integrating these holistic therapies into their care plan, individuals can take an active role in their healing journey and optimise their chances of a positive outcome.

In today's fast-paced world, it seems there's an ingredient lurking in every processed food we consume. Emulsifiers have become a hot topic of debate, leaving many wondering how they affect our health? In this article, we'll delve into the truth about emulsifiers and their impact on our well-being. Whether you're a health-conscious individual or simply curious about the science behind food additives, this is the ultimate guide for you. We'll explore the role of emulsifiers in the food industry, how they work, and the potential health risks associated with their consumption. We will examine all aspects of these substances, including their impact on the bacteria in our gut and their link to inflammation and chronic diseases. So, if you've ever wondered how emulsifiers, such as sodium carboxymethyl cellulose (aka CMC), polysorbate 80 and lecithin, impact your health, you're in the right place. Get ready to uncover the truth behind these commonly used additives and make informed decisions about the food you eat. Common types of emulsifiers found in food products Emulsifiers are substances that help mix two ingredients that rarely combine well, such as oil and water. In the food industry, there are several common types of emulsifiers that you might encounter in processed foods. One of the most widely used emulsifiers is lecithin, which is often derived from soybeans, sunflowers or eggs. Lecithin's ability to stabilise mixtures and improve texture makes it a popular choice for products like chocolates, salad dressings, and baked goods. Its natural origin and functionality make it a favourite among manufacturers who are aiming for a smoother product. Another common emulsifier is polysorbate 80, which is frequently found in ice cream, sauces, and baked goods. This synthetic emulsifier not only helps to maintain a creamy texture but also prevents ice crystals from forming in frozen products. Polysorbate 80 has been a topic of scrutiny because of its potential health implications, which we will explore later in this article. Despite some concerns, its effectiveness in maintaining product consistency makes it a staple in many food formulations. Food manufacturers use CMC as a thickener, stabiliser, emulsifier, binder, and gelling agent in many foods, including ice cream, sweets, baked goods, juices, dairy products, and meat products. It helps preserve the freshness and taste of food, and can increase its shelf life. Manufacturers also use CMC in low-calorie foods like diet breads, drinks, and sauces. Other emulsifiers include mono- and diglycerides (MDG), which are often derived from fats and oils. Many food manufacturers use these emulsifiers in margarine, shortening, and various baked products. They help to improve the shelf life and texture of food products. They can also enhance the mouthfeel of food, making them more enjoyable to eat. The role of emulsifiers in food manufacturing Emulsifiers play a crucial role in food manufacturing by enabling the production of stable and appealing products. For instance, the smoothness of mayonnaise or the creaminess of salad dressings is because emulsifiers keep oil and water mixed. This not only enhances the enjoyment of the food but also improves its overall quality and shelf life. As well as improving texture, emulsifiers also contribute to the efficiency of food production processes. By stabilising mixtures, they can reduce the need for additional processing, which can save both time and money during manufacturing. This means that food producers can create high-quality products more efficiently, ultimately leading to potentially lower prices for consumers. Using emulsifiers can also help minimise waste during production by ensuring effective use of ingredients. Health concerns associated with emulsifiers While emulsifiers serve critical functions in food manufacturing, there are growing concerns about their potential health effects. Research shows that some emulsifiers may disrupt the gut microbiome, which plays a vital role in digestion and overall health (1, 2). A balanced gut microbiome is crucial for nutrient absorption, immune function, and even mental health. When emulsifiers alter the composition of gut bacteria, it can lead to dysbiosis. This is a condition that may contribute to various health issues, including obesity, diabetes, and inflammatory bowel diseases, which can ultimately lead to cancer. It can also lead to obesity, allergies, and autoimmune diseases. Certain emulsifiers are synthetic compounds that may carry their own set of health risks. For example, the potential for CMC and polysorbate 80 to disrupt the gut barrier and promote 'leaky gut syndrome' raises alarms about their safety. When the gut lining becomes permeable, toxins and undigested food particles can enter the bloodstream, triggering an immune response and causing inflammation. This chronic inflammation can contribute to a wide range of diseases, from metabolic syndrome to inflammatory bowel disease (3). The connection between emulsifiers and inflammation is an area of growing concern in the scientific community. As mentioned earlier, research shows that certain emulsifiers, such as polysorbate 80, promote the growth of harmful bacteria in the gut, leading to increased intestinal permeability and systemic inflammation. This chronic inflammation is a known risk factor for various chronic diseases, including cardiovascular disease, diabetes, and certain types of cancer. The long-term consumption of foods containing certain emulsifiers may, therefore, pose a risk to those looking to maintain optimal health. Studies have suggested that emulsifiers may play a role in metabolic disorders too. For instance, research suggests that the consumption of emulsifiers can alter the gut microbiota in ways that promote obesity and insulin resistance (4). Given the rising rates of obesity and related metabolic diseases globally, understanding the role of emulsifiers in the diet has become more critical than ever. As more individuals grapple with weight management and metabolic health, the ingredients in their food, including emulsifiers, warrant careful consideration. Finally, the link between emulsifiers and inflammation extends beyond the gut. Scientists increasingly recognise chronic inflammation as a contributing factor to neurodegenerative diseases and mental health disorders (5, 6, 7). While they can enhance the quality and shelf life of food products, we should not overlook the associated risks. By prioritising whole foods and minimising the intake of processed products containing emulsifiers, individuals may have the potential to reduce their inflammation levels and improve their overall health. Label reading: How to identify emulsifiers in food products Understanding how to read food labels is essential for informed dietary choices. The ingredients on packaging often include emulsifiers, but they can be challenging to identify because of their scientific names. Familiarising yourself with common emulsifiers can empower you to make better decisions about the products you consume. For example, look for terms like lecithin, mono- and diglycerides, and polysorbate, which are all indicative of emulsifiers. As well as recognising specific emulsifiers, it's also helpful to be aware of the context in which they appear. You can often find emulsifiers in processed foods, including sauces, dressings, baked goods, and dairy products. When examining a product's ingredient list, pay attention to its position; ingredients are typically listed in descending order by quantity. If you see emulsifiers listed among the first few ingredients, it may show that they are a significant component of the product. Some products may contain multiple emulsifiers. This combination can enhance the stability and texture of the food, but the cumulative effects of consuming various emulsifiers are of some concern. By developing a habit of scrutinising food labels and being vigilant about ingredient choices, individuals can take control of their dietary intake and make choices that align with their health goals. Tips for reducing emulsifier intake in your diet Reducing emulsifier intake can be a valuable step toward supporting overall health, especially if you're concerned about their potential effects on gut health and chronic disease. One of the most effective ways to minimise emulsifier consumption is to prioritise whole, unprocessed foods. Fresh fruits, vegetables, whole grains, lean proteins, and healthy fats are typically free of emulsifiers and provide essential nutrients for your body. By focusing on whole foods, you can significantly reduce your intake of processed products that often contain emulsifiers. Another practical approach is to cook more meals at home. Preparing your meals allows you to control the ingredients you use and avoid emulsifiers commonly found in convenience foods. Explore homemade alternatives, such as salad dressings made from olive oil and vinegar, or sauces made from fresh ingredients. Not only will you be minimising emulsifier intake, but you'll also gain the satisfaction of creating nutritious meals tailored to your preferences. If you are looking for inspiration for preparing quick, healthy meals at home, check out https://www.naturallysupportingcancertreatment.com.au/mealplanning When shopping for packaged foods, consider looking for products labelled as "free from" or "clean label." These products often contain fewer additives and preservatives, including emulsifiers. You can also familiarise yourself with brands that prioritise natural ingredients and transparency in their formulations. By finding healthier options, you can effectively lower your emulsifier intake and support your overall well-being. Alternative options to emulsifiers in food manufacturing As concerns about emulsifiers continue to grow, food manufacturers are exploring alternative options that can provide similar benefits without potential health risks. For example, lecithin, which is usually derived from natural sources such as egg yolk, sunflowers, canola (rapeseed), cottonseed and soybeans, appears to have little impact on the gut (1). However, since canola and cottonseed are highly processed, and soybeans are usually GMO, it's best to avoid those sources. Another alternative is the use of whole food ingredients that naturally contain emulsifying properties. For instance, ingredients like avocado, nut butters, and egg yolks can act as emulsifiers in various recipes. They not only provide stabilisation but also contribute flavour and nutritional benefits. The trend toward using whole, minimally processed ingredients is gaining momentum, encouraging food producers to innovate and create healthier products that resonate with consumers. Researchers are exploring the potential of fermentation to create natural emulsifiers too (8). They know fermented foods are good for our health, and the fermentation process creates compounds that can stabilise emulsions. This approach not only offers a cleaner label but also aligns with the growing interest in functional foods that promote gut health. As the food industry continues to develop, the shift away from traditional emulsifiers toward more natural and health-conscious alternatives is likely to shape the future of food manufacturing. Conclusion The examination of emulsifiers reveals a complex relationship between food additives and health. While they play an essential role in food manufacturing, we cannot ignore concerns about their potential health effects. The implications of emulsifier consumption warrant careful consideration. By developing the habit of reading labels, individuals can make better dietary choices that align with their health goals. Reducing emulsifier intake through the consumption of whole foods, cooking at home, and finding cleaner alternatives can be beneficial for overall health. Ultimately, understanding the truth about emulsifiers empowers consumers to take control of their health and make informed choices about the foods they eat. As research continues, staying informed about food additives and their effects on our well-being will remain crucial in navigating the complex landscape of modern nutrition. You will find a great deal more about dietary choices in my book , Naturally Supporting Cancer Treatment. You can access a link to all the online stores that stock it in your country using the button below.     References 1. Naimi S, Viennois E, Gewirtz AT, Chassaing B. Direct impact of commonly used dietary emulsifiers on human gut microbiota. Microbiome . 2021;9(66). doi:10.1186/s40168-020-00996-6 2.  Chassaing B, Compher C, Bonhomme B, et al. Randomized controlled-feeding study of dietary emulsifier carboxymethylcellulose reveals detrimental impacts on the gut microbiota and metabolome. Gastroenterology . 2022;162(3):743-756. doi:10.1053/j.gastro.2021.11.006 3. Rousta E, Oka A, Liu B, et al. The emulsifier carboxymethylcellulose induces more aggressive colitis in humanized mice with inflammatory bowel disease microbiota than polysorbate-80. Nutrients . 2021;13(10):3565. doi:10.3390/nu13103565 4. Baran A, Sulukan E, Türkoğlu M, et al. Is sodium carboxymethyl cellulose (CMC) really completely innocent? it may be triggering obesity. International Journal of Biological Macromolecules . 2020;163:2465-2473. doi:10.1016/j.ijbiomac.2020.09.169 5. Sherling DH, Hennekens CH, Ferris AH. Newest updates to health providers on the hazards of ultra-processed foods and proposed solutions. The American Journal of Medicine . 2024;137(5):395-398. doi:10.1016/j.amjmed.2024.02.001 6. Li P, Qu R, Li M, et al. Impacts of food additives on gut microbiota and host health. Food Research International . 2024;196:114998. doi:10.1016/j.foodres.2024.114998 7. Zhang L, Yin Z, Liu X, et al. Dietary emulsifier polysorbate 80 exposure accelerates age-related cognitive decline. Brain, Behavior, and Immunity . 2024;119:171-187. doi:10.1016/j.bbi.2024.03.052 8. McClements DJ, Bai L, Chung C. Recent advances in the utilization of natural emulsifiers to form and stabilize emulsions. Annual Review of Food Science and Technology . 2017;8:205-236. doi:10.1146/annurev-food-030216-030154