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Testimony of Dr. David Heber before the U.S. Representatives Government Reform Committee. 7/25/02 Dr. David Heber is a distinguished physician and a professor of medicine and public health at UCLA. In his testimony he described the importance of nutrition to human health. In his testimony he included information on Chinese red yeast rice, green tea extract and PC Spes, and described their potent anti-cancer effects. Following are the portions of Dr. Heber’s testimony related to our nutritional recommendations. Deletions have been made. Testimony Before the House Government Reform Committee By David Heber, M.D., Ph.D., FACP, FACN July 25, 2002 I am a Professor of Medicine and Public Health and the Founding Director of the UCLA Center for Human Nutrition and the Division of Clinical Nutrition at the David Geffen School of Medicine at UCLA with federal funding for centers and training of physicians and scientists from three NIH Institutes including the National Cancer Institute, the National Institute of Diabetes, Digestive and Kidney Diseases, and the Office of Dietary Supplements Research in cooperation with the National Center for Complementary and Alternative Medicine. Over the past 20 years, I have participated in and witnessed a revolutionary expansion of our knowledge of nutrition science and the benefits of fruits, vegetables and dietary supplements including botanical dietary supplements. When I attended medical school almost 30 years ago, I was taught that you get all the vitamins you need by eating the basic four food groups. Today, we know that is not true and that there is a great deal of evidence suggesting that four basic vitamins including multivitamins with folic acid, vitamin E, vitamin C and calcium can benefit all Americans by reducing the risk of chronic diseases (1). Unfortunately, scientific breakthroughs and insights such as these are not being translated into health benefits for our population … Refined sugars such as high fructose corn syrup (the cola sweetener) and vegetable oils increase hidden calories in popular snack foods marketed to our children. In fact, it is estimated that 1/3 of all Americans get 47% of their calories from so-called junk foods. While nutrition experts often disagree on the solution to the obesity epidemic, they all agree eating more fruits and vegetables is healthy. Not only do fruits and vegetables provide fewer calories per bite than other foods in our overweight and obese society but they provide some 25,000 different chemicals called phytochemicals which can help prevent our most common diseases of aging including heart disease, diabetes and common forms of cancer. Evidence collected by the American Institute for Cancer Research finds that in countries where people eat over a pound of fruits and vegetables a day there is up to a 50% reduction in the incidence of certain common forms of cancer. The National Cancer Institute recommends that all Americans eat 5 to 9 servings per day of fruits and vegetables. My recent book ,"What Color Is Your Diet ?"(Harper Collins, 2001), recommends seven servings of different color grouping of fruits and vegetables each day so that individuals can obtain the benefits of a diverse group of phytochemicals for chronic disease prevention. For example, the red color in tomatoes is due to lycopene which concentrates in the human prostate gland and has been associated with reduced risks for prostate cancer. Lutein, a yellow/green pigment localizes in the retina where it has been associated with a reduced risk of age-related macular degeneration, the commonest preventable cause of blindness in Americans affecting over 13 million individuals. The anthocyanins which give blueberries, grape juice and red wine their red/purple color have been shown to prevent age-related declines in mental function in animals. Despite this accumulating scientific evidence, US per capita consumption of fruits from 1990 to 1998 increased only 0.6% per year and consumption of vegetables increased only 1.1% per year. At this rate, Americans will reach recommended intake levels for fruits and vegetables in 128 years and 33 years respectively. As you have heard we are facing a national and international epidemic of obesity, heart disease diabetes and common forms of cancer. Increasing fruit and vegetable intake will help to correct an imbalance of our genes and environment which has resulted from our great success in raising grains efficiently. Modern humans evolved about 50,000 years ago in Africa in a veritable Garden of Eden where our genes were in equilibrium with a varied and colorful diet of plant foods as well as many minor species of herbs and spices that enriched our diet and provided health benefits. One result of our modernization of food production has been the loss of this diversity. Existing Hunter-Gatherers in the outback of Australia who live in equilibrium with nature eat over 800 varieties of colorful fruits, vegetables and other plant foods. The plant world has much more to offer us in terms of health that we have yet to discover. Botanical dietary supplements are at the growing edge of nutrition science, and represent the restoration of even greater diversity than can be accomplished with increased servings of fruits and vegetables. Spices such as garlic and cumin have been known since ancient times to have health benefits. At UCLA, I directed the first U.S. clinical trial showing that Chinese Red Yeast Rice can be as effective as prescription drugs for lowering cholesterol (2). This ancient spice is a distant relative of the red spice on Peking Duck and Pork Spare Ribs available at your local Chinese restaurant. The use of botanical dietary supplements in the prevention and treatment of common forms of cancer has been dramatically rising in recent years in the United States (11-13), and our NIH-funded laboratories at UCLA have been studying such herbal products as green tea extract, Chinese Red Yeast Rice, and PC-SPES for their potent anti-cancer effects. PC-SPES was until recently being used by thousands of individuals with prostate cancer (14-17) . It contains a partially extracted mixture of eight different herbs: Dendrantherma morifolium, Tzvel; Ganoderma Lucidium, Karst; Glycyrrhiza glabra L; Isatis indigotica, Fort; Panax pseudo-ginseng, Wall; Robdosia rubescens; Scutellaria baicalensis, Georgi and Serenoa repens (15-19). In previous studies, we and others showed that PC-SPES mediated an antiproliferative effect on prostate cancer cells in vivo and in vitro (16-21). In addition, recent clinical studies showed that PC-SPES reduced prostate specific antigen (PSA) levels in more than 80 % of individuals with prostate cancer (22,23). CapCure, the Association for the Cure of Prostate Cancer, a non-profit foundation established by Michael Milken which has raised nearly 200 million dollars for prostate cancer research supported much of the basic research on PC-SPES including a clinical trial conducted at Harvard University and UCSF. This trial comparing PC-SPES to DES, a hormonal treatment for prostate cancer was stopped when one laboratory in Boston found trace amounts of a hormone DES in one lot of PC-SPES. The preliminary results demonstrated a significant 50% response to PC-SPES at the time the trial was stopped. In another study (18), conducted at the University of Washington the actions of PC-SPES in terms of gene activation in prostate cancer were shown to be entirely different than DES. Subsequently the California equivalent of the FDA found trace amounts of warfarin in several lots of PC-SPES imported from China and PC-SPES was withdrawn from the market. The manufacturer has since gone out of business, and there are deliberations planned in the next month which will determine the future of research with this herbal mixture including an NIH-funded study at Johns Hopkins University. These eight herbs are well-known and we have the facilities at UCLA and other institutions to proceed to investigate this mixture. The strategies and details for manufacturing enough material for the ongoing scientific studies and clinical trials in a properly controlled manufacturing environment are being actively developed. Dr. Phillip Koeffler, who has directed several studies in collaboration with me at UCLA and is Chief of Medical Oncology at Cedars-Sinai Medical Center in Los Angeles is convinced that there is much more to PC-SPES than can be explained by any of the reported contaminants based on our findings of substances in these herbs that inhibit cancer cell growth in several forms of cancer. I share his view on this matter. It is my view that we have the finest government in the world, the finest agriculture in the world and the finest medical research and drug development institutions in the world. However, these complex institutions are not working in concert to optimize health in this country. Hippocrates said in 500 BC "let food be your medicine and let your medicine be food." Our 21st Century science has brought us full circle to realize that it is no accident that 2/3 of our drugs are derived from plants or that vitamin deficiency diseases only became evident when and where mankind doesn't have a varied intake of plant products. A single orange has 170% of the recommended dietary allowance of vitamin C but it also has in its skin a fatty substance the citrus fruits developed to fight off fungi (called limonoids) which also happen to inhibit cancer cell growth. Drugs have their place and so do botanical dietary supplements. As the DSHEA law is currently being interpreted, physicians and the public cannot appreciate the full benefits of the science we are attempting to carry out on botanical dietary supplements and in some cases that science is being impeded. In the future, I hope more attention will be given to funding efforts in schools, groceries and other institutions to increase fruit and vegetable intake. Some solutions to the current dilemmas facing botanical dietary supplements include: 1) Certification of contents
and inspection I appreciate the opportunity to testify before this committee and hope we can work together to improve the health of all Americans by implementing the full extent of the DSHEA legislation and making it possible to develop to their full potential the health benefits of fruits, vegetables, and botanical dietary supplements such as PC-SPES and Chinese Red Yeast Rice. I hope this committee will be successful in finding ways to enable the American people to continue to have access to dietary supplements and for the scientific community through the National Center For Complementary And Alternative Medicine and the Office Of Dietary Supplement Research to build the science base for what I view not only as the medicines of the past but preventive formulas for the future utilized as self-care. As the late Dr. Ernst Wynder was fond of saying : " Nobody takes better care of you than you do." [Text and Non-text portions of this message have been removed] EXTENSIVE REFERENCES CAN BE FOUND IN THE FULL TESTIMONY OF DR. HEBER
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