The Role of Phytochemicals in Chronic Disease Prevention with Dr. Jed Fahey

Although lifespans are getting longer, most Americans spend the last 16 years of their lives (on average) managing multiple illnesses with various drugs. With most of our faculties compromised in those final years, quality of life is significantly reduced, and life is not as enjoyable as it could be. So is there anything we can do to expand our healthspan, not just our lifespan? My guest in this podcast, Dr. Jed Fahey, joins me to discuss the underappreciated, healthspan-promoting power of phytochemicals. Dr. Fahey is a nutritional biochemist with extensive research experience in phytochemistry. Following years of faculty appointments at the John Hopkins School of Medicine and Public Health, Dr. Fahey is now dedicating most of his efforts towards educating on “the dark matter of nutrition” – i.e. phytochemicals. In this interview, Dr. Fahey shares plenty of great pearls from his vast experience in the world of phytochemicals and zooms in on the protective role of the glucoraphanin-sulforaphane system. You wouldn’t want to miss his insights! As always, thanks for listening, and I so appreciate any comments, reviews, and ratings wherever you listen to New Frontiers. ~DrKF

The Role of Phytochemicals in Chronic Disease Prevention with Dr. Jed Fahey

What is missing in our current understanding of human nutrition? Can we live long, healthy lives just by consuming sufficient vitamins, minerals, and macronutrients? If there is one area that is mainly under-researched in our field, it would be that of phytochemicals. In this episode of New Frontiers, we are joined by Dr. Jed Fahey, nutritional biochemist and expert on phytochemistry. Dr. Fahey shares with us the crucial role of phytonutrients in extending healthspans (not just lifespans) based on his extensive research and teaching background at the John Hopkins School of Medicine and Public Health. He takes us through the challenges of researching the vast number of phytonutrients, the need to shift our perspective on superfoods, and the pitfalls of supplementation. Dr. Fahey also shares with us exciting findings from his extensive research on the many functions of sulforaphane in plants and humans.

In this episode of New Frontiers, learn about:

Dr. Kara Fitzgerald: Hi, everybody. Welcome to New Frontiers In Functional Medicine, where we are interviewing the best minds in functional medicine. And of course, today is no exception. This month I am talking to Dr. Jed Fahey. You may have witnessed his amazing IFM AIC lecture this year. In fact, that’s what lighted me to his work. And then actually he did a great series with Rhonda Patrick. So, if you want to do an extensive drill down into his work, you can look at that series of podcasts. So, there’s much to talk about. So, I’m not going to digress too much. Let me just give you his bio and we’ll jump right in. Dr. Fahey is a nutritional biochemist with extensive background in plant and human nutrition and phytochemistry. He was assistant professor at John Hopkins Medical School where he directed the Coleman Chemo Protection Center, a leading center for the study and development of plant-based protective agents.

He had faculty appointments in three departments at John Hopkins School of Medicine and Public Health, where he conducted laboratory and clinical trials, taught grad courses and mentored students since 1993. He spent the first 15 years of his career in agriculture biotechnology research and industrial process development. Dr. Fahey “retired” in mid 2020 to focus his attention entirely on outreach and educational efforts, which include podcasts, writing and lecturing widely. He maintains adjunct appointments at Johns Hopkins and elsewhere, and he may be available to consult for socially responsible food and supplement companies and foundations. Dr. Fahey, Jed. Welcome to New Frontiers.

Dr. Jed Fahey: Well, thank you so much for having me, Kara Dr. Fitzgerald. I’ll call you Kara for brevity, if that’s okay. And it’s a pleasure to join you. You reach the kind of audience that I really like talking to.

Dr. Kara Fitzgerald: Yes, yes, yes. And we’re really grateful that we found you. I’m so appreciative that Chris D’Adamo got you speaking. I’m assuming he brought you into the AIC this year at the Institute for Functional Medicine. And I know that I was in your talk. Your talk was very well received by our audience. Of course, we’re sort of born from nutritional biochemistry, Jeff Bland being one of the founders of the Institute for Functional Medicine. And so we just really appreciate your thinking. And I’ll say, and then I’m going to shut up and jump into questions, not just your nutritional biochemistry thinking, but this whole sustainability position that you’ve taken and you’ve expressed in your writings and folks as always, the show notes will be packed with Dr. Fahey’s commentaries and we’ll pop some of his key studies and so forth up there. So, talk to me broadly. Yeah, go ahead.

Dr. Jed Fahey: You’re too kind, but thank you very much for your introduction.

Dr. Kara Fitzgerald: You’re welcome. So, tell me what’s missing in our current understanding of human nutrition?

Dr. Jed Fahey: In a word I would say phytochemicals. And this is in part, it’s not because I’m a vegan, I’m actually not, although primarily I’m plant forward or mostly vegetarian or facultative vegetarian, but I very strongly believe that we are missing a huge part of what’s required for healthspan, to live a healthy life for a long time and then just don’t wake up one day when you’re a 100, 95, a 110. Pick your number. Because as everybody knows, everybody that’s listening, I’m sure, we are killing ourselves by overlapping chronic diseases that accumulate, reduce quality of life and make the end years or decades of life not as much fun as they should be. So, I mean, that’s sort of the, I guess my justification for saying we haven’t gotten it right. I’m certainly not the only one to think this, but I think that phytochemicals, which have been called, I love this term, the dark matter of nutrition.

Dr. Kara Fitzgerald: Yes, right. I … go ahead. Yeah, go ahead.

Dr. Jed Fahey: I think they are the key and the estimate of how many phytochemicals there are in our diets or in a good rich diet or in the edible plant world is something I’d love to, I don’t want to hog the mic, I’ll let you comment. But I’d love to dive into that and sort of pose that question in a minute. But yeah, what’s missing in nutrition, phytochemicals. And an appreciation for their potency, their power, their ability to nurture health. And just one more thing. There are only two of us fighting for the microphone.

Dr. Kara Fitzgerald: We’re not.

Dr. Jed Fahey: Just one more thing, while I’ve got the floor here. And that’s, there is this idea that you can live on vitamins and minerals and macro nutrients, meaning proteins, carbohydrates, and fats and maybe fiber.

And that’s exemplified by this company, Soylent that … not Soylent Green, that was a Charlton Heston movie, but Soylent was a bottled, supposedly complete nutrition product that was marketed about five years ago. We used to talk about it in the classes I taught and this was for people who didn’t like to eat. Didn’t want to take the time to eat. And they were supposed to be able to consume, I think, five bottles of this garbage a day, and people did it for months at a time without any other food. I challenge any of those people to live a healthy lifespan, to start doing that at age 20 and make it to a 100 without chronic diseases, because those things were completely devoid of phytochemicals. Okay, I’ll stop.

Dr. Kara Fitzgerald: Well that’s extraordinary thinking about it, first of all, what a creepy name thinking about the movie, but it just makes me think of infant formula. And when we transitioned from breast milk into thinking that formula was best, or processing grains and so on and so forth, and all these myriad kind of crazy things that we’ve done in the name of progress that we always discover are really insane. And it makes me think too, of as a clinician in practice, we prescribe elemental diets occasionally for people who are really unwell and they need something that’s very bioavailable in a powder form or something like that. And there are much better designed elemental diets today. But back in the day, they were probably they were kind of like Soylent or even worse.

So, there’s this whole class of phytochemicals. I’m going to say this, and then I’m just going to hush, because you’re touching upon an area that’s interesting and that I’ve been thinking about a lot on, which is the compression of morbidity that James Fry’s concept, where we basically live a really long time. We live robustly, our brains are intact, our bodies are mostly intact, and then we pass on. But when we look at what’s really happening, statistically, I know that the final 16 years of most Americans lives are spent with multiple illnesses and on a lot of different drugs and all of our faculties are compromised or gone.

And all of our, say our inheritance or money is given to pharma and hospitals and nursing facilities, et cetera. So, we’re propped up. We’re not really alive. And you’re saying, I’m going to turn the mic back over to you, but you’re really talking about phytochemicals as being a key difference between a compression of morbidity as Fry’s talked about, or the current healthspan or not healthspan, the current lifespan, which might be longer, but most of our final years are spent in really deep suffering. You wanted to speak to that?

Dr. Jed Fahey: Sure, sure. So, I mean, you used the words lifespan and healthspan in the same sentence, and yeah, so I don’t think that phytochemicals and I suspect, I mean, you go back to Carol Greider and Elizabeth Blackburn and telomeres I don’t think anybody is seriously saying that we’re going to extend lifespan beyond some predestined, genetically ordained number somewhere north of a 100 years old. But healthspan, I view as, and I mean, various people define it slightly differently, I guess, but I view healthspan as the quality of life within a lifespan. And so, the nomenclatures can be confusing and I trip up on it myself sometimes. But I think if we talk about enhancing or improving healthspan, it’s sort of a multiplicative function of years on the x-axis and quality of life on the y-axis.

And actually on my website, I think I’ve posted a figure that sort of puts that in graphic form. And I know that we talked about it in a paper that Tom Kensler and I very recently published. It was sometime this spring. And we talked about the essentiality, if you will, of phytochemicals in enhancing healthspan or making the life that you do live better. And so a lot of our … We actually thought this was going to be a sort of short opinion piece that we wrote, and it was going to be a no brainer. And we wound up doing a lot of digging into the literature to make sure we knew what we were talking about. And it is remarkable when you look at all of the phytochemicals that have been studied. Go to Scopus or Pub, I prefer using Scopus because it seems to embrace the plant and ag [agriculture] side of things a little bit better than PubMed.

But you quantify the number of papers on each of the sort of top, and we actually published this, the top 40 phytochemicals that get most research attention. That’s quite interesting. And then we contrasted that with the number of clinical trials that were done for each of them. And one of the conclusions that we came to, which I suppose is a no-brainer, we probably should have thought of this before we started, is that because there are so many phytochemicals and because it’s so attractive to researchers to pick a different one to do a study on whether it be a lab or an animal or a clinical study, there’s been, sorry, a plethora of studies on phytochemicals. Sure. But there hasn’t been a concentrated, certainly not a policy-driven focus on specific phytochemicals, because sooner or later, those clinical trials, as you know, get damned expensive and you can’t do high quality.

You can do low quality clinical studies and that’s awful, but you can do high quality clinical studies on a relatively small number of compounds. So, I think Tom and I came to the conclusion that this diffusion of attention is in part responsible for the fact that remarkably that 2020 to 2025 dietary guidelines for Americans, that Bible of nutritionists of the nutrition establishment anyway, does not mention the word phytochemicals or phytonutrients or anything like it once in the whole, whatever it is, 135 pages. I was shocked by that. And then I went and looked at some other sort of large compendiums with all the great gray haired minds of nutrition and discussion of the benefits of phytochemicals are missing.

And part of the reason, I don’t think it’s because all of the wise I’ll say gray haired, but all of the wise nutritionists of the world, I don’t think they completely ignore phytochemicals, but they can’t point to definitive clinical studies or meta-analyses as they can with things like vitamin D and vitamin C and various specific conditions. They can’t point to compelling evidence that will allow them to step over the line and put their reputations on the line and say pick a phytochemical, resveratrol, sulforaphane, N-acetylcysteine, whatever that it may be valuable to ensure you have in your diet. Anyway, time for me to shut up a minute.

Dr. Kara Fitzgerald: Well, I mean, just thank you for laying that out so starkly and painfully really. This omission. And I appreciate you sort of “retiring” and shifting your focus entirely to getting attention on this issue because you’re absolutely right that it’s essential. And I just want to quote you, so we’ll link to the paper that Jed just mentioned. This was March 2021 in Food Frontiers. “Phytochemicals: Do they belong on our plate for sustaining healthspan?” And you say in that, an extraordinary multitude of phytochemicals have been shown in preclinical settings to be potent allies in our fight against the entire spectrum of chronic diseases and many acute conditions such as infections. And then you go on to say that of course the research happening right now is woeful for the reasons you’ve just outlined and that we need artificial intelligence and machine learning and metabolomics and all of the omics and so forth to really drill down into these compounds, to see their utility.

And then when I was reading this, of course I was thinking, yes, of course, we need to do this deep drill down into this, into the beautiful spectrum of phytochemicals, many of which you described as dark matter. We don’t even know who they are yet, but many we do. And I guess my, I juxtaposed it with, so I read this proposition and of course, it absolutely resonates, but we evolved eating these compounds. It’s like, it’s just mind blowing that we would sort of forget that in the face of progress.

Dr. Jed Fahey: Absolutely.

Dr. Kara Fitzgerald: Go ahead.

Dr. Jed Fahey: I couldn’t. No, I couldn’t agree more. I didn’t mean to interrupt.

Dr. Kara Fitzgerald: Well, and I think hopefully with, certainly with you putting energy behind shaping the, hopefully, the research agenda at some level so we start to look at these in more meaningful ways using these amazing tools that we have will begin to put evidence behind it and understand, start to tease out some of who these players are. But I just want you to back up and say, phytochemicals, that’s a very broad term. Can you speak about them? Now, we understand them as essential, although sort of largely ignored, but they’re made from plants. I mean, what do they do?

Dr. Jed Fahey: So, I mean, there are a lot of things I can riff on from that question. So, let me try to answer your question directly and then I’ll wander, but what they do for the plant is they, I mean, they make the plant what you see. So, phytochemicals are low molecular weight compounds, small molecules, if you will, they’re not proteins, they’re not oils, fats, fiber, or what am I missing, carbohydrates or nucleic acids. They’re not the main things you hear about as the essence of life. And indeed you can survive or a young person can survive without any phytochemicals. Maybe. I mean, I don’t even know, but I suppose that they can. But phytochemicals are present in usually very, very low concentrations in plants, far less than 1% by weight, less than 0.1%, many of them.

And they’re signaling molecules for the plants, very importantly, they’re defense molecules for the plant. And when I say defense, it could be an antibiotic effect, antifungal. It could be an insect repellent effect. So, an insect takes a bite out of a plant. It’s got a taste that it doesn’t like, it goes and eats some other plant. And it could be an anti-desiccant response, or these could be compounds, these are compounds that for example, make a plant attractive to pollinators. So, all of the essential oils are phytochemicals. They are actually present in fairly high concentrations compared to other phytochemicals. And many of them, as you’re probably aware, exuded on the glands of leaves of plants. Anybody who’s familiar with cannabis knows about essential oils. They’re not actually oils, lipids, they’re unfortunately misnamed, but so they’re involved with scents, they’re involved with protection against ultraviolet radiation in plants.

And then last but not least, or it’s not even last but color. I mean, the color of a tomato, the color of a leaf, even if we discount chlorophyll, which is really a phytochemical, all of the accessory pigments that make plants the colors they are. So, I’ve mentioned a lot of types of compounds and we can dive deeper into that if you’d like, but interestingly, I think you repeated the word dark matter, or if not, let me mention it. In the paper of ours that you mentioned, we actually quoted someone else. We didn’t invent that term, but I absolutely love it. Calling phytochemicals the dark matter of nutrition. There’s a very well published, very highly respected group who I think sort of initially made that call. And they estimated this is by, I hope I pronounce his name correctly, Barabasi and Laszlo, I believe are the main authors, did a piece in 2020.

And Tom and I, Tom Kensler and I, in our paper, excuse me, used their estimate of 50,000 phytochemicals that exists. And we deliberately used that because it was published in, I think, Nature, it was published in a high impact journal. It was a great paper of theirs, but most people, most phytochemists, and I think most people that really think about this, would estimate the actual number of phytochemicals at far, far more than that. At least an order of magnitude, maybe two orders of magnitude five to 10 million some people have estimated. And when you, I mean, just pull up any picture of any plant or just look outside the window at the plants there. And I mean, it’s not a farfetched number.

Dr. Kara Fitzgerald: Well, can I just say that this has got to be in one way, I mean, this sort of answers the question on why there’s a dearth of research and we’ve decided to ignore them.

Dr. Jed Fahey: Exactly. Too much information, forget it.

Dr. Kara Fitzgerald: Yeah, that’s right. And the fact that we know that they interact synergistically and they’re just, there’s itty bitty amounts and we come from drug model brains. Just controlling a single variable and how do you do that? It’s just, it’s really challenging, I think. And so, as you guys pose logically, we have to just dive into these amazing tools we now have for broad and fast investigations and using AI and so forth so we can get what we’ve evolved from. I always find that amazing so we can get the beauty of broccoli and why it’s important.

Dr. Jed Fahey: Well, first of all, yes, I agree with you. And I want to talk to you about the AI side and the high estimate of the number of phytochemicals, but from the perspective of what we’re doing. I mean, you can do that in two ways. If you’re dead set on eating a, let’s say a lousy diet and eating all sorts of supplements, dietary supplements, then obviously knowing what those supplements perhaps should be, and their bioavailability and toxicity and all that is very, very important if you’re going to refine them and put them in a pill. But the other of that argument, and I think there’s a place for dietary supplements, especially with a Western lifestyle and as one gets older and just can’t get the, doesn’t eat as much doesn’t exercise as much.

I think the flip side though is, knowing how important any or all or some of these phytochemicals are for various conditions should guide nutritionists and dieticians and other counselors, and certainly physicians, naturopaths, medical doctors should guide them all to understanding more about how to eat healthy. And then I got my doctorate in nutritional biochemistry late in life. I got my PhD or it’s an ScD doctorate of science on the day that my son graduated from college when I was 50 years old.

Dr. Kara Fitzgerald: Good for you.

Dr. Jed Fahey: So, it was late. And I haven’t been in this game quite as long as some others, but I got my doctorate in a school of public health and in the coursework that I was forced to take, and I’m glad I did. I really got exposed to what happens in the rest of the world from a health perspective.

And in most of the world, whatever our population is now, it’s the great percentage of the world, certainly the tropics. People don’t take supplements. People can’t afford it. The people are lucky if they get enough food and get a varied diet. So, I think and understand, and this has come up again and again in the work I’ve done with Moringa, which is a nutritional tropical tree. I think understanding, eat colors, the colors on your plate and all that is great in the west, but that’s also great in the developing world, so called developing world, terrible term. But it’s great in the parts of the world where people don’t take supplements, because it may enable us to guide people towards certain crops.

I’m not expecting a panacea, but I mean, if they’re eating one thing and suffering from nutritional deficiencies, and there’s something else that was viewed as a famine food or a weed that we learn is useful to integrate into a diet. There are things that humanitarian organizations and aid organizations and the Peace Corps and so on can do to help persuade people to eat slightly differently. It’s an uphill battle, but anyway, I just want to make clear that all the work that goes towards understanding what phytochemicals can do to enhance healthspan does not have to lead to pills, to supplements, to nutritional supplements, but it can lead to slight changes or maybe major changes in dietary recommendations.

Dr. Kara Fitzgerald: Yeah. Okay. I think that, that’s a great, an important point. And I have a couple of questions. I think I want to just juxtapose what that looks like. So, what would that look like here, eating in the West? What would you suggest our plate should appear like? And then I want to talk about how those tweaks that people in the Peace Corps, et cetera, working with some of the less wealthy countries, how they’re advising them to tweak their diet and is Moringa playing a role in that? And I guess we should probably actually define Moringa in there as well. So, what’s a good plate look like here?

Dr. Jed Fahey: I would leave that to you and others. I mean, I’m not a dietician, but I think there are plenty of people who are giving recommendations for what a good plate looks like. It’s not a paleo diet. I don’t think. It’s not any of the more faddish diets. I think it’s a plant forward or predominantly plant diet and variety is I think really key. And I think all the advice about the colors eating for colors, eating different colors is good advice. I think fresh is good advice, eating fresh, to the extent you can. Eating fresh and eating local, I think is great advice. And there are a lot of intersecting sort of needs and constituencies here, but I think eating local is good from perspective of sustainability, supporting local, small farmers and so on and so forth.

I just came back from the farmer’s market. I live in mid-coast Maine, and it’s absolutely wonderful to be able to patronize local farmers who are growing vegetables. But being aware of how many food miles your food travels is also important. I think being aware that phytochemical content actually can decline, and I don’t have good data for this, but I think it’s partly intuitive as food is shipped and stored for weeks in a cold chain, whether it be from California, or from Peru or Mexico. When food was picked, when lettuce was picked two weeks ago or the list is long. I don’t know that those are as rich in phytochemicals as they were when they were picked, because after all, a lot of phytochemicals are antioxidants. We repurpose that function when we use them in our body when we take them in our body, but because they’re antioxidants, some of them actually get used up fighting the oxidative stress of a picked piece of produce or lettuce or tomato or whatever it may be.

So, I’m wandering a bit, I realize, but I guess to sort of come back to what the plate should look like. The other huge piece that I’d like to stress is that and Michael Pollan and many other writers have done this better than, more eloquently than I can, but stay away from the middle of the supermarket and as much as possible and all of the boxed and highly preserved stuff, it is very likely contributing to the decline in healthspan. And there’s one thing that we are quite sure of, and that’s that there’s usually a reduced, almost always reduced phytochemical content in things like packaged cereals and pasta and things like that.

There’s also, based on the heat used for extrusion and processing and drying. There’s also a very high load of things called advanced glycation end products or AGEs. And these are things actually on the board of a foundation called the anti-AGEs foundation, excuse me. And we’re trying to make people aware of some of the dangers of these compounds in things like bacon, for example, cooked bacon, they’re extraordinarily high. They can accelerate things like cataracts. It is advanced glycation end products or AGEs that you’re measuring when you measure hemoglobin A1C in diabetes, they’re probably a contributing factor to diabetes. They’re bad for you. And they lead to decline in tissue functionality. And they’re very widely present in highly processed foods, which is another reason to stick with as fresh a diet as you can. If you live in Alaska or Maine, it’s a little tougher. If you live in the central valley of California, I would think you could probably get away without any processed food. But I think hopefully you got the point. And the listeners got the point.

Dr. Kara Fitzgerald: In 2017 you published a piece in John Hopkins Health Review. It’s great. And we’ll link to it, because it’s just, it’s really, it outlines what you’re just talking about now. It’s titled “Superfood or Super Hype, Examining The Prevalence and Promise of Nutrient Packed Foods.” So, going back to the idea of the miles that it takes for a sexy, popular superfood nutrient to travel from far away country X to us, and likely we’re losing the nutrient value during that journey as you point out, but also we’re taking it from, we’re sort of messing with the other country, potentially what’s going on over there, and the fact that they need it.

And so I want to, you can speak to that, but the other, I think really important point you mentioned, and the fact that you just got back from your local farmer’s market is that there’s plenty of superfoods right here. And we can access a fabulous variety of nutrients, really pretty much anywhere in the US. Maybe the dead of winter in the far reaches of Alaska might be a little harder, you said, but by and large we can eat well with crops that are grown here or what we’re growing in our yard, or our local farmers, et cetera. Do you want to speak to any of that?

Dr. Jed Fahey: Sure, sure. I mean, you’ve hit the nail on the head. And so that opinion piece that you mentioned that I did a few years ago was, I loved having the chance to write that. And although it was challenging to me, because I actually helped at the beginning of its corporate lifespan, I helped a small company, which is now growing and thriving and doing beautifully called Kuli Kuli. And there they are selling Moringa leaf powder and some products that include Moringa in the American market.

And they’re selling it to people who obviously have disposable income to spend on cool, interesting and different foods. And I think that’s absolutely great. I helped them get their COA into Whole Foods. And they started selling there and I’ve been on their scientific advisory board ever since. They actually source sustainably from a wide range of primarily women-owned businesses and cooperatives primarily in Africa, where the founder Lisa Curtis was in the Peace Corps and got sort of turned on to Moringa. So, I think that’s all great. And I’m not knocking we rich compared to the rest of the world, Americans for eating all sorts of interesting superfoods. I’ve had a battle with a number of people about the use of the term superfood though, because I guess I should say I used to hate it, and I still don’t like the term.

And it’s because as you say, if you eat just about any fresh fruit or vegetable, I would call that a superfood and go to all the common stuff you see on the supermarket shelves on the produce shelves. And we could figure out what phytochemicals make them super. And the only one I’d probably leave off my personal list is iceberg lettuce. I see very little redeeming value in iceberg lettuce, but I’m sure lettuce producers of Salinas Valley would kill me for saying that. It’s a lot of water and I don’t think it’s particularly loaded with phytonutrients, but it’s got a lot of fiber, so it’s good for you.

So, that said, sure there are foods that everybody calls superfoods. I was trying to help, there’s a woman who was putting together a documentary called Superfoods of the Western World. She had National Geographic and Al-Jazeera and other large media outlets funding her, but I don’t think it ever got done, but I was helping her construct a list of superfoods of the world, because she insisted that as a producer, director, this was going to be her title. So, sure. I would put Moringa on there. I’d put blueberries on there. I’d put broccolis on there. I’d put black raspberries on there and the list can just keep growing and growing. But then the moniker of superfood also depends, I guess, on where you live. And then, hey, what do you know? It depends on your taste buds and what you like to eat. Why should you force feed yourself blueberries, if you don’t like the taste. So, pick something else, right? Pick apples and tomatoes. So, it’s …

Dr. Kara Fitzgerald: I love it. Your definition of superfood is just perfect. It’s very liberating. And it’s affordable.

Dr. Jed Fahey: I have a dear friend who started a sensory analysis company. Gail Civille, her company up in New Jersey does, among other things, taste testing for food products. And we actually worked with her. I had a master’s student work with her to develop some taste masking strategies for broccoli sprout extracts that we’re using in clinical trials, in China and in Baltimore, and then a few other places. And Gail in her infinite wisdom, as we were talking about things to eat, things to put this powder in said, and she says this to my class every year, or has said it to my class every year, she said, “If it doesn’t taste good, they won’t eat it.” And so you label something as a superfood, if it tastes like crap, people aren’t going to eat it.

If you have a clinical trial and you think everybody in that trial should eat a giant bowl full of fresh broccoli sprouts. Well, to most people that doesn’t taste good. So, they’re not going to eat it. Some people, yes. I mean, I think sometimes as nutritional biochemist or nutritionists or dieticians, I think sometimes we overlook the component of taste and sensory input. We’re not all the same and the better a food tastes, the more likely you are to eat it. Of course, it’s a huge challenge to do that without dumping piles full of sugar and salt into it. But it’s very, very doable. We all also know that.

Dr. Kara Fitzgerald: Yeah, well, I’m thinking about sort of those folks who are sort of supertasters, my sister puts herself into this category and can sort of … if I’m eating some kale in Connecticut, she can taste that and have a negative reaction in Ohio.

Dr. Jed Fahey: Over the phone, right?

Dr. Kara Fitzgerald: Over the phone. She was so upset that my daughter liked broccoli rabe when she was a little peanut.

Dr. Jed Fahey: Oh, God, I love broccoli rabe.

Dr. Kara Fitzgerald: I do like it too.

Dr. Jed Fahey: Stir fried with a little garlic.

Dr. Kara Fitzgerald: Absolutely. And a lot of olive oil. Yeah. I love it too. So, I want to talk a little bit about broccoli sprouts and you put a lot of energy into the nutrient value of sprouts and just kind of cruciferous veggies in general. And I want to talk a little bit about that, the biochemistry of it. But I’m just curious how you would respond to my sister who doesn’t even want to be in the same room with these. Should she get in there and sort of turn it into a pasta, or add a lot of sugar? I mean, are cruciferous, would you say something that we can’t get away from? We’ve got to figure out how to eat, even if we’re supertasters?

Dr. Jed Fahey: Oh God, that’s a challenge.

Dr. Kara Fitzgerald: I know.

Dr. Jed Fahey: I think probably not. I mean, there are so many other vegetables to choose from. I mean, if you insist on forcing your sister to eat crucifers, you could go to something like Maca or Mashua, Andean tubers, which have some of the same type of phytochemicals glucosinolates, but they taste very much like a potato. They don’t taste like broccoli at all. I think it’s interesting. There’s so many to choose from. I would be shocked if you had your sister look at all, I think there are 600 different crucifers, edible cruciferous plants. There’s a huge number of them. I’d be shocked if she couldn’t find something that she liked. But it’s interesting. So, I want to go back to the way you said something at the beginning of your question, you said I’ve spent, I’ve invested a lot of time and energy in studying the nutrients in broccoli sprouts.

And I just wanted to call you out of that and say, you’re showing your educational and training prejudice in the same way that we all do, because should we call … So, what we’ve studied is the glucosinolates and isothiocyanates in broccoli sprouts and they are phytochemicals. So, we get back to that question of are phytochemicals nutrients, should we call them phytonutrients? Which some people do. I actually had a paper with some USDA collaborators a long, long, long time ago, and phytonutrients was in the title. And I had to fight about it, because I didn’t like calling them phytonutrients.

On the other hand, a lot of people in the more social space and nutritional counseling space, I think like to shy away from the word phytochemical, because it connotes, a lot of people when they hear the word chemistry, they tune out. So, maybe phytonutrients is a better term, but I don’t know. I’d have to look it up, honestly, what the definition of a nutrient is, but I think it’s something that’s required for survival. And therefore, probably what we’ve studied in broccoli sprouts, meaning sulforaphane is not required for a person’s survival. It may be.

Dr. Kara Fitzgerald: Is it? I think that question needs to answered. So, I just looked it up as you were speaking, a substance that provides nourishment essential for growth and the maintenance of life. And this is from Oxford. I mean, I guess maybe we need to define what growth and maintenance of life are. It’s survival versus thrive.

Dr. Jed Fahey: Yeah, well, maybe just what we’re talking about now. Maybe what we’re doing is making a good argument to use the term phytonutrient instead of phytochemical, because we think it’s a nutrient in that it prolongs, or it enhances healthspan, but it’s a little different than a classic nutrient, obviously. So, maybe phytonutrient’s a good term, I don’t know. But you asked me about many minutes ago now about what’s on a good plate. And I hope I answered that to the best of my ability, which is, I don’t know, but plants, plant heavy. And certainly, I don’t think we need to eat a lot of animal protein. And I think as time goes on, it’s going to be harder to do that. We can survive without it. I don’t think it’s all bad, but I think when you start looking at cooking animal protein, most of it is cooked, except for sushi and shellfish, you should be thinking also about the massive amounts of advanced glycation end products or AGEs that you’re potentially adding to your dietary intake, as well as all the other things that have been assigned to meat from a sort of a negative perspective. But I’d rather not get into a vegetarian versus paleo versus carnivore debate, because there are others that will go at that debate beautifully. I don’t know if you’ve done a podcast with opposing points of view on that, but I’ve heard a few years ago and seen some published debates that are very interesting reading. I’m just not the person to do it.

Dr. Kara Fitzgerald: And I don’t know that the extremes really … I think that it’s a little bit, it’s not that interesting to me. I mean, I like what you said. You described yourself as being a facultative vegetarian, I think at the intro. And I think that’s pretty cool. That’s fun. It’s a fun use of the word facultative. But I have some liver sitting here in front of me. I don’t eat a ton of it, but it’s a multivitamin and a food matrix. And you don’t need a lot of it actually, you really don’t to get those benefits. So, I think there’s a place for animal protein. That’s my current position. So, why all your energy looking at broccoli? I mean, and sprouts and so forth. And what are the wonderment nutrients that you discovered and really started to drill down?

Dr. Jed Fahey: So, this started back in, excuse me, when I was in industry, before I came to Hopkins in 1993, I was actually working on the development of broccoli cultivars by another culture, culturing the anthers of the plant in tissue culture. So, I was sort of tuned into broccoli. And then I responded actually to a posting of a job that Paul Talalay had made. And he’s a revered and esteemed enzymologist who was the chairman of the pharmacology department at Hopkins, and had gone back to a faculty position when he recruited me. And he and Yuesheng Zhang, a medical student at the time, had just rediscovered sulforaphane and sulforaphane is a phytochemical present in broccoli. And they found very small amounts, but they also found that it upregulated the so-called at the time they were called phase two enzymes. They’re still called that, but they’re essentially a suite of, or a large group of, cytoprotective enzymes, meaning they protect cells against damage.

And that protection comes in the form of antioxidant protection, as well as the anti-inflammatory. There’s an immune regulating function, immune support. Over the years it’s been learned that there’s mitochondrial support using deliberately a very loose sort of supplement industry type term. But I mean, there are a lot of subtleties about the biochemistry that people know now. But back then it was the discovery was sulforaphane upregulates phase two enzymes, they’re protective, they’re antioxidant. Wow. And so Paul brought me on to find better broccoli. Well, in the winter and in the middle of Baltimore, on the 13th floor of a hospital, it was sort of hard to grow broccoli year round. And although we did have something like 10 sites on the Eastern shore of Maryland, when winter came, I obviously didn’t have a ready supplier of broccoli. And we started going small and going local.

So, I started growing broccoli seeds in the lab and discovered long and short of it, that broccoli sprouts were a much more potent source of not actually sulforaphane, but its precursor, which is very stable. It’s called glucoraphanin. And it stays in the plant and is mobilized when the plant’s chowed down on by insects or people, when cells are broken, or when it’s penetrated by a fungal hypha, or bacterial lesion. And then it activates within through an enzyme that’s also in those plant cells called myrosinase. It converts to sulforaphane very quickly. And sulforaphane is bactericidal and it’s a defense compound, and it upregulates actually antioxidant enzymes in the plant. So, that’s what was known back then. And simultaneously, in fact, in 1997, when we published our sprout paper or first sprout paper in the PNAS, there was a seminal paper done by a group in Japan, Masayuki Yamamoto and Ken Itoh and a whole group of investigators at Tsukuba University and Tohoku University.

And they linked this compound, this nuclear transcription factor called Nrf2, they linked its function with this. It was sort of the key to upregulation of these, what we called cytoprotective enzymes. And they sort of seeded the field that now over the past 25, 30 years has really mapped out how this nuclear transcription factor works to be protective and sulforaphane activates. And I won’t go into the details, but sulforaphane, it turns out is the major, the most potent activator of this response. Just to march back to those early days, when I started my work with Paul Talalay at Hopkins. Back then our focus was almost entirely on cancer protection. Protection against cancer. Many at Hopkins and elsewhere we’re of course, studying therapy and some therapeutics for some cancers had been developed, but the concept that you could protect against a wide variety of cancers by something that could be introduced in the diet was very, very novel.

And this is Paul’s idea, not mine, but I bought into it hook, line and sinker. And so our focus was on protection against future development of cancer. And sulforaphane clearly in all sorts of models was effective in that sense. And we even named the center that we developed the Chemo Protection Center. That’s a sort of unfortunate choice of words, because chemo protection really is associated with cancer and with drugs and cancer. But be that as it may, over the years as this Nrf2 signal mechanism, as knowledge of it evolved, and our knowledge of this glucosinolate, this glucoraphanin-sulforaphane system of phytochemicals evolved, we and others started looking at the efficacy of sulforaphane in a variety of other chronic conditions, other than cancer, including things like autism, where there now are, I think about eight clinical trials that we and others have done.

So, a lot of neurodevelopmental, neurodegenerative conditions are in the cross hairs. Some auto-immune conditions, diseases of the eye, diabetes. I mean, the list is essentially the list of chronic diseases. And almost all of them respond to some degree or another to … or are, I should say, the development of them has oxidant stress and inflammation in their pathophysiology or their developmental progression. So, let me shut up again, take a breath.

Dr. Kara Fitzgerald: Yeah. So, at least some of these studies are using supplements, or all of them?

Dr. Jed Fahey: At least some of them are. Yeah, that’s correct. When we started doing these sorts of clinical studies, we did some studies in China where we actually used, we grew fresh broccoli sprouts. We made hot water extracts of them and the subject drank those hot water extracts that contained glucoraphanin. It is incredibly difficult to do studies like that. And I should say those were liver cancer and air pollution prevention studies, and very interesting results. Successful. It’s incredibly difficult to do those sorts of studies. It’s easier to do them outside of the US, only because people outside of the US aren’t so fixated on taking handfuls of pills every morning, noon, and night, for whatever ails them. In this country it would be very difficult to do a study, certainly with fresh broccoli sprouts and/or with an extract.

And so we did switch to homemade supplements, meaning that I actually went back and forth across the country many, many times to Oregon Freeze Dry, biggest freeze drying plant in the world, I believe. And we boiled broccoli sprouts and freeze-dried them and made them into capsules or sachets that were used in the dosing of clinical studies. And then the nutritional supplement world after 1994, especially in the DSHEA, started coming out with broccoli containing or supposedly sulforaphane or glucoraphanin containing supplements. And long story short on that, Paul and I and his son started a company to sell broccoli sprouts as a protective food. It had to evolve away from fresh broccoli sprouts for a lot of reasons, including foodborne contamination risks that were perceived and some of which were real. The company started making a broccoli sprout extract, rich in glucoraphanin.

And I backed away from the company then to continue at Hopkins. But knowing that they had a responsibly produced product and having seen how the analyses were done all the time, I guided some of our clinical trials to use supplements that I at least knew the contents of which going into the study. And of course we analyze them. But it turns out to be your question was a lead in question, I suppose, but it turns out to be much easier to do those trials with pills or gel caps or tablets. So, with supplements, perhaps drinks, but you have to disguise that … make a placebo is very difficult in these studies and you want to have a placebo that fakes people out. You don’t want people knowing that they’re on treatment and placebo.

Dr. Kara Fitzgerald: I got to ask you this, before we talk about placebos. I mean, can you speak to, I mean, there’s a lot of products out there. And we’re not beholden to CME. So, you could speak to brands if you’re comfortable. I mean, I’m curious what you think is reasonable, because people … Yeah, go ahead.

Dr. Jed Fahey: Yeah, sure. And I’m happy to do that now that I’m not doing clinical trials as a PI at Hopkins. So, there are a lot of products out there. There are a lot of terrible products that don’t have what they say they have in them. And in fact, before I left Hopkins on the Chemo Protection Center website, I was going to start, we had analyzed a lot of these products, and I was going to start outing them. And I was going to make a list of sort of demonstrating with third-party assays, who had what. And the Hopkins lawyers wouldn’t let me do it. They shut that down, because they didn’t want to get involved, I suppose, and lawsuits with those whom one of the experts or the expert labs said was garbage.

So, we didn’t do that, but I can tell you that the company we started was Brassica Protection Products, and it makes a product called TrueBroc, T-R-U-E-B-R-O-C. And that product is not sold direct to consumers, except in some tea and coffee products that are on their website. They sell to supplement companies. And they actually, they have posted on their website, a list of the supplements that they are in. And so, yeah. And so going to that list online will allow you to see where they are. And I can tell you that companies that I’ve worked with on clinical trials, in other words, whose products, which contain TrueBroc, we’ve used in the clinic are Thorne’s Crucera. It’s called Crucera-SGS. And I think they have it in some other products. And XYMOGEN has a product that contains it.

Nutramax has a product called Avmacol, which has TrueBroc in it. And I mean, so the TrueBroc powder is 13% glucoraphanin by weight. And I that, I’m now consulting for them. Now that I’ve left Hopkins. And I know that all of their lots have at least that much in them. And so they sell them to the supplement companies and the supplement companies, some of them just encapsulate them and give them a funky name, a trade name, some of them combine them with other ingredients. And there it gets a little bit more dicey, meaning we’re getting smart enough as scientists to know how to measure the effects of multiple phytochemicals together. But for most of the time I was working on this area, we weren’t smart enough. And it’s doable with two compounds. We start trying to assess the efficacy and overlapping effects of three or four or five phytochemicals and it really gets difficult. And some of these products have, not the ones I just mentioned, but some of them have many, many, many phytochemical and mushroom components.

Dr. Kara Fitzgerald: And if it’s a proprietary blend, you don’t really know that you’re hitting a therapeutic amount. I would imagine.

Dr. Jed Fahey: Right.

Dr. Kara Fitzgerald: You just don’t … yeah.

Dr. Jed Fahey: Many times you don’t. And we still, we have good guesses on an appropriate dose, if you want to use the term dose. As soon as you use the term dose, you start thinking drugs and not phytochemicals, but that’s how, if you’re talking about a supplement, you have to think that way, because you at least … I mean, you can’t keep people from swallowing 20, if the recommendation is take two, but you have to do something to let people know that they could take too much. And interestingly, and this is where we go back to fresh food.

You’re not going to overdose on sulforaphane by eating broccoli. And just like you’re not going to overdose on, well, I mean, there’s a self-limiting, it’s not disgust, it’s fullness, satiety, or of course, in the case of your sister, it is disgust. But for people who like something like broccoli, you’re not going to, if you eat too much one day, you won’t eat it for another week or maybe you’ll never eat it again. But yeah, when you put these things, concentrate them and put them in supplements, we do have to worry about dose.

Dr. Kara Fitzgerald: So, I mean, unfortunately we have to wrap up, but this is a really interesting conversation. I mean, what would be the suggested amount? I’m looking at the Thorne’s Crucera, which is, I think a 100% this TrueBroc component, and it’s 50 milligrams in a cap. I mean, what has your research borne out as a recommended amount?

Dr. Jed Fahey: Well, it gets very complicated and it depends on whether it’s co delivered with myrosinase that assists in conversion. But I think 50 to a 100 milligrams a day is very reasonable of glucoraphanin. I mean, I would go with the, if you’re looking at their website, I would look at what their recommendation is. And I think it’s probably two capsules a day. And all of those supplement companies err on the low side, I think, because they don’t want people doubling or tripling and winding up with too much. There are very few concerns about interactions, but there are drug interactions that one should always be concerned about. So, when people are taking drugs and supplements, I mean Coumadin and blood thinners and vitamin K are a classic example and grapefruit juice and cytochrome induction is another. Changing the metabolism of some drugs with cytochrome, I guess it’s inhibition by grapefruit juice.

I can’t remember. So, it’s a sort of gray area, but I would go with the recommendations that the supplement companies give if you get a responsibly sourced supplement. And Kara, you probably know better than I do. And I know our mutual friend, Chris D’Adamo is lectured for my class on this, but there are ways, there are websites you can go to and there are ways you can assess the quality of nutritional supplements, dietary supplements, and get a little better feeling. So, I’d leave that to people like you to make recommendations on. And so just to one other point, I’m also consulting for a company called Foodnerd and they’ve taken a very interesting and sort of unique approach. They’re saying we’re going to minimally process fresh fruits and vegetables and make them into shelf stable products.

And that turns out to be extraordinarily difficult to do, but they’ve done it. And so they have products that are very low in AGEs and that retain most of the phytochemical wallop that the original fruits and vegetables that went into them had, but yet they’re shelf stable. So, they don’t have to be refrigerated. They have to be used within a week or two or three days. And I’ve been helping them. And I hope they do well. They’re fundraising now and sort of in the pilot, the early stages.

But this approach may help us, I hope, sort of sidestep to a degree, this issue that a lot of people just won’t load their plates with fruits and vegetables. Well, if they can put some of this in a bowl with milk, I think it will be very positive for improving otherwise cruddy diets. That’s a negative way to put my positive feelings about what this company’s doing. And they’re using sprouts almost exclusively as the primary ingredients of their cereals and energy packs and things like that.

Dr. Kara Fitzgerald: Are you still growing sprouts at home or are you?

Dr. Jed Fahey: Yes. I grow sprouts and I drink Moringa tea. And I grow all sorts of sprouts and will I say I’m better for it. I have more energy, blah, blah, blah. Sure. Okay. I think it’s good for me. Yeah.

Dr. Kara Fitzgerald: Well, Jed, it was just a really delight to be able to talk to you. And I would love to keep going. I’ve got more questions for you. So, maybe we’ll do a round two at some point, but I just want to say, I appreciate your mission and that you’re getting out there and really trying to put phytochemicals or phytonutrients into the mind of all of us and perhaps changing some of the government-based nutrient paradigms that are missing it. I mean, I think it’s time for a change and I hope that you can kind of spearhead that and we’ll support you. We got your back.

Dr. Jed Fahey: Well, thank you. And likewise, I encourage what you’re doing. I mean, I think, as you know, it’s extraordinarily difficult to get the message to people who are resistant to hearing it. And I’m sure you have a constituency that wants to hear what you have to say. In some cases, you’re probably preaching to the choir. And in other cases, you run into a brick wall. And I don’t know how to get past that brick wall, but if some of us don’t or all of us don’t figure out how to do it, as we all know, the healthcare system is going to tank. And our health is, collectively, is just getting worse and worse. And the unfortunate thing about that, I know you wanted to talk about this, I suspect you wanted to talk about it, but we didn’t get to it, is the whole issue of epigenetics and multi-generational effects, and that’s going to start to be seen based on crappy diets. So, that’s awful.

Dr. Kara Fitzgerald: Yeah, that’s right. Well, it’s an all hands on deck. However we want to pick the ball up and go with it. It’s a conversation that has room for all of us to be engaging in, in whatever way we’re called to. And I just appreciate your kind of putting your arms around phytochemicals and moving that forward. So, again, thank you so much. And I’m sure we’ll get to continue in one form or another this conversation. Actually before we go, and again, on your show notes, I just want to mention that we’ll have your website, which is packed with information, and that’s just, it’s your name, jedfahey.com, J-E-D-F-A-H-E-Y.com. And you’ve got a book coming out. Just tell me what the title is.

Dr. Jed Fahey: Well, I am unfortunately far from being finished with it. It is a work in progress, but there are too many other exciting things to do. And I haven’t made progress. Healthspan, not C-O-L-O-N, but punctuation colon. Healthspan: Squaring Off the Quality of Life Curve is a working title.

Dr. Kara Fitzgerald: Oh, I love it.

Dr. Jed Fahey: Well, we’ll see how it evolves. Maybe I’ll get you to help me co-write it. But anyway, thank you for your kind words. Yeah, we need to end this on a positive note. So, let me leave you with a saying, my new friend, Doug Evans, who wrote The Sprout Book, which is a really interesting book. It was just published a year or so ago. He ends every email message with, have the best day ever. So, Kara, have the best day ever, and to your listeners. Thanks so much for being with us.

Dr. Kara Fitzgerald: And right back at you. Thank you.

Dr. Jed Fahey: All right. Bye.

Dr. Kara Fitzgerald:  And that wraps up another amazing conversation with a great mind in functional medicine. I am so glad that you could join me. None of this would be possible, through the years, without our generous, wonderful sponsors, including Integrative Therapeutics, Metagenics, and Biotics. These are companies that I trust, and I use with my patients, every single day. Visit them at IntegativePro.com, BioticsResearch.com, and Metagenics.com. Please tell them that I sent you and thank them for making New Frontiers in Functional Medicine possible.

And one more thing? Leave a review and a thumbs-up on iTunes or Soundcloud or wherever you’re hearing my voice. These kinds of comments will promote New Frontiers in Functional Medicine getting the word on functional medicine out there to greater community. And for that, I thank you.

Dr. Fahey is a nutritional biochemist with extensive background in plant and human nutrition and phytochemistry. Dr. Fahey was an Assistant Professor at Johns Hopkins Medical School, where he directed the Cullman Chemoprotection Center, a leading center for the study and development of plant-based protective agents. He had faculty appointments in three departments at Johns Hopkins Schools of Medicine and Public Health where he conducted laboratory and clinical trials, taught graduate courses, and mentored students since 1993. He spent the first 15 years of his career in agricultural biotechnology research and industrial process development. Dr. Fahey “retired” in mid-2020 to focus his attention entirely on outreach and educational efforts which include podcasts, writing, and lecturing widely. He maintains adjunct appointments at JHU and elsewhere and may be available to consult for socially responsible food and supplement companies and foundations.

https://www.jedfahey.com

Complete list of Fahey commentary/studies

The Challenges of Designing and Implementing Clinical Trials With Broccoli Sprouts… and Turning Evidence Into Public Health Action (PDF)

Dr. Kara Fitzgerald FxMed Resources

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