On January 23, 1998 researchers at the Harvard Medical School released a major
study providing conclusive evidence that IGF-1 is a potent risk factor for
prostate cancer. Should you be concerned? Yes, you certainly should,
particularly if you drink milk produced in the United States.
IGF-1 or insulin-like growth factor 1 is an important hormone which is
produced in the liver and body tissues. It is a polypeptide and consists of
70 amino acids linked together. All mammals produce IGF-1 molecules very
similar in structure and human and bovine IGF-1 are completely identical.
IGF-1 acquired its name because it has insulin-like activity in fat (adipose)
tissue and has a structure which is very similar to that of proinsulin. The
body's production of IGF-1 is regulated by the human growth hormone and peaks
at puberty. IGF-1 production declines with age and is only about half the
adult value at the age of 70 years. IGF-1 is a very powerful hormone which
has profound effects even though its concentration in the blood serum is only
about 200 ng/mL or 0.2 millionth of a gram per milliliter(1-4).
IGF-1 and cancer
IGF-1 is known to stimulate the growth of both normal and cancerous
cells(2,5). In 1990 researchers at Stanford University reported that IGF-1
promotes the growth of prostate cells(2). This was followed by the discovery
that IGF-1 accelerates the growth of breast cancer cells(6-8). In 1995
researchers at the National Institutes of Health reported that IGF-1 plays a
central role in the progression of many childhood cancers and in the growth of
tumours in breast cancer, small cell lung cancer, melanoma, and cancers of the
pancreas and prostate(9). In September 1997 an international team of
researchers reported the first epidemiological evidence that high IGF-1
concentrations are closely linked to an increased risk of prostate cancer(10).
Other researchers provided evidence of IGF-1's link to breast and colon
cancers(10,11).
The January 1998 report by the Harvard researchers confirmed the link between
IGF-1 levels in the blood and the risk of prostate cancer. The effects of
IGF-1 concentrations on prostate cancer risk were found to be astoundingly
large - much higher than for any other known risk factor. Men having an IGF-1
level between approximately 300 and 500 ng/mL were found to have more than
four times the risk of developing prostate cancer than did men with a level
between 100 and 185 ng/mL. The detrimental effect of high IGF-1 levels was
particularly pronounced in men over 60 years of age. In this age group men
with the highest levels of IGF-1 were eight times more likely to develop
prostate cancer than men with low levels. The elevated IGF-1 levels were
found to be present several years before an actual diagnosis of prostate
cancer was made(12).
The evidence of a strong link between cancer risk and a high level of IGF-1 is
now indisputable. The question is why do some people have high levels while
others do not? Is it all genetically ordained or could it be that diet or
some other outside factor influences IGF-1 levels? Dr. Samuel Epstein of the
University of Illinois is one scientist who strongly believes so. His 1996
article in the International Journal of Health Sciences clearly warned
of the danger of high levels of IGF-1 contained in milk from cows injected
with synthetic bovine growth hormone (rBGH). He postulated that IGF-1 in
rBGH-milk could be a potential risk factor for breast and gastrointestinal
cancers(13).
The milk connection
Bovine growth hormone was first synthesized in the early 1980s using genetic
engineering techniques (recombinant DNA biotechnology). Small scale industry-
sponsored trials showed that it was effective in increasing milk yields by an
average of 14 per cent if injected into cows every two weeks. In 1985 the
Food and Drug Administration (FDA) in the United States approved the sale of
milk from cows treated with rBGH (also known as BST) in large scale veterinary
trials and in 1993 approved commercial sale of milk from rBGH-injected
cows(13-16). At the same time the FDA prohibited the special labelling of the
milk so as to make it impossible for the consumer to decide whether or not to
purchase it(13).
Concerns about the safety of milk from BST-treated cows were raised as early
as 1988 by scientists in both England and the United States(14,15,17-22). One
of the main concerns is the high levels of IGF-1 found in milk from treated
cows; estimates vary from twice as high to 10 times higher than in normal
cow's milk(13,14,23). There is also concern that the IGF-1 found in treated
milk is much more potent than that found in regular milk because it seems to
be bound less firmly to its accompanying proteins(13). The concerns were
vigorously attacked by consultants paid by Monsanto, the major manufacturer of
rBGH. In an article published in the Journal of the American Medical
Association in August 1990 the consultants claimed that BST-milk was
entirely safe for human consumption(16,24). They pointed out that BST-milk
contains no more IGF-1 than does human breast milk - a somewhat curious
argument as very few grown-ups continue to drink mother's milk throughout
their adult life. They also claimed that IGF-1 would be completely broken
down by digestive enzymes and therefore would have no biological activity in
humans(16). Other researchers disagree with this claim and have warned that
IGF-1 may not be totally digested and that some of it could indeed make its
way into the colon and cross the intestinal wall into the bloodstream. This
is of special concern in the case of very young infants and people who lack
digestive enzymes or suffer from protein-related allergies(13,14,20,22,25).
Researchers at the FDA reported in 1990 that IGF-1 is not destroyed by
pasteurization and that pasteurization actually increases its concentration in
BST-milk. They also confirmed that undigested protein could indeed cross the
intestinal wall in humans and cited tests which showed that oral ingestion of
IGF-1 produced a significant increase in the growth of a group of male rats -
a finding dismissed earlier by the Monsanto scientists(25). The most
important aspect of these experiments is that they show that IGF-1 can indeed
enter the blood stream from the intestines - at least in rats.
Unfortunately, essentially all the scientific data used by the FDA in the
approval process was provided by the manufacturers of rBGH and much of it has
since been questioned by independent scientists. The effect of IGF-1 in rBGH-
milk on human health has never actually been tested and in March 1991
researchers at the National Institutes of Health admitted that it was not
known whether IGF-1 in milk from treated cows could have a local effect on the
esophagus, stomach or intestines(26,27).
Whether IGF-1 in milk is digested and broken down into its constituent amino
acids or whether it enters the intestine intact is a crucial factor. No human
studies have been done on this, but recent research has shown that a very
similar hormone, Epidermal Growth Factor, is protected against digestion when
ingested in the presence of casein, a main component of milk(13,23,28). Thus
there is a distinct possibility that IGF-1 in milk could also avoid digestion
and make its way into the intestine where it could promote colon
cancer(13,22). It is also conceivable that it could cross the intestinal wall
in sufficient amounts to increase the blood level of IGF-1 significantly and
thereby increase the risk of breast and prostate cancers(13,14).
The bottom line
Despite assurances from the FDA and industry-paid consultants there are now
just too many serious questions surrounding the use of milk from cows treated
with synthetic growth hormone to allow its continued sale. Bovine growth
hormone is banned in Australia, New Zealand and Japan. The European Union has
maintained its moratorium on the use of rBGH and milk products from BST-
treated cows are not sold in countries within the Union. Canada has also so
far resisted pressure from the United States and the biotechnology lobby to
approve the use of rBGH commercially. In light of the serious concerns about
the safety of human consumption of milk from BST-treated cows consumers must
maintain their vigilance to ensure that European and Canadian governments
continue to resist the pressure to approve rBGH and that the FDA in the United
States moves immediately to ban rBGH-milk or at least allow its labelling so
that consumers can protect themselves against the very real cancer risks posed
by IGF-1.
References
- Wilson, Jean D. and Foster, Daniel W., eds. Williams Textbook of
Endocrinology, 8th edition, London, W.B. Saunders Company, 1992, pp. 1096-1106
- Cohen, Pinchas, et al. Insulin-like growth factors (IGFs), IGF receptors,
and IGF-binding proteins in primary cultures of prostate epithelial cells.
Journal of Clinical Endocrinology and Metabolism, Vol. 73, No. 2, 1991, pp.
401-07
- Rudman, Daniel, et al. Effects of human growth hormone in men over 60
years old. New England Journal of Medicine, Vol. 323, July 5, 1990, pp. 1-6
- LeRoith, Derek, moderator. Insulin-like growth factors in health and
disease. Annals of Internal Medicine, Vol. 116, May 15, 1992, pp. 854-62
- Rosenfeld, R.G., et al. Insulin-like growth factor binding proteins in
neoplasia (meeting abstract). Hormones and Growth Factors in Development and
Neoplasia, Fogarty International Conference, June 26-28, 1995, Bethesda, MD,
1995, p. 24
- Lippman, Marc E. The development of biological therapies for breast
cancer. Science, Vol. 259, January 29, 1993, pp. 631-32
- Papa, Vincenzo, et al. Insulin-like growth factor-I receptors are
overexpressed and predict a low risk in human breast cancer. Cancer Research,
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- Stoll, B.A. Breast cancer: further metabolic-endocrine risk markers?
British Journal of Cancer, Vol. 76, No. 12, 1997, pp. 1652-54
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receptor in cancer. Annals New York Academy of Sciences, Vol. 766, September
7, 1995, pp. 402-08
- Mantzoros, C.S., et al. Insulin-like growth factor 1 in relation to
prostate cancer and benign prostatic hyperplasia. British Journal of Cancer,
Vol. 76, No. 9, 1997, pp. 1115-18
- Cascinu, S., et al. Inhibition of tumor cell kinetics and serum insulin
growth factor I levels by octreotide in colorectal cancer patients.
Gastroenterology, Vol. 113, September 1997, pp. 767-72
- Chan, June M., et al. Plasma insulin-like growth factor I and prostate
cancer risk: a prospective study. Science, Vol. 279, January 23, 1998, pp.
563-66
- Epstein, Samuel S. Unlabeled milk from cows treated with biosynthetic
growth hormones: a case of regulatory abdication. International Journal of
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73-84
- Epstein, Samuel S. Questions and answers on synthetic bovine growth
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573-82
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supplementation of dairy cows - Is the milk safe? Journal of the American
Medical Association, Vol. 264, August 22/29, 1990, pp. 1003-05
- Brunner, Eric. Safety of bovine somatotropin. The Lancet, September 10,
1988, p. 629 (letter to the editor)
- Kronfeld, D.S., et al. Bovine somatotropin. Journal of the American
Medical Association, Vol. 265, March 20, 1991, pp. 1389-91 (letters to the
editor)
- Rubin, Andrew L. and Goodman, Mark. Milk safety. Science, Vol. 264, May
13, 1993, pp. 889-90 (letters to the editor)
- Challacombe, D.N., et al. Safety of milk from cows treated with bovine
somatotrophin. The Lancet, Vol. 344, September 17, 1994, pp. 815-17 (letters
to the editor)
- Coghlan, Andy. Milk hormone data bottled up for years. New Scientist,
October 22, 1994, p. 4
- Coghlan, Andy. Arguing till the cows come home. New Scientist, October
29, 1994, pp. 14-15
- Mepham, T.B., et al. Safety of milk from cows treated with bovine
somatotrophin. The Lancet, Vol. 344, July 16, 1994, pp. 197-98 (letter to the
editor)
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- Mepham, T.B. Bovine somatotrophin and public health. British Medical
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------End of References------
This article was first published in April 1998.
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