Intro 0:03
Welcome to Maximal Being, a podcast devoted to ditching fad diets and using real science to get you healthy and feeling great. I’m Doc Mok, a GI and functional medicine doctor who harnesses the power of gut health to get you achieving your goals. And I'm Jacky P, a well informed layman who challenges the experts and ask the questions that you want. Don't forget to hit the subscribe button or leave a comment, and now onto the show.
Doc Mok 0:32
What's going on Maximal Beings, Doc Mok here with maximalbeing.com. Don't forget to hit the subscribe button. Leave us a comment, it does help us to get the word out. If you have any questions, you can email us at [email protected]. Enjoy the episode.
Jacky Homme 0:48
Hello, hello, hello, Maximal Beings. It is I, Jacky P, your favorite layman. The layman with the plan. You must understand. Yeah a little spoken word for you today. I felt it. Sorry. It's It's good to see a Doc Mock. It's been a while.
Doc Mok 1:06
I miss you. A lot has changed over here. I mean, we started solid foods this week. And yeah, and you know how I always say like, if it's carrot, eat a carrot. Well, my son took it like an extra step. And he said, if it's a carrot, wear a carrot. So the part of solid foods has been wearing the food that he eats. And I would imagine that's probably good for your microbiome as well, for the listeners out there. Although I would specifically prefer all of you to put things in your GI tract, rather than on your dermatologic system.
Dr. Mokenge Malafa 1:41
Yes.
Doc Mok 1:43
For those who haven't listened before, I'm Doc Mok. I'm a therapeutic endoscopist. That's a GI doctor that specializes in fancy procedures related to cancer. And I'm also boarded in functional medicine. And I'm here with Jacky P, who, like he said, is the layman with the plan.
Jacky Homme 1:59
I'm the layman with the plan. I'm here just to make sure that Doc Mok and Dr. Malafa don't get into this crazy high medical genius jargon, right, to make sure the folks at home who don't have medical degrees can follow along and learn and listen and walk away with something you can share at the next cocktail party perhaps, I don't know. But before we get into it. Dr. Malafa, how are you doing today?
Dr. Mokenge Malafa 2:30
I am doing fantastic. And you are lifting me up just here in this introduction. So thank you, for for the invitation.
Jacky Homme 2:41
Well, we're very happy to have you. We're, you know, we're, I'm excited because, you know, there's a lot of nutrients out there that get a lot of attention. You know, you know, I love the OMG Omega three, right, that's a long term superhero of the show. But as we've learned in all the superhero movies, there's so many superhero nutrients out there, right, that we can talk about, and learn about and see how it impacts our health. But before we get into that, ooh, cliffhanger. I want to learn a little bit about you, Dr. Malafa, how did you become the Doctor Malafa we are sitting here and speaking with today. But give us a little bit at origin story.
Dr. Mokenge Malafa 3:25
All right. Well, it's a long story. And I mean a long story because I was actually born in Lagos, Nigeria. My parents are both Cameroonians. And so Cameroon had connection with France, because it used to colonize Cameroon. And so I left Africa as a teenager, actually, I was 15 and went to join my brother in France to get a higher education. I came from very humble beginnings because my parents couldn't afford going to college and university. So usually, we would go abroad to do this. So when we went to France, I wanted to be a doctor. But I came from the English speaking part. So I had to learn French and then learn how to get into the system. And that's where I met a great friend in in in Paris, who said, why don't you go to the United States? And, and I said, well, I don't know, I don't think, and this universities will look like a poor guy like me, and then help and he goes, well, I'm from the south side of Chicago. And I went on to, you know, and he was actually sent to Paris by by, at the time for computers, you know, to do sort of advanced computers with them. And, and I thought, wow, you know, there's rarely any. He said, trust me, you know, I came from humble beginnings. But I went, I played basketball for one or two University of Wisconsin systems. And it worked. So that's how I ended up in Wisconsin. So I went, I went to undergrad in Wisconsin, and I did my medical school in Madison. And then after that, I decided to go into surgery. So I am a surgeon, and also did training in Ohio and went out to California to specialize in cancer surgery. And I also specialized in doing research. That's where kind of the bog of looking at the role of nutrition and in affecting cancer I came in. And I've started I've worked in, I've been working on research looking at how to prevent cancer, sometimes using micronutrients. So that's, that's me. I'm now at Moffitt Cancer Center. And I've been here for over 20 years. And I'm Dr. Mok's colleague, so we work together and and take care of a lot of patients, especially patients with pancreatic cancer. Dr. Mok's started a awesome clinic called high risk clinic for patients that can develop pancreatic cancer, especially patients that have cysts in their pancreas. And so using that clinic model, were able to kind of have a lot of patients who are at high risk and so that kind of puts us at a at an awesome position to maybe apply some of our ideas about using health, nutrition and so on to hopefully modify the risk and prevent some of these patients from developing pancreatic cancer.
Jacky Homme 6:53
Okay, wow. Incredible story. Incredible story.
Doc Mok 6:58
You don't know this, but if I needed my pancreas to be removed, which I don't, but and I hope that I don't. I would let Dr. Malafa remove it. He is just such a gifted surgeon and pleasant colleague and just such a prolific researcher, he is being very humble but I mean the man, all of you should PubMed him right now and look up this man's publication history. He is he is a researcher to the max, he's a Maximal Being researcher.
Dr. Mokenge Malafa 7:31
You are very kind doctor Dr. Mok.
Jacky Homme 7:37
Wonderful
Dr. Mokenge Malafa 7:38
I didn't get him free lunch to say that.
Jacky Homme 7:43
He's like great. He owes you a couple beers later now. That'be great
Doc Mok 7:48
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Jacky Homme 10:21
Dr. Malafa, we appreciate you coming across from all the you know, from France to Wisconsin, down in Florida, we appreciate you coming here, sharing your story. And let's talk about it. You know, so I would like to hear a little bit, you know, of course, we always talk about nutrition and how it is the foundation of a good, sound, just healthy lifestyle. But what was it? Was there something in specific specifically, was there an aha moment or interaction or perhaps a patient that clued you in where you said, oh, you know, what, there might be something behind this, like, was there anything in particular, that I guess you could say was a catalyst for you to start going down this track?
Dr. Mokenge Malafa 11:16
Yes, it's actually the catalyst was that the research, I actually trained at City of Hope, an awesome, awesome institution in Southern California for hopefully, some of our listeners know about this. And City of Hope has really been in cutting edge in terms of not only caring for cancer, but actually doing research in cancer. For example, one of the things that was discovered there was how to put insulin together. So you know, so some of the researchers that that, so it's a really outstanding institution. So when I went there, I spent three years there, two of those years, I was in research, I was in the lab. And to be honest, I was really inspired while there, because as you know, I kind of got that California vibe of anything is possible kind of attitude. You had guys that the afternoon will go play soccer together. And they were just imagining all kinds of stuff, you know. So as we were talking, one of the areas that was so fascinating to me was, we were talking about this area called gene transcription, that was the area of research I was working on. And so we were talking about how cancer cells were basically regulated through signals that are sent to their genes. And it turned out that one of the areas that was so fascinating to me was that the fat soluble vitamins, vitamin D, vitamin A, and so on, became so they really were popular in those days. So they were people who were doing research with vitamin D, and preventing colorectal cancer. And perhaps the aha moment was in vitamin A, and looking at head and neck cancers, and so on. So retinoic acid, and so on, and one of and so with that work, you know, I was really like, wow, a simple nutrition could have these sorts of effects. And unlike patients that would have things like some skin lesions, or leukoplakia, and so on, people were investigating using retinoic acids and things like that to kind of modulate that. So and the mechanism, so I was studying some of the mechanism. And the mechanisms appear to be, you know, mechanisms that had to do with these basically, nutrients acting as transcriptional regulators. So it turned out that the transcription factors like vitamin D transcription factors, as well as vitamin A, ended up being important transcription factors in cancer. So I was like, wow, I was just I was smitten. I was like, wow, so maybe, and so I did some work in yeast and looking at how yeast regulate transcription. And so based on that work, I, when I started to think of what to do in the clinic, I thought, wow, you know, is there an area that's yet to be discovered? And I really what I was trying to do was find a new transcription factor for a novel compound, and I realized that vitamin E even though we knew a lot about vitamin E, but nobody had cloned the transcription factor. So that's what got me into that rabbit hole, I started to look at vitamin E. And I was wondering that unlike vitamin D, and A that had some side effects and so on, I was fascinated that vitamin E did not appear to have a lot of side effects. And people didn't know yet about how it actually worked. And there was a lot of theories behind what they thought it worked. So so that's that was my aha moment. And I started to work in that area.
Jacky Homme 15:28
Okay, okay, well, one, I love a good aha moment. It's I think that's where all the, all the greatest things of the world have come in. But Dr. Malafa, I feel like we've been having a great conversation, but I'm gonna have to pull a layman flag on you. I apologize. I've not put one out in a while, it actually kind of hurts. But you know.
Dr. Mokenge Malafa 15:49
It's usually on me.
Jacky Homme 15:51
Yeah. It's usually on Doc Mok. But for the folks out there who didn't go to school, in in medical school, you said transcription factor a multitude of times
Dr. Mokenge Malafa 16:03
Yes.
Jacky Homme 16:04
Catch up. What is a transcription factor? And why is it important? And why? Why was this like the key for vitamin E?
Dr. Mokenge Malafa 16:11
Yes, so the, it turns out all of, so we are basically made of proteins or genes, well we all know everybody knows were made of genes. So and our genes are turned, have to become proteins. So genes are DNA. So from DNA, we have to, they have to be transcribed. So they have to become RNA, and from RNA, they become protein. So what transcription factors are, those are the switches or the proteins that help to direct the probe the gene to make specific transcription, so RNA. And so what they are, they are proteins in the body that are kind of like key nodes or switches, that switch on genes, make them turn on, turn off, the side. So if you will, they're kind of like, the switches in your house, whether they turn the lights on or off. And so a lot of times we've been looking and to be honest with you even till today, I think a lot of us what we mean, in a lot of diseases, we all have been, the dream is that, wow, if you could just find that key switch, you can understand how to turn on and off, maybe you can learn how to turn on and off cancer cells too and maybe you could learn how to turn on and off any, you know, turn on the proteins you like and turn off the ones you don't like. So that's the field of transcriptional regulation and transcription factors.
Jacky Homme 17:54
Wonderful. Thank you for explaining that. And I think that was a great example, switches on your light and like I get it. That makes a lot of sense. All right. And then I also have a follow up question because you said side effects for vitamin A, and other vitamins. And me, I'm over here thinking, hey, there are vitamins or vitamins or nutrients, right, you can't have too much of a good thing. Right. So I know, I know, vitamin E is the star of the show. And you know, we're going to talk about vitamin E. But I think I would I would like to know, I just ordered, I just re upped on my multivitamins over the weekend. So when you talk about the side effects, and the other vitamins are these in applications when you're trying to treat like an acute illness, or is this just like, hey, someone is taking way too much vitamin A in their morning routine,
Dr. Mokenge Malafa 18:45
You got it Jacky P. The age when they take in too much. Usually, so vitamins by definition means we need them for life, you know, this is something we have to take from nutrient nutrients. So they're essential, we need to take them. But the key is we need to take them appropriately in the appropriate amount. The problem is if you take too much it can go the other way. So for example vitamin D is important and it is important in regulating calcium in our body. Now if you take too much vitamin D, you can get too much calcium or something like that. And so you could get side effects because of that. So that's an example of what we mean by side effects and so on.
Doc Mok 19:36
And a key difference for the listeners out there is that our vitamins are kind of in two main parties so water soluble, meaning that if you take that vitamin, it will dissolve in an aqueous solution something or something water based. Versus there are fat soluble vitamins like A D as in dog. A as in apple, D as in dog, E as in elephant, and K as in kite. All those four are fat soluble, so they'll break down in fat tissue. But as a result in you, the human, that is where it is stored in excess versus a water soluble vitamin. If you eat anything extra, most of the time, you will just urine it, urinate it out through your kidneys, and through your bladder and your urinary system. So if you have too much of the fat soluble vitamins, they'll kind of build up in your fat tissue, and not really go anywhere, right unless you're releasing that fat tissue. And so that is why A D, E, and K, you can actually have some bad side effects from taking too much. Back to you Jacky P.
Jacky Homme 20:39
Kiss your brain, it's so smart Doc Mok. I'd say I love hanging out with some smart folk. I learned my brain just soaking it up.
Doc Mok 20:49
Well, that's why I hang out with you, Jacky.
Jacky Homme 20:53
Oh come on. Stop it, stop it. So one, thank you, Doc Mok for clarifying that up. I think that's very helpful for a lot of folks.
Doc Mok 21:01
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Jacky Homme 22:51
So let's let's talk about vitamin E. So, you know, vitamin E, like this is, is this our guy? Is this is this, are we going to get to where you're gonna be like, What are your thoughts? Like? What? What is it about vitamin E that is giving you the, I guess the hope or I guess the you know, the, I guess the what's what's the word, the hypothesis that this is something that we should be unraveling?
Dr. Mokenge Malafa 23:21
Yeah. Well, the the the interesting thing, the reason vitamin E is so exciting is that it is kind of a paradox. Okay. So first of all, we, you know, it was thought that because vitamin E was so essential, and basically, it's a free radical, scavenger, or it helps us. So what happens is, all of our tissues, as Dr. Mok mentioned earlier, so all of our cells have membranes and the membranes are made up of fats or lipids. And those lipids when they are reacting and moving and doing all their job, they generate free radicals, which are like oxygen, things that can be very destructive to the cells. So the reason we need vitamin E in nature, or normally in as a vitamin, is that when we consume that, that comes and clears all those bad, free radicals. That's his job. And so it stabilizes membranes. So once scientists discovered this, people were very excited because they thought, wow, if that's the case, the we all know that free radicals cause all kinds of problems. They cause aging, that's what makes us get old. That's what that's what causes heart problems. That's what causes you know, outside, you know, the brain issues. That's what I am, by the way, and maybe that's what causes cancer to drives cancer. So clearly In, oh my god, this thing could be the magic pill. And it could help with a lot of diseases. And that's why people have been investigating vitamin E, to use it for health to try to protect against a lot of different diseases. Well, it turned out that as far as the story for cancer was concerned, it was kind of mixed story. So the thinking was that, yes, if you took vitamin E, as you said earlier, you know, Jacky P, is, is that if you, you know, it's good to get a balance of vitamins, no question about that. And I think if you're taking the normal amount of vitamins, it really puts you in an even keel and is good for your general health. No question. But now we're talking about people saying, well, if this one does that, if it really clears all my free radicals, maybe if I took a lot more, I may feel I may, you know, even it might even work better. Well, it turned out that maybe not because there were some trials, so there were trials that were done. And they found a famous trial is called the Alpha-Tocopherol, Beta-Carotene Cancer Prevention that looked at Vitamin E for protecting against lung cancer in smokers. Okay. And that study involves thousands of patients, and, and they tested them where they gave Alpha-Tocopherol, which is the vitamin E, in combi-, some good combination with beta carotene, and so on so forth. The disappointing thing was that, surprisingly, unfortunately, it didn't show the protection that we expected. In fact, there might have been more lung cancer in some that took the Alpha-Tocopherol, which was kind of not what you would have expected. Well, one of the things that happened with that trial is that people started to look at other cancers that it may have protected. And there were several, many papers that come out of that trial, initially saying, oh, well, it may not have worked for lung cancer. But look, it was protected against prostate cancer. So that led to a huge prostate cancer trial, but also looked at, will vitamin E protect against prostate cancer. And once again, when the results came out, people were we don't know. So you know, there was a lot of mixed signals. So here was this vitamin that people thought, oh, my God should be work or should be a free radical and free radical is the, but so why, okay, so what's changed? What is the paradox? Well, it turned out that in nature, there are two kinds of vitamin E, naturally, that occurs in nature. And that's the discovery, the recent discovery that has made the field more exciting. So there is the Tocopherol, Alpha-Tocopherol, which is the when we use that term, vitamin E, that's what most people are referring to. So we're referring to Alpha-Tocopherol. But there is another family, that's called Tocotrienols. Okay? They are very similar. The difference though, is that the Tocotrienols have a different chemical structure, put it that way, okay. And they come from different kinds of foods compared to the Tocopherols. In fact, the Tocotrienols usually come from whole grain foods, weeds, in things like blood knots, and so on. So, some, so about 20 30 years ago, somebody found out that when you test those two compounds, say against cancer cells, they behave very differently. This is what got my team very excited, because then all of a sudden, it looked like the Alpha-Tocopherol that we have been studying for years turned out to be not the type of vitamin E that has activity, at least against cancer cells, it may be I'm specifically focused now on cancer, since that's my area. So that's where we did research. So a lot of our work tried to and not just us, but a lot of people started to look into the field and realize that, oh my god, maybe we've been started studying the wrong molecule number one. And number two, maybe the way we thought that this molecule is working against cancer is not the way it's working. Because both molecules, both types of families, they all do free radicals. In fact, they all do it well together. They all do the same, but and that part of the chemical molecule that does free radicals is unchanged between them. But there's another part of the the molecule that's changed and that's the path that we think makes one, very active against cancer and the other one not as active. So so now that opens a very of as a researcher that whenever you have a paradox for us, that means excitement. That means discovery. That means trying to figure out what's going on. So, and a good exercise to do, I used to tell folks is if you did a search, you know, you're looking at, if you just put vitamin E and cancer, of course, there's hundreds or thousands of papers on PubMed. If you put Alpha-Tocopherol and cancer, you will have tens of thousands of papers. If you put Tocotrienol and cancer, you will see that there's only a few hundred. Because it's still a young field. You know, it's a field that we're showing that, that that Vitamin E has different properties. And so far, we have we have done phase one trials in humans, and there's several new clinical trials coming up. And we're doing a large phase two trial funded by the NCI looking at that active delta Tocotrienol and its effect in preventing cancer. And so that's the difference. That is the excitement about vitamin E is that now we think that oh, vitamin E that we thought was just one compound may not be one compound, and we thought only had one property, you may have more much more than one property. And in terms of and we're actually finding out that in other areas of health, that Tocotrienols are very, very excited. So there's a lot of investigation going on, on it's role in terms of modulating cholesterol or helping heart disease and helping other diseases. And in cancer, I'm convinced that that family of Tocotrienols is going to end up being very, very useful, and we're going to be able to demonstrate that it will have very strong activity against cancer.
Doc Mok 32:06
That was an awesome summary. Dr. Malafa. I really appreciate that. For the listeners out there. I encourage all of you to go back to our episode not too long ago on C 60, where we talk a little bit about free radicals. And then I don't know about a year ago now Jacky, we talked about glutathione. And so those are big players in this whole reactive oxygen species free radical scavenging benefit that Dr. Malafa is talking about.
The content included is not intended to be used as medical advice and viewers should consult their physician or health care provider should they have additional questions. The viewers should not rely on information contained in these presentation for immediate or urgent medical needs. Additionally, if you think you have a medical emergency, call your physician or go to the emergency department or call 911 immediately. Never disregard professional medical advice or rely on seeking medical care or delay medical care due to information contained in this presentation.
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