Sep 19, 2009

Pomegranate Juice Prevents Early Puberty?

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Recent headlines have trumpeted an exciting study about how pomegranate juice may prove very useful at preventing and even treating breast cancer. In test tubes, it’s proven quite effective against breast cancer cells. It turns out that pomegranate juice functions as something we call an aromatase inhibitor. Aromatase is an enzyme that takes testosterone and turns it into estrogen; it’s been linked to causing breast cancer. (This is one of the reasons I hate Atrazine, one of the most widely used pesticide weed killers in American agriculture: Atrazine stimulates aromatase. And we spray the stuff on our food!?). Aromatase inhibitor medicines are among the most exciting developments in preventing and treating breast cancer. And pomegranate juice contains clinically significant amounts.

As a pediatrician, my mind races to possible quicker benefits of pomegranate juice for kids:
  • Preventing early puberty in girlsPuberty is starting earlier in girls. In 1993, the average age for breast development was just before the 11th birthday, now the average is while they are still 9. It’s no longer unusual to see a girl with breasts in a 2nd grade class. (Early puberty increases risk for breast cancer later, by the way). Aromatase inhibitor medicines have been used successfully to treat precocious puberty. Might pomegranate juice be a gentle way to help prevent it? Someone please do the study!
  • Preventing breast buds in teen boys. Today about 60 percent of boys develop breast buds during puberty. These breast buds come from an imbalance between estrogen and testosterone. Brief breast buds then can be normal, but today, for 25 percent they last for 2 years or more. Aromatase inhibitor medicines have been used with some success to reduce their size and decrease their tenderness. Might pomegranate juice be a gentle way to prevent this? Someone please do the study! (And maybe one on adult men, too).
  • Preventing short stature in boys and girls. Aromatase inhibitor medications have also have also been used to add modestly to adult height in children with short stature. Might pomegranate juice be a gentle way to help here as well?
(N.B. Most of today’s kids get too many sweet calories in their drinks, and I agree with the Academy of Pediatrics in recommending no more than 4 to 6 ounces a day of fruit juice before age 6, and no more than 8 to 12 ounces for older children.)

Pomegranates are one of 21 types of foods that I recommend in Feeding Baby Green to teach your child to love. Each of these diverse foods have been eaten by humans for thousands of years, and are packed with goodness we have yet to discover – and inhibiting aromatase is just the latest example.

I recently visited the King Tut exhibition at the de Young Museum in San Francisco and alerted my friends on Twitter when I learned that pomegranate seeds had been hidden in his tomb. Among the wealth of treasures there, this fruit is right at home.

Alan Greene, MD

Adams, L.S., Zhang, Y., Seeram, N.P., Heber, D., and Chen, S. “Pomegranate Ellagitannin-Derived Compounds Exhibit Antiproliferative  and Antiaromatase Activity in Breast Cancer Cells In vitro.” Cancer Prevention, Jan 2010, 3(1):108-113.
Aksglaede, L., Skakkebaek, N.E., and Juul, A. “Recent Decline in Age at Breast Development: The Copenhagen Puberty Study.” Pediatrics, May 2009, 123(5):e932-939.
American Academy of Pediatrics, Committee on Nutrition. "The Use and Misuse of Fruit Juice in Pediatrics." Pediatrics, May 2001, 107(5):1210-1213.
Cernich, J., Jacobsen, J.D., Moore, W.V., and Popovic, J. “Use of Aromatase Inhibitors in Children with Short Stature.” Pediatric Endorcinologic Review, Sep 2004, 2(1):2-7.
Feuillan, P., Merke, D., Leschek, E.W., and Cutler, G.B. “Use of Aromatase Inhibitors in Precocious Puberty.” Endocrine-Related Cancer, 1999, 6:303-306.
Riepe, F.G., Baus, I., Wiest, S., Sippell, W.G., and Partsch, C.J. “Treatment of Pubertal Gynecomastia with the Specific Aromatase Inhibitor Anastrozole.” Hormone Research in Paediatrics, 2004, 62:(3):113-118.
Shulman D.I., Francis, G.L., Palmert, M.R., and Eugster, E.A. , for the Lawson Wilkins Pediatric Endocrine Society Drug and Therapeutics Committee. “Use of Aromatase Inhibitors in Children and Adolescent with Disorders of Growth and Adolescent Development.” Pediatrics, Apr 2008, 121(4):e975-983.


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