Q. My husband and I just recently started receiving Vegetarian Times in the mail. I noticed with interest your response to the fibrocystic breast disease question in issue number 55. I began abstaining from all caffeine-containing substances several years ago and, consequently, have had no further problems with this disease, which was a real challenge to me previously. In addition, I take 600 units of vitamin E daily. I hope that you may add this fact in a future issue, as I feel caffeine is an easy substance to eliminate from the diet as long as women are knowledgeable about what foods and beverages do and do not contain these methylxanthines. - Anty Shaman, R.D., Nutritionist, Allegany County Health Dept., Cumberland, MD

A. Thank you for taking time to write to me. I am sure your experience will be of great benefit to many VT readers. Fibrocystic breast disease is a rapidly growing, insidious breast condition affecting more and more women in America. The Medical News estimates that up to 20% of American women are plagued by this disease. It is a benign lump condition which only rarely turns cancerous; nevertheless, in addition to causing anguish and anxiety in those who have it, it also causes much discomfort, pain and tenderness, especially in those of pre-menopausal age. The orthodox treatment for severe fibrocystic disease used to be subcutaneous mastectomy. In this procedure, all the breast tissue except for the skin and nipple is removed and replaced with a silicon implant. Needless to say, such radical surgery was not very successful aesthetically or medically and caused great emotional trauma to the patient.

It appears that the solution to this distressful condition has finally been found. Two specific studies have helped shed light on both causes and possible cure and prevention of fibrocystic disease. First, Dr. John Peter Minton, M.D., professor of surgery at Ohio State University and professor of oncology at the American Cancer Society, has found in his studies of 47 women during a 3-year period that chemical substances, methylxanthines, which are found in such common beverages as coffee, tea, cola, and chocolate, are responsible for the breast lumps and the resulting discomfort. When women in his study stopped using those beverages, 65% showed a complete disappearance of all breast nodules and the painful symptoms within two to six months. This was confirmed by physical examination, mammography and echogram. There are many chemicals under the grouping of methylxanthines in coffee, tea, cola, and chocolate. The most common and harmful are caffeine, theophylline, and theobromine. Dr. Minton warns that although most women do respond with complete disappearance of symptoms within a few months after total withdrawal of the xanthine-containing beverages, for some women it may take as long as two years of total and complete abstention before satisfactory clinical results are demonstrated. He also notes that xanthines are present in decaffeinated coffees as well as in many herb teas, specifically in Cha Chung tea, Morning Thunder, Plantation Mint, Apricot Tea and many more. A large number of prescription and nonprescription drugs also contain caffeine, including Excedrin, Anacin, NoDoz, Vivarin, Dexatrim and Midol.

Dr. Minton is currently studying other biochemical activities that may be involved causatively in fibrocystic disease, especially in those few cases that do not respond to the xanthine-free regimen. His suspects include many wines as well as some cheeses. If you have any questions regarding his current research, as well as his continuous experiences with xanthine-free therapy for breast lumps. I suggest you write to him directly: Dr. J.P. Minton, Dept. of Surgery, Ohio State University, 410 W. 10th Ave., Columbus, Ohio 43210.

The other study referred to earlier in this column involves vitamin E. A research group of doctors under the direction of Dr. Robert S. London, M.D., director of reproductive endocrinology at Baltimore Sinai Hospital and assistant professor of obstetrics and gynecology at the Johns Hopkins School of Medicine, conducted an extensive study with vitamin E for cystic breast disease. They gave study subjects 600 IU of vitamin E per day for 8 weeks and found that the vitamin relieved symptoms and caused regression of the disease in the majority of these women. Although no one knows at present the exact mechanics of how vitamin E works, Dr. London says that on the basis of his current findings, clinicians in general should prescribe vitamin E for their patients with cystic breast disease.

So, avoiding xanthine-containing beverages and drugs and taking 600 IU of vitamin E a day seems, as the correspondent, Amy Shuman, R.D., has found, to be a rather safe and effective way of dealing with this distressing condition - fibrocystic breast disease - which affects so many women.

Naturally, I would also advise adherence to optimum nutrition and a health-building lifestyle as advocated in this column, abstaining from smoking (nicotine has been shown to increase the intracellular cyclic nucleotide level and possibly contribute to the development of cysts), and optimize your health with vitamins and supplements as well as regular exercise.

Q. My family and I are recent "converts" to your Optimum Diet and are very thankful to have discovered this healthful way of living. We have a five-month-old baby, whom I am nursing, and a four-year-old child. My question has to do with milk. I know you recommend using raw cow or goat milk provided the milk is from healthy animals which are fed organic food. It is my understanding that in the state in which we live (Iowa) it is illegal to sell certified raw milk and, therefore, we are unable to obtain such milk from health food stores or certified dairies. There are a few local farmers who milk for their own use, but the cows are not fed organic food. One such farmer gives his cows shelled corn, soybean-oil meal, salt, bonemeal and a vitamin mix. Some of the farmers even pasteurize their milk for their own use and strongly recommend us to do so also, because of possible bacteria.

Available in health food stores are evaporated and powdered goat's milk and powdered non-instant cow's milk. Could either of these be a good substitute? Would you recommend that we give our children local farmers raw milk, pasteurized or unpasteurized, or would reconstituted powdered or evaporated cow's or goat's milk be preferable? - K. H., Wapell, IA

A. In the March, 1982 issue of Vegetarian Times, I had a very thorough discussion on the pros and cons of including milk in my Optimum Diet as a supplement to the three basic food groups:

1. grains, seeds, nuts, and legumes;
   
2. vegetables; and
3. fruits.

By proper selection of foods from these three food groups, you should be able to develop a diet that will satisfy all nutritional needs for your family, including your two children, without the inclusion of dairy products. However, if you wish to incorporate some milk and milk products into your diet, you must first be sure that your "nutritional roots" justify such an addition (i.e., you descend from ancestry where milk was always a part of the traditional diet); and that the milk comes from healthy cows which are fed organic poison-free foods, and is not pasteurized, homogenized, or denatured in any way. Obviously, most Americans cannot get such high-quality milk today. Thus, it would be better to exclude milk and dairy products from the diet altogether.

To answer your direct question: yes, provided your nutritional roots are in the traditionally milk-consuming cultural base, using a small amount of evaporated or dried goat's milk or cow's milk (provided it meets the criteria mentioned above), especially in your young children's diet, would not constitute any dietary disadvantages and, perhaps, would even give you some advantages.