The Ketogenic Diet and cancer: Keto Diet

                 Chris Woollams with Keto Diet champion, Professor Thomas Seyfried of Boston College

The Ketogenic Diet, or Keto Diet, is a high fat (90% of calories), low carbohydrate (2% of calorories), lowish protein (8% of calories) diet, which was primarily used to treat epilepsy in children because, with little carbohydrate in the blood stream, the liver converts fat into ketone bodies as an alternative energy source, one that significantly alters brain metabolism, resulting in fewer seizures.

Several studies show, not surprisingly, that this diet makes the body more efficient at burning fat, others show it can cause large reductions in blood sugar and insulin levels, and others have shown it can benefit brain chemistry in other ways. Hence it has been studied for its ability to help people lose weight, to control diabetes, and even to reverse the early stages of Alzheimer’s. 

Preliminary research also shows a Ketogenic Diet may stop cancer progression, inhibit metastases and kill off cancer cells. But, research to date is restricted mainly to a couple of animal studies. In human cancer patients across all cancers, results are mixed with a few benefitting but the majority not, and according to Professor Thomas Seyfried of Boston College, one of the main champions of the ketogenic diet with cancer, there are 'still some flaws to be ironed out'. Indeed, you also need to choose your fats wisely, because with cancer there is plenty of hard evidence that saturated fat can increase metastases and spread cancer. 

In this thorough review we aim to look at the Truth about the Ketogenic Diet and its potential benefits and its potential flaws in treating cancer. 

Starving cancer cells with a Ketogenic Diet (Keto diet) 

i) First a simple explanation:  

All cells burn glucose. However, while healthy cells are flexible and can switch to burning fuels like fat when the glucose is in short supply, cancer cells are inflexible and derive their energy from a fermentation process which NEEDS glucose as an essential fuel source. Research has shown that they have 14 times the insulin receptors to gooble up available glucose; and research has shown they rob healthy cells of their glucose and even increase blood sugar levels from stores such is their avarice.  

However, drastically cut all the sugar and carbohydrates and the liver reacts. A high fat intake, with low to zero carbohydrates, will cause the liver to produce 'KETONE BODIES' and while these can be used by healthy cells as fuel in a process called KETOSIS, they cannot be used by cancer cells. Ketone bodies are also produced when animals are in the fasting state, again because glucose levels in the blood stream are low.

ii) Are all cancers the same?

Several cancers seem particularly ’responsive’ to glucose, for example, brain tumours and colorectal cancers. 

      1. With brain cells, high plasma glucose has been linked to an increased risk of dementia, and a Ketogenic Diet has been proven to reduce the incidence of fits in Epilepsy in children. Recent research has shown this to be true for adults. A product, high in fat, low in carbs and lowish in protein, called KetoCal has been used in research into Epilepsy. In research, healthy brain cells readily adapt to ketosis.

      2. Johns Hopkins conducted research into colorectal cancer between 2004 and 2009 and showed that restricting sugar in colorectal cancer increased survival. adapt to ketosis However this may be a paticular property of colorectal cancer cells - researchers from Copenhagen have shown that CRC cells have a specific enzyme that attaches itself to sugar molecules and healthy cells don't have this. 

     3. With other cancers the results tend to be more mixed. For example with prostate cancer we have hardly seen anyone even respond to a Ketogenic Diet. This may be because prostate cancer, like breast cancer, thrives on a high fat diet and is more driven by hormones than sugar levels.

iii) Potential Flaws in the Ketogenic Diet?  

   a) Not surprisingly, much of the work on the Ketogenic Diet and cancer features people with brain tumours 

For example, GBM, glioblastoma brain cancer. And here we come to the first glitch. Glutamine, an amino acid, broken down inside cancer cells to glutamate, can be another energy source for cancer cells.

And, as I sit here writing this, glutamine is in all my muscle tissue; 25% is in my brain. To believe you can limit a cancer cell's access to glutamate by cutting animal protein to just 8% of calories seems ludicrous. I need glutamine. The cells next to the cells with cancer may well contain glutamine/glutamate.

One UK GBM patient, Pablo Kelley, is 4 years on from diagnosis, with no evidence of any brain cancer. He used a Keto Diet. So far so good. But he has an important mutation, IHD-1 - he cannot use glutamate as an alternative fuel. Only glucose.

   b) Many people are claiming, but not actually employing, a strict Keto Diet.

Another GBM conqueror is Andrew Scarborough, who has done excellent work helping others with GBM. However, his website home page was headed "Eat meat, drink water" and further down the page it said "Lamb is your Friend". This is a nil carbohydrate, high glutamine Atkins Diet. And St Thomas' Hospital London has shown that the Atkins diet can work with GBM too. The question is 'For how long?' 

Maybe other fuel sources are not so important? Or maybe not all cancers are the same? There's work to be done yet!

   c) How does the Keto diet help with hormonally driven cancers?

Take cancers like breast or prostate cancer. They may be more responsive to cutting hormones than to cutting glucose. No one is saying cutting glucose to restrict cancer growth is not a good idea, but other factors are important too. How might a woman with breast cancer or a man with prostate cancer deal with their aggressive oestradiol? Some people turn to a good consumption of phytoestrogens - greens and beans; pulses like lentils and red kidney beans. This can work. These are not allowed on Seyfried's Keto protocol.

  d) How does the Keto Diet boost the immune system?

Cancer is a failure of the immune system. How might a Keto Diet help? People who consume the highest levels of soluble fibre have the best immune systems. Soluble fibre? Oats, psyllium, vegetables, nuts and seeds, pulses. No place for those on a Keto Diet.

  e) "Is the Ketogenic Diet really applicable to cancers other than brain and colorectal?" 

In conversations between CANCERactive’s Chris Woollams and Professor Seyfried, Seyfried sees no reason why not but freely admits there is work to do and the biochemistry is complex. 

   f) Will any fat help?

A further 'glitch' is that various 'health experts' particularly in America have hijacked the Keto Diet without really understanding the research or the limitations. You can't just throw any fat or oil down your throat if you have cancer. Saturated fat like dairy and red meat is linked to inflammation, a weaker immune response, more cancer metastases, more progression and poorer survival outcomes. Even Seyfried agreed with Chris Woollams that coconut oil, much-loved by many on the Keto Diet, was 90% saturated fat and would cause chronic inflammation. 

Go to: Saturated fat and cancer risk, progression and lowered survial

Your gut bacteria use coconut oil to produce TMA, which is converted by the liver to highly inflammatory TMAO. It is a proven driver of prostate cancer, as shown by both the Harvard School of Public Health, and the Cleveland Clinic in multiple studies. Olive oil, on the other hand, promotes the numbers of gut bacteria that make anti-inflammatory molecules.

  f) What about other fads like bone broth.

Other 'Health experts' advise cancer patients to heal their gut by consuming large quantities of bone broth. Yes, it helps. BUT. This contains high levels of glutamine and glutamate. And certainly not what a cancer patient needs, especially if they are trying to follow a Ketogenic Diet!!!

Go to: The Ketogenic Diet - what foods to eat; what foods to avoid

The Champions of the Ketogenic Diet

The champions of the Ketogenic Diet are Seyfried and D’Agostino. Professor Thomas Seyfried of Boston College is a biologist and, after years of extensive research, Seyfried fervently believes cancer is a metabolic disease, not a genetic one. Many people agree - Chris Woollams included. Dr. Dominic D’Agostino, Assistant Professor at South Florida University also concurs. Both have been involved with treating patients with advanced cancer successfully using a ketogenic diet. Seyfried was also part of a team that showed the Ketogenic Diet effects could be enhanced by Hyperbaric Oxygen.

In the UK, a Charity called Mathew’s Friends offers expert advice on the diet in relation to brain cancer. 

I am clear, as is Seyfried, that cutting sugar can help fight cancer. However, I think brain and colorectal cancers are particularly responsive to sugar and I'm not sure all cancers are. I feel this almost obsessive belief in some quarters that the Ketogenic diet can 'cure' all cancer and can restrict all chronic illness is naive, potentially misleading and dangerous.

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Sugar, cancer and the Ketogenic Diet

Cancer cells love glucose - it is essential to their survival. The fundamental tenet of the Keto Diet is that cancer cells need to ferment to survive. And to do this they must consume glucose.

Go to: 20 links between sugar and cancer

There is absolutely no doubt in my mind that sugar and insulin feed cancer's avarice. This avarice is known by oncologists who use PET scans involving a radiological dye combined with sugar, to pinpoint cancers in the body. One cancer treatment, Insulin Potentiation Therapy even uses this fact to get cancer cells to respond to much lower chemotherapy levels by the simultaneous infusion of insulin.

Finally, cancer cells have defective mitochondria. According to the Ketogenic experts, energy metabolism in these defective power stations leads to the production of harmful ’reactive oxygen species’. Glucose is essential to destroying these. Without glucose, the ROS kill the cell. 

ii) There is increasing evidence that high plasma glucose levels are linked to greater cancer risk, greater cancer growth, greater cancer aggression and lowered survival in those already with cancer. 

      * One study in the Journal of Clinical Investigation (Jan 2, 2014 - CLICK HERE) concluded that increased glucose uptake CAUSED cancer.

      * In another study, researchers at Colorado Cancer Center showed how leukemia cells even rob healthy cells to get more glucose and fuel their growth.

      * In a study by Weill Cornell, researchers showed that consuming just one can of a fizzy soft drink a day could fuel cancer growth. The researchers have almost 30 years experience of sugar and insulin's interaction with cancer growth and agression.

iii) There is increasing evidence that calorie restriction by cutting carbohydrates - that is, eating about 15% less calories than you need - can aid any cancer survival.

iv) There is increasing evidence that fasting (using a 3 to 5-day water only fast) can increase any cancer survival - because it reduces plasma glucose levels, and those of the hormones IGF-1 and insulin, both implicated in cancer development. Fasting also restricts glutamine levels, reducing glutamate. And, fasting increases plasma levels of ketone bodies and stops cancer progression. And fasting boosts the immune system. 

(Note also, that both Calorie Restriction and fasting have been shown to improve chemotherapy outcomes, reduce side-effects, and allow lowered doses of chemotherapy to be used.)

Unfortunately, in practice, 70 per cent of cancer patients cannot bear the thought of fasting even though it can halt cancer progression. 

The Ketogenic Diet does prompt good weight loss in overweight people and has been researched as a way of reducing weight better than low fat or low carb diets. However, over time, the same loss of weight is also delivered by a colorful Mediterranean Diet - see here.

Go to: The Rainbow Diet and how it can help you beat cancer

Which fats should you consume on a Ketogenic Diet?

In conversations with Seyfried, he is quite clear that it is best to plump for ’good’ fats like those promoted in the Rainbow Diet - Extra Virgin Olive Oil, avocado and avocado oil, oily fish and fish oil, nuts like walnuts and almonds, seeds like pumpkin and sunflower.

But what about fatty meats like lamb? It is important to restrict glutamine because that is an alternative fuel for the cancer cells; so animal protein should only be consumed in modest amounts.

So what about bone broth which is high in glutamate? "No, not on a Ketogenic Diet. Probably better not to."

And what about coconut oil? "No. It’s just saturated fat. It will result in terrible inflammation," said Seyfried, laughing. Seyfried agrees totally with my views on the 90% saturated fat dangers of coconut oil. If you want a high flash point oil for cooking, choose avocado oil.

Go to: Olive oil vs coconut oil

Indeed, there is more and more evidence that bad fat (LDL) drives metastases and lowers survival.

Flaws and pitfalls in the Ketogenic Diet

Flaw 1. in our experience with patients at CANCERactive, many people find the Keto Diet far too restrictive. They give up. 

Some people get very stressed over it - stress is not good when you have cancer. The main area for stress is that they cannot get their blood sugar levels down sufficiently, no matter what they do. That can be for many reasons, some of which may not be your fault - for example, if you are on a drug like Dexametasone - it puts your blood sugar up!

Flaw 2.  Many people think they are on a Ketogenic Diet but are not. One Professor with cancer who came to me for a Personal Prescription, recently told me that he was on a Ketogenic Diet: "60% of my calories are from fat!" A true Keto diet demands 90%. 

Another, Andrew Scarborough, who beat his glioma, has a website headed, ’Eat meat, drink water’. This is not a Ketogenic Diet - it is an Atkins Diet.

Flaw 3. There is little doubt that brain cancer and colorectal cancer are particularly responsive to glucose and there is research to support this.  (Johns Hopkins have researched colon cancer and a glucose restricted diet ’Colon cancer may yield to cellular sugar starvation. But, what other cancers have hard evidence for sugar dominance? 

True, all cancers love glucose, but breast, ovarian and prostate, for example, are more ’hormonally-driven’. 

And what of blood and lymph cancers? Professor Seyfried is clear on those. They don’t respond to a Ketogenic diet. At the moment. "We still don’t know enough about the biochemistry".

Flaw 4.  Cancer cells can use glutamate when there's no available glucose; and you are full of glutamate!

In 1924, Warburg (who went on to win a Nobel Prize) wrote ’On Metabolism of Glucose’ where he suggested that the prime cause of cancer was the replacement of the normal respiration of oxygen in healthy cells by the fermentation of glucose.

Healthy cells make energy by converting pyruvate and oxygen in the mitochondria. Unfortunately, mitochondria are switched off in cancer by a loss of crucial messages due to blockages in gene transcription.

But it’s not that simple. When glucose is absent, cancer cells seem able to use glutamine, an amino acid in protein, as a reserve energy source. Indeed, some researchers think that some cancer cells are ’addicted to glutamine’ (Click here for a review), which seems to support proliferation and survival. Indeed, in certain cases of hypoxia (oxygen starvation) glutamine seems to drive the cancer, although this may not be the case for all cancers

Glutamine is an amino acid, one of the building blocks of protein. Glutamine turns to glutamate in the cancer energy production system. And glutamine/glutamate is readily available all over the body, but especially in nerves, muscle tissue and brain. 

Indeed, glutamate can be made in the body from glutamine, folic acid, glucose, and other sources. Glutamate is known to fuel a cancer ’feeding pump’ and spread metastases. Indeed several research studies have focussed on ’normalising’ cancer cells by blocking the pump. And although the Ketogenic Diet restricts protein consumption as well as glucose consumption, you can see how this might not be anything like enough to stop cancer cells growing.

Indeed, researchers also at Johns Hopkins studied Lymphatic cancer. They showed that lymph gland cancer B cells could still feed even on a sugar-free diet due to their fondness of glutamine. And brain tumours although they seem to thrive on glucose, can also use glutamine.

Go to: Glutamate, glutamine, diet and cancer

Seyfried himself has addressed this point (Click Here). But I worry.

Protein anyway stimulates the mTOR pathway which can drive cancer. 

I would argue that it is nigh on impossible to restrict glutamate in the body; your muscles and nervous system would pack in! 

Cutting your protein to only 8% of calories so you restrict glutamine to cancer cells is rather like telling all the sailors on a sinking Aircraft Carrier to throw their hats overboard to save the ship. There is so much glutamine already in your body, it is hard to imagine how you could possibly restrict it, unless you turned to the almost vegetarian form of the Rainbow Diet for at least several months - which we do advocate for some people with cancer.

We are not being negative - it’s our job to provide you with honest objectivity.

Flaw 5. There are 'Health experts' who believe that using a Keto Diet for cancer is flawed. For example, while Seyfried and associates advocate the Ketogenic Diet not just for brain cancer but all cancers - see here - the late Dr. Nicholas Gonzalez wrote an 8 page summary debunking the Keto diet and listing other occasions in the past it had been trialled and failed - see here.

Flaw 6. We certainly would agree that people with cancer should restict 'empty calorie' carbs. Indeed, some UK oncologists use, diabetes drug, metformin, to do just that. Metformin cuts blood sugar levels. An alternative is the herb, Berberine.

We also agree that people should not eat high levels of saturated fat as it promotes inflammation and weakens the immune system. We are not against a little fish (and fish oils are highly anti-inflammatory), not small portions of organic grassfed meat (which containscancer-correcting compounds, like alpha lipoic acid).

So, we prefer a far less restrictive Rainbow Diet, coupled with 

     * 5-10 gm of raw ginger (an inflammation and blood sugar inhibitor), and

     * Metformin or, better, natural Berberine supplementation (both lower blood sugar levels and attack cancer cells), and

     * A small statin like atorvastatin or, better, natural lycopene supplementation (from tomatoes) to reduce LDL and triglycerides and restrict the cancer spreading 

Flaw 7. While we see the colourful Mediterranean diet working in practice across a whole range of cancers including blood and lymph cancers, there are also clear and long-term research studies (with humans) to support it for cancer prevention, and increased cancer survival. You can find them in the Rainbow Diet research centre. But the Keto Diet has only a couple of short-term studies, and they are with rats or mice (for example, 2).  In one of the few studies with humans (a 2017 pilot study on the Ketogenic Diet with 16 patients who had metastatic cancer with no treatment options), only 5 completed the 3 month trial, and 2 died early(1). 

Flaw 8. Finally, if you are going to restrict carbohydrates to just 2% of calories, you miss out on a wide range of protective and corrective foods with definite anti-cancer properties? For example, the use of pulses is important in restricting hormonally-driven cancers, and people consuming high levels of soluble fibre foods (oats, vegetables, pulses, nuts and seeds) have the strongest immune systems, yet these foods are largely banned in the Keto Diet; the use of potent anti-cancer but starchy vegetables like beetroot and carrots, and sweet fruits like pomegranate, yield cancer-fighting anthocyanin, polyphenols and carotenoids. How does a patient get these in volume in a Keto diet?

Fasting causes ketosis

While calorie restriction may have benefits against cancer, when you next have a meal, glucose, insulin, IGF-1 and glutamine levels all spike. This causes mood swings, cellular inflammation and may refuel the cancer cells. 

However, complete fasting (3-5 days) can prevent this. Fasting done in this way, according to expert Professor Valter Longo, induces a state of ketosis in the body, where flexible healthy cells deprived of glucose switch to burning Ketone bodies produced by the breakdown of fats when fasting.

The most important thing to understand is that these benefits - lowering of blood sugar, insulin, growth hormone, stopping cancer progression and rebooting the immune system - are larely short-term benefits. However, Longo has shown that people who undertake fasts have beaten their cancers, and better results are achieved where people have had no chemotherapy.

Go to: Calorie Restriction, fasting and cancer

Of course there is research on a Keto diet. It’s a hot topic. Clinical trials with humans are taking place right now in America on the Ketogenic Diet and also on the use of calorie restriction and fasts whilst having Chemotherapy and radiotherapy.

In 2012, Dr. Dominic D’Agostino and researchers from the University of South Florida Medical School showed in animal studies, that animals with metastatic cancer can survive better using a carbohydrate-free diet than those using chemotherapy!

On June 5th 2013, research results were published by researchers from the University of South Florida (Angela M Poff, Csilla Art, and Dr Dominic D’Agostino) and Thomas N. Seyfried of the Boston College. In mice with metastatic cancer and using a Ketogenic Diet and Hyperbaric Oxygen in combination and alone, with control groups, the researchers reported that:

A "Ketogenic Diet alone significantly decreased blood glucose, slowed tumour progression and increased mean survival time by 56.7% in mice with systemic metastatic cancer. While Hyperbaric Oxygen Therapy alone did not influence cancer progression, combining the Ketogenic Diet with Hyperbaric Oxygen elicited a significant decrease in blood glucose, tumour growth rate and a 77% increase in mean survival times compared to the controls (Ref: PLOS One).

Go to: Hyperbaric Oxygen and cancer

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What's in a Keto Diet?

The diet needs to be done under strict supervision by a competent professional (a nutritional therapist trained in the Keto Diet).

The latest thinking on the Ketogenic Diet is as follows:

a. Carbohydrates, especially refined carbohydrates, glucose, fizzy soft drinks, high fructose corn syrup, high glycemic index foods should all be avoided. Remember, even honey is 50 per cent glucose and fructose! The Ketogenic diet involves the use of only non-starchy carbs from plants. So no fizzy soft drinks, no puddings, no bought fruit juice or smoothies, no ice cream, no cakes, biscuits or chocolate.

b. The diet focuses on ’good fats’ like extra virgin olive oil, flaxseed oil, and those of raw nuts and seeds, avocado and eggs. Fish oil is good for you. ’Bad’ fats causing inflammation should be avoided - so limit trans fats, coconut oil and cows’ dairy. More than 70 per cent of calorie consumption in the Keto diet comes from ’good’ fats.

c. Protein consumption should be only light to moderate; and it should be from quality natural, fresh protein sources (pulses, fish, chicken), not dried meats and the like which can have added carbohydrate. High protein consumption can increase glutamine levels, the cancer cells reserve fuel when glucose levels have depleted. 

Go to: The Ketogenic Diet - what foods to eat; what foods to avoid

Go to:  2014 Interview with Professor Thomas Seyfried

#TalkingKeto: Professor Tom Seyfried www.youtube.com Interview with Professor Tom Seyfried about treating Cancer with Ketogenic Dietary Therapies.

Keto Diet - what foods could 'protect and correct'?

In 2012 the National Cancer Institute in America conducted research (Cancer Watch) into what foods could restrict a cancer tumour’s regrowth. This followed the confirmation that at the heart of most tumours were cancer stem cells (Cancer Watch) and, currently, no drugs were available to kill them off. 

At CANCERactive we firmly believe in using an anti-cancer diet as part of your Integrated Cancer Treatment Programme. Diets can fulfil several aims. The Rainbow Diet, where you incorporate a plethora of colourful foods into your diet, along with, for example, oily fish and sunshine to provide a nutritionally nourishing diet which includes highly ’bioactive’ compounds, these being both protective and corrective of cancer, fits totally with the NCI research that bioactive compounds like those in sulforaphanes, curcumin, piperine, theanine and choline plus vitamins A and D, genistein, and EGCG from green tea.

The idea that about 50 or 60 bioactive compounds can Correct, not just Protect, fits with the rapidly developing Science of Epigenetics, which has proven that the term ’mutation’ is often used somewhat incorrectly to include changes in the methylation and acetylation around the core genetic code. These changes cause blockages and a loss of crucial messages but are reversible. In effect, cancer is a metabolic disease, not a genetic one. It can be reversed.

The American Cancer Society in 2012 issued a report endorsed by the NCI stating that there had been an ’explosion’ in research into complementary therapies since 2006, and that there was overwhelming evidence that diet, weight control and exercise could increase survival and prevent a cancer returning.

The Rainbow Diet - better than the Ketogenic Diet? 

The Rainbow diet is about being SENSIBLE about sugar. Natural plant sugars are bound to be consumed. But added, empty calorie, sugar is not necessary. You should graze and eat six small meals a day to control insulin surges. Such ’grazing’ and a lack of common glucose and High Fructose Corn Syrup from fizzy soft drinks, no cakes, biscuits, chocolate, ice cream and so on, is sensible eating. But the strength of the Rainbow Diet is 'What You Eat' - not what you leave out - the diet uses a host of epigenetic bioactive compounds - primarily the pigments in fruit and vegetables, to protect and correct.

The Rainbow Diet still restricts glucose and foods like ginger and berberine help; it focuses on good fats, is full of corretive and protective foods like pulses, vegetables and fruits, and it restricts inflammatory fats like cows' dairy, coconut oil and red meats. 

The Rainbow diet works with all chronic illness; the Rainbow Diet works with all cancers. There are over 70 human studies in the past 6 years!

Glucose, fat and cancer?

1. In Cancer Watch we have covered about six research studies over the last three years all pointing to the fact that people with the highest levels of blood glucose develop more cancer, and those with cancer and high blood glucose levels have the poorest survival rates. Research on high fructose corn syrup suggests it may be even worse (Click Here)

2. When it comes to fat, research from the VITAL study (Cancer Watch; November 2012) from the Fred Hutchinson Cancer Centre in Seattle showed that bad fats could drive the recurrence of breast cancer while fish oils could prevent it.

3.  Research in the Oncologist. (2013;18(1):97-103; Champ et al - click here) showed that Calorie Restriction may well improve survival times for those undergoing radiotherapy and even chemotherapy, and clinical trials are planned.

You can read more about the Rainbow Diet by Clicking HERE.

Brain and other solid tumour cancers

Let us at some more esearch.

Brain and other solid tumours thrive on glucose - there are several research studies confirming this:

a. Researchers Seefried and Mukherjee from the Biology Department of Boston College first proposed in 2005 that brain tumour cells were inflexible in that they could use glucose but not ketones as an energy source, unlike flexible healthy cells which could use either. They argued that metabolic therapy was the way forward as little progress had been made with drugs for five decades.

b. Researchers from Ohio State University Cancer Center showed that a molecule miR-451 switches off in the absence of glucose and shuts down ’the engine of the tumour’ but causes the brain tumour to grown and spread where there is an abundance of glucose.

c In January 2009 researchers from Johns Hopkins noted that there was a strong link between hyperglycemia and cancer risk; and after following brain cancer patients they concluded that those with the highest blood glucose levels survived least. They also concluded this was likely to hold true for most cancers (Cancer Watch 2009; Click Here).

Breast, lung and other cancers

d. In 2009 researchers discovered that insulin resistance was linked to breast cancer. Where women had higher levels of blood glucose as a result, their breast cancer risk increased 1.7 times (Cancer Watch; Click Here).

e In 2010 researchers from the NCI showed that metformin, the diabetes drug which reduces blood sugar levels, was linked to lowered levels of lung cancer in studies (Cancer Watch; Click Here).

f. MD Anderson (November 2012) have shown that a protein, Pyruvate Kinase M2 (PMK2), which is active during infancy, is turned back on by cancer tumours and activates what they called The Warburg effect (after the Nobel Prize winner). They state, ’any solid cancer tumour, but in particular brain cancers, will use PMK2 to activate glycolysis’ (the burning of glucose to provide energy for cancer cells). (Nature Cell Biology - Weiwei Yang, Ph.D., Yanhua Zheng, Ph.D., Yan Xia, Ph.D., and Haitao Ji, Ph.D.)

g. In research by Elizabeth Maher et al March 2012, NMR in Biomedicine, the conclusion reached was that glucose was essential to a brain tumour but other sources from inside the cell, like glutamine, may also provide ’reserve’ energy.

Despite all this, all too often patients are given foods like ice cream, sugary tea, sugared buns and Ribena whilst lying in their post-operation beds. This is crazy. In fact, ten years ago I talked to Catherine’s oncologists about starving the brain of glucose. They actually laughed.

Katie Sheen’s Story

Katie Sheen, a nutritional therapist and lecturer at the University of Worcester, became interested in eating to combat cancer 10 years ago when her brother-in-law was diagnosed with a low grade astrocytoma. He and his family launched Astro Fund, the only charity in the UK to focus on low grade glioma research.  Says Katie, "My brother-in-law saw that the astrocytoma is such a perversely beautiful cell: it looks like a starburst. So that’s how the charity was named; he wanted it to be a light in the darkness".

Katie’s focus on the ketogenic diet could be, at the very least, a torch or a beacon for those looking for an adjuvant therapy for brain cancer: working on her dissertation, she discovered that the Mayo Clinic was using this diet as a mainstream treatment for children with medication-resistant epilepsy:

"Basically its the antithesis of what you’d imagine." says Katie. "It’s a very high fat, calorie-restricted diet (whipped cream and animal fats permitted), with adequate protein and very low carbs. There are variations (MCT, Modified Atkins, which you can read about on the website Matthews Friends). But the whole point of the diet is that it put the body into ketosis.  That’s the state the human body goes into under starvation, when it burns fat for energy. Healthy brain cells can use ketones for energy but a brain tumour can only use glucose". Says Katie, "It’s such an incredibly simply metabolic approach: you starve the tumour of sugar".

Investigating further, Katie came upon the work of Dr Thomas Seyfried at the Biology Department of Boston College, Massachusetts, who was researching the ketogenic effect on brain cancer. He cited the example of two children with high grade brain tumours, both of whom were beyond further medical help. Their nutrition department was allowed to try the diet: One child responded well and survived at least another 10 years. (Nebeling et al, J Am Coll Nutr. 1995 Apr; 14(2): 202-8).  In Italy, a 65 year old woman with glioblastoma multiforme started a calorie-restricted ketogenic diet in combination with chemotherapy.  Tumour regression was seen on scanning, but 10 weeks after lapsing from the diet the tumour progressed further (Zuccoli et al, Nutrition & Metabolism 2010;7:33).

A number of groups have researched this diet in animal models for brain and prostate tumours.

Nobody is suggesting that this approach is a substitute for medical treatment but it could a very useful adjunct: 

"Now", says Katie, "a research group led by Adrienne Scheck in Arizona is doing experimental work on a glioma mouse model and getting very good results so we hope to be able to get a phase I clinical trial under way in the UK soon, to build on promising results from a German trial which has just published. (www.astrofund.org.uk)". 

The Keto diet vs The Rainbow Diet

For me, there's no contest.

I get very worried when fad and fashion comes to science thinking. And the Keto Diet seems no exception. If you restrict glucose, clearly you restrict cancer cells. But for how long? Oncologists using metformin with stage 4 grade 4 patients, seem to extend their lives, for months or even a few years. But it is clear that, unless you have a mutation which stops your cancer feeding on glutamate, research shows you could even heighten your cancer's growth. 

Calorie restriction and fasting are being researched in America in Clinical Trials as both seem to help the cause of Chemotherapy and Radiotherapy. Again, this is short-term.

I definitely believe that people with cancer should restrict their glucose consumption.

I also believe they must restrict their 'bad fat ' consumption as this can drive metastases. And coconut oil is a prime example. This is not what most people on a Keto Diet do. 

But I fervently believe there are foods that are especially helpful in the fight against cancer and that many of these are restricted from the Keto Diet. Whole carbs, soluble fibre, oats, nuts and seeds and more.

I think you should restrict your meat consumption and stick to fish, with organic grass fed meats only occasionally. You should definitely not touch bone broth which is full of glutamine and glutamate.

The most interesting thing to me was when I challenged Seyfried on the issue of glutamine and he admitted there were still a few flaws that needed to be sorted out.

Do I believe that diet alone can beat cancer? Not really, but I do believe it is a massive factor in the armoury; in the package of actions against cancer. Do I believe that diet is the Ketogenic Diet. No, not at all. It's theory, with little research, and, in my opinion, nothing like as helpful as the colourful Mediterranean Diet - a Diet proven to restrict cancer in humans.

I will be interested to see the results of the clinical trials.

To read about Fasting, Calorie Restriction and Cancer CLICK HERE.

To read about Hyperbaric Oxygen CLICK HERE

Refs

1. Effects of Ketogenic Diet on quality of life in cancer patients

2. Ketogenic Diet reduces cancer progression and cachexia in Mice with colorectal cancer