Calorie Restriction may well improve cancer survival
by Chris Woollums
We told you as long ago as 2006 to beware those NHS leaflets that tell you to fill up on sugary buns, milky sugary tea and cheeseburgers when having chemotherapy. As CANCERactive has told you in the past, glucose is the favourite food of cancer cells according to 6 or more research studies we have covered; and cows’ dairy contains IGF-1 growth hormone, just the hormone tumours need to flourish. Diets with sugar, salt, saturated fats and cows’ dairy help feed your cancer at the very moment your oncologist is struggling to kill it off.
Indeed, researchers at the Fred Hutchinson Cancer Research Center, Seattle reported in November 2012 from the VITAL study that saturated fats could drive breast cancer, while fish oils could reduce it. And there have been at least six studies in the last few years showing glucose drives cancers. People with the highest levels of blood glucose develop more cancers and survive least.
The problem seems to be that NHS dieticians are soooo busy they only have time to see the 7 per cent of cancer patients for whom cachexia (where the drug actually causes severe weight loss) puts lives at risk. And we can’t have a patient dying because of the drug can we?
But why hand out the booklet to everybody, when it could be doing more harm than good?
Eat a sugar-free nutritious diet
We have long maintained that cancer patients on chemo- and radiotherapy need a NOURISHING and NUTRITIOUS diet with all the colours of the rainbow on their plates. You can obtain calories from a good supply of whole foods even though you restrict carbohydrates and empty sugars. And now we are not alone in this thinking as recently American cancer centres like Memorial Sloan-Kettering and the MD Anderson Cancer Centre in Texas are saying exactly the same thing.
Now comes research that suggests stacking up the high fat and empty calorie meals may be completely the wrong route to go:
According to Dr Andrew T Turrisi, section Editor for The Oncologist, research in alternative cancer treatment is full of promise and potential and there has been much recent interest in the role of calorie restriction (CR) with orthodox treatments. CR is diet modification that reduces caloric intake by 20-40%, without restricting essential vitamins and nutrients and can be achieved through dietary reduction or fasting
As we have told you at CANCERactive for some years, CR seems to affect a variety of molecular pathways, increasing longevity and reducing cancer risk. Now it seems it can make cells more responsive to radiation, chemotherapies, and even targeted molecules; and it can increase the percentage of healthy cells over tumour cells* (Nutrition Restriction and Radiation for cancer treatment – When less is more).
Researchers studied CR with breast cancer showing that both CR and radiation therapy down-regulate several signalling pathways that cancer progression up-regulates, and suggested combining these two therapies was likely to produce better results. Next stop clinical trials, they suggest.
Interestingly the piece states: This also provides a scientific rationale for "diets" and "nutrition management" often questioned by patients fearful of the pharmaceutical industrial complex, yet gravitationally inclined toward "natural methods" and diets.
Readers, at this point, might like to read about
2 The Ketogenic Diet -
The Ketogenic diet - a diet to beat cancer?
The anti-cancer diet
(Chris Woollams) At CANCERactive we firmly believe in using an anti-cancer diet as part of your Integrated Cancer Treatment Programme. A ´cancer diet´ can be as general as 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. Or a ´cancer diet´ can be as specific as the Ketogenic Diet.
The basic principles are not far removed. At the heart of both diets is a total lack of empty calories (glucose, high fructose corn syrup and the like), negligible sodium salt intake, and a preponderance of good fats over bad. Specific research of interest includes:
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. But this is hardly surprising - uniquely, cancer cells feed on glucose. 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.
4 Research from the NCI in 2012 (Click here) showed that a poor diet encouraged cancer stem cells to regrow, whilst a good diet containing certain ´bioactive´ natural compounds such as sulphoraphanes, theanine, vitamin A and E, curcumin, resveratrol, piperine, inositol, genistein and EGCG, stopped the cancer regrowth..
You can read more about CANCERactive´s views on ´A Diet for Chemotherapy´ by Clicking HERE. You can read more about the Rainbow Diet by Clicking HERE.
This article is about the use of ´The Ketogenic Diet´. Although past work has focused on the Ketogenic Diet with brain tumours, this anti-cancer diet seems to have potential with almost any solid cancer.
Brain and other solid tumours
Let us start with a short review of research.
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).
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 may also provide 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.
So let´s look in more detail at the specific cancer diet, or anti-cancer diet called:
The Ketogenic Diet:
This article is in two parts - the first is Katie Sheen´s story of how she helped her brother; the second is more specific and relates to the latest findings about the best form of this cancer diet.
1. 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)".
2. An update on the Ketogenic Diet
The diet needs to be done under strict supervision by a competent professional (a nutritional therapist with the appropriate skill could do this).
The latest thinking is as follows:
a. Carbohydrates, especially refined carbohydrates, glucose, fizzy soft drinks, high fructose corn syrup, high glycemic index foods should all be avoided. The ketogenic diet involves almost zero carbs consumption.
b. The diet focuses on ´good fats´ like extra virgin olive oil, flaxseed oil, coconut oil and those of raw nuts and seeds, avocado and eggs. Whilst ´bad´ fats like trans fats are to be avoided, it seems you can eat a small amount of saturated fats in products such as butter. More than 70 per cent of calorie consumption in the cancer diet comes from fats. The rest comes from quality natural, fresh protein sources (pulses, fish, chicken)., not dried meats and the like which can have added carbohydrate.
c. Healthy, normal cells have ´flexibility´ and can use carbohydrates or ketones (produced by the metabolism of the fats) as a fuel source. Cancer cells can not. They can only use glucose. Without it they die.
d. Dr Dominic Agostino and researchers from the University of South Florida Medical School showed in 2012 with animal studies, that animals with metastatic cancer can survive better using a carbohydrate-free diet than those on chemotherapy.
e. Dr Agostina refutes that such a high fat diet can be bad for your heart describing it as a myth. In the last 30 months he claims he has spoken to many cancer survivors who had previously been ´written off´, with no further orthodox treatment available. He is convinced that the Ketogenic Diet is a viable anti-cancer diet.