Ketogenic Diet

[Paul Edwards]

One of our members PeterH has been on a Ketogenic Diet. He posted information about the Ketogenic Diet in another topic.  That information is more appropriate to a topic of its own and has been moved to this topic.

 

This moderator is not as enthusiastic as PeterH about the Ketogenic Diet:

 

Anecedotal evidence is not scientific evidence (However, it's great that PeterH feels that it's working for him)
 

It's early stages so far as evidence about the Ketogenic Diet is concerned (there are a number of stage 1 clinical trials).   Also there is little evidence about the long term effects of the Diet

 

The Ketogenic Diet has potential risks as set out in this table from the Iowa University Research Paper that PeterH mentions:
 

 

 

 

 

 

Peter H says:

 

Personally, I would look VERY seriously at a Ketogenic Diet—in 2.5 months on the diet my rising PSA (after surgery and radiotherapy) fell 20% and, frankly, I find it hard to see a downside. The science I find compelling:

 

1   We know that any carbohydrate eaten is turned into glucose (some carbs much faster than others).

2   We know that an elevated glucose level (hyperglycaemia) is bad for us and, consequently,

3   A glucose spike triggers a corresponding insulin spike, designed to “push” the excess glucose into all available cells

4   We know that tumor cells are primed to take maximum advantage of this “feast” (Indeed, this is the basis of body scanning procedures whereby radioactive sugars are injected into the blood and tumors are detected because their uptake of the sugars is many times greater than that of normal cells). It is interesting that we have used this characteristic of tumors for many years for diagnosis, but not used it for treatment.

5   We know that most normal cells can function perfectly well on a diet of ketones made by the liver from fatty acids.

6   We know that most tumors have damaged mitochondria that makes them dependant upon glucose. They are unable to process ketones

7   An insulin spike also triggers production of hormones such as Insulin-like Growth Factor–1 (IGF–1), that promote tumor growth

8   An insulin spike also triggers the tumor to produce Tumor Angiogenic Factors (TAF) to stimulate the production of an enhanced blood supply to the tumor—to feed its insatiable appetite for glucose

9   Tumor cells are more prone to attack from free radicals than normal cells. This is the basis of radiotherapy which generates free radicals in the vicinity of the tumor. Indeed, anti-oxidants are best avoided during radiotherapy treatment for this reason, but nobody tells you.

10  Tumor cells deprived of their normal glucose “fix” become stressed and are even more prone to free radical attack. Conversely, because of reduced inflammation resulting from the KD, normal cells fed on ketones enjoy enhanced protection from free radical attack.

 

1.     Iowa University published a really interesting research paper (2014), Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism. In its conclusion it stated:

Despite recent advances in chemo-radiation, the prognosis for many cancer patients remains poor, and most current treatments are limited by severe adverse events. Therefore, there is a great need for complimentary approaches that have limited patient toxicity while selectively enhancing therapy responses in cancer versus normal tissues. Ketogenic diets could represent a potential dietary manipulation that could be rapidly implemented for the purpose of exploiting inherent oxidative metabolic differences between cancer cells and normal cells to improve standard therapeutic outcomes by selectively enhancing metabolic oxidative stress in cancer cells.

Although the mechanism by which ketogenic diets demonstrate anticancer effects when combined with standard radio-chemo-therapies has not been fully elucidated, preclinical results have demonstrated the safety and potential efficacy of using ketogenic diets in combination with radio-chemo-therapy to improve responses in murine (mice) cancer models. These preclinical studies have provided the impetus for extending the use of ketogenic diets into phase I clinical trials that are currently ongoing.

The complete paper is available, free at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215472/

 

Note that there are no large scale trials proving the efficacy of this, nor are there any large scale trials proving that it doesn't work. This is simply because there are no large scale trials. Funding for trials is always difficult, usually provided by a drug company and, here, there is nothing to sell. Despite this there are >60 ketogenic diet trials in progress around the world, 12 of them targeting various cancers (but not prostate cancer).

 

Finally, rather than asking your oncologist if you should go on a Keto Diet, ask him/her to read the Iowa University research paper and then to tell you where they have gone wrong.