Thursday, May 5, 2016

Cancer, glucose, and ketogenic eating

The message below pasted from my friend Mike DiLandro's excellent monthly newsletter. There is some big interest lately in the idea that a ketogenic diet can fight cancer, because cancer cells are known to feed off of glucose. Ketogenic diets have also been found to help cognitive disorders like ADHD, autism, and Alzheimers, and they have been used with great success to elicit rapid fat loss. A ketogenic diet is where you restrict carbohydrates to an extremely low level, thereby teaching your body to burn ketones (energy rich by products of fat metabolism in the liver when carb intake is extremely low) as an alternative source of fuel to glucose. It's the ultimate expression of the primal/paleo concept where you escape from dependency on regularly timed high carbohydrate as your primary energy source, and instead become expert at burning internal fuel sources. 

These abilities (we call it 'fat adapted' or 'primal adapted) are hard-wired into our genes through 2 million years of selection pressure to survive with very unreliable food sources--until the advent of civilization from the cultivation of grains (a reliable source of food that transitioned us out of hunter-gatherer existence). Today, with our obsessive overfeedings of high carbohydrate meals, we have shut off our genetic abilities to survive and thrive on high fat and irregular eating patterns and are utterly reliant on regular doses of carbs (ever get cranky, foggy and loopy after skipping even a single meal? Then you are carb-dependent!

Right now I am 22 days into an experiment with a ketogenic diet, where my daily carb intake is 50 grams per day or less. Practically, this means I am eating ample servings of vegetables and snacking on nuts and nut butters, but consuming no other carbs to speak of. No grains, no sugars, no sweetened beverages, not even fruit or my lovely 85% dark chocolate! What I can report so far is more regulated daily energy levels and never feeling hungry. Fooling around with ketogenic eating is not advised until you have built some excellent momentum from low carb, primal aligned eating. I have been off grains and sugars for 8 years now in my primal journey, so I am simply dialing back my carbs even further to see what happens. For those interested and inclined, the health benefits are outstanding. Dr.'s Phinney and Volek detail the potent anti-inflammatory effects of ketogenic eating in their book, The Art and Science of Low Carbohydrate Living. 

Okay now let's read about the origin of chemotherapy, the role of glucose in cancer progression, and how ketogenic eating might help. From Mike DiLandro:

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Tripping Over the Truth” is a chronological history of the fight to cure cancer.  For those of you old enough to remember President Richard Nixon declaring war on cancer, it is sad that almost 50 years later we have still not been able to eradicate this family of devastating diseases.  Some of you may have also recently listened to the documentary series “The Truth About Cancer” (https://thetruthaboutcancer.com/ ).  If you did, you truly begin to question the approach we take in battling cancer: surgery to cut out as much as possible, followed by radiation and chemotherapy treatments.

In “Tripping Over the Truth”, Christofferson describes how chemotherapy was invented.  At the end of World War II, Germany bombed a fleet of US ships that were stationed in Italy.  One of those ships that was destroyed was secretly carrying nitrogen mustard gas.  Sailors that were blown from their ships into the water were exposed to the mustard gas and killed.  What doctors who autopsied the sailors who perished learned, was the mustard gas all but ceased the division of certain types of cells that were prone to divide fast.  The doctors then formulated that nitrogen mustard gas could be injected in humans to try and kill cancerous cells.  70 years later we are still using a variety of chemotherapy drugs, but their downside is that they don’t just target the cancer.  Chemotherapy is analogous to dropping Napalm on a jungle.  You are going the burn more than just the bad guys.

The key message I got out of “Tripping Over the Truth”, is that we have been looking in the wrong place for the cause of cancer up until very recently.  Dating back to the early 20th century, there were two schools of thought on cancer’s cause: genetic or metabolic.  Over time the great majority of scientists believed that cancer was caused by genetic reasons and thus based their attacks on cancer down this path.  Unfortunately, recent developments from the Human Genome Project and subsequent related gene mapping programs have proven that cancer cannot be caused genetically.  Basically, we have been looking at the problem all wrong for almost 100 years for how to cure cancer.

To understand the metabolic cause theory of cancer we need to look back to German Scientist Otto Warburg, who was born in 1883, and his Warburg effect.  According to Wikipedia (with some notes from me in parentheses), “In oncology (the branch of medicine that deals with cancer), the Warburg effect is the observation that most cancer cells predominantly produce energy by a high rate of glycolysis (the splitting of glucose molecules to form Adenosine Triphosphate [ATP] energy) followed by lactic acid fermentation, rather than by a comparatively low rate of glycolysis followed by oxidation of pyruvate (an end product of glycolysis) in mitochondria (the cell’s power houses that create ATP) as in most normal cells.  Malignant, rapidly growing tumor cells typically have glycolytic rates up to 200 times higher than those of their normal tissues of origin.  Otto Warburg postulated this change in metabolism is the fundamental cause of cancer.”

To clarify, food is digested and supplied to cells mainly in the form of glucose.  Glucose is broken down further to make ATP by two pathways.  One is via anaerobic (without oxygen) metabolism occurring in cells, also known as glycolysis.  The major physiological significance of glycolysis lies in making ATP quickly, but in a minuscule amount. The breakdown process continues in the mitochondria, which is more efficient for ATP production.  Cancer cells seem to be well adjusted to glycolysis.  In the 1920s, Otto Warburg first proposed that cancer cells show increased levels of glucose consumption and lactate fermentation even in the presence of ample oxygen (known as “Warburg Effect”).  Based on this theory, the switch to glycolysis promotes the proliferation of cancer cells.  Many studies have demonstrated glycolysis as the main metabolic pathway in cancer cells.

More recently in March 2008, Dr. Lewis C. Cantley and his colleagues announced that the tumor M2-PK, a form of the pyruvate kinase enzyme, gives rise to the Warburg effect.  Tumor M2-PK is produced in all rapidly dividing cells, and is responsible for enabling cancer cells to consume glucose at an accelerated rate.  Forcing the cells to switch to pyruvate kinase's alternative form by inhibiting the production of tumor M2-PK, led to their growth being curbed.  The researchers acknowledged the fact that the exact chemistry of glucose metabolism was likely to vary across different forms of cancer, but M2-PK was identified in all of the cancer cells they had tested.

So what are some potential remedies suggested in “Tripping Over the Truth”?  Well, since cancer consumes glucose at an accelerated rate, starving the body of glucose is strongly advised.  Christofferson talks about using a ketogenic diet, which involves eating mostly fats and thus keeps your body in ketosis.  We are not talking about just your run of the mill, low carb Paleo diet either.  Christofferson’s ketogenic recommendations are to keep your daily carbs limited to 12 grams and your daily protein to 1 gram for every kilogram (kg) of body weight.  As an example, if you weigh 194 pounds, that equates to 88 kgs or 88 grams of protein.  Since both carbs and protein are 4 calories per kg, you would only get 400 calories per day from carbs and protein (12 + 88 = 100 grams X 4 calories/gram = 400 calories).  All of the other calories you intake will need to come from fat.  This fat could come from the fat in meats, eggs, avocados, coconut oil, nuts, seeds, olives, etc.  You just need to account for the carbs and protein in whatever you eat and stay below the daily limits.

In addition to a ketogenic diet, Christofferson explains how using a hyperbaric chamber can also be used to fight cancer.  Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube.  Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a hazard of scuba diving.  In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure.  Under these conditions, your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure.  Your blood carries this oxygen throughout your body.  This helps fight bacteria and stimulate the release of substances called growth factors and stem cells, which promote healing.  The argument runs that using a hyperbaric chamber will overcome one of the main influences of cancer, namely that cancer exists in a low-oxygen environment and plentiful oxygen can kill it off.
The dismissal of the Warburg effect, which Otto Warburg discovered 100 years ago, not only has caused cancer researchers to attack the cure for cancer incorrectly, but has also put countless patients through the standard, extremely grueling cancer treatment protocol of invasive surgery, radiation and chemotherapy.  Imagine instead, just changing to a ketogenic diet and using hyperbaric oxygen therapy, if you learn of a positive cancer diagnosis.  Not only would your body not be ravaged, but the cost savings would be phenomenal.  Some chemotherapy treatments can cost upwards of $500,000.00.  Dietary changes cost almost nothing and hyperbaric therapy is very inexpensive.

I highly encourage anyone, whether you have a cancer diagnosis or not, to read “Tripping Over the Truth”.  I also recommend checking out the documentary series “The Truth About Cancer”.

Thanks,

Mike DiLandro (paleomiked.com)

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