Remember way back in the 1980s and 1990s when fat was the enemy and doctors and nutritionists espoused the virtues of a high-carb, low-fat diet? When a plain baked potato was considered a healthy lunch and eggs, bacon and butter were bad? The food industry jumped on the bandwagon, stripping products of fat and cramming them full of sugar to keep them palatable just so they could label them as low-fat and thus boost sales.
By the early 2000s, though, that approach had turned completely on its head. The Atkins Diet, which promotes high protein and fat and low carbohydrate consumption, is often credited with leading the way toward the low-carb revolution. It gave way to the paleo diet movement, where people eat like our hunter-gatherer ancestors. And other fad diets have come and gone in between, each branding carbs and sugar as the enemy.
[See: The 10 Best Diets for Healthy Eating.]
More recently, the ketogenic or keto diet has begun garnering attention among ultra-endurance athletes and those seeking to lose weight. People following this diet eat no more than 10 percent of their calories from carbohydrates, about 20 percent from protein and the remaining 70 percent from healthy fats. Maintaining this ratio of macronutrients for a period of time (typically between two and seven days) causes your body to go into ketosis, a state in which the liver produces ketones — energy molecules derived from fatty acids produced by the liver as a byproduct of breaking down fat for fuel. The idea is that by depriving your body of carbohydrates, which it can more easily burn for energy, you force it into a fat-burning mode that torches reserved fat stores and bingo, you lose weight or can run, swim or bike nearly endlessly on minimal food.
But other things also happen in the body and the brain when ketones are present. For one, it can quell seizures in epileptics. Angela Poff, a research associate in the Department of Molecular Pharmacology and Physiology at the University of South Florida, says “it had been known for a really long time that fasting or starvation could basically cure seizures, at least for the time you could continue to fast.” To extend the timeline of benefit, “physicians developed a diet that they felt would mimic the metabolic state of fasting, which is essentially a very high-fat diet,” called the ketogenic diet. Today, “it’s a standard of care therapy for refractory epilepsy, meaning seizures that don’t respond to the typical anti-epileptic medication,” Poff says.
Around the time the ketogenic diet was being developed, the work of a German biochemist named Otto Warburg began to uncover a potential application for this diet in the treatment of cancer. Warburg observed that cancer cells typically derive energy from different sources than healthy cells. Poff explains: “In general, most cancers have a higher reliance on glucose than a normal cell, and so the idea was if you use this diet that lowers glucose, it might be helpful” in killing off the cancer by depriving it of its preferred fuel source.
Early studies have suggested this assumption is true, at least in some cancers, but Poff is careful to add that a lot more research needs to be done before we fully understand how it all works. “Most of the work in this field is still pre-clinical, meaning it’s been conducted in animal models. It’s been done in various cancer types, but most of the work has been done in brain cancer specifically. But there’s very little clinical data all around. There’s some case reports and very small preliminary clinical studies in small groups of patients, usually very late-stage patients with various types of cancers. So in the clinical realm, which is the most important in telling us whether this is going to be useful, we have a long way to go.”
[See: Breast Pain? Stop Worrying About Cancer.]
She also notes that it’s probably not a good fit for every type of cancer; a study that came out last year found that a genetic mutation that’s common in melanoma actually uses ketones to grow faster. So while Poff says she’s “very encouraged by the research that’s out there, it’s by no means conclusive and there’s a lot more research that needs to be done.”
But for Thomas Seyfried, professor of biology at Boston College, the results in animal studies and limited testing in humans aren’t just promising, they’re revolutionary. He’s adamant that treating cancer as a metabolic rather than a genetic disease (meaning to target how the cells fuel themselves rather than genetic mutations within them) will lead to a vast reduction in the number of deaths from cancer. He’s been working to develop a treatment protocol that might one day find its way to a treatment center near you.
“It’s called ketogenic metabolic therapy,” and he says in this context, “the ketogenic diet shouldn’t be considered a diet like green salads or other such stuff. It’s essentially medicine, and the process primarily tries to remove one of the driving fuels for the disease, which is glucose, and transition the whole body over to ketones, which the tumor cells can’t use as a fuel. So it’s very simple,” he says. The approach was outlined in a recent paper that Seyfried believes will serve as the “blueprint for the destruction of cancer” once all the particulars have been worked out.
“It’s a cocktail of drugs and procedures and foods and they all work synergistically to gradually eliminate the tumor while maintaining the health and vitality of our normal organs. The whole goal of this metabolic therapy, which involves the ketogenic diet, is to gradually degrade and eliminate tumor cells without toxicity so the patient emerges from the therapy healthier than when they started,” he says.
The approach is still new and has only been tested in limited settings. Seyfried says his team is still working out the particulars of which patients are best suited to the treatment and when and how drugs and the other elements of the therapy should be administered for the best outcome. But he’s enthusiastic that this approach will fundamentally alter the way cancer will be treated in the future.
He points to one particular case study of a woman in Turkey with stage 4 triple-negative breast cancer, an aggressive form of end-stage breast cancer, whose tumors — in her breast, liver and lymph nodes — disappeared after she underwent chemotherapy, combined with metabolic therapies, as being indicative of where cancer treatment should be aiming to go. In that woman’s case, she was treated with a ketogenic diet, hyperthermia treatment (a potential alternative to radiation in which heat is used to damage and shrink tumors) and hyperbaric oxygen therapy (in which oxygen is delivered to the patient at a higher pressure than at sea level to increase the amount of oxygen in the body to make cancer cells easier to kill). These metabolic treatments are still in clinical trials and not widely available, but Seyfried says that taken together, this metabolic approach is a “disruptive technology based on sound biology of the problem. This is not some hocus pocus; this is based on a fundamental problem with the cancer cell as a biological entity. We’re simply targeting the very process by which that cell tries to survive.” He says this metabolic approach to treating cancer “is a paradigm shift that’s coming. It’s just a matter of time” until metabolic therapies become commonplace, but until then, more work remains to be done.
In the meantime, if you’re interested in trying a ketogenic diet as part of your treatment for breast cancer or to reduce your risk of developing it ( obesity is a major risk factor for virtually all types of cancer, and following a keto diet might help you drop some weight) be sure to talk with your doctor first. Some doctors and nutritionists worry that the diet’s reliance on red meat and animal products may actually elevate your risk of colon cancer. There’s also limited data on how the diet impacts health long term. Because it’s quite restrictive, it can also be challenging to maintain this approach to food over the long haul.
[See: 7 Innovations in Cancer Therapy.]
If you have breast cancer or another disease, Poff says it’s absolutely critical that you communicate with your doctor about any changes you make to your diet. Although most people have no real problem adapting to a really low-carb diet, she says it can be dangerous for people with metabolic diseases that prevent the normal metabolism of fat, and people with any sort of liver disease should only proceed under the care of a physician.
“I think it’s really important anytime anyone completely makes such a huge diet change that they’re being overseen by their doctor and keeping an eye on their blood lipids (fats in the blood) and blood parameters. While the data that’s out there about keto in the healthy population shows that, for the most part, people respond very favorably in terms of their biomarkers improving, there’s some small groups of people who have concerning changes in their biomarkers as well. So, we’re not all the same by any means, and it’s possible” that a keto diet will not provide benefits for you.
And for cancer patients, she urges caution. “It’s absolutely critical for a cancer patient, if they wanted to do something like this, that they work very closely with their oncologist and a ketogenic diet-trained dietitian.”
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Can a Keto Diet Slow the Growth of Breast Cancer? originally appeared on usnews.com
