Can we target cancer with ketogenic diets? Can you help?

Posted: August 22, 2016 in Uncategorized
We have a good deal of enthusiasm in the keto/paleo/low-carb community. We have the real sense that we can we use carbohydrate restriction to take advantage of the characteristic metabolic features of cancer — inflexible reliance on glucose. Enthusiasm may have outstripped the data, however, and several groups are trying to fill the gap. The barrier rests with the difficulty for anybody to obtain funding from NIH or other major government or private agencies. On top of this looms the long-standing resistance to low-carbohydrate diets making things particularly difficult. Our group is carrying out some good experiments and we employ a dedicated technician and we can efficiently use limited funds. Your backing can help.  A $ 15 donation gets us several days of supplies for the in vitro experiments that provide the biochemical underpinnings for attacking cancer in the clinic. Our project at experiment.com provides background, a place for discussion and reports from the lab.

The current metabolic point of view in cancer — emphasizing flexibility of fuel choices —  derives from renewed interest in the Warburg effect. Warburg saw that many cancer cells were producing lactic acid, the product of glycolysis. In other words, the tumors were not using the more efficient aerobic metabolism even when oxygen was present in the environment. The tumor cell’s requirement for glucose suggests the possibility of giving the host an advantage by restricting carbohydrate and offering ketone bodies as an alternative fuel.constant_ATP_UCP2

We showed previously that we could inhibit the growth of 7 different cancer cell lines and repress the production of ATP (the”‘energy molecule” in cell culture by adding acetoacetate (one of the ketone bodies) to the medium.  Control normal cell lines were not affected. In addition, we showed that ATP reduction was associated with the level of a molecule called uncoupling protein-2 (UCP-2).  I explain in other posts what “uncoupling” means and how it figures into energy efficiency. First, the big picture..

What is the context of inhibition by ketone bodies ?
The real context, of course, is human cancer. Our 28 day pilot human trial of 10 subjects with advanced cancers on a very low carbohydrate ketogenic diet (KD) was published in Nutrition (Elsevier) in 2012.  A small study — nominally just to show safety and feasibility, it was nonetheless well received. Of note, is that we found that those patients with the greatest extent of ketosis had stable cancers or partial remission, while those with the least ketosis showed continued progressive cancer. Despite a favorable editorial and the Metabolism Award from the journal. Unfortunately, our proposal to scale up to 65 patients was rejected by the NIH/NCI which we find very discouraging perhaps related to a commitment to drug therapy. In any case, we appeal now for help in supporting dietary cancer research.
You can help. To donate:  Our project ia at experiment.com
Comments
  1. hsugarmill says:

    What do you think of an anti-cancer diet that contains phytonutrients that

    a/ inhibit de novo lipogenesis as well as glucose and glutamine metabolism?

    b/ bind to copper in cancer cells?

    I’ve been compiling lists of phytonutrients in foods that do either or both in lab studies. Plants rule! Can a plant-based diet put you in ketosis? Do long overnight fasts help?

    • rdfeinman says:

      Unfortunately we are not at the stage where we can evaluate these although may well be part of the picture. Ketosis is primarily controlled by the level of carbohydrate and insulin so a plant-based diet can be low-enough and a fast will help.

  2. Richard S Stone says:

    Clearly cancer has a certain path of development, with certain factors that we KNOW being somewhat effective in limiting camcer. First, Cancer cells appear to have a preference for more carbohydrate-based diets. Cancer doesn’t need protein? I think the answer is Insulin based: IGF promotes cancers and vascularization. Tumors need vascularization. Carbohydrates are sugars, in the end, and that creates an insulin response.

    Second. Vitamin D interferes with cancer growth.

    Third, the better diet, low or almost no carbs, is a start, but there is an improvement on that: fasting and IF.

    I think the answer is that a combination of the above is the key. One factor at a time is probably not enough to show very much. Fasting and IF greatly reduce insulin and promote autophagy, vitamin D (with A and K2) should slow or stop cancer growth.

    Take a look at the blog of Jason Fung, M.D.: Intensive Dietary Management.

    Richard

  3. […] Source: Can we target cancer with ketogenic diets? Can you help? | Richard David Feinman […]

  4. […] Source: Can we target cancer with ketogenic diets? Can you help? | Richard David Feinman […]

  5. drpijak says:

    Several recent reports questioned the conventional concept that in cancer cells the energy is produced only through glycolysis without major contribution from mitochondrial respiration . There is evidence that not only carbohydrate but also aberrant lipid metabolism plays an important role in PCa growth and progression. This altered metabolism includes lipogenesis and β-oxidation, which provides fuel and lipid signaling mediators to sustain growth and resistance to stressful environments. Alternative energy pathways like fatty acid oxidation (FAO) have been getting increasing attention in cancer research. Association of FAO with apoptotic machinery has been reported in cancer, suggesting that FA metabolism provides a survival advantage to the cancer cells and closely communicates with the cancer signaling pathways. What do you think about it?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964437/
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809061/

  6. Gretchen says:

    In beta cells, more UCP-2 and less ATP means less insulin release. Less insulin release would mean higher BG, which would mean more glucose for the cancer cells. Don’t know if this is relevant.

    • rdfeinman says:

      Sorry for delay but for some reason, these are not showing up in my email. I am not sure about this. Do you have a reference? Also, what is described is in vitro response to the cancer cells themselves. Others that are normal appear to do fine with acetoacetate. in other words, in a whole person, we hope to target just the tumor (although still premature).

      • Gretchen says:

        Sorry for *my* delay. I’ve been in Maine. I’m not sure what you want a reference for. I think it’s well accepted that beta cells work by increasing ATP in cells and that UCP-2 inhibits insulin release. It was 20 years ago I researched this, so I don’t have reference at the tip of my shrinking brain.

  7. Nate says:

    Sorry, this comment is off topic, but I’m alarmed. The National Academy of Medicine is about to appoint a slew of calories in, calories out people to review the science behind the 2015 Dietary Guidelines. See: http://www.nutrition-coalition.org/stop-the-national-academy-of-medicine-from-stacking-the-panel-on-dietary-guidelines-with-government-insiders/

    Where is everyone? Why are the American LCHF gurus not sounding the alarm? Do you guys not remember how we even got the US Congress to spend a million dollars to investigate the USDA’s Dietary Guidelines? Congress members don’t know how our money is being spent. We need to tell them.

    Short story about my Easter ham. Tyler Jones learned to farm by being an intern at Polyface Farm with Joel Salatin. One year Tyler’s Easter hams were confiscated by the USDA. (The reason was due to some miscommunication between the new USDA inspector and the previous one.) As it happened, Joel Saladin gave a talk where I lived and I got to ask him how best to get my ham back and the rest of Tyler’s hams. He said call and write your Congress person. I did that. Sure enough it took only a few weeks and we got all of the hams back.

    Every American LCHF eater should be writing NAM and their Congresspeople. Why is not every American blogger on the Diet Doctor page not commenting and rallying the troops?

    • rdfeinman says:

      “Why is not every American blogger on the Diet Doctor page not commenting and rallying the troops?” It is not easy to rally the troops. One of the places contributions go is toward freeing up to deal with Congress. So, a little bit we are doing this for the troops.Thirty-nine dollars ($ 39) out of my pocket that I don’t have to use for supplies for the late, is $ 39 that I can use for the on-sale Amtrak ticket to Washington. You are right, that they listen but it takes many voices to move things.

  8. […] Ketogenic diets may help fight cancer, and you can help researchers prove it. […]

  9. […] Ketogenic diets may help fight cancer, and you can help researchers prove it. […]

  10. rdfeinman says:

    There was a comment that seems to have disappeared

    youjejune@gmail.com
    107.152.104.14

    I find it great that you are trying to do this with your own funding efforts, and am confident you will succeed in securing the necessary resources, but do you have the rejection of grant statement from the NIH/NCI? I’m interested in their arguments against funding your project.
    Approve | Reply | Quick Edit | Edit | History | Spam | Trash

    In any case, Gene made these comments:

    “The first reviewer declared that we weren’t even measuring ketone bodies in the urine, so how could our protocol accurately call itself a ketogenic diet?”

    Technically speaking, the reviewer was correct: We did not propose to measure KB’s in the urine because we indicated that we’d measure KB’s in the serum, a far better measure. And we would do this as we had already demonstrated in our 10 patient pilot human trial, whose graph of betahydroxybutryate vs. insulin concentrations comparing baseline (pre-Ketogenic diet vs. all weekly data points) was inserted on page ONE of the grant proposal. The problem was that the reviewer didn’t know that BHB was a ketone body.

    In short, it is very difficult to get a metabolic ketogenic dietary cancer therapy fairly reviewed by a study section in which the reviewers don’t know anything about the metabolism.
    The above is one example, but provides the flavor of the problem.

  11. […] Ketogenic diets may help fight cancer, and you can help researchers prove it. […]

  12. […] Ketogenic diets may help fight cancer, and you can help researchers prove it. […]

  13. Philip Thackray says:

    Hello,

    I’d like to donate to this project but would prefer to send you a check. If this is possible would you give me a contact and address and “steering information” (if necessary).

    Philip Thackray

    • rdfeinman says:

      Thanks for your support. You can send a check to
      The Nutrition and Metabolism Society
      60 Terrace Place
      Brooklyn, NY 11218
      Att: R. Feinman

      and we are a 501(C)(3) not-for-profit

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