Interesting new pharmacology for sure, but the end of the article is critical here:
"Additionally, an accompanying commentary by William Katt and colleagues indicated that there are no FDA-approved drugs that target glucose and glutamine metabolism. This is because previous drug candidates proved to be too toxic for use in humans."
It's really hard to go after glucose because it's kind of everywhere. If there's a way to target this compound more specifically, maybe it could be useful. As it stands now, it's very very far from being a viable drug (and it doesn't sound like the authors claim otherwise). Cool science though.
The issue is that cancer is polyclonal so there is a sub-population that predominantly relies of aerobic glycolysis, but the sub-populations that mostly metabolise glutamine or fatty acids will escape treatment... so you need a bit of a shotgun approach, in combination with traditional anti-cancer agents.
Is this actually true? Having done the ketogenic diet and bringing carbohydrates down to almost nothing, my brain definitely didn't starve. In fact, running on ketones was amazing.
It kinda depends on what exactly they mean. Is it true that if you had zero glucose available in your bloodstream at all
your brain would be unable to function? Yes. Is it true that if nothing you ate contained any glucose your brain would starve? No. There's a process called gluconeogenesis which produces more than enough glucose for your brain to function no matter how few carbs you eat.
The amount of glucose you need in your blood stream to keep everything running smoothly is a very small amount easily produced by your body through a process called gluconeogenesis.
I went 60 days sans any calories and my body self regulated glucose just fine.
I won't say fasting for 21 days was the most pleasant experience, but it is entirely doable by the average healthy person. Nice job going 60 days. The hardest part for me was the social aspect, family/friends' repeated concerns because I'm 'starving myself', sitting at the dinner table while everyone else eats, etc.
For the remainder:
I felt tired, cranky, cold (especially at night), and on occasion I would have trouble getting to sleep. My inflammation was markedly decreased. I have dermatographia (skin writing) where I can use my fingernail to draw a line on my arm (for example) and within a couple of minutes it will swell up like an allergic reaction. After about 5 minutes it goes away. I tried doing this halfway into my fast and while the inflammation was still there, it was much much much less noticeable (and not puffed up.)
As far as overall goal, aside from losing some weight was trying to reset my immune system which has been out of sorts for the past couple of years. I've been through a battery of tests to figure out why I've been feeling less than normal (brain fog, neuropathy, etc.) for the past 2-3 years and I was hoping it would help. Alas it did not. I lost 31lb and gained about half of it back after a couple of months. I wasn't following any particular diet after the fast, particularly because when I experience these bouts of brain fog/malaise, I don't feel motivated to stay on track.
I've started walking 5-7 miles a day and exercising over the past couple of months and have noticed some improvement. I did a 3 day water fast a few weeks ago, who knows if that was a factor. I'm maybe 85% of the old me, which is a massive improvement from where I was coming from. Hopefully things continue to improve (or simply doesn't get worse.)
Ketones were always at or near the limit the meter is designed to test for. I think anything over 8.0 mmol/L and it would yell at me to see a doctor. Lowest I recorded was 7.0, and almost every reading was over 8.0. Felt fine the whole time.
Echo what you said about the hardest part being social though.
The fact that humans can fast for weeks or months isn't evidence in favor of:
> The amount of carbohydrates you need in your diet to survive is exactly zero.
> Two normal men volunteered to live solely on meat for one year, which gave us an unusual opportunity of studying the effects of this diet. The term “meat,” as used by us, included both the lean and the fat portions of animals. The subjects derived most of their calories from fat and the diet was quite different from what one, who uses the term “meat” as including chiefly lean muscle, would expect.
> 11. In these trained subjects, the clinical observations and laboratory studies gave no evidence that any ill effects had occurred from the prolonged use of the exclusive meat diet.
People in the Arctic circle like the Inuit always lived almost entirely off of meat and Mongolians and other steppe pastoralists come very close, adding dairy.
> These studies were supported in part by a research grant from the Institute of American Meat Packers.
Inuit populations suffering lower incidence of heart disease is a myth.
> The mortality from all cardiovascular diseases combined is not lower among the Inuit than in white comparison populations. If the mortality from IHD is low, it seems not to be associated with a low prevalence of general atherosclerosis. A decreasing trend in mortality from IHD in Inuit populations undergoing rapid westernization supports the need for a critical rethinking of cardiovascular epidemiology among the Inuit and the role of a marine diet in this population.
> Most studies found that the Greenland Eskimos and the Canadian and Alaskan Inuit have CAD as often as the non-Eskimo populations. Notably, Bang and Dyerberg's studies from the 1970s did not investigate the prevalence of CAD in this population; however, their reports are still routinely cited as evidence for the cardioprotective effect of the "Eskimo diet."
They don't have lower incidence of ischemic heart disease than white westerners, they don't have lower levels of atherosclerosis, and these have actually improved as their diets have become more western and less traditional.
No malnourishment in the linked study or in Inuit populations.
> Inuit populations suffering lower incidence of heart disease is a myth.
I never claimed they did. I was responding to your claim that you don’t see how a long term all meat diet can be healthy and that malnourishment is certain with an all meat diet. If the Inuit incidence of cardiovascular disease is not lower I presume it’s also not higher or it’d have been mentioned.
The claim was not that an all meat diet was healthier, but that it was roughly as healthy. If their incidence ischemic heart disease and atherosclerosis is no lower than white westerners but they don’t get diabetes because they don’t eat carbs that’s (incredibly weak) evidence of health benefits.
Again, I’m not saying the diet is healthier, I’m showing evidence that it is healthy in the long run and that malnourishment is not a certainty.
This is a lot of work to go to in order to hang on to a pet diet that is shown to cause arterial injury and doesn't lead to greater weight loss than less harmful diets.
Eating is definitely optional if you have the body fat.
I also adhered to a strict no coffee/tea policy.
In my case I tend to feel less hungry after drinking lots of flavored water (e.g., lemon juice or flavored electrolyte powder ), but I haven't yet done long fasting. I want to try soon.
Also, have you noticed any cognitive decline when you were fasting for weeks? Difficulty concentrating, memory loss, lightheadedness, mood, ability to interact with people?
And no, no cognitive decline whatsoever. If anything I had more energy. Also, I was supplementing electrolytes, and I ended my fast at like 25% bodyfat though, so keep that in mind.
water, black coffee, and salt do not produce this reaction.
Were you working during this period or off work? Sometimes starting the fast is troublesome when one knows there's going to be energy level issues.
I like the idea of avoiding coffee/tea, that's something I think could help in the long run.
One other negative experience but that was due to my own stupidity and I've since learned better.
Basically if you're above 15% bodyfat, you only need two things to live. Water and electrolytes.
If anyone has any questions, more than happy to answer e-mails.
Kinda kicking myself for not getting a good set of blood tests for the 'before' results.
Thanks for sharing your story!
Essentially got really really bad cramps in my legs each morning towards the end of the first 30 days. Fixed itself as soon as I added in the magnesium and potassium supplements. Likely caused because I drank too much water during the early parts of the fast.
This is day 61, I'd estimate like 4k-ish calories.
07:51 - Woke to Alarm
08:34 - Weight 199.8 - Bodyfat 26.1
08:41 - Start First Meal - Handful of Spinach Wilted in 2 tbsp Butter - 5 Olives - 1 Dill Pickle Spear - 6 oz Pickle Juice
08:45 - End First Meal
08:50 - Drank 1/2 Liter Water
08:57 - Start Sauna 165.0 F
09:00 - Drank 1 Liter Water
09:12 - End Sauna 182.5 F
09:15 - Shower
10:23 - Finished 2nd Breakfast - Single Egg omelette, cheese, olive oil, more spinach wilted in butter and 3 pickle spears.
11:35 - Lunch /w Dave - Bunless Burger, Bacon, Cheese, Fried mushrooms, Onions, Pickles and a Fried Egg on top. Salad with blue cheese dressing.
12:18 - 16 oz nitro cold brew
13:25 - 32 oz San Peligrino Unflavored Zero-Cal
16:23 - 5 Guys Bacon Cheeseburger - 2 Patties - Bacon - Mushroom - Lettuce Wrap - Mayo - Side of Mayo
18:09 - 9 olives - 3 Servings
19:23 - 9 Jimmy Dean Sausage Links dipped in 6oz Chunky Blue Cheese dressing.
Did your stomach not get upset with you the following day?
Most people break their fast with something really easy to digest like pickle juice etc.
> "If you do not consume enough carbohydrates in your diet, your body will synthesize the glucose you need."
>If you do not consume enough carbohydrates in your diet, your body will synthesize the glucose you need.
the body would preferentially reserve all glucose for the brain
The brain does use ketones in starvation sitautions, but it always needs to use some glucose, so over time the available glucose ends up redirected there.
From what I can find it appears that the heart does utilize ketone bodies for fuel, contrary to what you are asserting. There is correlation to heart failure, possibly from stress in utilizing an energy source with less efficient bioavailability.
For simplicity here's the wiki link as a summary
I'd love to see the research that shows your point in more detail.
your hypothesis seems to be that a lack of carbohydrates (read: sugar) caused an individual to develop diabetes, but "diabetes" generalizes down to:
- the body (pancreas) does not produced insulin at all (type I)
- the body's cells are resistant to the produced insulin (type II)
we should be able to basically rule out type II because there should have largely been no insulin produced by this individual (glucagon would take priority due to low blood sugar), so insulin resistance seems super unlikely. and type I has a mix of factors but they are largely all autoimmune, where various pancreatic cells are destroyed by the body itself, causes generally unknown.
"losing the ability to process sugar" seems really sketchy, because those are all critical cellular processes that don't just go away. i realize you're probably not biologically trained but that statement doesn't make a whole lot of sense.
so which form of diabetes did this individual get diagnosed with?
I have no idea as to the validity of this anecdote but the idea isn't unprecedented. For example, correcting an iodine deficiency can cause the same thyroid issues that a deficiency can cause.
They're simply not, the body can manufacture all the glucose it needs.
The ketogenic diet is glucose sparing, that is your insulin levels are dramatically lowered since the very small amount of glucose you're eating should go to the tissues that require it, not into your fat cells.
So if you're on a ketogenic diet and then eat a lot of glucose, your body takes a little while to ramp back up insulin. That's not the same thing as insulin resistance or impaired insulin production in diabetics.
Your brain would literally starve without it. If you do not consume enough carbohydrates in your diet, your body will synthesize the glucose you need.
This medication is intended to block glucose transport to cancer cells while not blocking to non-cancer cells. Even if a zero carb diet would be a good idea for a cancer patient in general, there is absolutely no chance that a zero carb diet would be equivalent to the intended mechanism of this medication because people with a zero carb diet still have plenty of glucose.
> In fact, the late George Cahill did an experiment many years ago (probably would never get IRB approval to do such an experiment today) to demonstrate how ketones can offset glucose in the brain. Subjects with very high levels of B-OHB (about 5-7 mM) were injected with insulin until glucose levels reached 1 mM (about 19 mg/dL)! A normal person would fall into a coma at glucose levels below about 40 mg/dL and die by the time blood glucose reached 1 mM. These subjects were completely asymptomatic and 100% neurologically functional.
it is not controversial that the brain can survive long periods of time on principally ketones, but what has not yet been proven (for obvious ethical reasons) is whether or not the brain can sustain itself with absolutely no glucose whatsoever.
again, the ratios are key. i'm not contesting that ketones can be used as the principal fuel source, just that "the important thing is ATP" because the brain needs some glucose.
I find it amusingly absurd how so many people here seem convinced that our primary food source is somehow a poison. People with 0 carbs in their blood are colloquially known as 'dead'.
I wonder if people even know what ketone bodies are... They are a downstream product of glucose processing(also downstream of fats - the inputs are different but the outputs are identical in a few ways), acetyl-coA, stuck together for bloodstream transport with the coenzyme temporarily removed.
Excess protein (in fact, even in the amounts society recognizes as "normal") is bad for you. https://www.youtube.com/watch?v=2R07FL1wVo4
But still, I gave him the benefit of the doubt and sincerely asked him, and ask others here, "Please provide me with studies that show that it's 'horrible for the brain'." I don't mean that to be snarky. I've looked and haven't been able to find the studies. Maybe I've been looking in the wrong places and I would love to read the studies* that show how bad it is.
Towards the end of the conversation with this guy I found it amusing that he stopped chiding me long enough to ask, "So... wait, what is Keto?"
* Peer-reviewed, scientifically rigorous studies only please.
Seriously, I had an accident in March that necessitated a brain operation and left me in the hospital for over a month. The most surprising after-effect is that I can't always predict or recognize the symptoms arising from that.
Was your keto diet the only change in your life? Going from obese to athletic in 6 months probably includes some other good habits like going to gym/physical activity and good sleep etc. So maybe your change in a lifestyle helped you improve you mood and focus, not necessarily the keto diet in particular?
There's literally thousands of articles on it on pubmed.
Paleo humans never ate meat sounds silly, though.
The mechanism seems to be that during periods of fasting, normal cells "hunker down" and restrict the consumption of nutrients and other materials. Cancer cells don't do this though and continue to consume the nutrients, which are actually chemotherapy drugs in the patients.
Fasting therfore increases the absorption of chemo by the cancer cells and reduces the consumption by normal cells keeping the patient healthier.
Fasting also enables the body to more completely rid itself of cancerous cells by consuming them in the absence of alternative sources of nutrition.
Lots of reasons why fasting is a good thing.
Your understanding of how chemotherapy works with cancer and healthy cells seems flawed. Chemo harms all fast-growing cells, healthy or not. That’s why people have terrible tastes, stomach problems, hair and skin problems during chemo; those are all fast-growing cells. They grow fast whether you are fasting or not; but killing them in large numbers (what the chemo does) raises the body’s demand for energy and nutrients just to maintain health. That demand must be met with healthy food and drink.
Edit to add: Fasting by a healthy person may reduce their chances of developing cancer; that seems plausible to me. My point is that people undergoing chemotherapy should follow the directions of the doctors. In my experience, those directions are to eat well while receiving treatment.
Here is one of the articles I'd found in my research:
I only found preclinical studies. And anecdotal results from others who have tried it. I've been unable to find any good evidence that the efficacy of the chemotherapy is enhanced, only that side effects can be mitigated.
Two oncologists I've seen are not supportive of my fasting but haven't strenuously objected to my decision either.
FWIW, a third oncologist opposed my undergoing chemotherapy at all. I've found, in general, a lack of consensus as to proper treatment, at least in my situation. I've now consulted with seven specialists (four oncologists and three surgeons) and the recommendations haven't been consistent. And most of them decline to give definitive directions, leaving the major decisions to me. My point being that, at least in some situations, following the directions of doctors isn't necessarily an option.
Edit: Added some details
> [Short Term Fasting] during chemotherapy is well tolerated and appears to improve QOL and fatigue during chemotherapy.
> Abundant and convincing preclinical evidence shows that STF can decrease toxicity and simultaneously increase efficacy of a wide variety of chemotherapeutic agents.
> For general cancer prevention, it may be beneficial to add intermittent or short-term fasts in combination with a plant-based cancer prevention diet
>Fasting may also protect patients against the harmful side effects of chemotherapy or radiation therapy.
> They concluded that a 3-day fast could help regenerate a strong immune system
> Additional research in both rodents and monkeys have shown that when CR was started by 12 months of age, lifespan was increased and incidence of spontaneous cancers was reduced by 50%.
> Furthermore, it is theorized that cancer cells do not respond to the protective signals generated by fasting, thus leaving them vulnerable to both the immune system and cancer treatment.
I feel like this is sufficient to refute your several oncologists' anecdotal opinions which are not supported by the research.
> There is a growing body of evidence supporting the role of fasting in both cancer treatment and prevention.
Lots of links to sources in that article too.
You have to be very careful relying on the advice of oncologists. Think about what their motivations are. What are their biases? I dealt with this very personally for a long time and found oncologists to be ... human and suffer from all the same problems as other humans.
Their patients are ... dying and they don't want to die. It's a very emotional time for all involved.
There's an impressive body of research on this subject already, it's just unfortunate that many (most?) oncologists haven't caught up yet with the science.
A common objection is that chemotherapy causes weight loss, and it's important that patients keep their weight up. Where this argument falls down, is when you look at why chemo patients lose weight - and it's primarily due to the treatment reducing their appetite.
So if you're then able to reduce side effects of chemo (which it appears fasting does), patients are then more easily able to eat and maintain/recover their weight.
It's not. Unless you have the appropriate training and experience, you are not capable of making treatment recommendations.
Sorry if that seems harsh, but this is not something you can just Google your way through. This is not one of those things where you can find the hidden truth by reading a few things online and posting citations.
You either have medical training or you don't. If you don't, be very careful about make big medical decisions based on a few things you read online. Plenty of people apply the same heuristic to decide that vaccines are bad, homeopathy works, you can treat cancer with an all-fruit diet, etc.
> You have to be very careful relying on the advice of oncologists. Think about what their motivations are. What are their biases?
Think about what your motivations and biases might be. You're human too.
The research clearly indicates that there is a benefit to fasting, yet you say the research is wrong because of the opinions of several oncologists.
I'm biased because several oncologists told me something that wasn't true.
You have to distinguish between these two statements:
a) There is research that indicates that there is a benefit to fasting
b) The research indicates that there is a benefit to fasting
Statement a) is true; but b) is what you said.
Going from a) to b) is the hard part. It's not enough to know what some research says, you need to place it within the broader context of the field of knowledge before you can make declarative statements of benefit. And cancer is an incredibly complex and fast-moving field of knowledge.
The oncologists I spoke with were aware of research into voluntary fasting, but on balance recommended against it. One reason is that unlike with a healthy person, ending the fast may not be under the patient's control, depending on how they tolerate their chemotherapy. Chemotherapy ends up looking like intermittent fasting for a lot of patients anyway.
Chemotherapy is also cumulative, which means that decisions that appear beneficial in early rounds may end up limiting the total number of sequential rounds that a patient can tolerate.
If someone is not habitually fasting, adding it on top of chemotherapy adds a significant confounding factor to a process that is already hard to predict.
And aside from voluntary fasting, there is a lot of evidence that patients who can eat well and keep their weight up have better outcomes from chemotherapy than those who can't/won't eat and lose weight.
This is what I was told by people who spend their lives studying the treatment of cancer.
It sounds like you are saying that the right answer depends on an individual's circumstances. I would agree. Certainly fasting could be harmful for some people depending upon their overall medical situation.
> If someone is not habitually fasting, adding it on top of chemotherapy adds a significant confounding factor to a process that is already hard to predict.
For my situation, the clinical evidence I could find suggested that chemotherapy does not have a statistically significant impact on the probability of disease-free survival. Even the oncologists who are recommending chemotherapy have been reluctant to claim it would necessarily be beneficial. This increased my interest in adding the significant confounding factor of fasting. In fact, you could say that I've been actively seeking significant confounding factors as the default path is rather dark.
As you noted, cancer is an incredibly complex and fast-moving field of knowledge. Given the currently limited research into the impact of fasting, I decided to conclude that maybe it can be helpful (especially since the biological hypotheses made some sense to my primitively educated mind).
Returning to your earlier point, I'm not sure it's currently possible to make a blanket claim of fasting being good or bad with respect to its impact on cancer patients. It seems that it would depend upon the patient's individual situation and priorities.
What I object to is someone without medical training reading a few articles online and then posting universal declarations that fasting is good for everyone on chemo, and that people shouldn't trust oncologists for some reason. Obviously that's not you.
You said I was "dangerously wrong" because someone else you talked to said I was wrong, but you have provided no evidence supporting your case, other than hearsay.
I have provided evidence. You concluded with:
> This is what I was told by people who spend their lives studying the treatment of cancer.
Which, again, is appeal to authority. It's a logical fallacy.
How much evidence do I need to provide?
> Current data in humans suggests that IF may be beneficial for chemotherapy outcomes, particularly for reducing toxicities. IF appears to be safe in appropriately selected patients, and the adverse effects associated with fasting appear to all be of low grade.
> Growing preclinical evidence shows that short-term fasting (STF) protects from toxicity while enhancing the efficacy of a variety of chemotherapeutic agents in the treatment of various tumour types. STF reinforces stress resistance of healthy cells, while tumor cells become even more sensitive to toxins, perhaps through shortage of nutrients to satisfy their needs in the context of high proliferation rates and/or loss of flexibility to respond to extreme circumstances.
> Both chronic calorie restriction (CCR) and intermittent calorie restriction (ICR) have shown anticancer effects.
> Fasting and FMDs have the potential for applications in both cancer prevention and treatment.
Do you have any evidence that fasting is deleterious to the health of cancer patients? Except what you said someone said?
Did you ask those oncologists for any evidence supporting their case or did you just take their words at face value?
I suspect that one thing fasting does is frees up those cells to do other stuff.
Anecdotally, I've seen people comment on HN and Reddit that fasting helped them with some chronic health issue or other. Here's an HN comment that says he was on antibiotics constantly until he tried fasting:
If you find any such studies, please share. Thanks.
more completely rid itself of cancerous cells by consuming them
Papers it discusses include:
* Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy – Lizzia Raffaghello, Valter Longo et al. (2008)
* The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study – Stefanie de Groot et al. (2015)
* Fasting and cancer treatment in humans: A case series report – Valter Longo et al. (2009)
* Fasting-Mimicking Diet Reduces HO-1 to Promote T Cell-Mediated Tumor Cytotoxicity – Di Biase et al. (2016)
* The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study – Bauersfeld et al (2018)
Actual long term fasting (ie, 3-5 day hardcore mode shit) allows the body to maximize autophagy to kill off damaged cells. The western diet of 3 square meals a day and keeping insulin levels alarmingly high (which both frequent and carb-laden diets promote) stops autophagy (for safety reasons; you don't want to accidentally attack cells doing their tasks to absorb and utilize nutrients).
So yeah, given what is known about cancer today, I personally eat keto omad (one meal a day intermittent fasting) within a 4 hour window every day, and periodically fast on top of that.
There are many things to consider, including refeeding syndrome, it is highly advised to seek MD advice prior to undertaking such a diet.
Lastly, there is a ton of research highlighting fasting and its effects on stem cell regenerative properties.
Ketogenesis is arguably the most ideal state for our bodies to operate in, but it is also arguably the hardest one to maintain in our society. It is difficult for most to consistently ignore that big-ass box of krispy kreme donuts your asshole coworker brings in every day. Just one of those per day is probably enough to keep you stuck in glycogenesis for the rest of the morning and into part of the afternoon.
If you look at the push of HFCS and other crappy food options with incidence rates of cancer over the last 3 decades, I am pretty sure you will see some correlation there. Obviously, it is hard to draw a causal link between these, but at a certain point I am going to give up on the academic explanation in favor of a series of practical observations and whatever inferences I can draw from those. I am also acutely aware of the influence of profit seeking in the medical & academic communities. When I see a study come out that says something along the lines of "sugar isn't actually that bad for you" I immediately think big sugar or corn financed this research piece for their own benefit.
I have personally fasted for stretches as long as 5 days, been on one-meal-a-day, and have been on ketogenic diets for months at a time. I have also been a complete waste of a human, eating and binging on all manner of sugary, carb-loaded foods and other unspeakable horrors. I can tell you that 100% of the time, I felt better in the ketogenic state. Sure, you can argue for that very brief feel-good you get from slamming that donut, or the mental fortitude required to force yourself into keto. But, at the end of the day, once you are keto it's easy. It's just the transition phase that sucks. As with most things.
Krispy Kreme donuts are easy to avoid ... Donuts from your local hole in the wall donut shop on the other hand.
OTOH, intuition is sometimes wrong.
It should be a pretty simple study to do. Just make sure to get enough people involved. Then correlate amount of fasting with the incidence of cancer over some period of time. I guess the duration of the study would be the only impediment.
This is what I've read on the topic and longetivity studies on people who go on long term fasts seem to support it.
That's what I've been told/read on the topic, but I'm not an expert by any means.
I always respected the religions that observed some sort of fast, as it was a cool way they encoded health & longevity into their population.
Edit: I don't want to provide sources. Me not providing a source on demand for the HN crowd does not mean this is not true. Do your own research, or don't.
It would make sense that by limiting food intake, cancers would progress slower.
It's just that when treating cancer, there may be opportunity to modify its intake and see benefits.