Both fasting and ketogenic diet have major health benefits, incur no additional cost and are considered generally safe for most people. There is evidence of reduced treatment side effects, evidence of better physical function, better quality of life and better sleep, and generally improved body and metabolic terrain, which indicates an environment within the body that is less supportive of cancer development, growth or spread.
Fasting for 12 or more hours every night and occasionally for longer periods, can contribute to lower body weight, blood sugar and insulin resistance, plus fewer unpleasant chemotherapy-related side effects. In cancer care, fasting can alter the metabolism of cancer cells and may improve the effectiveness of chemotherapy and reduce side effects. There is good evidence of lower levels of insulin-like growth factor-1 (IGF-1) (higher levels are linked to higher risk of cancer and worse outcomes) among people fasting or restricting calories by more than 30% but not among people restricting calories by 30% or less.
Dr Nasha Winters wrote about the benefits of fasting in her book, Metabolic Approach to Cancer. Since her book was published, fasting has become increasingly popular as a therapeutic intervention. PubMed database shows over 5,000 scientific articles published on fasting and its effects on health. In a study published in the journal Cancer Research, researchers found that fasting 48-72 hours prior to chemotherapy treatment significantly reduced the side effects of the treatment while simultaneously increasing the effectiveness of the treatment against cancer cells.
Fasting, or calorie restriction, is considered an important component of an anti-cancer ketogenic diet, as it supports the body’s retention of ketones and also restricts cancer growth from extra calories or body weight.
A ketogenic diet is low in carbohydrates, moderate in protein and high in fat. It can improve insulin resistance and support healthier blood sugar levels. The goal of a ketogenic diet is to decrease glucose and increase ketones to alter the metabolism of cancer cells and their associated stromal cells. It has been studied primarily in malignant glioblastoma.
The ketogenic diet may help deprive cancer cells of their main energy source, glucose, due to its high-fat and low-carbohydrate design. Healthy cells can use both glucose and ketones for energy, but cancer cells heavily rely on glucose, using about 10 times more than healthy cells. This unique characteristic of cancer cells is used in PET scans to detect areas with increased metabolic activity in the body. Since cancer cells take up more of the radioactive glucose used in these scans, it’s easier to pinpoint cancerous areas. By limiting glucose intake, the ketogenic diet makes it harder for cancer cells to thrive. This reduction in glucose levels also lowers insulin and Insulin-Growth-Factor levels, which can otherwise promote tumour growth.
Moreover, the ketogenic diet may help reduce inflammation in the body, which is widely believed to contribute to cancer development and progression. By reducing inflammation, the body may become better placed to fight cancer cells and hinder their growth.
While further research is required to fully understand the ketogenic diet’s role in cancer, early studies have suggested that the ketogenic diet could enhance the effectiveness of chemotherapy and radiation therapy.
Ketogenic diets selectively starve tumours by providing the fat and protein that otherwise could not be used by glucose-dependent tumour cells. In ketogenic diets, the 4:1 ratio of high fat to low carbohydrates mimics the metabolic effects of starvation.
Both fasting and ketogenic diet have major health benefits, incur no additional cost and are considered generally safe for most people except those who are significantly underweight.
Data from case reports and trials suggest ketogenic diet is safe and tolerable for patients with cancer. Although it would be ideal to conduct a larger trial using a randomised therapeutic approach, the current emphasis on drug-based trials is a formidable obstacle.
However, people with cancer show reduced treatment side effects, evidence of better physical function, better quality of life and better sleep, and generally improved body and metabolic terrain, which indicates an environment within the body that is less supportive of cancer development, growth or spread.
Some caution is necessary when following ketogenic diets with certain cancers and expert advice should be sought. The ketogenic diet is not universally suitable for all cancer types and may be contraindicated in certain cases. It may not be recommended for individuals with kidney or liver cancer, or those with pre-existing kidney or liver conditions, due to the potential for exacerbating these issues. Additionally, some research suggests it may not be beneficial for breast cancer, and may even promote metastasis in some models.
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Fasting and other dietary regimens have been used to treat epilepsy since at least 500 BC. To mimic the metabolism of fasting, the ketogenic diet was introduced by modern physicians as a treatment for epilepsy in the 1920s. For two decades this therapy was widely used, but with the modern era of antiepileptic drug treatment its use declined dramatically. By the end of the twentieth century, this therapy was available in only a small number of children’s hospitals. Over the past 15 years, there has been an explosion in the use of, and scientific interest in the ketogenic diet.
The role of fasting in the treatment of disease has been known to mankind for thousands of years and was studied in detail by ancient Greek and Indian physicians. An early treatise in the Hippocratic Corpus “On the Sacred Disease” describes how alterations in diet played a role in epilepsy management. The same author also describes in “Epidemics” from the collection, how a man was cured of epilepsy when he abstained completely from consuming food or drink.
Intermittent fasting initially gained popularity for its potential to aid in weight loss. Research has expanded to explore the broader health benefits of intermittent fasting, including improvements in insulin sensitivity, metabolic health, and potential effects on longevity.
Another alternative is called the fasting-mimicking diet which is a calorie-restricted diet that still allows for the consumption of specific foods. It is designed to mimic the physiological effects of fasting without requiring complete abstinence from food. Where fasting or intermittent fasting requires complete abstinence from food, fasting-mimicking diet allows a small amount of calorie intake.
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