It’s time to bat around another reader-inspired question about an important subject within the realm of health that virtually everyone reading this right now has had to deal with in their lifetime through a diagnosis of a family member or friend–that would be CANCER. Researchers have been looking at what the possible culprits in what is causing this terrible disease for decades, but unfortunately most of the studies have been geared towards finding a pharmaceutical answer. Oftentimes, the natural nutritional remedies aren’t even investigated because there is no money to be made promoting that to cancer victims. It’s just such a shame that finding a cure for cancer seems to be predicated on how much money can be made treating people that have it. If I’m wrong about this, then somebody tell me otherwise. I guess I’ve just become so jaded by how health is viewed from the very medical professionals who purport to be about improving health.
One of the most exciting areas of research that is taking place right now is how a ketogenic, low-carb diet could be used as a therapeutic tool for treating people afflicted with cancer when chemotherapy and other procedures have proven ineffective. Thanks to the great work of people like Dr. Eugene Fine and Dr. Thomas Seyfried who are testing this theory about how ketones can help shrink the size of cancerous tumors and quite possibly be used as a preventative measure for people concerned with getting cancer. The funding for these kind of studies has been paltry compared with the drug research, but the outlook for the ketogenic approach looks quite promising.
Enter the following monkey wrench one of my readers shared with me recently regarding this study published in the September 21, 2010 issue of the scientific journal Cell Cycle claiming that ketone bodies can INCREASE tumor growth by as much as two-and-a-half times reflecting a “Reverse Warburg Effect.” Personally, I’d never heard of anything like this, especially in light of the work of Fine and Seyfried on the BENEFITS of ketones in REDUCING cancer cell growth as part of their studies. Here’s what my reader wrote to me in an e-mail:
I am a long-term lowcarber (very high-fat — all manner of fat from grass-fed animals, eggs, nuts etc.) and am often in ketosis — more often than not. I love livin’ la vida low-carb and find it the easiest way to avoid the type 2 diabetes and obesity that has plagued so many members of my family. However, today someone posted some disturbing information on another low-carb diet forum regarding recent studies like this one claiming to show that ketones fuel cancer. Do you have any thoughts on this?
Since this was such a foreign concept to me based on all that I know about how low-carb ketogenic diets respond to cancer in just the opposite manner (see here , here , and here for just a few examples), I couldn’t help but ask some of my expert friends in the low-carb community to respond. Here’s what they had to say:
GARY TAUBES , author of Why We Get Fat
FRED & ALICE OTTOBONI , author of The Modern Nutritional Diseases
DR. THOMAS SEYFRIED , Boston College cancer researcher
Here’s Dr. Seyfried’s letter that never got published in the journal:
October 20, 2010
Dear Dr. Blagosklonny,
I am writing in reference to an article that appeared in the September 1 issue of Cell Cycle by Bonuccelli, et al., entitled: “Ketones and lactate “fuel” tumor growth and metastasis: Evidence that epithelial cancer cells use oxidative mitochondrial metabolism”.
The authors have made serious errors in their data interpretation and the conclusions of their article. There is no evidence in the biochemical literature that ketone bodies can be made from pyruvate in fibroblasts. It is common knowledge in biochemistry that ketone bodies are derived from fatty acid beta-oxidation in liver mitochondria. This information is also presented in the cited articles from Veech and co-workers.
The authors present evidence showing that the ketone body 3-hydroxy-butyrate does not enhance lung metastasis (Fig. 4A), yet the paper title indicates that ketones fuel tumor growth and metastasis. The paper title and abstract are therefore misleading.
Furthermore, no evidence was presented in the paper showing that the MDA-MB-231 cells can survive using only L-lactate or ketone bodies as metabolic fuels. While the authors recommend that it may be unwise to use lactate-containing i.v. solutions in cancer patients, the authors should also recognize that lactate is metabolized to glucose in the liver through the Cori cycle. It is well documented that glucose can stimulate tumor growth. No information was provided on food intake or body weights of the treated and control mice. No information was presented on blood glucose or ketone levels in the tumor bearing mice used in the study. It is difficult to assess the effects of drug injections without this information. Finally, no evidence was presented showing that OxPhos is operational in the MDA-MB-231 tumor cells. Gene expression profiles do not provide the required biochemical and physiological evidence for establishing operational OxPhos in tumor cells.
Unfortunately, the author’s provide misinformation. Such information will cause confusion in the field. I am surprised that the reviewers of this paper did not mention these issues in their critique, as some of the evidence and statements presented contradict basic principles of biochemistry as specified in any general textbook on the subject. If further evidence is needed to support my concerns, I would suggest contacting Drs. Richard Veech, Theodore B. VanItallie and Jong Rho.
DR. STEPHEN PHINNEY , low-carb researcher and co-author of The New Atkins For A New You
DR. ERIC WESTMAN , low-carb researcher and co-author of The New Atkins For A New You
KAREN RYSAVY , long-time low-carber at “Truly Low Carb”
DR. MARY VERNON , low-carb practitioner in Lawrence, Kansas
Dr. EUGENE FINE , cancer researcher at Albert Einstein College of Medicine
So, that’s what the experts say in response to this idea that ketones that are produced while on a low-carb diet actually “fuel” cancer cell growth. But what do YOU think? Is it possible for cancerous tumors to grow in the presence of ketone bodies based on all that you know about the role low-carb diets play in this? If sugar feeds cancer (and it does!), then how can the absence of sugar in the blood which occurs when carbohydrates are restricted lead to higher rates of cancer? Is it even fathomable? Let the discussion begin.