Fight Cancer with a Ketogenic Diet

Transcription

A Safe, Science-Based, Non-Toxic Dietary Alternative for Cancer Treatment
FIGHT
CANCER WITH A
Use the Warburg Effect to treat cancer at the metabolic level
Minimize the unpleasant side effects of chemotherapy and radiation
Improve the success rate of your standard treatment program
Fight Cancer with a
Ketogenic Diet
A New Method for Treating Cancer
Second Edition, January 2014
By Ellen Davis
www.ketogenic-diet-resource.com
All rights reserved. No part of this book, including interior design,
cover design, and icons may be reproduced or transmitted in any form,
by any means (electronic, photocopying, recording, or otherwise)
without the prior written permission of the author, except for the
inclusion of brief quotations in a review.
Copyright 2013 by Ellen Davis
(Clickable) Table of Contents .................................................................................. iii
Dedication .............................................................................................................. vi
Acknowledgements ............................................................................................... vii
Using This Book .................................................................................................... viii
Introduction .............................................................................................ix
Chapter 1 ................................................................................................. 1
What is a Ketogenic Diet?........................................................................................ 1
Cancer Cells Are Sugar Addicts ................................................................................ 2
High Blood Glucose Fuels Cancer .................................................................................. 4
How Foods Affect Blood Glucose and Insulin ........................................................... 5
Ketogenic Diet: Why It Works .................................................................................. 7
Chapter 2 ................................................................................................. 9
The Scientific Evidence ............................................................................................ 9
What About Pediatric Cancer Treatment? ............................................................. 10
Chapter 3 ............................................................................................... 11
Who Should NOT Follow a Ketogenic Diet? ........................................................... 11
Contraindicated Metabolic Conditions ........................................................................ 11
Contraindicated Health Conditions.............................................................................. 11
Contraindicated Medications ...................................................................................... 12
Important Note on Steroids ........................................................................................ 12
Chemotherapy or Radiation Treatment ....................................................................... 12
Chapter 4 ............................................................................................... 13
Goals, Side Effects, Benefits, and Monitoring Progress .......................................... 13
Goal #1: Reduce Blood Glucose and Insulin, and Increase Ketones .............................. 14
Dr. Seyfried’s G/K Index ........................................................................................ 14
Notes on Carb, Protein and Caloric Restriction ...................................................... 16
Goal #2: Minimize and Treat Side Effects .................................................................... 17
About Heart Palpitations or a “Racing” Heart ........................................................ 21
Note on Elevated Cholesterol ............................................................................... 22
About Nausea ....................................................................................................... 22
Ketosis versus Ketoacidosis ................................................................................... 23
Benefits of a Ketogenic Diet ........................................................................................ 24
iii
Monitoring Progress ................................................................................................... 26
Laboratory Tests ................................................................................................... 26
Measuring Blood Glucose and Ketone Levels ........................................................ 27
Troubleshooting Stubborn Blood Glucose Levels ................................................... 28
Tips for Diet Success ................................................................................................... 30
Chapter 5 ............................................................................................... 33
Starting A Ketogenic Diet....................................................................................... 33
About Fats ............................................................................................................. 33
About Coconut Oil....................................................................................................... 34
About MCT Oil ............................................................................................................ 35
About Dairy Fats and Dairy Proteins ............................................................................ 35
About Protein ........................................................................................................ 37
About Glutamine ........................................................................................................ 37
About Carbohydrates ............................................................................................ 38
Calculating Total versus Net Carbs .............................................................................. 39
Increasing Carb Limits Over Time ................................................................................ 40
About Fiber ................................................................................................................. 41
About Water ......................................................................................................... 41
About Fasting and Intermittent Fasting ................................................................. 42
Fasting Tips ................................................................................................................. 43
My Personal Experience with Fasting .......................................................................... 44
Chapter 6 ............................................................................................... 45
Customizing Your Ketogenic Diet ........................................................................... 45
Step By Step Directions ............................................................................................... 45
Using the Food Exchange Lists .............................................................................. 50
Why Use Exchanges? ............................................................................................ 51
Meal Exchanges .......................................................................................................... 53
Tips on Using Your Customized Ketogenic Diet Plan .............................................. 54
Allowed Foods ....................................................................................................... 55
Foods To Avoid ...................................................................................................... 61
Reading Food Labels.............................................................................................. 64
Dining Out on a Ketogenic Diet.............................................................................. 65
General Tips................................................................................................................ 65
Tips for Specific Cuisines ............................................................................................. 65
Beware of Hidden Dining Pitfalls ................................................................................. 67
Travel Tips ............................................................................................................. 68
iv
Ketogenic Cooking Techniques .............................................................................. 69
Time Saving Cooking Tips ............................................................................................ 69
Quick Ketogenic Snack Ideas ....................................................................................... 70
Useful Kitchen Supplies ............................................................................................... 71
Recipe Resources ........................................................................................................ 71
Recommended Cookbooks.......................................................................................... 72
Chapter 7 ............................................................................................... 73
Other Factors to Consider ..................................................................................... 73
What about Exercise? ................................................................................................. 73
Alcohol Consumption .................................................................................................. 73
Stress .......................................................................................................................... 73
Illness, Medications and Menstrual Cycles .................................................................. 74
Sick Days ..................................................................................................................... 74
How Long Should I Stay on the Diet? ........................................................................... 75
Concerns about Acidity and Alkalinity ......................................................................... 75
Antioxidants................................................................................................................ 76
Ketogenic Diet and Vegetarianism: Not a Fit, But…...................................................... 76
Resources for More Information ........................................................................... 78
Final Words and Thank You ................................................................... 79
Appendices ............................................................................................ 80
Appendix A: Recommended Supplements ............................................................. 80
Appendix B: Recommended Health Professionals.................................................. 81
Appendix C: Suggested Ideal Weight Ranges ......................................................... 84
Appendix D: Daily Calorie Requirements ............................................................... 85
Appendix E: Ketogenic Macronutrient Levels ........................................................ 86
Appendix F: Macronutrient Worksheet ................................................................. 97
Appendix G: Food Exchange Lists .......................................................................... 99
Alphabetical Food Exchange List ............................................................................... 106
Appendix H: Exchange Record and Food Diary .................................................... 109
Appendix I: Meal Exchange Log ........................................................................... 111
Appendix J: Conversions and Measurements....................................................... 113
Appendix K: References ....................................................................................... 115
Appendix L: Glossary ........................................................................................... 119
v
A ketogenic diet (KD) emphasizes foods rich in natural fats and adequate in protein, and
restricts foods high in carbohydrate.
While the USDA recommendations call for 45-65%
of calories from carbohydrate, ketogenic diets restrict
carbohydrate intake to about 2-4% of calories. The
charts at right compare food group intake between the
Standard American Diet (SAD) and a ketogenic diet for
cancer treatment.
When carbohydrate containing foods (sugars and
starches) are digested, they are broken down into
blood sugar (glucose) in the body. The more
carbohydrates we eat, the more glucose is made. High
blood sugar is toxic to the body, so there are metabolic
processes which push that sugar into our cells to be
broken down into energy or fuel for the body. Only
after this sugar has been metabolized can the body
turn to using stored or dietary fat for energy needs.
Reducing carbohydrate intake reduces blood
glucose levels and this causes our internal biochemical
pathways to switch to metabolizing fat and using the resulting products for energy. These fat
derived substances are called ketone bodies. And once the body is using ketones as a main fuel
source, there are some profound and positive health effects. Ketogenic diets are terrific for
weight loss and addressing minor health issues such as heartburn and achy joints, however,
they are much more powerful than those popular uses would suggest.
In other words, this diet is not a “fad.” It is a potent regulator of metabolic derangement,
and when formulated and implemented correctly, it can be extremely effective.
In this eBook we will explore the details of this dietary approach and discuss how it works,
why it works and how to implement it.
1
In 1924, Dr. Otto Warburg, a Nobel Prize winning biochemist proposed the hypothesis that
cancer is a metabolic disease. Dr. Warburg showed in his studies that cancer cells exhibited a
preference for the utilization of sugar (glucose) as a fuel, even when the oxygen that normal
cells use for energy creation was available. He wrote:
“Cancer, above all other diseases, has countless secondary causes. But, even for
cancer, there is only one prime cause. Summarized in a few words, the prime
cause of cancer is the replacement of the respiration of oxygen in normal body
cells by a fermentation of sugar.”
~Otto H. Warburg
Until recently, Dr. Warburg’s hypothesis (known as the Warburg Effect) has been
marginalized by the persistent belief in the oncology world that cancer is a genetic disease.
However, in his new book, Cancer as a Metabolic Disease: On the Origin, Management, and
Prevention of Cancer, Dr. Thomas Seyfried proposes the idea that Dr. Warburg was correct, and
that cancer is instead a metabolic disease. Furthermore, the genetic markers on which the
cancer research community has so fiercely focused are actually just downstream effects of the
defective metabolism of cancer cells.
What does it mean to say that cancer is a metabolic disease? Metabolic diseases are
conditions in which the metabolism, or the making of energy from the food we eat, is broken or
abnormal in some way.
Normal body cells are able to create energy by using the food
we eat and the oxygen we inhale to complete normal cellular
“respiration” and make ATP (adenosine triphosphate), our main
cellular energy source. Most of this energy production happens in
the mitochondria, tiny organelles known as the “powerhouses” of
the cell. There are two primary types of food-based fuel that our
cells can use to produce energy:
•
The first cellular fuel is glucose, which is commonly known as blood sugar. Glucose is a
product of the starches and sugars (carbohydrates) in our diet, and it is converted into
energy in our cells via a process called glycolysis. In normal cells, glycolysis is an initial
metabolic reaction which provides substrate molecules to the mitochondria so that the
more effective and normal “oxygen dependent” cellular respiration can be completed.
2
•
The second type of cellular fuel comes from fatty acids. There are various kinds and they
come from fats we eat or from the metabolism of stored fat from our fat cells. When blood
glucose is low, fatty acids are broken down by the liver into products called ketone bodies
or ketones. Ketones can be used by the mitochondria of most cells to produce energy. The
process of creating ketones is called ketogenesis, and the metabolic state which favors
using ketones as the primary source of energy is called ketosis.
When glucose levels are low, most normal cells will switch to using ketone bodies for fuel.
Ketones allow normal cells to be metabolically flexible, so to speak. Even the brain and nerve
cells, which are heavily dependent on glucose, can utilize ketone bodies for fuel. This ability of
most normal cells to use ketones (when glucose is unavailable) indicates that their cellular
mitochondria are healthy and functioning properly.
In contrast, most cancer cells have dysfunctional mitochondria and limited metabolic
flexibility. They can’t access mitochondrial energy pathways so they can’t utilize ketones, which
leaves only the pathway of glycolysis (shown on the right side of the picture below):
Photo Credit: http://hyperphysics.phy-astr.gsu.edu/hbase/biology/celres.html
This lack of flexibility leaves cancer cells dependent on glycolysis and other less efficient
forms of cellular energy production to keep themselves alive. In fact, this metabolic inflexibility
is why a ketogenic diet can effect cancer cells. By lowering glucose levels in the blood, the KD
exploits the Achilles heel of cancer cells by forcing them to literally “run out of fuel.”
3
While our brain depends on glucose for part of its energy needs, some cells such as our red
blood cells are entirely dependent on glucose for survival. Since glucose is so crucial for life,
several metabolic mechanisms are in place to ensure that blood sugar remains at steady levels
necessary to support the needs of the body.
Insulin is the primary hormone involved in the regulation of glucose levels in the body.
Insulin is made by cells in the pancreas, mostly in response to a rise in glucose levels that
accompanies digestion of foods containing carbohydrates. Insulin’s function is to “push” blood
sugar into cells where it can be metabolized for cellular energy. This works great until a few
hours after a meal. At that point,
insulin has completed its job and
blood sugar levels begin to drop. If
the next meal is skipped or delayed,
a different hormone, glucagon, calls
on the liver to release a stored form
of glucose called glycogen. The liver
may also produce new glucose from
“precursor” molecules in a process
called gluconeogenesis.
The image at right is from a
study which looked at carbohydrate
metabolism and its effects on insulin
and blood glucose. It’s a good
example of how insulin and blood
glucose rise in lock step when
carbohydrates are consumed.
Whenever we eat a large
amount of carbohydrates, our
digestive system breaks them down
into blood glucose. Each time blood
glucose surges, the pancreas makes
insulin and releases it into the bloodstream. More insulin in the bloodstream means that more
glucose will get pushed into cells. Cancer cells are primed to take advantage of this extra
glucose for growth, so lowering glucose and insulin in the bloodstream is a priority.
4
Blood glucose and insulin levels are regulated in part by the types and amounts of foods we
eat and digest. Foods in the human diet are composed of several important macronutrients:
fats, carbohydrates, and proteins. Upon digestion in the body, each of these macronutrients
has a different effect on blood glucose and insulin:
Macronutrient/Foods
Most dietary Fats and oils are in the
form of “triglycerides” which can be
either saturated, monounsaturated,
or polyunsaturated.
Effect on blood glucose and insulin
upon digestion
Fats have little to NO effect on blood
glucose or insulin levels.
Proteins are primarily found in foods
such as meats, eggs, poultry, fish and
some plant foods (e.g. soy, nuts and
beans). During digestion, proteins are
broken down into smaller units called
amino acids.
Proteins have a moderate effect on
blood glucose and insulin. The more
protein consumed, the greater the
effect. In addition, certain amino acids
have a pronounced effect on blood
glucose and cancer cell metabolism.
Carbohydrates (carbs) are found in
foods such as fruits, vegetables,
beans, grains (e.g. wheat, rice and
corn) and all starchy or sweet foods.
Upon digestion, carbohydrates are
broken down into simple sugars
(glucose, galactose and fructose).
Carbohydrates have the greatest effect
on blood glucose and insulin. Carbs
eaten in any amount or form will raise
blood glucose and cause a rise in
insulin to push blood glucose into cells.
Most whole foods are a combination of the three macronutrients, usually with one
macronutrient being the “dominant” one. The exception to this rule is in the case of highly
processed foods such as doughnuts or French fries. Processed foods are usually high in both fat
and carbohydrate, a particularly unnatural combination.
Whole foods, on the other hand, have healthier ratios. If a whole food such as an avocado is
high in fat, it will most likely be low in protein and carbohydrate. If a whole food like steak or
chicken breast is mostly protein, it will likely be moderate in fat and low in carbohydrate. Our
food nourishes us in a loose three-way “ratio” and understanding this ratio will help you design
5
meals consistent with a ketogenic diet. Here are a few examples of how the calorie percentage
ratios work in real foods:

Olive Oil: olive oil is 100% fat, with 0% carbohydrate and 0% protein.

Baked Potato: a plain white potato is 80% carbohydrate, 10% non-digestible fiber, 10%
protein and 0% fat.

Chicken Breast: a baked chicken breast is 62% protein, 38% fat and 0% carbohydrate.

Raw Spinach: raw spinach is 30% carb, 30% non-digestible fiber and surprisingly, 40%
protein.
Here’s a visual representation of those percentages:
Understanding and managing these ratios will help you determine what foods to eat so you
consume correct amounts of each macronutrient.
The overall target of a ketogenic diet is to maximize fat intake, limit protein to what is
needed for “repair and maintenance,” and restrict carbohydrate intake. When carbohydrate
and protein intake are controlled and fat intake is emphasized, circulating blood glucose and
insulin will remain low and stable AND there will be a corresponding rise in ketone body
production. The metabolic state of elevated ketones coupled with low blood sugar and insulin is
called nutritional ketosis and this is our goal.
Getting to and staying in the state of nutritional ketosis is how we create an inhospitable
metabolic environment for cancer cells.
6
Adhering to a ketogenic diet and staying in a state of nutritional ketosis has the effect of
changing the body’s metabolic environment into one that is incompatible with cancer cell
metabolism.
Cancer cells thrive on high levels of glucose and depend on high insulin levels to obtain that
glucose. High insulin levels also set the stage for increased production of other hormones which
enhance the metabolic conditions for cancer advancement. A ketogenic diet emphasizes the
consumption of fats because these foods have almost no effect on blood glucose and insulin
levels. In contrast, sugars and starches (foods high in carbohydrate) elevate blood glucose and
insulin significantly. Excess protein will elevate blood glucose as well. Lowering carbohydrate
and protein intake while increasing fat consumption effectively bottlenecks the sugary fuel
that drives cancer growth. In response to the bottleneck, the liver creates ketone bodies from
stored and dietary fat to supply energy the body needs. Once glucose supply is limited and
ketones are elevated, food supplies for cancer cells get scarce.
In addition, lower levels of insulin inhibit hormones such as insulin-like growth factor 1 (IGF1) and other metabolic pathways which promote cancer progression. And that’s not all.
Because cancer cells have defective mitochondria, low glucose supplies leave them with no way
to repair the oxidative stress which constantly bombards all cells. Hence they are more likely to
sustain fatal injuries from interactions with oxidizing free radicals. Radiation therapy works by
increasing free radical activity around cancer tissue and studies have shown that being in
nutritional ketosis seems to enhance this destructive free radical effect.
Meanwhile, normal cells thrive in this new metabolic environment since they can
metabolize ketone bodies quite well. In fact, switching to ketones for energy needs results in a
lower rate of oxidative damage in normal cells. So not only are cancer
cells endangered, normal cells sustain less free radical damage and
get a boost toward good health when a ketogenic diet is adopted.
This ability of normal cells to switch fuel states from glucose to
ketones (i.e., nutritional ketosis) is a crucial adaptation which has
most likely permitted our continued survival on planet Earth. Ketone
bodies act as a backup system when blood glucose levels fall, either
as a result of starvation or carbohydrate restriction. Without this
adaptation, the human race from Paleolithic man to the modern
castaway might have perished during times when food was in short
supply.
7
Put another way, a ketogenic diet has
a sort of domino effect on cancer. It
lowers high blood sugar which reduces
insulin levels in the blood. Reducing
insulin levels effectively inhibits the
production of IGF-1. In turn, low insulin
and low IGF-1 levels inhibit other
hormonal drivers of cancer like TAF
(tumor angiogenesis factor), a substance
that cancer cells secrete in order to build
a blood supply network for themselves.
And to top it all off, low glucose supplies
leave cancer cells without a way to repair free radical damage, and this compromises their
ability to survive.
This antioxidant and anti-inflammatory effect of nutritional ketosis is why calorie restriction,
fasting and ketogenic diets (which produce ketones and mimic fasting without the hunger) have
such beneficial effects on human health. In fact, nutritional ketosis and ketone bodies
themselves are being studied extensively as a treatment for many metabolic diseases. A
growing number of research papers
have been published on ketogenic
diets and the anti-inflammatory effect
Lower IGF-1
of ketone bodies on conditions such
as epilepsy, Multiple Sclerosis, ALS,
Lower
Lower TAF
Parkinson’s Disease, Alzheimer’s
Insulin
Disease, head trauma, Type 2
Diabetes, cardiovascular disease,
autism, migraine headaches, stroke,
Lower
Increased
Cancer Cell
Starvation
Blood
Free Radical
depression, acne and of course,
and Death
Glucose
Damage
cancer.
This is all rather technical, so I’ll
end this section with the short story: to fight cancer, it is crucial that you lower blood glucose
and insulin levels and increase circulating ketone bodies.
This is exactly what a ketogenic diet does.
8
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Fight Cancer with a Ketogenic Diet

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