Ketogenic diet could help ‘starve’ tumours -- but is it safe for the general population?

A high-fat, low-carb diet that has been used to help people with epilepsy is being looked at for its potential to starve brain tumours in cancer patients.

Doctors are monitoring the case of Adam Sorensen, a Calgary teen who was diagnosed with stage 4 glioblastoma multiforme, the most aggressive form of brain cancer. Following surgery and radiation, he started the ketogenic diet two and a half years ago. His most recent brain scan in March was clean, despite the fact that his type of cancer usually recurs within 18 months.

Sorensen’s diet consists of 80 per cent fat, 15 per cent protein, and five per cent carbs.

Not to be mistaken for Atkins, the ketogenic diet is controversial when it comes to being used for weight loss.

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How does it work?

Developed in 1924 by Dr. Russell Wilder at the Mayo Clinic, the diet is high in fat and low in carbohydrates and supplies adequate protein, according to the Charlie Foundation for Ketogenic Therapies.

Normally, the body uses carbohydrates (such as sugar, bread and pasta) for its fuel. With the ketogenic diet, fats become the primary fuel instead.

Ketones are formed when the body uses fat for its source of energy. According to the Epilepsy Foundation, ketones are likely one of the key mechanisms of action of the diet in people with epilepsy.  Higher levels of ketones – a state called ketosis – often lead to improved seizure control.

Highlights

The kinds of foods that provide fat for the ketogenic diet are butter, heavy whipping cream, mayonnaise and oils, such as canola and olive oil.

It is more strict than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins.

Success with some epilepsy patients

Jim Abrahams, who founded the Charlie Foundation in his son’s name, says the diet worked for his child when nothing else did. Charlie started having seizures around age one; by two, he had had brain surgery and was taking various combinations of medications.

“He was having 40 to 60 seizures a day, completely loaded up on drugs,” Abrahams tells Yahoo Canada. “We sort of gave up hope.”

After he started reading about the ketogenic diet, however, Abrahams and his wife decided to give it a try. “Within two days of starting the diet the seizures were gone,” he says. “Within a month he was off all medications. We got him back.”

That was more than 20 years ago. Charlie was on the diet for about five years in total, and now continues to do well.

The Charlie Foundation is organizing the Global Symposium on Diet Therapies in Banff this September with the University of Calgary. The fifth meeting of its kind will examine the diet on epilepsy, brain cancer, autism and cognitive disorders.

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Ketogenic diet and cancer

In 2012, researchers at Barrow Neurological Institute at St. Joseph’s Hospital and Medical Center found that it was possible to treat brain tumour cells in a mouse model using a combination of ketogenic diet and radiation therapy.

Cancer cells are known to use glucose to grow; however, they are not as efficient at using ketone bodies as replacement for glucose, which has led some scientists to theorize that ketogenic diet could help “starve” certain forms of cancer.

Ketogenic diet and weight loss

The high-fat, low-carb approach to losing weight – and keeping it off – remains up for debate.

Kristen Mancinelli, a registered dietitian and public health nutritionist based in L.A., says the ketogenic diet promotes more, and more rapid, weight loss than traditional low fat or low calorie diets.

“Removing carbs from your diet – bread, potatoes, sugar, cereal, and grains –  causes you to drop weight fast,” says the author of the newly released The Ketogenic Diet: The Scientifically Approved Approach to Fast, Healthy Weight Loss. “You’re rarely hungry on the ketogenic diet. Many people who can’t control their hunger when carbs are in the picture find they’re quite able to stick to their keto eating plan. 

“Sugar and carb cravings disappear after a couple of weeks,” she adds, “and some people experience a great freedom from ‘addiction’ to certain foods.”

Mancinelli cautions that people with diabetes, hypoglycemia, kidney disease, or other conditions that disturb metabolism should not attempt to follow a ketogenic diet. Diabetics who attempt a ketogenic diet could trigger ketoacidosis, a potentially fatal condition for them.

People’s cholesterol will likely increase on the diet, she notes.

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“There’s disagreement on the health impact of cholesterol, though increasingly nutrition recommendations are moving away from villainizing fat and cholesterol and more toward pointing the finger at sugar and low quality carbohydrates as the cause of diet-related disease,” Mancinelli says. “Both fat and carbs are important in the health equation. Whatever you do, do not eat a very high fat, high carb diet. That is a recipe for poor health. If you go high fat, get rid of the low quality carbs.”

Toronto registered dietitian Andrea Falcone, however, says that solid research into the safety and efficacy of a ketogenic diet for weight loss is lacking.

“Everything in the research is short term, small sample size, so you really cannot address huge benefits with…research that has been done to date,” she says, noting that people who have tried the diet for weight loss haven’t been followed over the long term.

“On most of sample sizes, they [participants] are relatively overweight or obese, so anytime you put a restriction of some macro nutrient or major food group of somebody’s diet they’re going to lose weight, whether you restrict fat, protein, or carbohydrates.”

By severely restricting carbohydrates, she says, “you are not providing the body with the proper balance of nutrients,” and used over a long period, the diet could be “ very hazardous to our overall health.”