Ketogenic Diet for Cancer Care
Let's start by saying: No, keto is not suitable for everyone or for every cancer type.
In mainstream media, "keto" has become a bit of a buzz word, particularly for fast weight loss and for supercharged energy levels. Bulletproof coffees, MCT oil, and butter and bacon seem to be back on the menu.
Since realising its application in children with treatment-resistant epilepsy, there is plenty of emerging research around other clinical applications for this high fat diet. The research is quite fascinating, but is it relevant for patients with cancer? And if so, how should it be structured to be safe, sustainable and enjoyable?
Due to cultural influence, many Australians tend to have a huge reliance on carbohydrates as a food source. Cereal for breakfast, sandwich for lunch, and pasta for dinner - does that sound familiar? Even our kids are often already eating this way.
Carbohydrates in those quantities can be very problematic, particularly if the carbohydrates are refined or processed. Not only are we inadvertently limiting the other, more nutrient-rich foods we are having, but the constant elevation of our blood sugar levels is having significant detrimental impacts on our metabolism, immune system, gut health and nervous system. Which is one reason why chronic lifestyle diseases are on the rise.
What is a Ketogenic Diet?
A "Keto Diet" means switching from using carbohydrates as energy (ie glucose) to using fatty acids. Ie: a very low carb, high fat diet.
That's right. You eat fat, to loose fat.
Glucose is not the only available source of energy. The body is quite capable of using alternative sources when carbs are sparse. This is a simple, evolutionary back up plan, as before industrialization, refining processes and 24hr fluorescent supermarkets we didn't have access to white bread, cookies galore, and cereals in colourful boxes. Fruit was the main source of simple carbohydrates, and was only available seasonally. Other than that, we relied on low carb plants, root vegetables, nuts and seeds, and local meat and fish to survive.
The body is quite capable of switching between different energy systems. In times when carbs are not available, the body switches over to using fat as its energy source. This process completely bypasses the insulin pathway. Instead, fatty acids (either from the diet or from fat stores) are converted in the liver to ketone bodies, which can then be readily used for energy. In fact, ketone bodies produce far more energy per unit than glucose does, making ketones a very efficient source of energy (think high octane fuel versus plain petrol for your car).
All or nothing
The downside to this process is that the body needs to learn to efficiently go into "ketogenesis", it take practice, particularly if you are used to a high carb diet. And as soon as carbs are present again, the body jumps right back to its old ways. So if you want to reap the full benefits of a ketogenic diet, you need to do it right and do it consistently. The more you do it, the more efficient your body is at it.
There are potential side effects though, including gastrointestinal upset, nausea, constipation, excess strain on the kidneys, hypoglycaemia, micronutrient deficiencies and unwanted weight loss. A Ketogenic Diet should only ever be attempted under the supervision of a health practitioner.
What are the benefits of a Ketogenic Diet in cancer care?
As said above, a Ketogenic Diet is actually not suitable for all cancers across the board. It is suitable in SOME types of cancer, and for SOME types of people (taking their BMI, digestive capabilities, co-morbidities and lifestyle into account).
Overall for keto and cancer, the research is still evolving. Most currently available research articles are animal studies, preclinical trials and individual case reports. While animal studies are quite promising, with many showing evidence for an increased anti-tumour effect when used in conjunction with chemotherapy and/or radiotherapy, large scale human trials are still limited. The clinical benefit of a Ketogenic Diet in cancer care is largely hypothetical at this stage, and should be applied with caution. Further, actual compliance to a strict Ketogenic Diet is proving to be challenging, potentially predisposing patients to a yo-yo diet effect: something we want to avoid.
What we do know is that a Ketogenic Diet CAN be useful for weight loss and particularly loss of central adiposity and visceral fat. It can, under practitioner supervision, be used as a tool in certain types of cancer and metabolic conditions to reduce fat mass and increase insulin sensitivity.
So should I really be eating bacon?
Uh, no. Above all, we advocate for a nutrient rich, anti-inflammatory diet approach, and deli meats including bacon are loaded with saturated fats and preservatives. IF going keto, a low sat-fat, pescovegetarian approach is much better, using fats such as oily fish, coconut oil, avocado and extra virgin olive oil, and balancing that with plenty of leafy greens.
The key takeaway here?
A Ketogenic Diet has not been clinically shown to starve cancer. It may have hypothetical applications or be used as a tool for specific goals, but must be designed in a safe, tolerable and sustainable way, and tailored to the individual patient's needs.
If you'd like to learn more about what a Ketogenic diet looks like, if it is suitable for you, how to tailor it to your needs, and to implement it sustainably and safely, book in with one of our Nutritionists here at MIOG.