Going Ketogenic

During a recent stay in hospital, one of the nurses commented that I look happy and seem to be coping really well. I suppose to an outsider I do. Most of the time I put on a brave face and soldier on because, let’s face it, what choice does anyone in my situation have?

One of my favourite coping strategies is denial, or as a therapist at a Breast Cancer Care event labelled it “temporary sanctuary”. I find my temporary sanctuary in cooking, hill-walking, yoga, meditation, eating curry, sewing and colouring-in (my new favourite hobby). All of these things enable me to put cancer to the back of my mind. Of course this only works during times of stability. It takes something trivial, like shit scan results (okay that’s quite big), and the normally contained panic hits you in the face like a wet kipper, which leads me nicely onto my next subject, the ketogenic diet.

The bad news I received in February (brain mets and progression elsewhere) has elevated my cancer threat level from moderate to critical. No more time for dilly-dallying  around and pretending this isn’t happening. I saw the scans of my brain. This is real. I have cancer. It’s spreading and I don’t like it.

I have been searching for the elusive cure since my primary diagnosis on 1st June 2012. I have researched and ingested every supplement and cancer fighting food known to man. I’ve consumed forests of broccoli, mountains of mushrooms, gallons of green tea and juiced till I’ve turned orange. I have over-dosed on Vitamin D, dabbled with CBD oil, but not cannabis oil cos that’s illegal in the UK, although I’m happy to accept donations from charitable growers. Hell, I’ve even done a bit of Aspirin. There aren’t many things I haven’t tried or at least considered . Lack of evidence usually puts me off, which is why I’ve never wasted any money on Essiac tea or apricot kernels.

By the way if you want to know how to piss off a secondary cancer patient ask them if they’ve ever heard of Gerson Therapy, Cannabis Oil or considered juicing. I can guarantee you’ll be hit in the face with a wet kipper.

I’ve tried numerous dietary regimes. I’ve done and still do intermittent fasting as well as water fasting on a regular basis. After watching ‘Fat sick & nearly dead’ I contemplated doing a 60 day juice fast until a friend pointed out that I’m not morbidly obese, nor is there any evidence that it cures cancer.

I came across the ketogenic diet during one of those best-avoided midnight Google journeys. The ketogenic diet is a low carbohydrate, moderate protein, high fat diet. Cancer cells require higher rates of glucose to function than healthy cells, so the basic principle of the ketogenic diet is to starve the cancer cells of their main fuel supply. It sounds simple but it’s not.

In a typical western diet around 50% of our daily calories come from carbs. Carbs include bread, pasta, rice, grains, potatoes and any product that contains or converts to sugar in the body. In the ketogenic diet for cancer, carbohydrates are limited to around 5%. Typically around 75-85% of calories will come from fat, 10% from protein and 5% from carbs. A useful comparison is the Atkins diet which is similarly low in carbs but much higher in protein.

The keto diet was first developed in the 1920’s when it was discovered that fasting helped control seizures in children with epilepsy. Fasting wasn’t a long term solution and so the ketogenic diet was borne, which mimics the effects of fasting without starving the body. More recently it’s been shown to be effective in treating and managing certain types of cancer. I’ve posted a few links at the bottom of this post which show research into low-carb/ketogenic diets and cancer.

Before you all panic and say “but you can’t stop eating carbs!”, the body can function quite easily without carbohydrates. In fact the body can function without lots of things, we’re just conditioned to believe we need sugary cereal for breakfast, sandwiches for lunch and pasta and rice or potatoes for dinner.

When the body is starved of glucose (the end product of carbohydrates), the liver produces an alternative source of fuel called ketones and puts the body into a state called nutritional ketosis. This is an adaptive response, with ketone bodies acting as a back up system when there is limited glucose available, either due to starvation or carbohydrate restriction. This is how our ancestors survived when food was scarce. It’s also how some modern day hunter-gatherers such as the Massai and Inuit Eskimos survive.

There are different versions of the ketogenic diet. The restricted ketogenic diet works by creating an inhospitable environment for cancer cells. It can help treatment in several ways:

1) It lowers blood glucose and insulin. Cancer cells rely on high levels of glucose to function. By limiting the supply, cancer cells are less likely to thrive.

2) Cancer cells are metabolically inflexible so they are unable to metabolise ketone bodies. It’s believed ketone bodies may also have anti-inflammatory/anti-cancer effects.

3) It lowers circulating levels of cancer promoting hormones such as IGF-1 and TAF (tumour angiogenesis factor).

4) It increases free radical damage to cancer cells. Cancer cells have faulty mitochondria and without glucose they have no way of repairing the oxidative stress (which happens to all cells) caused by free radicals.

5) Following on from point 4, radiotherapy works by increasing free radical activity around cancer cells & research has shown that the effects of radiotherapy are enhanced during nutritional ketosis.

So what do you eat on this diet? When I first read about it I expected I’d have to munch my way through blocks of lard but it’s not like that at all, in fact it’s really healthy. On a typical day I eat the following:

Breakfast: Ketogenic Porridge (made from dessicated coconut, flaxseed, ground nuts, coconut oil & coconut milk)

Morning coffee: Bulletproof coffee (coffee + coconut milk or cream)  – it is delicious!!!

Lunch: scrambled eggs, mushrooms & spinach with ketogenic bread (made from nuts/seeds etc)

Snacks: avocado, olives, macadamia nuts or fat bombs (made from nuts, coconut, coconut oil)

Dinner: Chicken breast or Fish with green veg (all cooked in coconut oil)

The high fat percentage of the ketogenic comes from using oil with every meal – even the coffee is high fat. I thought I’d struggle with eating this way as I’ve always had a low tolerance for fatty/greasy food, but it’s actually been okay. The main problem I’ve had is sticking to the diet.

My nutritional therapist (http://www.carolgranger.co.uk) who is an expert in the ketogenic diet, advised me that it’s really beneficial to stick to the diet around the time of treatment and I was really good for the few weeks pre- and post-radiotherapy. However, I fell off the wagon during trips away with family and friends. It went completely pear shaped during a recent stay in hospital – hospital food is completely the opposite to ketogenic.

I’m now back on the keto wagon and feeling very virtuous after achieving nutritional ketosis for the last week. There are ways of measuring this which I will explain in my next post.

The rules are no grains, no legumes, no root vegetables and no sugar. So no bread, pasta, rice, beans, lentils or potatoes. No sugar at all (or anything that converts to glucose in the body) not even artificial sweeteners.

If you have cancer and want to know more about the diet:

1) This site has one of the most comprehensive guides to following the diet and explains how it can be used to manage numerous health conditions. I really recommend purchasing the e-book by Ellen Davis if you want to understand how the diet works and how to put it into practice:

http://www.ketogenic-diet-resource.com/

2) Patricia Daly’s (also a cancer patient) website and e-book also has lots of great resources and an e-book full of yummy recipes:

http://patriciadaly.com

3) This site isn’t necessarily aimed at people with cancer but has lots of great recipes and also a really handy app (if you have an iPad) for calculating your daily nutrient (and net carb) intake:

http://ketodietapp.com/Blog

4) Dominic D’Agostino: http://ketonutrition.blogspot.co.uk/2012/08/kd-for-cancer-treatment.html

I am relatively new to the keto diet but if you want to ask me anything I will try and help or at least point you in the direction of someone who can advise.

Research links:
http://www.nutritionandmetabolism.com/content/8/1/75

http://www.nutritionjrnl.com/article/S0899-9007(12)00186-4/abstract?cc=y

http://www.cancer.gov/cancertopics/types/lung/research/ketolung

https://clinicaltrials.gov/ct2/show/NCT01975766