Matthew’s Friends’ nutrition experts, dietitian Sue Wood and nutritional therapist Catherine Zabilowicz recently attended the ‘International Congress for Integrated Health’ in Germany. The emphasis was on cancer and the ketogenic diet (KD) and included interesting and knowledgeable speakers from the world of research and clinical practice.
Ketones for human brain development
The first presentation was by Dr. Stephen Cunnane, a physiologist who looked at our evolutionary advantages over other animals due to the fact that our brain cells can be fuelled by ketones. Our larger brains evolved over time from the point when our diets became more nutrient dense and our lifestyle more sedentary, this led to more fat deposition and therefore more ready fuel for the brain. Interestingly only rats are able to utilise ketones for brain function as efficiently as humans.
Human babies are born fat and this stored fat can be used to provide added fuel for our brain in the form of ketones which are essential in early life. A baby’s brain is 11-12% of its body whereas in an adult it is 2%. Fuelling this large organ is not possible purely by glucose as babies don’t consume enough in breast milk and ketones are important for synthesising very important fats for brain development. Premature infant brains are more at risk due to the fact that less fat has been laid down.
Ketones and Alzheimers
The second speaker was Dr. Mary Newport who gave an inspirational presentation on the positive effects of coconut oil in Alzheimers disease. She had treated her husband very successfully by supplementing his diet with a daily dose of coconut oil along with reducing his consumption of glucose inducing carbohydrates. Coconut oil provides fats to make ketones and these get pushed into the brain whereas glucose needs to be pulled into the brain. Thus ketones provide the fuel to improve brain function. In early onset Alzheimers, the uptake of glucose in the brain diminishes and without ketones for energy damage ensues. Ketones protect the brain from hypoglycaemia (low blood glucose).
Ketogenic Diet and Brain Cancer
Prof. Dr. Adrienne Scheck is a renowned researcher with a wealth of knowledge in the world of brain cancer and ketogenics. Her research into cancer cell metabolism has highlighted the theory that aberrant cellular metabolism is a hallmark of cancer. Individual genetic makeup may increase a person’s susceptibility to cancer but it is the epigenetic effect of our environment and lifestyle choices which is ultimately seen as the cause of genetic instability and gene expression.
In using the KD in mouse models of malignant gliomas, Dr. Scheck has shown that the diet increases survival time and the anticancer effects of chemo and radiotherapy. Many chemical signals within the body which enhance cancer cell proliferation were found to be reduced in those animals on the KD. The ketones produced from a KD also appear to sensitise brain stem cells to radiation. Stem cells are thought to be highly resistant to treatments leading to relapse.
Ketogenic Diet and Cancer Treatment
Prof. Dr. Colin Champ is a radiation oncologist who is a proponent of the KD and is involved in research into its use in cancer patients. He cited the diet of the Maasai tribe in Africa, which is high in fat (particularly animal fats) – typically around 70% – and low in carbohydrate – around 20-25%. They lead a healthy lifestyle in general too but their consumption of high fat certainly doesn’t lead to them suffering from typical lifestyle diseases often thought to be linked to a high fat diet.
Dr. Champ has studied the effects of the KD and calorie restriction on mouse models with brain tumours that were given radiation. Those on a KD alongside standard radiation lived considerably longer. He also studied the glucose levels of breast cancer patients who were undergoing chemo / radiotherapy and he found that those with lower glucose levels fared considerably better than those with very high levels.
Ketogenic Diet, Calorie Restriction & Cancer
Dr. Rainer Klement also presented the evidence for consuming a ketogenic diet alongside radiotherapy. He compared the KD to fasting and found that the high fat levels produced almost the same metabolism as found in fasting where ketones are produced for fuel. Calorie restriction has also been found to reduce growth signalling chemicals and therefore suppress tumour growth whilst improving DNA repair pathways in normal cells. The KD also decreases the amount of lactic acid in tissues and as cancer cells thrive in an acidic environment this may assist in reducing cancer growth.
Fat and Cell Membranes
Dr. Damien Downing spoke of the importance of healthy fats in the diet as these are very important components of a healthy cell membrane. A cell membrane is made up of cholesterol, saturated and unsaturated fats. There needs to be a balance of the essential omega fats to ensure this is reflected in the membranes for optimal cellular functions particularly within the mitochondria (the energy factory of our cells).
Protein Intake and the Ketogenic Diet
Dr. Heinz Rheinwald gave his presentation on the body’s need for amino acids and particularly in regard to the need for them when following a KD. We have a turnover of about 300-400g of protein daily and around 40% of this protein comes from the diet. The fact that proteins when broken down within the body provide a source of glucose, is a reason that protein is sometimes reduced on the KD. In general we advise those on a KD to eat an adequate supply of protein but it can often be difficult to get enough protein into children who are on the KD for epilepsy. Children need plenty of protein for growth but it often needs to be restricted more for seizure control. Protein is also needed for the production of enzymes in the body and enzymes are essential for the synthesis and the breaking down of ketones.
In view of this Dr. Reinwald talked of the importance of supplying the body with sufficient essential amino acids. He introduced us to a food supplement called MAP (Master Amino Acid Pattern) where all 8 essential amino acids are present in the correct ratios and how these can be used to attain maximum protein synthesis without increasing glucose availability. This is achieved by the essential amino acids being available in the optimal proportions at the same time and this optimises the building and repair of tissues within the body without degradation to glucose and toxic nitrogen. He recommends MAP for anyone who requires a greater intake of protein such as children or those who are ill, and especially if they are following a KD. It sounded very interesting and plausible research but the cost of MAP would unfortunately be a prohibitory factor for most.
Glucose Metabolism in Tumours
Prof. Dr. John Ionescu runs a clinic in Germany specialising in using some alternative therapies such as vitamin C and bicarbonate infusions. He also recommends to his patients a low glycaemic or ketogenic diet in line with the ‘Warburg effect’ that cancer is a metabolic disease where cancer cells use glucose to fuel themselves and produce an acidic environment in which they thrive.
Metabolic Tumour Typing
Florian Schilling reiterated the important fact that in cancer cells, glucose metabolism is in general the only pathway for energy production, hypothesising that this is due to damaged mitochondria. This leads to genes which promote cancer being switched on. His approach to cancer is to firstly put the cells under pressure and then when they are stressed hit them hard. He recommends the KD alongside MAP (see above) supplementation, metformin (an antidiabetic drug used to reduce glucose levels), bromopyruvate (being researched for its anticancer properties), and 2-deoxyglucose (blocks the metabolism of glucose in cells). When using this combination it is important that the person is keto-adapted.
Nutritional Immunotherapy of Cancer
Prof. Dr. Marco Ruggiero gave a fascinating lecture on a product called Rerum which acts as an immunomodulatory agent and stimulates the macrophages in our immune system. The product consists of 3 molecules bound together, chondroitin sulphate, oleic acid, vitamin D3 and vitamin D2 which work in synergy. These compounds also have an anti-inflammatory effect, an important consideration after a cancer diagnosis.
Overview written by:
Catherine Zabilowicz
Ketogenic Dietary Assistant – Oncology
Matthew’s Friends Clinics.