Ketones are compounds produced by the liver during times of fasting or extremely low carbohydrate intake.
Ketones are used as an alternative fuel by the brain and muscles. They also activate pathways linked to lifespan and health-span extension.
The ketogenic diet stimulates ketone production but requires extremely high fat intake that has harmful health consequences.
Safer alternatives directly supply ketones that can be absorbed and used by the body. Beta-hydroxybutyrate regulates energy expenditure and helps modulate metabolism. Mangiferin and a resistant starch also boost the body’s ability to make its own ketones.
It is now possible to obtain the benefits of ketones without the difficulties and downsides associated with prolonged fasting or the ketogenic diet.
Issue:Oct 2019
Healthy Way to Benefit from Ketones
The low carb/high fat ketogenic diet has become a popular way to lose weight. But ingesting bad fats increases cardiovascular risks. Scientists have identified a healthy method to increase ketones without the difficulties of a ketogenic diet.
Issues with the Ketogenic Diet
One way to raise ketone levels is by forcing the body to create more of them. That’s the goal of the popular ketogenic diet. Severely restricting carbohydrate intake and replacing those calories with a large amount of fat makes the liver pump out ketones.
But there are several downsides to this strategy:
Eliminating carbs means dramatically reducing intake of fruits, vegetables, and whole grains. These foods are a source of dietary fiber, which is critical for digestive health. Insufficient fiber has been linked to gastrointestinal disorders and colorectal cancer.17,18
Very low carbohydrate intake has been linked to premature mortality.11
A high-fat diet can cause elevated triglycerides, other lipid abnormalities, and detrimental metabolic changes, all risk factors for cardiovascular disease.10,19
In people on a ketogenic diet, the risk of atherosclerotic plaque development in arteries, which often leads to cardiovascular disease, may be increased.9
High-fat, low-carb diets can negate or even reverse the brain benefits of ketones, leading to deterioration in attention, processing speed, and mood.10
In other words, the potential problems of the ketogenic diet may outweigh the benefits. It is not recommended for people unless they have a specific medical condition for which it is indicated.
Raise Ketones the Healthy Way
Scientists recently set out to create a healthier way to raise ketone levels without the risks of the ketogenic diet or prolonged fasting.
They accomplished this by combining the ketone beta-hydroxybutyrate with two other nutrients that aid in the body’s ketone production.
When ingested orally, beta-hydroxybutyrate is easily absorbed into the bloodstream, providing the same benefits as ketones produced by the liver. Beta-hydroxybutyrate can increase blood levels to the range typically induced by a ketogenic diet.20
Mangiferin is a compound found in plants, especially mangos—hence the name. It has been shown to help spur the production of more ketones by the body.
In one randomized trial, researchers demonstrated that 150 mg of mangiferin per day significantly increased blood levels of ketones, presumably by stimulating the liver to boost production of them.21
In response to mangiferin supplementation, beta-hydroxybutyrate increased by about 18% and acetoacetate levels increased by approximately 10%.
A resistant starch, like cassava, is a complex carbohydrate that is not efficiently broken down by our digestive enzymes.22
Benefits of “Resistant Starch”
Other forms of starch are broken down into simpler carbohydrates, which raise blood sugar levels after a meal, triggering insulin secretion.
Because they are not digested rapidly by humans, resistant starches do not raise blood glucose or cause an insulin response.
Besides being a source of fiber, resistant starches have several other beneficial effects. They help support healthy gut bacterial growth, promote a feeling of fullness, increase insulin sensitivity, and preserve lean body mass.23
Resistant starches also enhance the body’s production of butyrate, which is used to make more ketones, and to stimulate many of the same longevity-promoting pathways as ketones.5,24,25
The keto diet requires you to be on an extremely low-carb diet for the entire time you are dieting, but the Atkins diet only requires severe carb limiting in the first of its four phases.
Though the keto diet requires dieters to consume copious amounts of healthy fats to aid in ketosis, the Atkins diet limits fat and encourages protein consumption instead.
The Atkins diet has no qualms with processed food, but the keto diet favors whole, fresh foods.
This article was reviewed by Samantha Cassetty, MS, RD, nutrition and wellness expert with a private practice based in New York City.
Both the ketogenic diet and the Atkins diet cut carbs and encourage weight loss, but that's about all they have in common.
The ketogenic diet was created in the 1920s as a therapy for epilepsy, but the diet has gained popularity in recent years as a rapid weight loss tool. Commonly referred to as keto, the diet is similar to other low-carb diets, including Atkins, but its guidelines include some key differences.
The difference in carb limitation for the keto diet and Atkins diet
According to the Mayo Clinic, a person who consumes 2,000 calories a day should get between 45% and 65%, or 225 to 325 grams, of those calories from carbohydrates. But when you eliminate the number of carbs stored in your body, it goes through a series of adaptations in order to, ultimately, burn fat reserves to get the energy it needs to function. This fat-burning state is called ketosis and the ketogenic diet requires you to remain in this fat-burning state long-term. The Atkins diet, on the other hand, induces ketosis, but only in the first phase.
The makeup of a typical keto diet is around 60% fat, 30% protein, and just 10% carbohydrates, although it's common to go as low as 5% carbs. For someone who consumes 2,000 calories per day, this means eating no more than 50 grams of carbohydrates a day, and sometimes as few as 20 grams. That's about 80 to 200 calories' worth of carbs. This is the way you eat for the entire time you're on the keto diet. The Atkins diet is different.
That Atkins diet is comprised of four phases: induction, ongoing weight loss (OWL), pre-maintenance and lifetime maintenance. The phases start with a dramatic reduction in carbohydrate intake - you're only allowed around 20 grams per day. But then you slowly reintroduce carbs once you achieve your weight loss goals. And once you've maintained your goal weight for a month, you enter the final phase, lifetime maintenance, which as the name suggests, should be the way you eat for life. In this last phase, you can increase your carbohydrate consumption and you're allowed to consume anywhere from 40 to 120 grams of carbs daily.
The Atkins Diet also functions on net carbs. You can calculate net carbs by checking the nutrition labels on your food. Just subtract the grams of fiber you consume from the total grams of carbs and that's your net carb intake for that meal.
Fiber has very little impact on blood sugar, which is why fiber-filled carbs don't count towards your daily limit on Atkins. The keto diet, on the other hand, makes no exception for carbs, fibrous or not.
The keto diet requires generous portions of fat, but the Atkins diet favors protein
According to Amy Miskimon Goss, an assistant professor of nutrition sciences at the University of Alabama at Birmingham, the Atkins diet has traditionally recommended eating protein to subdue hunger, whereas a well-formulated ketogenic diet limits protein and uses fat to soothe a rumbling stomach instead.
Since the Atkins diet is more holistic, especially in its "lifetime maintenance" phase, there are no exact percentages for protein consumption.
The keto diet, on the other hand, is strict in its insistence upon high-fat consumption. In order to maintain ketosis, the keto diet requires dieters to consume a diet of mostly fats. In fact, you should be consuming about 60% to 75% of your daily calories from healthy fats found in foods like avocados, nuts, and extra virgin olive oil.
Keto encourages whole foods, but Atkins does not
Goss explains that a ketogenic diet should also be based on whole foods. This means eating salmon instead of beef jerky, unprocessed foods rather than anything heavily processed with excess sodium, and staying away from artificial preservatives.
The Atkins Diet, however, does not have these restrictions. The Atkins diet company encourages people to eat Atkins-brand bars, shakes and other pre-packaged foods that are specifically designed to support the lifestyle. That said, with the popularity of the keto diet, you can find many keto-friendly, processed, packaged foods as well.
If you're doing a keto diet, you might want to work with a doctor
Goss says that maintaining a keto diet without the assistance of a doctor or nutritionist can be tricky and even dangerous. According to the Merck Manual, a popular resource for medical professionals, eating fewer than 100 grams of carbohydrates every day causes keto acids to accumulate in the body from ketosis. In small amounts, keto acids don't harm the body, but if the body sustains ketosis, the acids can trigger side effects that range from nausea and fatigue to dizziness and abnormal heart rhythms.
"It's critical that patients with any chronic condition, especially diabetes or hypertension taking medication, to consult with their doctor before starting a keto diet because it's likely that medication adjustments will need to be made," says Goss.
PI3K inhibiting drugs have shown little success. Now researchers may have figured out why.
4th July 2018
A ketogenic diet is low carbs and high in fat. This can help keep insulin levels low, which is believed to improve the effectiveness of certain cancer drugs.
For their study, scientists tested the drugs in mice who’d been fed either a standard or ketogenic diet. While it was largely ineffective for the mice eating standard fare, the treatment shrunk the tumors of mice who’d eaten the ketogenic diet.
The drugs in question work by inhibiting the PI3K pathway, a cell-signaling network that’s overactive in many types of cancer. However, while there are lots of PI3K inhibitors in development, researchers and pharmaceutical companies have struggled to make them effective. “While more than 20 PI3K inhibitors have entered cancer clinical trials, only two have been approved,” said Benjamin Hopkins, a postdoctoral medical researcher at Cornell University who is one of the study’s authors.
The researchers posited that insulin may be the reason these drugs aren’t living up to their promise. The PI3K enzyme regulates glucose metabolism.
When glucose levels are high, the body produces insulin. Insulin stimulates the PI3K pathway which then leads to cell proliferation and tumor growth. This means that rising insulin levels could counteract any drugs taken to inhibit the enzyme.
So the team started looking for ways to keep patients’ insulin low while they’re taking PI3K inhibiting drugs.
They tested two approaches in mice: a diabetes medication and a ketogenic diet, which prevents glycogen from being stored in liver and muscle tissue. “Both interventions caused dramatic improvements in responses to multiple PI3K inhibitors in multiple cancer types,” said Hopkins.
The researchers stress that their study doesn’t suggest a ketogenic diet alone would help prevent or treat cancer. In a leukemia model, the ketogenic diet even seemed to make the cancer worse in mice who hadn’t received a PI3K inhibiting drug.
“But the combination of a PI3K inhibitor and ketogenic diet was effective in a surprisingly wide spectrum of cancers,” said Hopkins. “Our study suggests that more patients would respond to these drugs if their serum insulin could be maintained at low levels during therapy by these interventions.”
To see if their approach will also work in humans, the study’s authors plan to conduct a clinical trial within a year. This could provide some of the answers researchers, drug developers, and patients are looking for. Hopkins explains: “Patients often ask whether they should change their eating habits when diagnosed with cancer, and physicians admit that there is little evidence that this can improve the outcome. Conducting a clinical trial to test this idea is critical.”
We join Yuka Muranaka and Dr. Tetsuo Muneta in our Eastern Medicine documentary to discuss the ketogenic diet and its potential as…
By Ty & Charlene Bollinger June 4, 2019
Video Transcript: Keto in the Land of the Rising Sun | Clip from Episode 1 of Eastern Medicine: Journey through ASIA
Yuka Muranaka: Two years ago, I was diagnosed with uterine cancer sarcoma, a very aggressive type of cancer. I decided to have surgery and have my uterus removed, but since the cancer was very aggressive, the doctor recommended that I have chemotherapy as well.
I took one round of chemotherapy, but it caused an allergic reaction, so I stopped after one round and took no more chemo. Chemotherapy was very painful, and I didn’t like it. I had to apologize to my body because I had put toxic poison into my body.
My family was very worried about me, and they wanted me to take more chemotherapy because they believe in that medicine. I declined all other forms of conventional treatments and medications. Then I decided to come to this Cancer Control Society convention to discover other ways. This was two years ago. I tried the macrobiotic diet, but it didn’t work. Then I began to eat a ketogenic diet with healthy meats, vegetables, and good oils. I have been doing this for the past 2 years, with no sugar and low salt.
Two years ago, I was diagnosed with uterine cancer sarcoma, a very aggressive type of cancer. I feel very strong now! I am very athletic naturally, and I really love sports and exercising, like aikido and like jogging. After 6 months on the ketogenic diet, my skin became vibrant, and my hair (which fell out from chemo) grew back. I’m very happy. My family now admits that I was right!
Ty Bollinger:You were right. That’s awesome. Well, that’s good, it’s a great story. Thank you for sharing your cancer story, and I’m so glad that you’re doing well. You look great. I can tell you’re healthy and I’m glad that your family now thinks you’re right, because clearly, you’ve done something right. So, thank you so much. Yuka utilized the ketogenic diet to treat her advanced cancer.
Dr. Tetsuo Muneta: Ketone bodies are made of fat. If you consume a lot of sugar or grains, ketone bodies will not be produced. But if you decrease sugar intake, and have a low-carbohydrate diet, ketone bodies will be produced in your body. On the ketogenic diet, your diet should consist of lots of good fats, meat, eggs, and cheese. Some examples of “good fats” are saturated fats from animal sources and coconut oil, which contain MCTs, which are medium-chain triglycerides.
These are appropriate fats for the ketogenic diet. The advantage of the ketogenic diet is that the energy source is not sugar, so it starves cancer cells, while at the same time, giving energy to normal cells. This is why the ketogenic diet works for cancer. The mitochondria are the “energy generators” for the cells in our body, and they can use sugar or fat for energy.
However, in cancer cells, we typically see damaged mitochondria and/or inactive mitochondria. As a result of damaged or inactive mitochondria in the cancer cells, they begin fermenting sugar, called glycolysis, and they are not able to utilize the ketone bodies for energy. Cancer cells cannot live without sugar to provide energy.
Thus, the ketogenic diet works by reducing sugar intake and starving the cancer cells to death. If I were diagnosed with cancer, I would utilize the ketogenic diet. I already eat a “loose” ketogenic diet, but then I would work on it even harder and be even more strict.
In magazines, online, on billboards, in social media…we are inundated with images of chiseled bodies eating plates of bacon in connection with the ketogenic diet.
By Charlene Bollinger January 25, 2019
In magazines, online, on billboards, in social media…we are inundated with images of chiseled bodies eating plates of bacon in connection with the ketogenic diet. Today, health produce promoters that are more interested in making a buck than helping people are making unrealistic claims which may be, quite frankly, dangerous to your health. If you are considering “going keto,” make sure you do it the right by following these simple yet powerful tips!
How NOT to Eat Keto (AKA The “Dirty” Keto Diet)
Before we dive in to doing the keto the RIGHT WAY, let’s talk about the WRONG way to practice the ketogenic diet. To put it simply, eating healthy the keto way does not mean eating commercially-bought bacon for breakfast, a fast food burger for lunch, and a one-pound steak for dinner, with nothing else on your plate. It does mean eating organic, hormone-free and non-GMO proteins, plenty of fiber in the form of vegetables and some low-sugar fruits, and, most importantly, healthy sources of organic, toxin-free fats.
Anybody that advises that you to “just cut the carbs” to go keto is just plain wrong. That’s a dirty keto diet. What’s more, following bad advice about eating ketogenic can be harmful, especially if you have certain conditions.
Taking the easy way out by simply cutting carbs and going carte blanche on everything else is the dirty way to do keto. It doesn’t work and could make you sick. The clean way is the common-sense way. Here are some tips to get you started.
13 Tips for Keto Diet Success (AKA “Clean Keto”)
#1. Eat clean food.
No matter how you eat, going clean with what you consume just makes sense. The first step for clean eating is to stay away from anything processed, mixed with strange ingredients you can’t pronounce, or that comes in plastic containers or tin cans. You get the point: clean eating means eating whole foods, first and foremost. However, in today’s toxic world, I really suggest going beyond simply staying away from processed junk. I could write a whole article on the toxic sludge that goes into today’s commercial meat and dairy and the cancer-causing substances that get sprayed on those veggies you get in the commercial produce aisle.
Consider why you are eating keto. You want to clean out your body, prevent disease, have more energy, be able to concentrate better, and lose weight. Eating keto cleanly kick-starts your body’s own detoxification pathways, supports the liver and gut and gets rid of neurotoxins. It doesn’t make sense to put MORE toxins in the body at the same time!
P.S. Unfortunately, this means that, no, you can’t load up on bacons at every meal. Bacon (and all pork) is technically a keto-friendly food, but a lot of commercial pork products contain nitrates that can trigger inflammation.
Also, consider this: according to Consumer Reports, 80% of all antibiotics sold in the U.S. are given to commercial livestock animals. Still, the noxious bacteria Yersinia enterocolitica is found in roughly 69% of all pork products. If you can’t imagine a world without bacon, consider limiting your consumption to once a week and going nitrate-free.
#2. Eat lots of high-fiber vegetables.
Yes, you still have to heed your grandmother’s advice and “eat your veggies” when you go keto. Fresh vegetables contain so many substances that the body needs for vital functions. These includes fiber, vitamins, minerals, and a plethora of disease-busting, metabolism-regulating phytonutrients or “micronutrients.”
According to a comprehensive study conducted by the University of Minnesota in 2012, phytonutrients “function as antioxidants, phytoestrogens, and anti-inflammatory agents.” Food really is medicine, and a lot of that medicine comes in the form of vegetables. The good news is that a truly keto diet will wake up your taste buds. If you don’t love them already, after a while, you are going to really savor all the rich and tasty varieties of veggies on your plate. Make sure you “eat the rainbow” of vegetables with every meal.
#3. Consume CLEAN sources of fat.
In addition to cutting carbs to a minimum, upping health fat consumption really is the cornerstone of any solid keto program. Lowering carbs and upping fats is what is going to slide you into burning ketones instead of sugar for fuel. Some of this fat may come in the form of animal products, such as organic, grass-fed butter.
But keep in mind that this is not your only option for healthy fats. The body loves variety, and that includes eating a variety of fats. Organic flaxseed oil, evening primrose, avocado oil, and coconut oil are all great options. Also don’t discount fat-intense foods, such as wild-caught salmon, raw nuts, seeds, and avocados. Extra virgin and organic/non-GMO olive oil is excellent as well. In the Bible, the olive leaf was a symbol of peace. Looking at its healing effects, you can see why. Olive oil contains oleic acid, which has been shown to drastically reduce inflammation and reduce cancer cell growth.
#4. Eat to support your gut.
If you follow the above three recommendations only, your gut will already be on its way towards healing. Healthy fats that contain Omega 3s such as the ones described above can decrease inflammation in the gut and promote the growth of good-for-you gut bacteria (whose job it is to eat up the bad guys). Odds are, though, if you have been eating high carbs for a while, your gut is not as healthy as it could be. Be gentle with your digestive system when you first go keto. Try some organic bone broth, cultured vegetables, prebiotic foods, and extra probiotics and digestive enzymes to support your pancreas and give your GI tract an added boost.
#5. Eat the right amount of food for you.
To be sure, your body is going to through a lot of changes as your progress through your keto journey. As your hormones rebalance, those particular hormones that are specifically designed to regulate when you are really hungry and when you have had enough will “wake up.”
This is all good news. Eating keto can be a life-changer, including changing your emotional and habitual relationship to food. If you are used to overeating or not eating enough, try eating until you are comfortably full and satisfied. If you are not sure if you are really full, slow down while eating and wait a few minutes in between bites. This can also help you enjoy the wonderful, healthy nutrients you are putting in your body.
#6. Include intermittent fasting.
Intermittent fasting (IF) should be an integral part of any sound keto plan. Typically, IF requires a person to abstain from eating solid food for 14 to 18 hours. This allows a whole variety of powerful healing mechanisms to take place. One of these processes is cell autophagy, when old cells die off and become recycled as part of detoxification. Pay attention to your body when it comes to IF.
If you become dizzy, nauseous or hypoglycemic, be sure to eat something! One good “keto hack” is to drink some coffee or tea (caffeinated or decaf) with some coconut oil, ghee or grass-fed butter blended in it. It may sound strange but, guaranteed, it is delicious and will help you stay in IF mode and at the same time feel full and satisfied.
#7. Stay away from high-inflammation foods.
Simply kicking the sugar and gluten found in high-carb foods will do wonders for your inflammation levels in general. However, there may be other foods that you are reactive to. Remember that inflammation and disease go hand and hand, as does inflammation and weight gain. Other common inflammatory foods may include dairy products (especially milk) and some nightshade vegetables.
#8. Stay hydrated.
Your body is at least 60% water. Fluids are responsible for some pretty major functions in the body, including digestion and circulation of blood. In fact, drinking adequate amounts of water can help those same functions that eating keto can help, including maintaining healthy muscle mass, boosting gut health and helping your detoxification pathways.
Studies show that as little as a 1 percent dip in hydration levels can negatively affect mood, attention, motor function, and even memory as well. Make sure that your water is fresh and filtered, including for fluoride.
#9. Keep moving!
Consistently engaging in long periods of sitting or lying down negatively impact your long-term health. On the other hand, a vast amount of research shows a connection between moderate yet consistent exercise and a reduction in inflammation and improved immune function. The keto diet done right gives you oodles of energy to move your body. And remember, even a short walk every day can do wonders on all levels.
#10. Lower stress.
According to the American Psychological Association, more than half of the working adults in the United States are concerned by how stressed they feel. This may sound like a dramatic statement but it is absolutely true: eating keto won’t do your body any good if you keep up the cycle of chronic stress. Keto done right gives the body the chance to detoxify and heal. But that healing can only happen when the body is in what is called the “relaxation response.” With chronic stress comes overproduction of stress response hormones, including cortisol, which keep the body on high alert and inflamed. Make the most out of your keto. Do it the right way by cleansing and healing from the inside out.
What can you do each day to lower stress while you help your body through keto nutrition?
Meditation is a go-to for some, but it is not for everyone. Taking a walk in nature, two minutes of stretching, taking a “breathing break” every now and again, even consciously moving your thoughts towards gratitude a few times a day can help gradually reduce stress.
#11. Pay attention to your body.
Here is the deal: you are a unique individual and you have no one to compare yourself to but you! On a regular basis while you are on the keto diet, ask yourself the following questions:
How am I feeling in general today?
Do I feel stable mentally?
Do I have more energy than when I started?
Am I clear and focused?
Keep in mind that everybody’s body is going to react differently too – especially the first phase of the keto diet. Some may have severe symptoms of the common “keto flu” while others have none. Paying attention to your body simply means “tuning in” to how you are feeling on any given time and also what your body needs right now to heal. It may be rest instead of having coffee or receiving a hug instead of reaching for a muffin. When you pay attention to your body, really listen to it. If you know it needs to rest, try to give it a short one even if you are in the middle of a busy day.
#12. Use common sense.
If all of these recommendations on how to do keto the “right way” seem like common sense, that is because they are! Sometimes the most profound change happens through the simplest means. Eating keto doesn’t have to be complicated.
#13. Consider the long-term.
Eating keto can become a long-term, health-affirming lifestyle if you do it right, even if you have health issues, are over 65, or are an athlete. There are many kinds of healthy ketogenic diets to choose from, from strict to seasonal, to cyclic. None of these are meant to be a “quick fix,” however. Any keto diet plan worth its weight is a lifestyle change that puts you in the driver’s seat for longevity, energy and a brand new, super focused, on fire you.
You absolutely can energize your life, become more mentally clear, loosen up your joints, clear up skin issues, recover from disease, reduce pain, and reshape your whole body with a ketogenic diet. If you use common sense, listen to your body and eat clean all the way, you will be absolutely amazed at how you will look and feel in a very short amount of time!
We tend to associate breakthrough treatments with new — and often unaffordable — drugs.
But it seems a remarkable improvement in the survival time of patients with brain cancer has been achieved using a combination of four old drugs (a statin, a diabetes pill, an antibiotic tablet and a dewormer) that cost just £400 a year.
Testing times: Vicki Searle and her son Henry, who was diagnosed with an inoperable brain tumour when he was 19
Results from an ongoing trial run by the private Care Oncology Clinic in London suggest that giving this new combination treatment doubled the average survival time.
Survival rates for brain tumours have remained unchanged for at least 20 years, when the brain cancer drug temozolomide came on to the market. Around 15 per cent of adult patients survive for more than five years after diagnosis. For glioblastoma, the most aggressive type of brain cancer, the figure is between 6 and 10 per cent.
The new study involved nearly 100 patients with glioblastoma — the fast-growing type of brain cancer affecting politician Tessa Jowell — treated at the clinic over three years with the combination treatment, as well as radiotherapy and chemotherapy.
The average survival time for glioblastoma is estimated to be between eight and 14 months — the average survival time for the patients given the new combination treatment was 27.1 months.
Earlier this year Tessa Jowell spoke movingly in the House of Lords to highlight the lack of funding for research into brain cancer — she suggested that the survival rates reflected the fact that less than 2 per cent of UK cancer research funding goes to this area.
Developing a new cancer drug can take ten years, and the cost for treating one patient can be deemed prohibitive — one of the latest cancer drugs, pembrolizumab, used for advanced melanoma and lung cancer, costs nearly £100,000 a year. The drug cocktail used at the Care Oncology Clinic is available now and costs only a few hundred pounds.
One of those who’s been treated with it is Henry Searle who was diagnosed with glioblastoma just over three years ago at the age of 19.
It was discovered too late for surgery, and even with chemotherapy and radiation therapy, he was expected to live for only 14 months.
Alarmed by these odds, Henry’s parents — Vicki, who works in the tourism industry and Jonathan, a chiropodist — were determined to give him every chance, and despite objections from his oncologist, they got him started on the drug cocktail which had just become available at the clinic.
Defiant: His oncology team told him that even with the 'gold standard' treatment (chemotherapy and radiotherapy) he was only expected to live for 14 months
Two years after Henry’s diagnosis, his NHS consultant wrote to the family to say that while they needed to keep an eye on him, there was ‘no evidence of active disease’ and that Henry didn’t need further cancer treatment via the NHS. (His family continue to seek alternative treatment for him outside the NHS to stop the cancer returning).
Henry is still on the drug cocktail (the last time he had chemotherapy was in 2015) and today his scans show the tumour is no longer growing. And the cost of this life-changing treatment? Between £200 and £400 a year plus £1,000 for four consultations.
It involves four old — therefore cheap — drugs long used for other conditions and so considered safe. Two are among the best-selling medications in the world: atorvastatin, a type of statin, and the diabetes drug metformin.
The other two are an antibiotic, doxycycline, used for dental infections and acne, and mebendazole, a deworming pill. So how could this apparently random combination of drugs reduce tumours?
What links them is that in various ways they interfere with a tumour’s ability to absorb or use the resources they need to grow. The way the body controls energy is known as metabolism. The metabolism of cancer cells is different from the one that powers healthy cells.
Cancer cells need much greater amounts of glucose, the form of sugar our bodies use for energy. So making it less available, which metformin in particular does, means that the drug combination is effectively starving the cancer cells.
Weakened by the energy drop they become more vulnerable to attack by the chemotherapy and radiotherapy routinely used to treat cancer.
Miracle: Two years after Henry’s diagnosis, his NHS consultant wrote to the family to say there was ‘no evidence of active disease’ and that Henry didn’t need further cancer treatment
The idea behind this approach to cancer is known as the metabolic theory — meaning it deals with the use of energy in the body. Because the drug cocktail targets the way cancer cells get their growth factors and raw material for making energy, it has the potential to be effective for a variety of cancer types.
The drug cocktail was put together by the Care Oncology Clinic’s co-founder Dr Robin Bannister, a research scientist, from a list compiled by the clinic’s researchers trawling through thousands of studies on licenced drugs that were also shown to have anti-cancer properties.
The normal route for testing a new treatment is what’s called a randomised controlled trial, where it is compared against an alternative, often a placebo. As the patents on the drugs in the new cocktail have run out, there is no incentive for the drug companies to do these (expensive) trials.
Instead, the results were based on what’s known as a ‘service evaluation’, where data is gathered from patients in a real-world setting as approved by the Medicines and Healthcare products Regulatory Agency — the UK drug watchdog.
The clinic plans to use this data to supply NICE with the evidence it needs to make the treatment available on the NHS. ‘Giving these safe drugs to patients in a real-world trial allows us to gather valuable information on how they impact on cancer,’ says Robin Bannister.
One of the clinic’s physicians, Dr Padman Vamadevan, who has previously worked in the NHS, says the results are ‘slowly changing the attitudes among consultants whose patients attend the clinic’.
‘When we started, not many oncologists were familiar with treating the metabolic features of cancer, so they were sceptical,’ he says. ‘But now patients report that their doctors are genuinely interested in this research as they see the apparent benefits.’
Combination: Because the drug cocktail targets the way cancer cells get their growth factors and raw material for energy, it has the potential to be effective for a variety of cancer types
Dr Lucinda Melcher, a clinical oncologist at the North Middlesex University Hospital in Edmon- ton, admits that she was not initially convinced.
Her husband Adam Blain, a 48-year-old lawyer, has glioblastoma and having had all the NHS had to offer, he began treatment at the clinic over three years ago.
‘I was sceptical at first because their drug regimen was then not backed up by any evidence but the team there was obviously professional and committed and the treatment is scientifically plausible,’ says Dr Melcher.
Adam, a father of three, who is still on the drug cocktail, has had to stop working but has a good quality of life, although his short-term memory is poor, says his wife.
But while Dr Melcher is delighted her husband has beaten the odds, she is not convinced that it was due to the drug combination.
‘It could still be chance,’ she says. ‘It’s possible that Adam is one of the 10 per cent of these patients who survive five years on the standard treatment, especially since his tumour was completely removed which improves your chances.’
Robin Bannister points out that: ‘Every oncologist has their own list of “miracles”; people who have lived far longer and better than was expected.
‘And that is why we need to conduct studies with enough patients to make sure the chance element can be accounted for.
‘The hundred people treated in this trial makes it one of the larger studies ever done with glioblastoma.’ (This compares with one of the trials for temozolomide, which involved over 500 patients.)
The study is continuing. The next step is to compare the results of the nearly 100 glioblastoma patients treated at the clinic with a closely matched group of NHS patients who only received the standard treatment of radiotherapy and chemotherapy.
The results will make the findings of the trial more reliable and are expected to be published in a journal later this year.
For more information, visit: careoncologyclinic.com
EXPERTS WHO THINK A HIGH-FAT DIET CAN FIGHT BRAIN TUMOURS
Raffi Kalamian Walsh was just four when a routine eye check picked up a worrying change and he was diagnosed with brain cancer.
Over the next 14 months, Raffi was given weekly chemotherapy followed by 12 weeks of a different chemo drug followed by two operations to remove part of the tumour. Two months later a scan showed it was back and spreading.
‘I can’t begin to describe how devastating it was to watch our young child being taken apart, piece by precious piece,’ says Raffi’s mother Miriam, who, with her husband, Peter, had adopted Raffi when he was two.
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Tragic: Raffi Kalamian Walsh was just four when a routine eye check picked up a worrying change and he was diagnosed with brain cancer
Three years after his diagnosis Raffi began treatment with a combination of five cancer drugs. ‘Within weeks my normally cheerful little guy was nauseous, fatigued, and unable to focus,’ recalls Miriam.
‘When he opened his mouth to speak, all that came out was gibberish.’ While searching for information about Raffi’s drugs, Miriam stumbled on a radically different approach to cancer, based on the idea that a very high fat, low carbohydrate diet could slow tumour growth. It was being investigated by Professor Thomas Seyfried, a biochemistry researcher at Boston University.
Miriam explains: ‘Professor Seyfried had shown it was possible to slow the growth of brain tumours in mice.
‘I knew it was not yet tested in people, but Raffi desperately needed something different.’ Surprisingly her son’s doctors agreed.
The five cancer drugs were stopped and within three months Raffi’s tumour had shrunk by almost 15 per cent. He returned to being a talkative, energetic little boy.
The ketogenic diet involves avoiding foods containing sugar: sweets, biscuits, puddings, along with grains, pasta and bread, even wholegrain types, plus starchy vegetables such as potatoes or cooked carrots, as well as all legumes, beans and pulses.
Instead the diet is built around fats including butter, cream, coconut oil, olive and avocado oils and some omega 3 oils, small portions of protein such as meat, fish or eggs, as well as salad and non-starchy vegetables (such as broccoli and green beans).
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Strength: Over the next 14 months, Raffi was given weekly chemotherapy followed by 12 weeks of a different chemo drug followed by operations to remove part of the tumour
Fruit is limited to berries, as these are low in sugar. The aim is to starve cancer cells of glucose, their preferred fuel. Lacking carbohydrates the body burns fat instead and your liver starts pumping out substances called ketones which can replace glucose as fuel for the brain and muscles.
Crucially, however, tumours can’t use ketones as fuel.
Miriam concedes Raffi struggled with social events: ‘because there were cakes and sweets everywhere,’ she says. ‘But that was a walk in the park compared to what he had endured in terms of gruelling treatments.’ During his first nine months on the diet Raffi also received a low dose of chemotherapy drug, before relying just on the diet.
The odds against Raffi were daunting — at his diagnosis doctors said he had a one in three chance of any response to treatment.
‘The first three years on the diet were phenomenal,’ says Miriam. ‘He seemed almost completely well again.’
Miriam was so impressed by the immediate and beneficial effect of the diet that she signed up for a master’s degree in nutrition. Her book – Keto for Cancer – just published in the UK – tells the story of Raffi’s remarkable success as well as being a handbook for anyone wanting to follow the diet.
Raffi remained on the diet for six years. ‘Much of the time he was living pretty normally,’ Miriam says. ‘In contrast, children with brain tumours following the standard protocol often undergo treatment after treatment until the end.’ Dr Nelofer Syed, a senior research fellow and lecturer in cancer biology at Imperial College London, agrees the ketogenic diet has great potential.
‘Early research shows that it can improve the effectiveness of both chemotherapy and radiotherapy and that cancers find it difficult to use ketones for energy,’ she says.
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Loss: He died nine years after he was diagnosed, at the age of 13 in April 2013
She is the co-author of an article summarising research on the diet, published last year in the journal Frontiers In Molecular Neuroscience.
It reported on lab studies showing the diet could, among other things, reduce the ability of tumours to hook up to a blood supply and make it harder for cancer to spread. However as yet, there have been no big studies testing the diet against other therapies, and Cancer Research UK does not recommend it as an alternative to the standard healthy balanced diet.
‘We’d all love better evidence,’ says Dr Syed, ‘but providing patients do it under the supervision of a dietitian who is trained in delivering it, I think it is worth trying.’
The ketogenic diet is already approved by NICE for children with epilepsy;a big randomised trial for childhood epilepsy showed it could reduce or even stop the seizures.
Ultimately, however, the diet couldn’t save Raffi. He died nine years after he was diagnosed, at the age of 13 in April 2013.
Not every patient will benefit as dramatically as Raffi did and his success doesn’t ‘prove’ the diet works. ‘Its value is as an add-on to what you’re already doing with your oncology team,’ says Miriam. She adds: ‘The diet kicked the can down the road for six years.
‘During a period when most people with cancer are in clinics or hospitals, Raffi was out riding his trike.’
Keto For Cancer by Miriam Kalamian (Chelsea Green, (£18.99).
