In a German biochemist, named Otto Warburg, hypothesized that the primary cause of cancer was a dysfunctional metabolic process causing cancer cells to utilize large amounts of energy glucose. Then, his theory was considered controversial and implausible, but over the last decade his theory has sparked new interest in the dysregulated energetics seen in tumor cells. This dependence on glucose allows oncologists to use positron emission tomography PET scans to locate tumors within a patients body. By mixing radiolabeled dye with sugar glucose they can follow where the highest amount of glucose is being consumed in the body. The same year that Warburg made his discovery the Ketogenic Diet was discovered to be beneficial for epilepsy. The Ketogenic Diet was designed to mimic the effects of starvation on the body, when it was discovered that fasting helped to relieve difficult to control seizures. Tumor cells have an increased reliance on glucose, suggesting that treatments affecting cellular metabolism may be an effective method to improve current therapies. Indeed, metabolism has been a focus of cancer research in the last few years, as many pathways long associated with tumor growth have been found to intersect metabolic pathways in the cell.
Typically, cancer nutritionists recommend that patients eat a plant-based diet that emphasizes fruits, vegetables and whole grains and limits red meat. The goal of the ketogenic diet is to put the body into ketosis. Cancer cells use more glucose than normal cells to maintain their growth. Since the ketogenic diet deprives the body of glucose, scientists have proposed that it might also keep cancer cells from getting the energy they need to grow. Currently, two small clinical trials are looking at the effect of the keto diet in patients receiving standard treatment for metastatic breast cancer and glioblastoma. A recent study found the diet inhibited the growth of cancer cells in mice with non-small cell lung cancer, which relies heavily on glucose for its growth. Jocelyn Tan, an oncologist with Veterans Affairs Pittsburgh Healthcare System, has conducted research on how the keto diet affects cancer patients. Q: How did you become interested in the keto diet? A: In , I found two papers that looked at the effect of a low carbohydrate diet in cancer patients. Both were very small studies looking at if the diet was safe. So, I thought we could improve upon those small studies with a slightly larger study.
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Combining a ketogenic diet with standard chemotherapeutic and radiotherapeutic options may help improve tumor response, although more research is needed. As early as bc, fasting was used as an effective treatment for many medical ailments. Fasting continued into modern times, and in , Guelpa and Marie proposed fasting as an antiepilepsy treatment. A low-carbohydrate, high-fat diet was thought to be an alternative to fasting or starvation, having many of the same desired effects while continuing to nourish healthy cells. The term ketogenic diet KD was later coined by Wilder and Peterman, who formulated the fat-to-carbohydrate ratio that is still used today: 1 g protein per kg of body weight in children and 10 to 15 g carbohydrates daily, and fat for the remainder of calories. Use of the KD as an adjuvant to cancer therapy also began to emerge. In , Braunstein noted that glucose disappeared from the urine of patients with diabetes after they were diagnosed with cancer, suggesting that glucose is recruited to cancerous areas where it is consumed at higher than normal rates. During that same time, Nobel laureate Otto Warburg found that cancer cells thrive on glycolysis, producing high lactate levels, even in the presence of abundant oxygen. Warburg conducted many in vitro and animal experiments demonstrating this outcome, known as the Warburg effect. By the midth century, KD use in epilepsy treatment and cancer research had waned.