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Posted 10/14/2020 10:36 PM (GMT 0)
Hi Guys. I just finished a very interesting, though highly technical, book on the subject of the glacially slow discovery of the over all health benefits of nutritional ketosis. I.E., various degrees of intermittent fasting, ketogenic diets, low carb diets, etc. All of the slightly different approaches that lead to two very important benefits to various health issues, including cancer: reducing high blood insulin/insulin resistance, and the benefits of ketones themselves. The book is titled: "Ketones The Fourth Fuel" by Travis Christofferson. Subtitled: "Warburg to Krebs to Veech: The 250 year Scientific Journey to Find the Fountain of Youth'. ( I still remember studying the mind boggling "Kreb's Cycle" back in my early college Chemistry/biology courses. Yep, it is all in this book to bug me again)

It is very technical, especially in the first half of the book, as it tells the history of these giants in science, finally leading up to the impressive current science on the benefits of of ketones, plus of course what usually goes hand in hand with the presence of those ketones in your blood stream: low blood insulin(as well as often low blood sugar). All of these things are normally found together, although most recently there are actually ways to actually consume the ketones. Which might be helpful in certain disease states even without being in the state of nutritional ketosis.

This book led me to yet another book on this subject: "Keto for Cancer" by Miriam Kalamian with a forward by Thomas Seyfreid, who wrote the book "Cancer as a Metabolic Disease". This is written by a lady whose child got brain cancer, and who, after zero progress despite many traumatic treatments, discovered the potential benefits of nutritional ketosis for this disease. This pushed her to obtain a Masters in nutrition and other degrees, as she sought to learn as much as possible about this subject. I have just started this book. Much of these two books focus on the evidence for advantages of a state of Ketosis to augment RT and chemo. As well as advantages regarding dementia.

Anyway, I just thought I would let Y'all know about these 2 books as being of potential interest to some folks here at HWPC. Has anyone here looked into these approaches to augmenting treatment for PC?
Posted 10/15/2020 12:21 AM (GMT 0)
Since this last came up about a month ago, I'd just gotten off of my boat and returned home to Knoxville. When here, for some strange reason, I can become somewhat depressed. When I get this way, I tend to not care what happens to my body. And I've put on 10 lbs of the 30 I had lost in the last year and a half. (Where I live, it's in the woods and can't see out....it can become depressing).

I know I'm going back to the boat tomorrow. Just knowing that, I've begun to stop eating again. It makes me feel healthier to be thinner and have that "edge of hunger" with me. I guess what I'm saying is....healthy mind, spirit and body. That happens when I am on my boat. (It's like I become a different person.....LOL....which you all might or might not be glad to see happen).

So, I weigh 184 lbs now. I should be on the boat for at least a couple of months this go. So....I'm pretty sure my attitude, eating habits, etc......in a month my money is on my being back down to the low 170's.

I think there's something to this fasting. I can't say that I believe it "cures cancer".....but I've seen enough on here that it seems to correspond to my case.....as "happenstance" as that may be.

Thanks for the reference material BB. I won't read it. But, I think there may something here. (cashless is a difficult case to ignore)
Posted 10/15/2020 3:20 AM (GMT 0)
Thanks for your comments, IT! Interesting about forest life in Knoxville vs boat life! And I agree, Cashless' case is hard to ignore. And I have always been quite suspicious that, along with whatever else he might be accomplishing, he is in some degree of ketosis. Which only makes sense, as he always claims one of the things he is shooting for is low insulin. Low insulin and ketosis tend to go hand in hand.
Posted 10/15/2020 3:07 PM (GMT 0)
One question which often arises, and one which I also have, is: Even if it turns out that ketones- or a state of ketosis - are good for many aspects of our health, and for most cancers, does that apply to PCa? Since, apparently PCa is not the voracious sugar feeder that most cancers are. Which is why some of the PET scans used for most cancers will not work for PCa and different types of carriers must be used for the scans.

So, that has left me wondering over the years. OTOH, I have often pointed out here that even if PCa does not love sugar, it still loves insulin, which is a major growth factor in all cancers. And less sugar = less insulin. And indeed, type 2 diabetics, who tend to run higher blood insulin levels even if their blood sugar is well controlled(and in fact sometimes even must inject extra insulin), are known to have a much poorer prognosis with all cancers, including PCa. Also, there is the open question(or at least I don't know the answer yet): are ketones toxic to cancer cells, including PCa?

I found this article last night, which does a pretty good job of discussing the question of ketosis vs PCa. I will link to it in the next post.
Posted 10/15/2020 3:10 PM (GMT 0)
https://drgeo.com/does-a-keto-diet-work-for-prostate-cancer/
"To date, the most reliable evidence for KD in suppressing tumors has been reported for glioblastoma (a type of brain cancer)..........................................

Ketogenic Diet and Prostate Cancer: Yes or No?

There have been no studies on a KD and prostate cancer.

However, there is a small pilot, non-randomized study going as we speak looking and this dietary approach among a sample of 12 overweight or obese prostate cancer patients on active surveillance. The result will not be available until the Spring of 2021.

Besides there being no studies, should a man with prostate cancer implement a KD?

Yes and no.

Here’s the deal;

In one mice study looking at the effects of a no carbs keto diet (NCKD), 10% carb diet and a 20% carb diet on prostate cancer showed is no difference between low-carbohydrate and no-carbohydrate diets regarding prostate cancer growth and progression.

The other important point is that most types of prostate malignancies are not glycolytic cancers like glioblastoma’s thus the Warburg effect does not apply. Clinically this is relevant, as these cancers will not appear on fluorodeoxyglucose (FGD) PET scans. However, in the late stage, more aggressive metastatic prostate cancer there may be more of a Warburg effect and have a high glucose uptake.

In other words, low-grade prostate cancer and high-grade metastatic prostate are two entirely different animals in how they behave.

Dr. Geo’s Take On the Ketogenic Diet and Prostate Cancer

A low carbohydrate diet, which is what promote in the CaPLESS Method, of about 50 to 60g of carbs total (not sugar, carbohydrates) a day is still, eliminating refined; processed carbs is still essential for early-stage prostate cancer without metastasis or positive FDG PET scan.

The reason why a low carb diet is vital to beat non-metastatic prostate cancer is not that of glucose uptake of cancer cells, but the problems excess insulin and insulin resistance cause in promoting disease. In fact, there are data to suggest that patients with early-onset, type one diabetes mellitus (not type two) whose pancreas is no longer able to produce insulin are significantly less likely to develop prostate cancer, independent of diet changes.

If a huge guy is diagnosed with prostate cancer, then his high basal metabolic index (BMI) increases the risk of not only getting prostate cancer but dying from it.

It is a good idea for an overweight person with prostate cancer to restrict carbs more than most as low carb diets, and a KD has shown to help with weight loss.

Intermittent fasting of 12 to 16 hours a day is an excellent practice for prostate cancer and overall longevity.

Lastly, ketones from fasting would be contraindicated in cancer patients with rapid weight loss (cachexia) unless higher fat intake is consumed to avoid further weight loss. Additionally, ketone bodies have been shown to suppress protein catabolism during starvation – meaning that one can maintain muscle from breaking down while utilizing ketones for energy.

Adding medium-chain triglyceride (MCT) to KD in a study to five severely cachectic cancer patients for one week induced a significant weight gain of 2 kg and improved their performance status.

The bottom line is this: A low-carbohydrate, non-ketogenic diet is recommended for prostate cancer with few exceptions: one if the patient has a high BMI, or if prostate cancer is more advanced and shows on glucose dependent PET scan.. "

I feel that last paragraph is potentially a little confusing. What I think he is saying is: A low carb, but not low enough to be ketogenic, diet is recommended for prostate cancer in general, which would be men not yet diagnosed or men of low risk. Exceptions to that rule ( meaning low enough carb to actually lead to ketosis) IS recommended for overweight men(who have a poorer prognosis and who likely have high insulin), and/or men who have advanced PCa who are also men whose PCa would show up on a glucose dependent PET scan. IOW, most folks who are considerd high risk of their PCa actually killing them. At least according to this article. But, the above seems to back up some studies I have linked to in the past regarding higher blood insulin levels being linked to much higher PC risk. I will supply a couple of those links in the net post.
Posted 10/15/2020 3:13 PM (GMT 0)
Here are a couple of links regarding insulin levels vs PCa. The thing related to the OP of this thread is: more ketones = less insulin. Normally, if a diet is leading to ketones in the blood, there is likely little to no insulin production. If you have one, you don't need the other:


https://www.ncbi.nlm.nih.gov/pmc/articles/pmc2364268/
"the insulin levels of high risk patients were significantly higher than the insulin levels of medium and low risk patients (P=0.05) but the insulin levels of medium and low risk patients were not significantly different from one another. .....................Increased T stage was independently correlated with increased serum insulin levels (P<0.001)............The relationship between increased insulin level and advanced tumour stage in prostate cancer we describe here is biologically quite plausible, since insulin is a growth factor. Further studies may document whether serum insulin levels might be a useful biomarker of prostate cancer stage....."

https://pubmed.ncbi.nlm.nih.gov/11353789/
( WHR = waist hip ratio) "Results: After adjustment for body mass index, WHR, IGF-I, and sex hormone levels, higher serum insulin levels were associated with a statistically significantly elevated risk of prostate cancer (P<.001). Men in the highest tertile of insulin levels had a 2.56-fold (95% confidence interval [CI] = 1.38 to 4.75) risk of prostate cancer compared with men in the lowest tertile. Regardless of the tertile level of WHR, higher serum insulin levels were associated with an increased risk of prostate cancer: Men in the highest tertiles of WHR (>0.900) and insulin (>8.83 microU/mL) had 8.55 times (95% CI = 2.80 to 26.10) the prostate cancer risk of men in the lowest tertiles of both, and those in the lowest tertile of WHR (<0.873) and highest tertile of insulin had 4.30 times (95% CI = 1.17 to 15.70) the risk.....Conclusion: Our results suggest that serum insulin levels may influence the risk of prostate cancer in Chinese men. Further research, especially prospective studies, is needed to confirm these findings in high-risk populations and to clarify the underlying mechanisms involved. ...."
Posted 10/15/2020 4:28 PM (GMT 0)
I don't think it's accurate to say there haven't been studies relative to PCa. For example, see:

Beneficial effects of ketogenic diets for cancer patients: a realist review with focus on evidence and confirmation (2017)

https://link.springer.com/article/10.1007%2Fs12032-017-0991-5

See also the Reference section there. There appear to be a number of 2020 studies on low-carb diet and PCa.

Djin
Posted 10/15/2020 6:20 PM (GMT 0)

DjinTonic said...
I don't think it's accurate to say there haven't been studies relative to PCa. For example, see:

Beneficial effects of ketogenic diets for cancer patients: a realist review with focus on evidence and confirmation (2017)

https://link.springer.com/article/10.1007%2Fs12032-017-0991-5

See also the Reference section there. There appear to be a number of 2020 studies on low-carb diet and PCa.

Djin

Thanks for the link, Djin, good article! I particularly like tis quote: " Evidence for pro-tumor effects was lacking completely. Feasibility of KDs for cancer patients has been shown in various contexts. The probability of achieving an anti-tumor effect seems greater than that of causing serious side effects when offering KDs to cancer patients. Future controlled trials would provide stronger evidence for or against the anti-tumor effect hypothesis." So at least no harm has been found, so that's good!

But I think the article I last linked to was specifically referring to controlled human trials for PCa only. He mentions 1 trial which will be complete in 2021, but I don't know what the date of writing for his article is. Maybe he did not yet know about newer trials coming on board. But, I can't find any completed human trials for ketosis vs PCa in the reference section you link to. If you did, please let me know.

Thanks again!
Posted 10/15/2020 7:57 PM (GMT 0)
The more I study on it, the more I wonder if the relationship between blood sugar and/or higher insulin is not a relationship that is being way under studied. Especially re: cancer in general- and even just general health- And also of PCa specifically. Remember the previous linked study on Chinese men that showed 3 times worse PC for those with the highest blood insulin, and 8 times worse for those who had both the highest blood insulin and the largest waistlines? Here is a similar study from 2019 :
https://cancerpreventionresearch.aacrjournals.org/content/12/2/103.long
"Thus, we investigated the association between hyperglycemia and prostate cancer risk and mortality using multiple biomarkers simultaneously to classify hyper- and normoglycemia............We conducted a prospective analysis of 5,162 cancer-free men attending visit 2 (1990–1992) of the Atherosclerosis Risk in Communities (ARIC) study followed for total (N = 671) and lethal (N = 69) prostate cancer incidence and prostate cancer mortality (N = 64) through 2012. ..................
We evaluated the multivariable-adjusted association of hyperglycemia with prostate cancer incidence and mortality ............Compared with men who were normal on all three biomarkers, men who were high on ≥1 biomarker had an increased risk of lethal [HR, 2.50; 95% confidence interval (CI), 1.12–5.58] and fatal (HR, 3.20; 95% CI, 1.26–8.48) disease, but not total prostate cancer incidence (HR, 0.98; 95% CI, 0.81–1.20)..................Our findings indicate hyperglycemia is associated with an increased risk of lethal and fatal prostate cancer, but not total prostate cancer incidence......".

There it is again: looking at biomarkers associated with too much sugar going in and insulin being produced, if you have these biomarkers, the risk is 3.2 times greater for death from PCa if you already have it, but not related to the chance of getting it to start with. But most of us are in the "already have it" category, and mainly concerned with not joining the "fatal" category. It appears the relationship of too much sugar and the resulting insulin with PCa fatality is pretty stout. So even if early stage PCa does not(like most cancers) actually eat much sugar, it appears that if one wants to avoid being in the "late stage" or "fatal" category, having less sugar and more importantly less insulin and more ketones might be something worth striving for.
Posted 10/15/2020 8:28 PM (GMT 0)
July 2020
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7379157/

"The Evolving Role of Diet in Prostate Cancer Risk and Progression

Recent data have further solidified the association between insulin resistance and prostate cancer.............
Regarding therapeutics, hyperinsulinemia may be the cause of resistance to PI3K inhibitors in the treatment of prostate cancer, leading to new investigations combining these drugs with ketogenic diets.
Summary:

Given the recently available data regarding insulin resistance and adipokine influence on prostate cancer, dietary strategies targeting metabolic syndrome, diabetes and obesity should be further explored..............

Elevated BMI is also a risk factor for the progression of low grade to high grade prostate cancer [7]. The homeostatic model assessment of insulin resistance, or HOMA-IR, has now been shown to be associated with prostate cancer risk in a recent meta-analysis, with previous studies showing obesity correlating with higher grade and Gleason score at diagnosis, as well as higher recurrence rates and poorer prognosis.........................

Metabolic Disease and Prostate Cancer

Several studies have examined the impact of various components of metabolic syndrome and their effect on prostate cancer. Data from the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) revealed a strong association between metabolic syndrome and the incidence of high grade prostate cancer [12]. In this study, 8122 men were randomized to placebo or dutasteride following a negative prostate biopsy. Patients then underwent biopsies at 2 and 4 years, with BMI, hypertension, hypercholesterolemia, and diabetes risk factors recorded. Study results revealed that the presence of 3 or more metabolic syndrome components was significantly associated with increased risk of high grade prostate cancer (OR 1.94, p=0.017).........................

Obesity has also been linked with prostate cancer progression. In a study of 565 men from Canada, men undergoing active surveillance were found to have a 50% increase in prostate cancer progression for every 5 point increase in BMI over 25 [7]. A meta-analysis demonstrated that obesity was particularly associated with an increased risk of aggressive prostate cancer.................

Ketosis may offer unique benefits in cancer prevention and prognosis above and beyond carbohydrate restriction. Ketosis induces many physiologic changes that can be leveraged for therapeutic benefit. The historic work at Johns Hopkins University pioneered the use of the ketogenic diet in the treatment of refractory pediatric epilepsy in the 1920’s, with staggering results [61]. The early work was validated in extensive clinical studies over the years, with systematic reviews and meta-analysis demonstrating the efficacy of the ketogenic diet for this condition[62]. Currently, a number of ketogenic diet-based clinical trials are ongoing in several disease states, including adult epilepsy, metabolic syndrome, diabetes mellitus type II, Alzheimer’s disease, and cancer.

Of particular relevance to cancer and the mechanisms described previously, the ketogenic diet reduces insulin resulting in downregulation of oncogenic signaling pathways, decreases circulating glucose leading to decreased tumor biomass production, and increases ketone bodies with direct HDAC inhibition [38,47,63]. In light of these promising mechanisms, it is not surprising that the ketogenic diet has been shown to be efficacious as an adjuvant to numerous cancers in clinical studies, including ovarian, endometrial, pancreatic, and lung cancers [64,65]. While there are currently limited clinical studies evaluating outcomes of the ketogenic diet among prostate cancer patients, a recent review suggested that the anti-cachectic properties of ketones could be beneficial as adjuvant treatment [66]. The ketogenic diet is currently being evaluated for prostate cancer patients under active surveillance (NCT02194516)................................................".

Post Edited (BillyBob@388) : 10/15/2020 2:38:42 PM (GMT-6)

Posted 10/17/2020 1:28 PM (GMT 0)
Slightly OT, but related to a subject that many people are concerned with lately: Covid-19 deaths. More specifically, higher blood sugar vs CV-19 death and complications. And of course, one thing these patients with higher sugar had zero of was blood ketones. And whatever the correlation or causation may turn out to be regarding blood ketones and low insulin, or it's opposite high insulin and no ketones, for cancer and specifically PCa, the evidence for the relationship of these controllable conditions and general health continues unabated.

So, this study was out of Wuhan, China. It found that nearly half of hospitalized patients with COVID-19 without a prior diabetes diagnosis have hyperglycemia, and the latter is an independent predictor of mortality at 28 days. It speaks to many of us Americans: "Several previous studies have demonstrated a link between hyperglycemia and worse outcomes in COVID-19 and at least one diabetes diagnosis, but this is the first to focus specifically on patients without a prior diabetes diagnosis.........Wang and colleagues found that an FBG(fasting blood sugar) ≥ 7 mmol/L (≥ 126 mg/dL) on admission -- present in 45.6% of persons without a prior diabetes diagnosis -- was an independent predictor of 28-day mortality.......................A total of 605 patients did not have a previous diabetes diagnosis. They were a median age of 59 years, and 53.2% were men.

A little more than half, 54.4%, had an FBG < 6.1 mmol/L (< ~110 mg/dL). The rest had dysglycemia: 16.5% had an FBG of 6.1 mmol/L to 6.9 mmol/L (110 mg/dL to 125 mg/dL), considered the prediabetes range, and 29.1% had an FBG ≥ 7 mmol/L (≥ 126 mg/dL), the cutoff for diabetes.

"These results indicate that our study included both undiagnosed diabetic patients and nondiabetic patients with hyperglycemia caused by an acute blood-glucose disorder," the authors noted. .....Over 28 days of hospitalization, 18.8% (114) of the patients died and 39.2% developed 1 or more in-hospital complication..........

Compared with patients with normal glucose (< 6.1 mmol/L), 28-day mortality was twice as high (HR = 2.06) for persons with an FBG of 6.1 to 6.9 mmol/L and > 3-fold higher for ≥ 7 mmol/L (HR = 3.54)..

Complications were more than twice as common in patients with an FBG of 6.1 to 6.9 mmol/L/110-125mg/dl (odds ratio [OR] = 2.61) and 4 times more common (OR = 3.99) among patients with an FBG ≥ 7 mmol/L(125mg/dl) compared with patients with normoglycemia.".

So, it seems that once again, that having even slightly elevated fasting blood sugar(FBG) can be very risky for our health in multiple ways. In this case doubling the odds of Chinese men of dying of CV-19 if they are in the hospital with it, and even much worse for the actual undiagnosed diabetics. Which also makes me wonder about the implications for our improved health of being closer to the other extreme, i.e. even generating some ketones once in a while, to be used for energy rather than sugar. I wonder if that might end up being helpful for everything from cancer to heart disease to improved mortality from CV-19. It is well known to be good for reducing our spare tires. I guess as the studies march on, time will tell.




https://www.medscape.org/viewarticle/936567?nlid=137804_2713&src=wnl_cmemp_201016_mscpedu_nurs&uac=158102pn&impid=2622605&faf=1
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