Ketosis

So in the first post we discussed how cancer cells appear to require large amounts of glucose to survive. If that is the case, the obvious question is whether or not it might be possible to attack cancer by lowering blood glucose levels. Theoretically if we could reduce blood glucose levels to zero then the cancer would perish, but of course so would we. Even if you do not eat any carbohydrates at all, your liver will make glucose out of proteins and fats in order to maintain your blood glucose at the minimum level necessary for survival.

Just because we can't lower our blood glucose levels to zero doesn't mean that striving to keep our blood glucose levels at the lower end of the normal range wouldn't be helpful for treating or preventing cancer. Blood glucose levels can vary between somewhere around 80 to over 200 of whatever the measure is. Normal fasting blood glucose is somewhere around 90. After carbohydrate-containing meals, blood glucose spikes into the mid to upper 100's. It could be that cancer cells prefer a high fasting blood glucose, or it could be that they benefit most from the frequent spikes caused by carb-heavy meals. So anyone trying to fight cancer by targeting blood sugar would want to try to lower both fasting blood glucose and avoid frequent/high blood sugar spikes.

The only real option for drastically lowering blood sugar is to eat a "ketogenic" diet. On a ketogenic diet you basically substitute fat for carbohydrates, keeping carbohydrate intake at less than 50 grams per day, without increasing protein intake. When carbs are absent from the diet and protein intake is moderate, the body switches from burning glucose as a primary fuel to burning fat. The process of burning fat produces molecules called "ketones" as a byproduct. Ketones are water soluble, so they disperse throughout the body, and mitochondria will switch to burning them instead of glucose or fats. This allows many of the cells which supposedly require glucose, particularly in the brain, to replace glucose use with ketones. Eating a ketogenic diet and producing and burning ketones for fuel is called being in "ketosis."

Ketosis is a natural state. It starts to kick in anytime we go without food for awhile, something that our ancestors probably did regularly. Even people on normal diets supposedly start transitioning to ketosis while sleeping overnight before breaking their fast in the morning or afternoon. What's really cool though is that ketosis appears to have a lot of positive affects on cellular processes, especially in the brain. In particular, ketogenic diets are becoming well-known for their success in treating childhood epilepsy.

But back to cancer. So a ketogenic diet will put a stop to post-meal blood sugar spikes, which could help with cancer. Fasting blood glucose will probably go down (although over an extended time ketogenic diets will raise fasting blood glucose, which could be bad, but we don't need to worry about that at this point). Through exercise or perhaps other tricks someone in ketosis can attain a blood sugar level so low that it would cause a hypoglycemic crisis in anyone not in ketosis, but yet feel no effects of hypoglycemia. The cellular energy crisis which causes the hypoglycemic symptoms never happens because the person in ketosis has plenty of fat and ketones available to with which to run cellular processes. But that's about as low as one can expect to get blood sugar, and only transiently.

So avoiding post-meal blood glucose spikes and lowering fasting blood sugar could potentially help fight cancer. It certainly wouldn't be expected to hurt. But ketosis is a complex physiological state and what's interesting is that it might have important effects on cancer apart from its effect on blood glucose, especially in combination with chemo and/or radiation. More as soon as I can get to it...