Remembering Kevin Moore

The LLVLC Show (Episode 628): Dr. Eugene Fine Uses Ketogenic Diet In RECHARGE Cancer Trial


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In Episode 628 of “The Livin’ La Vida Low-Carb Show with Jimmy Moore,” I’m so pleased to finally be able to share about the great research that has been conducted by clinical professor of radiology and nuclear medicine in regards to the effect of the ketogenic diet on various cancers named Dr. Eugene Fine. After having such an engaging conversation last Thursday night with Dr. Colin Champ in Episode 31 of the “Ask The Low-Carb Experts” podcast on the topic of “Ketogenic Diets And Cancer” where we mentioned Dr. Fine’s work, I’m so excited to bring to you this researcher who has been closely examining the connection between an Atkins-styled low-carb ketogenic diet and patients with advanced stage cancer in order to see what if any impact changes in nutritional composition can make on cancer tumors.

Dr. Eugene Fine is from the Albert Einstein College of Medicine and he recently published his momentous pilot study of 10 cancer patients in the October 2012 issue of the scientific journal Nutrition. While it was admittedly a very small study of just participants, Dr. Fine is hopeful that the preliminary results he has seen so far will help spur on funding for future research in a much larger population of cancer patients who so desperately need an alternative and/or supplemental therapy to chemotherapy. Listen in as Dr. Fine and I discuss how he came across the ketogenic diet, why he believes ketones work to slow down or even reverse the growth of cancer, what results he saw in his 10 cancer patients and where he sees the future of ketogenic diet cancer research going. If you, a friend or family member are dealing with a cancer diagnosis, then this episode is a MUST-LISTEN!

Listen to Dr. Eugene Fine share about his ketogenic diet cancer study:

  • In medical school, he was fascinated by the Warburg effect
  • There was no real application of this when he left medical school in 70s
  • In nuclear medicine, he uses PET scans to detect cancer in patients
  • When the RECHARGE began and how Dr. Richard Feinman was involved
  • Dr. Feinman got him interested in carbohydrate-restriction for cancer
  • The trial began in 2006 after getting funding from the Atkins Foundation
  • He found out that low-carb doesn’t really starve the tumor as believed
  • Ketone bodies are the result of carbohydrate-restriction
  • Animal trials and one human case study was out there before his trial
  • Cancer cells are “excellent at pirating glucose from the blood”
  • Even at glucose levels that are way below normal
  • On a low-carb diet, your blood glucose is still between 60-100
  • So the cancer can still be fed enough glucose to exist
  • But low-carb lowers glucose concentration and thus insulin
  • Lowering insulin helps to reduce the growth of cancers
  • Ketosis itself has been found to cause inhibition of cancer growth
  • There’s “safety” being in a ketogenic state for virtually everyone
  • Cancer cells are “clever” at evading any kind of therapy to combat
  • He was hopeful there were groups of patients who would respond to this
  • His pilot study looked at a variety of cancers and how they would respond
  • It was difficult to find patients that met their entrance criteria
  • They wanted cancers that were defined by glucose dependent phenotype
  • A positive PET scan identifying the cancer as glucose dependent
  • There was a concern about finding patients that weren’t too thin
  • Since low-carb produces weight loss, they didn’t want skinny patients
  • Dr. Fine’s 2010 lecture at a Nutrition & Metabolism Society event
  • The people in his trial had attempted almost all other therapies first
  • The goal was to get the patients through 28 days of a low-carb diet
  • They wanted to ensure “safety and feasibility” with evidence of efficacy
  • Monitoring of the changes was conducted by checking the PET scans
  • The concern about this being “too long,” so 28 days seemed reasonable
  • The diet consumed in the trial mimicked the Atkins induction phase
  • Dr. Thomas Seyfried promotes calorie-restricted low-carb for brain cancer
  • His purpose was not to calorie restrict, but it happened spontaneously
  • They encouraged the patients to eat often and tried to overfeed them
  • The patients were about 35% calorie-restricted–without forcing it
  • Satisfaction with the high-fat, low-carb eating naturally cut calories
  • How they measured the level of ketones and compliance with the diet
  • Although they prescribed 50g carbohydrates daily, it was self-reported
  • They measured beta-hydroxybuterate (ketones) in the blood during the AM
  • Most of the patients had baseline of .3 millimolar or less blood ketones
  • What was most important is the relative ketosis compared to baseline
  • The absolute values of ketones wasn’t as important as relative change
  • Four of the patients has continued progression of their disease
  • Five patients had their disease stall and one patient saw improvement
  • The patients who didn’t respond had a horrible relative ketone change
  • But the ones who responded well saw the most relative change in ketones
  • This pilot study was too small a sample to make too much of it
  • But it is important that this hypothesis has been tested to open the door
  • His hope is this study will allow for an even bigger investigation
  • Whether it’s possible if bringing blood ketones higher would help more
  • He had to be naive to think diet alone would succeed in all patients
  • But he wanted to know what percentage would succeed on ketogenic diets
  • Read Dr. Fine’s guest blog post on Dr. Richard Feinman’s blog
  • Breast, cancer, esophageal and ovarian cancer patients didn’t respond
  • But the ones who saw no progression or improvement were all over
  • It wasn’t the tumor type that determined who would respond well
  • The important thing was that these tumors were glucose dependent
  • The one who had partial remission had ovarian cancer
  • The patient who had 5.0 millimolar did not have biggest percentage change
  • He wondered about why the patients who had higher baseline of ketosis
  • It was very hard to determine exactly what the patients were eating
  • Comparing relative ketosis to relative insulin values was important
  • Insulin can fluctuate very rapidly much more quickly than ketones
  • Blood ketones tend to be the lowest in the AM, highest in the PM
  • The overnight fast in a non-low-carber tends to produce ketones in AM
  • They measured consistently in the morning for convenience to patients
  • It would be great to see what changes over the day in blood ketone levels
  • The more data points you have, the more certain you will know results
  • They measured blood sugar levels and saw a “small, average” drop
  • Why he excluded including cancer patients who also had Type 2 diabetes
  • He wants to look at biomarkers to determine in advance who would respond
  • Additionally, he wants to know if genes play any role in diet and cancer
  • The future of carbohydrate-restriction with cancer is with drug therapy
  • This could be “promising” as it would allow for less chemotherapy, drugs
  • Reducing toxicity and saving money on chemotherapy and drug therapy
  • A larger trial of more patients will provide better research on this
  • There’s a lot more traction being gained in this area of research

    There are four ways you can listen to Episode 628:

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    What did you think about the research that Dr. Eugene Fine is conducting using ketogenic diets with cancer patients? We’d love to hear your thoughts, so share them in the show notes section of Episode 628. See all the latest updates in Dr. Fine’s RECHARGE Dietary Cancer Trial and read the full text of his pilot study of 10 cancer patients who were put on a low-carb ketogenic diet that was published in the October 2012 issue of the scientific journal Nutrition. Coming up on Tuesday, chiropractor and applied kinesiologist Dr. Avery Carpenter will explain why she believes low-carb nutrition is appropriate for everyone, including those who have issues with it (she’ll explain specifically what’s going on and how to overcome the difficulties). And finally on Wednesday, we are pleased to have a returning podcast guest in professor of medicine Dr. Richard Johnson from the University of Colorado who first appeared in Episode 223 of the podcast in January 2009 discussing his book The Sugar Fix where he hypothesized that fructose alone was the root cause behind obesity and chronic disease. I challenged him about his theory during that podcast encouraging him to examine the role of ALL carbohydrates on metabolic health. And so he did. Now Dr. Johnson is back to discuss his newfound support for low-carb nutrition in his brand new 2012 book entitled The Fat Switch published by the great online health advocate Dr. Joseph Mercola.

    JOIN US ON THE “ASK THE LOW-CARB EXPERTS” PODCAST THIS WEEK: Coming up in Episode 32 of “Ask The Low-Carb Experts” on Thursday, October 25, 2012 at 7PM ET we’ll be pleased to welcome a heart surgeon named Dr. Steven Gundry to take on an interesting topic for those of us who are livin’ la vida low-carb–“High-Fat Diets: Good vs. Bad.” I had Dr. Gundry on “The Livin’ La Vida Low-Carb Show” in Episode 179 and 180 back in 2008 (definitely one of my favorite interviews from the early days) discussing his book Dr. Gundry’s Diet Evolution. He knows just a thing or two about healthy fats and how they respond inside your body as well as the ones that are not-so-healthy. Start getting me your questions NOW regarding good fats vs. bad fats for me to ask Dr. Steven Gundry by e-mailing them to AskTheLowCarbExperts@gmail.com no later than 3PM ET on the date the podcast airs. You can also ask your question LIVE on my show by calling (712) 432-0900 or Skype the show for FREE by calling the username freeconferencing.7124320900. Whether you call or Skype, be sure to use the access code 848908. Listen LIVE and leave us a review at iTunes if you like what you hear. This is your chance to interact with the best nutritional health experts in the world, so don’t be bashful.

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