Nutrition and Cancer – Cancer 10

//Nutrition and Cancer – Cancer 10

As it became clear that environmental influences affect cancer rates, the prime suspect was the diet. The natural question, therefore, was what specific part of the diet is responsible. The immediate suspect was dietary fat. From the late 1970s to the 1990’s we were gripped in a hysterical fat phobia. We thought eating fat caused everything bad. It caused obesity. It caused high cholesterol. It caused heart disease.It probably caused bad breath, hair loss and paper cuts, too. There was no actual proof that dietary fat, which humans had been eating since, well, we became human, that this was actually true. But it didn’t really matter, because the entire scientific world was viewed through the lens of the dietary-fat-is-bad lens. Who needs proof if you have dogma? 

All bad things were caused by dietary fat, so it probably caused cancer, too. Nobody really had any idea why dietary fat should cause cancer. Nobody had ever really noticed that people eating a lot of fat got a lot of cancer. But it didn’t matter. Blame fat for everything was the name of the game. So play on!

Based on this hearsay, the National Institute of Health sank millions of dollars into an enormous trial to prove that dietary fat caused weight gain, heart attacks and breast cancer, too. This Women’s Health Initiative enrolled close to 50,000 women into a massive randomized controlled trial – the gold standard of evidence based medicine. Some women were instructed to follow their usual diet, and the other group would reduce their dietary fat to 20% of calories and increase grains and vegetables/ fruits.

Over the next 8.1 years, these women faithfully reduced their dietary fat and their overall calorie intake with the fervent belief that it would reduce weight, heart disease and cancer. Was their faith in their doctors and researchers justified? Ah, well, the answer is no, no and no. Published in 2007, there were no reductions in heart disease. Their weight was unchanged. And their rates of breast cancer – well that was no better either. It was a stunning defeat. If reducing dietary fat did not reduce breast cancer rates, then it was a pretty good chance that dietary fat did not cause breast cancer.

Lowering dietary fat and caloric intake resulted in no measurable benefits at all. This, the only large scale randomized controlled trial of a low fat diet ever done, was a disaster all around. The benefits of a low fat diet, if any exist, are so minuscule that they are undetectable. This directly contradicted the prevailing beliefs of the entire scientific community. We could either:

  1. Believe the science, this expensive and hard won knowledge that restricting dietary fat had no benefits
  2. Ignore the results, because it did not agree with our preconceived notions. 

The winner was #2. It was just so much easier to keep doing what we were doing, even if it was totally ineffective. People would get sicker, but hey, at least we didn’t need to relearn the nutritional science. Just bury our heads in the sand and call this huge important study Fake News.

So, the next thought was that perhaps cancer was caused by a lack of nutrients rather than excess nutrients. Here, the gaze landed upon dietary fiber. The legendary Irish surgeon Denis Burkitt spent most of his career in Africa, where he noticed that all of the ‘diseases of civilization’ were noticeably absent in African native populations. This included cancer, which was rare in Africans eating a traditional diet. Africans ate lots and lots of dietary fiber, so he concluded that high dietary fiber could prevent cancers. Following this line of reasoning, he wrote an international best-seller ‘Don’t forget fiber in your diet’.

It was a pretty coherent hypothesis, but evidence did not exist at that time to say whether this was actually true. So, once again millions of health research dollars were mobilized to find an answer. Would eating more fibre prevent colon cancer of adenomas (a pre-malignant form)? In 1999, an analysis of over 16,000 women of the Nurse’s Health Study over 16 years showed no correlation between the amount of fibre they ate and the risk of adenomas.

The next year, definitive proof of its futility was published in the prestigious New England Journal of Medicine. A trial of 1303 patients randomly assigned patients to cereal fibre supplements or not, and then measured how many people developed adenomas.

Unfortunately, that number turned out to be exactly the same, whether they got the extra fibre or not. Yes, fibre might make your bowel movements better, but no, they did not prevent cancer. Darn.

So, what about vitamins? People love to take vitamin supplements on the belief that our modern processed diet is lacking in some essential nutrient, which makes us sick. Folic acid is a B vitamin that is necessary for the growth of many cells. Supplementation with folic acid has reduced the incidence of neural tube defects significantly. Maybe it could reduce the rates of cancer, too.

In the early 2000s, there was a huge wave of enthusiasm for B vitamin supplements. Homocysteine levels in the blood were correlated with many diseases, and it turns out that high dose B vitamins could reduce homocysteine levels. Unfortunately, as we later learned, this would have no beneficial effects as homocysteine was only a marker of disease and not causal. Would folic acid supplements reduce colon cancer?

randomized controlled trial of folic acid supplementation to high risk patients came up with a shocking answer. Shockingly bad, that is. There was no protective effect to taking folic acid supplements. Further, it seemed to increase the risk of advanced cancer, and also increased the rate of having adenomas. Yowzers! Here researchers were trying to prevent cancer, and instead they gave patients more cancer. Worse was yet to come.

In 2009 the NORVIT trial of high dose folic acid and Vitamin B supplementation also showed MORE, not less, cancer. There was a 21% increase in cancer and a 38% increase in cancer death. Double Yowzers! Of course, with hindsight, this stands entirely to reason. Cancer cells reproduce at prodigious rates. This requires all sorts of growth factors and nutrients to grow. With lots of nutrients, the rapidly growing cancer cells are best able to take advantage. It’s like sprinkling fertilizers onto an empty field. You want grass, but the weeds (being the fastest growing plants) are the ones who take up the nutrients and grow like, well, weeds. Cancer cells are highly active and grows like, well, weeds.

What about beta carotene and vitamin E? This nutrient gives carrots it’s orange colour and perhaps this supplement would work to reduce cancer because of it’s anti-oxidant effects. Vitamin E was all the rage in the 1990s for this same reason, and high dose supplementation was supposed to cure cancer. Epidemiologic studies (observation studies – one of the most dangerous and error-prone studies in medicine) showed that diets high in these foods were associated with better health. Perhaps supplementation would help.

Unfortunately, it didn’t exactly turned out as hoped. A randomized study in 1994 showed that neither agent was able to lower the rates of cancer or death. Beta carotene not only did not prevent cancer, it increased both rates of cancer and death. Giving cancer cells the vitamins needed for high levels of growth turned out to be a not-so-good idea. We weren’t saving patients, we were killing them! Triple yowzers!

This stems from the simple fact that cancer is not a nutrient deficiency disease like scurvy. Scurvy is a disease of vitamin C deficiency, so giving vitamin C cures it. Cancer is not a disease caused by vitamin deficiency, so therefore supplementing vitamins is not especially helpful.

So, here’s what we are left with.

  1. Diet plays a large role in cancer
  2. Cancer is not caused by too much dietary fat
  3. Cancer is not caused by lack of dietary fibre
  4. Cancer is not caused by vitamin deficiency
  5. Cancer is tightly related to obesity

While it may sound trivial, these 5 bits of knowledge took, literally, hundreds of millions of dollars of research money, spread over 25 years to discover. The 5th fact is only gaining recognition within the last few years.

Recently, the CDC released a report “Trends in Incidence of Cancers Associated with Overweight and Obesity – United States, 2005-2014” highlighting the fact that at least 13 cancers are associated, and these accounted for an astounding 40% of all cancers diagnosed in 2014. It comprised 55% of cancers in women, and 24% in men. Worse, the incidence of these obesity associated cancers was increasing rapidly. Adult weight gain of only 5kg (11 pounds) increased the risk of breast cancer by 11%.

What this all means is that cancer is not necessarily a specific vitamin or macronutrient disease (carbs vs protein vs fat). More generally, cancer is concerned with the overall metabolism. Cancer is a metabolic disease at heart. The two most commonly mutated genes in human cancers, p53 and PTEN are now recognized  to be intimately related to signals in cell metabolism.

 

Start here with Cancer Part 1

Continue to Cancer Part 11 – Cancer’s Seed and Soil

2018-04-25T16:58:20+00:00 35 Comments

About the Author:

Dr. Fung is a Toronto based kidney specialist, having graduated from the University of Toronto and finishing his medical specialty at the University of California, Los Angeles in 2001. He is the author of the bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’. He has pioneered the use of therapeutic fasting for weight loss and type 2 diabetes reversal in his IDM clinic.

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35 Comments on "Nutrition and Cancer – Cancer 10"

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Eric
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Time restricted feeding.
Shorter eating windows
Better result’s!
I combined trf and ketogenic diet.
Also look at eran segal work on gut.
Micro biome
Eric
Still eating once a day
2000 kcal
80% fat
16% protein
4% carbohydrates

Hap
Guest

why Is there not a campaign against Starbucks? Perhaps if you advocate enough leftism and virtue signaling…..you can purvey any toxin. In California it’s sugars and dope. The opiate of the brain sucked out masses.

You tell me what you see consumed every day in the “coffee houses”

Enough whining about McDonald’s

I want to see a “documentary “. About Carmel machiolatte with whip cream feted by the critics at NYT.

Hap
Guest
Apparently, most if not all of you have issues with “carbs”….and “sugar”. However, nobody seems to want to take on Starbucks. I go to Starbucks, but not frequently, in order to get a coffee. All I see there are shiny baubles which looks like fat, carbs , and sugar everywhere and people consuming them including these massive mixed, blended, and shaken monstrosities that are nothing but coffee flavored fat and sugar. However, the media and the entertainment industry is always eager to blame MC Donalds or Burger King etc….but never STarbucks. What is up with that? Isn’t it the case… Read more »
Walter
Guest
It’s a class thing. The elite go to *$, but don’t patronize McDonalds. Besides MDs serves meat which is a no no. A lot of nutritionists are militant Vegans. But yes there is a lot of sugar and fat drinks at MDs. Basically those drinks are equivalent to ice cream, but somehow it doesn’t register. Fortunately, this allows people to get the saturated fat they need. Perhaps that’s the explanation, that their bodies are crying for saturated fat and somehow coffee drinks are acceptable. They eat skinless boneless chicken breasts and sandwiches with no butter by high soy oil mayonnaise… Read more »
Hap
Guest

So far you are the only one with the you know what’s..to attempt an answer.
Thanks

Hap
Guest
Lets see….all cause mortality, including cancer, is decreased by preserving and increasing lean body mass (muscle), also by sauna bathing, but also by certain types of energy restriction (not necessarily absolute)…..for instance time restricted feeding resulted in up to a 40% reduction in recurrence rates of breast cancer (UCSD) although caloric intake and composite diets samein control and experiemental cohorts. Dr Verdin of Buck institute states that “exercise” is first on the list. He agrees with Jack Lalaine that exercise is King and diet is Queen. What actually did Dr Verdin mean when he said “exercise”? weight lifting …, some… Read more »
Richard
Guest
I’m a big fan of exercise, and I think it is essential, as a part of living. I have not read anything that directly supports a contention that exercise can help with cancer. Of course people who exercise might tend to not be as obese as those who do not exercise, and obesity is one of the actual cancer relationships Dr. Fung cites. There is some good support for the contention that Vitamin D prevents cancers from progressing. See below for an example. https://www.vitamindcouncil.org/researchers-discover-vitamin-d-deficiency-negatively-impacts-breast-cancer-prognosis/ There are more references on the Vitamin D Council site. There is not much money, if… Read more »
Hap
Guest
Richard Thank you for your comments. I have a very long commentary for you on a number of your points. For brevity we start here Does strength promoting exercise confer unique health benefits? A pooled analysis of eleven population cohorts with all-cause, cancer, and cardiovascular mortality endpoints. Emmanuel Stamatakis, I-Min Lee, Jason Bennie, Jonathan Freeston, Mark Hamer, Gary O’Donovan, Ding Ding, Adrian Bauman and Yorgi Mavros Correspondence to Dr. Emmanuel Stamatakis, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia 2006 (phone: +61 2 8627 1867, email: and proceed to conclusion….you will need to read and study on your own.… Read more »
Hap
Guest
BTW we need to “move on” from the pharma and doctor bashing that Dr Fung uses to fill out the noise. You folks are free to use the internet or whatever resource you wish to learn and put into practice whatever cockamamie nonsense that comes in to your heads. Fasting is not one of those cockamamie things. Vitaming D is certainly oK….but how but getting the F out into the sun, stop wearing so much sunscreen, and out of all day artificial lighting and artificial temperature zones.? How about looking at your sleep and tracking your sleep stages.? All of… Read more »
Richard
Guest
Hap, I guess we all have our pet issues that we like to think are really important. So important that everyone else is simply wrong and/or not thinking clearly. Dr. Fung wrote a brief blog post, or now three of them, related to cancer and cancer research. And the goal is how best to attack the cancer cure “problem.” The issues relate mainly, as I understand what Dr. Fung is saying, to past researchers looking in the wrong place for answers, somewhat like looking for something lost not where it was likely lost, but instead, in some other place because… Read more »
cindy
Guest
My comment is anecdotal-but I’ll start by saying THANK GOD Dr. Fung has the stones to speak out against the erroneous reports of research and ineffective treatment modalities. As a retired ICU nurse, I am filled with disgust in what I have seen- in cardiac care, diabetic care, and cancer treatment- both from the perspective of treatment modality and patient education. Personally, I am an overweight person in my 60s who has had type II diabetes for ~12 years, so I obviously have insulin/glucose issues. I recognize the value of exercise because it makes one feel better, but I have… Read more »
Hap
Guest
I applaud you for you herculean efforts in the unit. Everybody has a story. Any oncologist worth his/her salt ,and yes salt consumption (despite WHO guidelines) of between 3-6gm/day has not been shown to increase disease risk…..except in the elderly with HTN and CVD….will tell you , that long term survival of cancer is more a function of the immune system of the patient than jolts of chemo or radiation. However, these treatments have their place. If you don’t want them for whatever reason , you can sign out AMA….. However, many people in the predicament of cancer are not… Read more »
Hap
Guest
Ok…so you are a lawyer and therefore know BS and gibberish when you see it. I am a physician with 35 years of practice and a full professor in the school of medicine. I see cancer every day. In fact I see it using glucose as Warburg predicted, since I am a Molecular imaging specialist. I am fully aware of the problems and deficits of modern medicine and the dead ends of inquiry over the past half century. Some of it is misguided and some is tainted significantly by corruption and wrongheadedness….why should it not be that way, as it… Read more »
Richard
Guest
In my view of things like this, meaning things that are complicated and multifactorial, it is well to consider the best approach to be first solving, or resolving, the issues that are within our control, rather than to attempt to solve everything at once. First, as you suggest, fasting (with reduced insulin and sugar and increased autophagy) (and not to mention reduced obesity…) may be part of the “cure” for cancer. I suggested vitamin D as another part of the issue. Having done that, what else is within easy reach? More and better sleep? Yes. Exercise? Yes. And then we… Read more »
jaz
Guest

Hap, I was watching an interview Dr Rhonda Patrick did with Prof Guido Kroemer a cell biologist and autophagy expert (a google search will find the interview easily). He personally eats OMAD and throws in a 5 day water fast from time to time. There are no guarantees of course, but if one wanted to do all they can to avoid cancer is this a good start, and what else?

Hap
Guest
Jaz None of us would want the scourge of cancer and it does seem that the preponderance of cancer is related to environmental inputs. I also listen to Dr Patrick…..she has very interesting and competent guests in her own podcasts and appears on many others as a guest. sometimes she traffics in information overload…..and that may be a stumbling block for much of the public. Dr Kroemer was a particularly interesting and informative interview. I would listen to her interviews with Dr Verdin of buck Institute, Dr Panda of Salk , Drs Longo and Mattson, and Dr Laukennen of Finland.… Read more »
Mark Lundqvist
Guest

How am I supposed to go out into the sun when the sun is only strong enough to make me produce Vit D three months out of the year?

Joan day
Guest

I bought an FDA approved narrow band, UVB vit D Lamp i use 5 to 10 min three times a week. It is awesome. There only certain hours mid day you get vit d anyway.

Patrik
Guest

How to prevent cancer in one sentence (for free! :):

Eat more animal fat, less breakfast and exercise some.

Very interesting article as always. /Patrik, Sweden

Richard
Guest

No,no! Too complicated.

Mary
Guest

I must have missed something. I was waiting for the sugar is toxic & causes cancer results. I feel like the article left me hanging like a bad novel. Anybody??

Jef
Guest

As we start a new year I’d like to thank Dr. Fung for all the work he does in producing this blog. I learn new things from every post.. I also learn from the spirited discussions from the very learned readers of the blog.

paula
Guest
This discussion intrigues me. I am interested of course, because I have metastasic breast cancer (at this point deemed incurable. For cases like mine, chemotherapy is not the first line of therapy (it would destroy the quality of life, and once it has failed, is rarely effective enough). First line of therapy is much more benign, and hope is on the horizon. There are many very exciting therapies that will work for a time, I am being treated with a kind of targeted therapy which goes for specific proteins to prevent the cancerous cells from reproducing, I don’t know much… Read more »
Katrina M Iannuzzi
Guest

Look forward to these blogs Loveeeee them

Terri Drake
Guest

Dr. Fung. It’s the sugar that is causing cancer. Cancer grows when it feeds on sugar and sugar is in everything. Also sugar causes obesity. It’s all connected in my opinion. I have seen people who are not obese get colon and breast cancer. How do you explain that? They never smoked, drank or were obese. Is it the sugar?

Gailene
Guest

I’d like to go back to cholesterol, and whether one needs to reduce it after age 60, and how to do that. Is taking a statin the only way, with its side effects?

Hap
Guest

A fixation on cholesterol is not a good idea. there are many lifestyle modifications to try before getting sucked into statin rx. OTOH….if you have had a heart attack and you have persistent dyslipidemia…..a Statin might be something to try based on reasonably reliable evidence.

Yes, statins have many known side effects and with time others will be discovered.

Richard
Guest
The problem with a fixation on cholesterol is that there is a great deal of doubt about whether cholesterol is the cause or the result of various cardiovascular (or other) issues. At present, the way I see it, is that high “bad” cholesterol, or bad ratios between the various levels of types of cholesterols, and triglycerides, etc., is a marker for damage probably already incurred. It is (probably, indeed almost certainly) not the cause of the damage, but more likely the result of the body trying to repair or cope with some level of damage, as best it can, considering… Read more »
Benthamite
Guest
The cholesterol level in a ruptured atheroma is between 7 & 22% percent autopsy studies. This has been known for about 100 years, as to pathogens in the intima media. The most important risk lowering thing is to promote endothelial cell health. To do this one needs to reverse insulin resistance. It all starts with the reactive sugar fructose. I have extensive materials on my website. you can start at http://healthfully.org/rmbp/id18.html on my website. There is an internal google search engine. What you wrote I like, diet is the fix. It is why those eat a low sugar diet, including… Read more »
Roger Bird
Guest

Thank you, Jason.

Benthamite
Guest
Carbs promote cancer, because cancer has defective metabolism. The Warburg hypothesis is beyond dispute. Cancer cells have damaged mitochondria. The mitochondria can turn on apoptosis, thus by turning off the mitochondria cancer cells avoid apoptosis (cell orderly dismantling). Without functional mitochondria cancer cells can’t produce ATP from fats. They produce ATP (the energy molecule) in the cytosol by the very inefficient anaerobic metabolism. Eating more carbs feeds the cancer cells, and fasting and a ketogenic diet starve the cancer which need glucose for the production of ATP. Thus I suspect some dirty tricks in the published results of the WHI.… Read more »
Hap
Guest
Anaerobic glycolysis is only less efficient in that it results in much less ATP per cycle. However, it is the type of energy strategy used in humans for high force production in a short time. It is much faster than aerobic glycolysis……so things are not exactly as they are represented as in absolute terms more ATP generated in short order. You might be surprised to know that among mammals human being have one of the lowest mitochondrial density. Mitochondria are a two sided phenomenon….that can make energy currency and a lot of it over time…..but the price is high…reactive oxygen… Read more »
William Justice
Guest

You nailed it with your last statement concerning the P53 and Pten genes which are altered by a bad environment, including food. So metabolic diseases have a huge influence. Cancer therefor is mostly, if not totally, an epigenetic disease, and not a genetic disease as the dogma often states. This is probably why it is unknown in some parts of the world, regardless of diet in some cases. Once again you get to the bottom of things!

HawkeMS
Guest

One cant under estimate the role environmental and other chemical toxins that play a big role in cancer cell formation. Its not ‘just” being overweight too much sugar and no exercise. As I know plenty of people like that and don’t have cancer. BUT I also know SEVERAL people who DO have cancer and are very perplexed as they exercise eat a fabulous low carb no sugar organic diet etc etc. And what about all the childhood leukemias and brain tumours?? I mean 2-5 year olds Much food for thought.

Nutrition Geek
Guest
Just as an interesting observation, the naturopath Rudolf Breuss in the early years of the 20th century recommended a severely restricted juice fast of 1 cup of his juice recipe plus filtered herbal tea for 42 days. This strict fast contains about 78 calories and 19 grams of net carbs per day. His reasoning for its effectiveness might have been wrong in that he thought the culprit was solid foods, but the method of severe carb and calorie restriction is in line with the research done by Dr. Thomas Seyfried and others who have used a severely restricted ketogenic diet… Read more »