In February, 2009, over seven years ago, I posted: Sugar Feeds Cancer. Reading that post now, I have to wonder if I failed to make a critical distinction between building and feeding.
So the classic alternative view, simply stated—let’s call it ‘Warburgian‘—is that cancer cells lack the ability to fuel from ketones (fat metabolism), require glucose (sugar), and even typically respirate differently (fermentation)…so starve them by means of various approaches to very low-carbohydrate dietary intake—restricting your metabolism into making essential glucose rather than feeding it glucose, thereby ensuring it gets just enough, not too much. Makes obvious sense, even by means of my gross simplification.
But is this just aspirin for a headache, discounting other variables and assuming it’s even effective? I seem to recall that at least in some mouse models, it has been shown to be effective.
Putting on my critical distinction hat, what builds growing humans and what fuels them? Well, if you take human mammalian milk, it’s a pretty “balanced diet” of protein, carbohydrate (lactose…sugar), and fat. Low-fat-diet advocates will acknowledge that the relatively important amount of human-chick-aminal fat—that outweighs the other macros—is important for fat-head development. High-fat-diet advocates will say it falsifies the notion that animal fat is bad for you, per se. What if they’re both right, there is wide overlap (you can be healthy with an emphasis on either); but also, both discount the role of protein?
You can’t build a human on exclusively fat or carbohydrate, or any combination of the two, excluding protein. This is no new revelation but since nobody talks about protein except muscle heads, perhaps it’s an essential that requires some emphatic call for detente in the war over fat vs. carbohydrate. What if protein turned out to be the most important variable in dietary concerns and cancer is a telltale, or canary, or analog, or whatever?
To put it most simply: human bodies (made up of cells) are built by protein. All three macronutrients—protein, carbohydrate, and fat—can fuel them but in hierarchical order, carbohydrate is king (and alcohol is king of kings). Some would say fat comes next, but I have come to wonder that what if, in the absence of healthy carbohydrate as the body’s easiest food source, if it doesn’t cause undue chronic stress (rather than healthful and autophagic acute stress, such as in fasting). This is becoming my chief quibble with forever low-carbohydrate diets as a lifestyle. Ray Peat folks have been saying this for years. When you stop and listen, it’s not that sugar is a great nutritious food, but that it lowers chronic stress. Calculated tradeoff, and, not letting the mediocre be the enemy of the good: which is a less stressful, happy, healthy life.
We have new research and it’s very interesting the timing in which it dropped, since just over the last few days, I have seen references to this NYT article dozens of times: AN OLD IDEA, REVIVED: STARVE CANCER TO DEATH. I must admit that I didn’t read it before now. See, I never stake a position and hold it. I stake a position and then see how old and rusty it gets over time, lying in wait. From my first post on this, I always understood there was something to it; but eventually, understood that if it was everything to it, we’d know it by now (No, I am not a cancer conspiracy fan. Neither am I an idiot.).
Indeed: Scientists surprised to find that amino acids, not sugar, supply most building blocks for tumor cells. It’s an article covering a study published about a month ago in Cell: Amino Acids Rather than Glucose Account for the Majority of Cell Mass in Proliferating Mammalian Cells (Aaron M. Hosios, Vivian C. Hecht, Laura V. Danai, Marc O. Johnson, Jeffrey C. Rathmell, Matthew L. Steinhauser, Scott R. Manalis, and Matthew G. Vander Heiden). Thanks to Dr. Mike Eades for sending me the full text, plus a couple of supplementary articles.
Cancer cells are notorious for their ability to divide uncontrollably and generate hordes of new tumor cells. Most of the fuel consumed by these rapidly proliferating cells is glucose, a type of sugar.
Scientists had believed that most of the cell mass that makes up new cells, including cancer cells, comes from that glucose. However, MIT biologists have now found, to their surprise, that the largest source for new cell material is amino acids, which cells consume in much smaller quantities.
The findings offer a new way to look at cancer cell metabolism, a field of research that scientists hope will yield new drugs that cut off cancer cells’ ability to grow and divide.
“If you want to successfully target cancer metabolism, you need to understand something about how different pathways are being used to actually make mass,” says Matthew Vander Heiden, the Eisen and Chang Career Development Associate Professor of Biology and a member of MIT’s Koch Institute for Integrative Cancer Research.
Get it? What makes them grow and proliferate is not necessarily what constitutes their preferred fuel for routine operation—any more than that’s true for a human infant, or probably any other baby mammal; and since we’re talking baby tumorous growths, that’s probably a reasonable way of thinking about it generally, in order to derive a general understanding—and I’m the best there is for trying to do that rather than impress you with my metabolic pathway knowledge (I have never once written ATP—adenosine triphosphate—on this blog in over 4,500 posts…nor do I wax on about beta oxidation).
…To determine where cells, including those in tumors, were getting the building blocks they needed, the researchers grew several different types of cancer cells and normal cells in culture dishes. They fed the cells different nutrients labeled with variant forms of carbon and nitrogen, allowing them to track where the original molecules ended up. They also weighed the cells before and after they divided, enabling them to calculate the percentage of cell mass contributed by each of the available nutrients.
Although cells consume glucose and the amino acid glutamine at very high rates, the researchers found that those two molecules contribute little to the mass of new cells—glucose accounts for 10 to 15 percent of the carbon found in the cells, while glutamine contributes about 10 percent of the carbon. Instead, the largest contributors to cell mass were amino acids, which make up proteins. As a group, amino acids (excluding glutamine) contribute the majority of the carbon atoms found in new cells and 20 to 40 percent of the total mass.
Although initially surprising, the findings make sense, Vander Heiden says, because cells are made mostly of protein.
“There’s some economy in utilizing the simpler, more direct route to build what you’re made out of,” he says. “If you want to build a house out of bricks, it’s easier if you have a pile of bricks around and use those bricks than to start with mud and make new bricks.”
Folks, I don’t know why it is, but this kinda shit is just my favorite to blog about…perhaps because I think it’s a great opportunity to generalize in a way that’s truly educational. At any rate, I don’t know how one could possibly come away without feeling they learned something, that something made even more sense, or an ah-ha moment.
So where does that leave me with respect to LC diets? Well, offhand, still therapeutic but if one is honest, perhaps this gives clues into why they’re notably therapeutic and in particular, like pharmaceutical level when it comes to no-shit pure ketogenic for epilepsy and interestingly, brain cancer (though the latter is less established).
So I’m not going to reign down with my quibbles over the years regarding folks overextending ketogenic pharmacology—as specifically proven or very promising therapies—to general lifestyle ketogenic prophylactology. I’ve gotten to where, when I hear Americans generally implicate carbohydrate without distinction, as Gary Taubes did just now, once again, I have one word, to serve as both falsification and dismissal: Asians.
You see, if you take a drug that cures your cancer or other ailment, it does not follow that not taking the drug as a lifestyle is what caused your cancer or ailment. But it seems to me that some elements of that thinking are prevalent in many dietary circles and low-carb is no exception.
That said, we now have greater insight into effective drug therapy vis-a-vis a ketogenic diet. We now know from various avenues including the epilepsy interventions that protein level is important. It may be for a different reason. For brain stuff, your goal is to produce lots of ketones. But now we seemingly have another, different reason to consider ketogenic for cancer, without getting wrapped up in what caused it (Asians!). Once you have cancer, you can go at it two ways. Starve it by restricting glucose down to minimum and also, keep building blocks (protein) to a minimum. This describes a fully, objective ketogenic diet.
That said, it appears from the research that low protein might outweigh low glucose by factorial magnitude for cancer (4-5 times, I’m getting the gist?) and this would be a distinction from it’s role for brain stuff like epilepsy, where ketone production is job one, and I think glucose limitation exceeds protein restriction in that application.
Well, so there you have my take.