Welcome to Straight Talk on Health. I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the practical application of health information. Nutrition. Exercise. Diet. Supplementation. I look at the science behind them, and let you know whether it’s something to consider or not. You can check out other things that I do on my website drchet.com and sign up for my free emails.
I've been fascinated with the concept of fasting almost for my entire career. The reason is that it makes sense to me. We are here because our ancestors survived. Not only did they survive disease and pestilence but they also survived periods of feast and famine. I think it's a natural order of things that we go with reduced amounts of food for periods of time. We can call it a fast or we can call it something else but reduced amounts of food appear to have beneficial effects on our body.
That's why studies that focus on fasting and cancer treatment always catch my attention. I’ll review a couple today. The first began with a press release that talked about a pilot study on fasting. I also obtained the paper itself. With information from the press release and the data in the study itself, gave me some additional insight into the fasting - chemotherapy connection. I’ve followed this researcher and the work in his laboratory for several years. I've talked about some of his original work with cancer patients for years but here’s a brief recap.
About 12 years ago, a research lab recruited stage 4 cancer patients, ovarian and lung cancer, and put them on a fast for two days before beginning chemotherapy. The objective was to see if fasting would enhance the immune system in such a way as to make the chemotherapy more effective. When I say fast, I don't mean abstinence from food. I mean that they held the patient to 800 calories per day. They did that for two days. And then the patients went through the normal treatment. The prognosis for this type of patient was not good. The goal was not to cure them; the goal was to see if their lives could be extended. Looking ahead, the objective with cancer treatment in the future is to help people manage it. And that means staying alive long enough so that the next treatment available might result in a cure.
What happened to these two groups of subjects? Those that fasted lived an additional three to six months longer than those who did not fast. When you think about it, as long as it doesn't prolong pain and suffering, that's huge especially at the end of life. The researchers took the information and continued to develop both the fasting protocol and additional treatment protocols.
During the intervening years, the researcher and his laboratory developed what has been called the human fasting mimicking diet (HFM) program. The objective of this plant based diet program is to maximize the nutrients, vitamins, minerals, phytonutrients, and minimize the burden of fasting. It seems as though their objective is to trick the body into thinking an individual is fasting while really providing nutrients that sustain energy levels and micronutrient content. All that means is there's an energy source and there are vitamins and minerals. But the body, including any type of cancer cells, is tricked into thinking the individual is actually fasting.
The complete course of the program is 5 days. The first day is about 1000 calories for the typical person and it goes down to 750 calories for the next four days. What's unique about it is that it's a low protein, high fat, and moderate carbohydrate approach with no sugars nor refined carbohydrates. Put into percentages, it would be fewer than 10% calories from protein, approximately 50% of the calories from fat and the remainder from plant-based carbohydrates. In that all carbohydrates originate from some type of plant, the focus was on vegetables, fruit, some beans, and not much else.
I actually put together a one day approach just to see what it would be like. My target was 1000 calories so that meant fewer then 100 calories from protein. I only used vegetables with no starches and no bread or pasta products. I used olive oil and other fats during the day. This isn't the right expression but it was actually a piece of cake. Multiply that times 5 and it might get a little old but if it was well-planned in the foods that were going to be used, completely doable. In the approach for people who want to just enhance their immune system, they might do it a couple of times a year. For people being treated for disease conditions, that would be up to the oncologist in charge of their treatment. And it's still early in the process so let's review another research paper to gain more clarity
In test tube studies, they found that selecting the nutrients to mimic the fasting diet I just talked about, seemed to kill cancer cells. If they infused the test tubes with vitamin C, that also seemed to kill cancer cells. What happens in test tubes doesn't necessarily mean it's going to happen within an animal or a human. When they did it sequentially In other words, they fasted the cancer cells first and then exposed them to vitamin C, it killed virtually all the cancer cells in the test tube. At this point in time , there are two clinical trials going on with actual cancer patients to see how effective this approach would be.
Now before you get too excited, they looked at a specific type of colorectal cancer cells that had a very specific gene mutation that made it susceptible to antioxidant exposure. Could it work on every type of cancer with all the potential mutations possible? No one knows.
This is very complicated but as well as I can put the facts together, the low protein in the diet reduces the cancers defense system. With its defenses down, the cancer cells can be damaged and killed by the vitamin C. That sets up the cancer cells for treatment with chemotherapy. That's the order of things that they're using in the human-based clinical trials going on right now.
Protein seems to have a role to play in our health as it relates heart disease and cancer and maybe even type 2 diabetes then we've thought about in the past. It's horribly complicated and it might not apply to every disease or condition but using this fasting mimicking diet just may not be a fad like the intermittent fasting we hear about today; rather it could be essential means cleansing the immune system periodically throughout the year. And at the end of the day, your immune system protects you from all diseases and conditions.
Let’s check another study that was recently published. In this case, the trial used a mouse model. Immunotherapy is another form of cancer treatment but it’s very specific to individual cancers. In this case, researchers used mice that had a triple-negative form of breast cancer that is very resistant to immunotherapy. I couldn’t begin to explain the methodology involved in the testing but the diet was a form of FMD appropriate for mice. They exposed the mice to the FMD for four days. On the second day of the fast, they exposed them to one of two forms of immunotherapy. The used the standard diet for a couple of days and then repeated the fast and immunotherapy. What they found was that they stopped the production of energy via glycolysis and instead used another system using oxidative phosphorylation. That probably doesn’t mean much but what that appeared to do is make the Tumor Microenvironment more susceptible to the immunotherapy to reduce tumor growth. At the same time, it reduced the severe side effects of the immunotherapy. The research suggests that based on the results of the rodent trial, clinical trials in humans could proceed. They recognize that mice have higher metabolism than humans but it may open more potential treatments for triple negative breast cancer and other cancers as well.
I said that intermittent fasting may just be a fad as people try to use it to lose weight. The FMD is different The real benefit may be to give our body a rest from our typical diet and allow it to renew us in a significant way. The future is exciting. That’s it for this episode. Until next time, this is Dr. Chet Zelasko saying health is a choice. Choose wisely today and every day.
References:
https://doi.org/10.1038/s41467-020-16243-3
Diabetologia. 2024 Jul;67(7):1245-1259. doi: 10.1007/s00125-024-06137-0. Epub 2024 Mar 28.
Cell Reports 40, 111256, August 23, 2022
