Tuesday, April 15, 2008

Kwasniewski and cancer

Some problems are more difficult to influence than others. I have this mental image of nutrition as comparable to having your car serviced. Treat your car with respect and you will have to be unlucky for it to break down. If you ignore servicing, say you never top up the brake fluid, eventually the brakes will fail. If you end up writing the car off, say by being unable to stop at a roundabout, there is no point going back to the wreck, pouring some brake fluid in to the master cylinder and expecting the car to become functional again. It won't.

Some people get broken, I suppose all of us do eventually. But it seems improbable that diet could reverse the degree of "broken-ness" represented by cancer, one of the most serious of metabolic train wrecks. But there are reports of remission. Spontaneous remission is one thing. Engineering that spontaneity is quite another.

Can it be done?

Kasha Mikoda has left a comment on the Praise the Lard post. It's a personal account of the management of her father's non-small cell carcinoma of the lung, with mets. By Kwasniewski. It's there for the reading. Non-small cell cancer includes squamous cell, large cell and adenocarcinoma, prognosis guarded.

Her comment brought to mind an old article I read some time ago about the nutritional management of lung cancer, here.

And of course there are always the two children described by Nebeling.

In terms of an evidence base, case reports in peer reviewed publications carry little weight and non published case reports are just off the radar. But then getting a prospective trial set up to provide an evidence base, even a pilot study, is fraught with difficulties. For a flavour of the current state of difficulty anyone can browse the article which started Kasha off on her journey to Kwasniewski. Attempts at collaboration with mainstream medicine by Kwasniewski never got off the ground.

After that there is patient compliance! Look at this quote from Dr Schmidt in the article cited by Kasha:

Four of the patients were so ill, they died within the first week of the study. Others, says Schmidt, dropped out because they found it hard to stick to the no-sweets diet: "We didn't expect this to be such a big problem, but a considerable number of patients left the study because they were unable or unwilling to renounce soft drinks, chocolate and so on."



Of course these people were end stage and probably considered themselves beyond hope, so why not enjoy whatever food they could manage... But for the life of me I can't see why one has to be absolutely at the end stage of cancer before it is considered ethical to advise that you should stop eating sweets, especially when a PET scan confirms that the cancer lights up like a... Well, like a cancer feasting on glucose in a PET scanner.

Peter

59 comments:

Chris said...

This is interesting Peter

There is a good collection of stuff on ketogenic diets and cancer here:

http://tinyurl.com/57opv4

and I've been gathering some similar stuff at my blog here:

http://tinyurl.com/5tdlgc

Chris said...

Just saw that there is an article in the Guardian today as well about treating epilepsy with a ketogenic diet:

http://tinyurl.com/3so6r8

Peter said...

Hi Chris,

It's funny. you get so used to living and eating nutritional research that you tend to forget that it's a total unknown to most people. They don't realise that Freeman's book is available, with recipes, from Amazon for about £8 plus postage. I would admit that kids don't seem to grow to their maximum potential on the Ketogenic Diet, but they equally don't do too well with brain damage from 100 fits a day despite the benzos etc. Never mind the concussion from drop fits.

Thanks

Peter

Chris said...

It is sad and frustrating that a lot of suffering - for epileptics a least - might be prevented with a relatively simple diet change. But then again we do not want to give the kids heart disease ;-)

Robb Wolf had a good post a while ago on ketosis and cancer - with some good links - http://robbwolf.com/?p=18

One of the things he mentions is his girlfried who died of a brain tumour and his thoughts on whether a ketogenic diet could have helped.

I wonder if the so called healthy diet promoted sometimes - e.g. loads of fruit and fruit juices -could actually make things a lot worse through flooding the cancer with glucose.

Chris said...

Just saw that Freeman's book - with some interesting recipes - is on Google Books:

http://tinyurl.com/52qjhr

I keep meaning to get Lyle McDonald's Ketogenic diet book. I'll try to remember to order it tonight.

Peter said...

Shocking recipes! Most of them seem to have a gross deficiency of all of the essential nutrients found ONLY in potatoes and white bread. Or Fanta.

Peter

More seriously, there is at least one case report of pancreatitis out there, the girl died if I remember correctly. Trying to do a ketogenic diet using "healthy" oils such as sunflower may well be a recipe for disaster. No info about this from the pancreatitis abstract. In fact there are several reports of adverse events out there but you can never tell from the abstract alone exactly what was being done with respect to fatty acid profile and fluid depletion. In the Parkinson's post I put up some of the participants used PUFA to avoid any rise in cholesterol attributable to sat fats. They'll have hit a few free radicals in the process!

Peter said...

Re the comment in the last post, this was the abstract:

The PUFA ketogenic stupidity!

Peter

Paul said...

Peter,

Any chance of a brief primer on how to avoid the type of keto-disaster that you mention? I think that I understand the high level - saturated fat good, MUFA good, PUFA ok (or is it?) as long as the omega-6 to omega-3 ratio is correct. But what does that translate to in your weekly diet? Is your main fat lard, or do you like any vegetable/nut oils (olive, macadamia, avocado, coconut...)? And I remember your cream-choc pie but what do you actually think of dairy as a source of fat?

Thanks,
Paul.

Peter said...

Hi Paul,

No one gets in to that sort of disaster with mild ketosis. These kids are off the ketonuria scale 24/7, to the point of metabolic acidosis and the dehydration is deliberate. The easy option is to follows Kwasniewski, 50g/d carbs and minimal ketosis. The only bulk vegetable oil I use is olive oil, and that's always as a flavouring bulked up with butter. I couldn't manage without dairy and the fatty acid profile of cream and butter are pretty excellent. Not quite sure if the same applies in the USA, you do some pretty strange things to your cows over there!

The EFA aspect is all a bit in the air at the moment while I sort through Chris Masterjohn's references about levels actually needed. He follows close to Peat in his leanings. I have a lot of time for Chris Masterjohn, so will follow this up in detail. For me it would simply boil down to whether I continue to take my 5g/d fish oil, the rest is already as saturated as I can practically get it anyway.

The funny thing is that Kwasniewski doesn't care about PUFA, ratios, EPA etc except to avoid all PUFA expet those present in small amounts in animal fats.... He never tells you why, but he has an uncanny knack of being right!

So the jury's out at the moment for me on EFAs.

Peter

Paul said...

Thanks, Peter. No spare copies of Kwasniewski exist on Earth, so I appreciate you channeling!
Paul.

rnikoley said...

Well Peter, this really sent me off on a link chase this morning, with lots of reading. Some of the commenters put up links as well, and I've assembled it all right here, in case anyone wants a reference.

http://www.honestylog.com/root/2008/04/will-the-blogos.html

Chris said...

Here is another paper jsut out today...saying the same thing - take away the glucose and the tumours die.

http://tinyurl.com/6bomo9

Lee said...

I didn't know that Dr.K was still practising. Hope he is still looking well and in good health. If you are reading, Kasha, perhaps you can give us a bit more detail on the diet/treatment that your father was given.

Just found this site: http://optymalni.info which is about the optimal diet and treatments. Most of it converts to English using the English version link.

david said...

Hi everybody. Yesterday my mom received a preliminary diagnosis of non small cell lung cancer. Her oncologist has scheduled a consult with a thoracic surgeon for today to arrange a surgical biopsy of the lung. My mom had an EBUS (Endobronchial Ultrasound) about 1 week ago that was positive for cancer. The oncologist believes this may be a recurrence of breast cancer that my mom was treated for 5 years ago.

I'm very familiar with the ketogenic diet. I've used it myself and lost 200 lb over the past several years. I swear by it.

Peter, any opinion you have on my mothers situation would be appreciated as well.

Kasha, I would love to hear about the experiences your father has had and any opinions you might have on dietary treatment for cancer.

All opinions welcome.

My yahoo email is les211us@yahoo.com

Looking forward to hearing from everybody.


Thanks.

David

Peter said...

David,

I discussed this with my mother during the end stages of her mesothelioma. The one thing which was clear is that the person with the tumour has to be the one to decide what they are going to do. All we can do is provide the information. A combination of circumstances meant that my mother never got in to ketosis and the end result was on a par with those of Dr Schmidt's patients who did not make it through the first week. Being too late finding out about all this stuff was very depressing... I'd only heard of Atkins well after the time of her diagnosis and Kwasniewski much later.

Peter

Sven said...

If anybody is interested in books from Kwasniewski (in english) there is a (web-)shop in Germany that has everything available.

www.die-optimalen.de

Peter said...

Hi again David,

I just feel my initial reply was a bit stand offish. Loosing 200lb is amazing! You must know the ins and outs of ketosis pretty well. The other thing worth a mention is that I have a paper somewhere which "associated" egg consumption with a marked decrease in mammary tumour relapse. If (big if) the association is causal eggs knock spots off of Herceptin. Hard to tell, the paper had lots of mathematical modeling which was beyond me.

Anyway. What I meant to say was congrats on finding your way around a ketogenic
diet and good luck to you and your mother.

Best wishes

Peter

PS Thanks for the link Sven, but I couldn't find anything in English. Am I missing it? My favourite Dr K book is Homo Optimus. The metaphysics is a bit heavy but it gives a much better idea of Kwansiewski that Optimal Diet does.

Sven said...

You´re right, there is nothing in English. But if anybody is interested in the books just send an email to the guy running the site.

die.optimalen at online.de

I asked him if he is shipping abroad and he said "yes".
I just ordered "Homo Optimus".

Stephan said...

David,

It might be worthwhile to normalize her vitamin D levels immediately. Check out these links from the vitamin D council:

http://vitamindcouncil.org/newsletter/2008-jan.shtml

http://vitamindcouncil.org/researchCancer.shtml

Best of luck.

david said...

Hey Peter. Thanks for the response. I didn't find it standoffish at all. Any information on the egg paper would be great.

Sorry about your mom. Difficult times.

My mom has a good spirit and is optimistic but realistic. I've discussed the diet with her a great deal and of course she has seen my dramatic weight loss so she seems up to it. We will probably get started tomorrow after some more discussion.

As far as my weight loss I will probably start a blog of my own someday and post my before and after pictures. They are pretty intense. I went from a 60 inch waist to a 34 - 36 and am still losing fat.

I've got a lot of opinions about carbohydrate sensitivity, binge eating disorder and morbid obesity.

Thanks again.

David

Dr. B G said...

HI David,

Sorry to hear about your mom...
The link below if for breast CA prevention -- they emphasize 4 things
1)low glycemic index foods (they should just say low carb diet
2) sufficient vitamin D
3) high dose fish oil
4) sufficient vitamin E (only buy NATURAL tocopherols)

http://www.007b.com/breast-cancer-prevention.php

The D amount is to get the blood level to 25(OH)D 60 ng/ml. This may require 4000 IU daily or 12,000 IU daily -- it depends on the person. Vitamin A is a co-factor for D3 in the body -- you need some as well for the D to work right.

Here is a good link for vitamin A from Weston A price

Http://www.greenpasture.org/content/VitaminA.pdf

Hope she does well... hang in there!

-g

Dr. B G said...

David,

I found this link to a cancer group at Jefferson in Philly, Pennsylvania invaluable.

http://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1003&context=jmbcim

Good luck and I hope that helps...

david said...

Thanks for the replies and information everybody.

David

Ketogenic Diet said...

" I would admit that kids don't seem to grow to their maximum potential on the Ketogenic Diet"

-Peter

I wonder if this is due to the fact many traditional ketogenic diets have very little protein.

Ketogenic Diet said...

Regarding saturated fat and cholesterol values. I can't find the source but I read that as long as linoleic acid intake is not deficient, cholesterol values do not skyrocket.

My LDL went from 130 to 220 after 1) malabsorbing thyroid supplement (was takng it with protein and fiber shake)
2) cutting out ALL vegetable oils, and eating more sat fat (coconut and animal/butter etc)

After thyroid levels normalized (low thyroid hormone = decreased LDL receptors), the LDL remained high. I'm currently on OTC niacin (sorta going along with Dr. Davis, but not as concerned as I used to be about the LDL--not taking statins).

I'm wondering about increasing linoleic... then I read the post about the PUFA disaster when used in ketogenic diet. I think I missed the jist of it... I could only read the abstract.

mtflight@gmail.com

team smith said...

http://www.cybernaut.com.au/optimal_nutrition/books.html

hi, i just found this link with Dr. K's books in English for those of you interested. the link to order the books is at the bottom of the page.

i have Optimal Nutrition that my sister procured from the Optimal Deli in Chicago. i think i will order Homo Optimus for a deeper perspective. i am going to start trying to make some of the recipes in the book since i have a bit of a hard time getting in enough fat and particularly getting my p:f:c ratio correct. today i am trying the "white cheese" and i want to make his cheese pancakes. (hoping to also get my 3 YO to eat these too.)

amanda

Peter said...

I was thinking along the lines of serious ketogenic diets might also reduce the anabolic effects derived from insulin, but the low protein is a real possibility...

The whole LDL cholesterol thing is a personal decision thing. My LDL is considerably higher than yours but I can't see me ever wanting to do anything about it. If I did the problem of PUFA and free radicals and the association of linoleic acid with carcinogenesis would worry me...

Peter

Stan said...

Re: the anabolic effects derived from insulin, but the low protein is a real possibility...

Could be. Kwasniewski was saying that anabolic effect of insulin on children (growing too tall too fast) is an unhealthy aberration to be avoided. Children on his diet are supposed to grow slowly, mature late and have very long lifespan. On the other hand when the wheat eating Europeans arrived in Quebec and in Upper Canada (now Ontario) for the first time, their average height was 5 to 5.5ft while the locals, mostly meat eating Indians were 6.5ft on average (for men). Now both populations are identical. Perhaps it is a matter of having adequate proteins intake and perhaps children need a lot more of it than 1-1.5g/kg.
Stan (Heretic)

Chris said...

Protein intake is something that I've been thinking about a fair bit recently. My diet is generally pretty fatty - eggs, meat, cream, fish, butter, dripping, lard, some veggies (leeks, spinach, mushrooms) the odd apple. I'm pretty active too with weights, hillwalking, running sprints etc and the general wisdom - e.g. here -would be that I should be getting about 1 gram per lb of lean body mass Which for me would be about 150 grammes - what feels like a huge amount of food.

Plus there is the insulin issue associated with all that protein...

Ketogenic Diet said...

I thought one of the issues is the insulin:gucagon relationship. Carbohydrates stimulate insulin only. Fat's obviously don't. Protein stimulates glucagon and insulin in tandem. This is allegedly why protein intake is not harmful like carbohydrates even they have a similar insulin response (glucagon is the key?).

Chris said...

Just remembered that Emma had a post on the optimal diet here

Peter said...

Well Chris, Emma sums it up well. Carnitas and chips at the end of the late shift. Optimal, with the cream through the day...

Peter

kless said...

OT question from a lurker,

Has anyone here heard or come across papers saying low carb (more towards zero carb than just low)diets causing hypothyroid?

Peter said...

Hi kless,

If you search Jenny's blog I think you will find that she finds that very LC worsens her pre existing thyroid signs. I don't know if this is personal impression or lab number based, but that's what she has said in the past on Dr Bernstein's forum. Though I disagree with much of her outlook on many things, I think she is mostly factually accurate. I disagree on a lot of interpretation.


Barry Groves had a set of numbers from a pre and post conversion LC person showing marked improvement in thyroid parameters but he uses up at 50-70g/d of carbs. He's reorganised his site and I can't relocate the information.

So maybe... There is almost nothing on extreme LC in the literature as these studies don't get easy funding, ethics committee approval or patient compliance. The few I have on hard drive were short term and didn't look at thyroid function.

BTW my own morning temperature is always way sub normal but my peak exercise ability is fully acceptable, by my standards anyway (I'm not Chris!).

Another BTW You realise I hate gluten. Thyroid probs are usually auto immune in origin. Gluten intolerance is associated with.... guess what? Going extreme LC might help on this front as it will probably be low or zero gluten.

Peter

Dr. B G said...

Hey Kless,

Here's Dr. Hyman's take on thyroid and adrenal depletion:

http://www.ultrawellness.com/blog/thyroid-II

As Peter has posted here before, if your LC for excessive amounts of time, your cortisol can go up. Which may affect your adrenal glands, which I suppose could then start to affect your thyroid (although if your gluten-free I somehow doubt that, and if you don't vitamin D (or A or Mag) deficiency -- not very likely imo)...

This guy is on our public broadcast station (PBS) often (esp during fund raising season)...

-g

Stan said...

Dr b g wrote: if your LC for excessive amounts of time, your cortisol can go up. Which may affect your adrenal glands, which I suppose could then start to affect your thyroid...

Not only may but it did exactly that in my case! Back 9 years ago I had two episodes of tachycardia in the first 6 months on my high fat ZERO carb diet! Yes, I was trying to be holyer than the Pope and since (I reasoned) carbs are "evil" thus if 50g is good then 0g would be even better! 8-:)

Not true! It's better to follow Dr. K to the letter: 50g of carbs is good and zero grams is worse, so is 100g!

Please new lowcarbers; don't do that! Eat you veggies - pardon chocolate!

Stan(Heretic)

Stan said...

(cont. of my previous post)

If you consume zero carbs and if your blood glucose suddenly goes down then the liver will try to suddenly produce more glucose out of whatever available. This will also lead to stimulation of adrenal hormones. Adrenal hormones stymulate thyroid. If you then experience a so called "panic attack" (rapid heart beat from too much thyroid hormones) that will create a state of shock and will further stimulate adrenal hormones in a run-away effect, through a positive feedback.

I don't recommend that! 8-:)

Stan(Heretic)

P.S.

Please feel free to correct me if I described something inaccurately (I am a physicist not a doctor).

Chris said...

We are getting a bit off topic here!

Low carb and hypothyroid - there is a discussion of this on Lyle McDonald's forum here. I'd warn you that the folks there use a bit of bad language and the like so avoid if you would be offended.

It is a complicated subject as far as I can tell. There is some discussion of the difference between true hypothyroidism and what is called ESS Euthyriod sick syndrome

one study quoted is:

J Endocrinol Invest. 1982 Jan-Feb;5(1):47-52.Links
Effect of dietary carbohydrates during hypocaloric treatment of obesity on peripheral thyroid hormone metabolism.
Pasquali R, Parenti M, Mattioli L, Capelli M, Cavazzini G, Baraldi G, Sorrenti G, De Benedettis G, Biso P, Melchionda N.

The effect of different hypocaloric carbohydrate (CHO) intakes was evaluated in 8 groups of obese patients in order to assess the role of the CHO and the other dietary sources in modulating the peripheral thyroid hormone metabolism. These changes were independent of those of bw. Serum T3 concentrations appear to be more easily affected than those of reverse T3 by dietary manipulation and CHO content of the diet. A fall in T3 levels during the entire period of study with respect to the basal levels occurred only when the CHO of the diet was 120 g/day or less, independent of caloric intake (360, 645 or 1200 calories). Moreover, reverse T3 concentrations were found increased during the entire period of study when total CHO were very low (40 to 50 g/day) while they demonstrated only a transient increase when CHO were at least 105 g/day (with 645 or more total calories). Indeed, our data indicate that a threshold may exist in dietary CHO, independent of caloric intake, below which modifications occur in thyroid hormone concentrations. From these results it appears that the CHO content of the diet is more important than non-CHO sources in modulating peripheral thyroid hormone metabolism and that the influence of total calories is perhaps as pronounced as that of CHO when a "permissive" amount of CHO is ingested.

Paul said...

Something is in the air, the low-carb forum is also discussing cancer and low-carb/glucose

http://tinyurl.com/5ykn2d

On a related topic, I am reading The Rise and Fall of Modern Medicine by LeFanu, and it led me to Bradford Hill's minimal requirements for proposing causation in a medical study. Original is here (is easy to google summary versions too)

http://www.edwardtufte.com/tufte/hill

Paul.

Dr. B G said...

Chris,

THAT is a fantastic abstract! Thank you!!

My sister had Grave's and of course doesn't everyone have hypothyroidism? Now I now why so many people are adamantly opposed to gluten, wheat and most carbs. How did this research get buried??! It's like decades old... As Peter might say... in dog years... that's... *hee heh*

Hey, I'm gonna try out CrossFit (i'm preparing myself for a big b*tt kicking)....
-g

Lee said...

"Paul said...
No spare copies of Kwasniewski exist on Earth, so I appreciate you channeling!"

I bought my copies from the publisher, here:

http://www.wgp.com.pl/index.php?id_j=en

I just emailed them and they said that they have English language versions of both books. They respond to emailed enquiries in English but take a day or two to reply.

Paul said...

Thanks a lot for the link, Lee, also Amanda earlier. I have been mentally debating the cost, but I'm likely to bite sooner or later, if nothing shows up used on Amazon that is,

Paul.

Peter said...

Hi Paul,

Austin Bradford Hill was one very astute person. Thanks for the link.

Peter

Sven said...

According to Dr. K PUFA should be avoided (of course). But he seems to ignore the PUFA-content of animal fats. Lard has more PUFA than beef tallow. Nevertheless pork/lard seems to be Dr. K´s favourite. Is this because of his Polish background?
He is also very fond of fat from egg yolks. Same story: Quite a lot of PUFA.
Nevertheless he claims there is no cancer while on OD. I find that hard to believe.

Douglas Porter said...

Chris Masterjohn recently published a massive report entitled "How Essential are the Essential Fatty Acids?". It is available at his website http://www.cholesterol-and-health.com/Special-Reports.html. It costs $15 if purchased individually or half that if purchased on a subscription basis. If you are going to have an opinion on EFAs or PUFAs, I would highly recommend reading this report. All of his writings are worth reading and much of it is free on his website.
Porter

Peter said...

Hi sven,

We just don't know... I've heard of at least one person via the AHOA forum who developed cancer while on a Weston Price derived type of OD.

Hi Douglas,

Chris Masterjohn's PUFA treatise is a typical meticulous Masterjohn work and is proving a great challenge. One of my biggest problems is that I feel quite down on Ray Peat after checking three random refs from one of his essays and disagreeing with his interpretation on all three. Now Chris M has reached the same conclusions and I have a great respect for him. I've not had time for anything recently except gutting a bathroom (hence minimal blogging despite having about four posts in my head) so detailed reading on EFA is on hold and will undoubtedly delay posting or be delayed itself!

Peter

Chris said...

Here is another one just published:

Growth of human gastric cancer cells in nude mice is delayed by a ketogenic diet supplemented with omega-3 fatty acids and medium-chain triglycerides


from BioMed Central - Latest articles by Christoph Otto, Ulrike Kaemmerer, Bertram Illert, Bettina Muehling, Nadja Pfetzer, Rainer Wittig, Hans Ullrich Voelker, Arnulf Thiede and Johannes F Coy

Background: Among the most prominent metabolic alterations in cancer cells are the increase in glucose consumption and the conversion of glucose to lactic acid via the reduction of pyruvate even in the presence of oxygen. This phenomenon, known as aerobic glycolysis or the Warburg effect, may provide a rationale for therapeutic strategies that inhibit tumour growth by administration of a ketogenic diet with average protein but low in carbohydrates and high in fat enriched with omega-3 fatty acids and medium-chain triglycerides (MCT). Methods: Twenty-four female NMRI nude mice were injected subcutaneously with tumour cells of the gastric adenocarcinoma cell line 23132/87. The animals were then randomly split into two feeding groups and fed either a ketogenic diet (KD group; n=12) or a standard diet (SD group; n=12) ad libitum. Experiments were ended upon attainment of the target tumor volume of 600 mm3 to 700 mm3. The two diets were compared based on tumour growth and survival time (interval between tumour cell injection and attainment of target tumour volume). Results: The ketogenic diet was well accepted by the KD mice. The tumour growth in the KD group was significantly delayed compared to that in the SD group. Tumours in the KD group reached the target tumour volume at 34.2 +/- 8.5 days versus only 23.3 +/- 3.9 days in the SD group. After day 20, tumours in the KD group grew faster although the differences in median tumour growth continued significantly. Importantly, they revealed significantly larger necrotic areas than tumours of the SD group and the areas with vital tumour cells appear to have had fewer vessels than tumours of the SD group. Viable tumour cells in the border zone surrounding the necrotic areas of tumours of both groups exhibited a glycolytic phenotype with expression of glucose transporter-1 and transketolase-like 1 enzyme. Conclusions: Application of an unrestricted ketogenic diet enriched with omega-3 fatty acids and MCT delayed tumour growth in a mouse xenograft model. Further studies are needed to address the impact of this diet on other tumour-relevant functions such as invasive growth and metastasis.

Chris said...

Don't know if anyone else heard this one on the bbc news this morning....

apparently a ketogenic diet is good for epilepsy. I didn't realise that this was news?!

Peter said...

Hi Chris,

Missed it but my wife passed it on. It's been in the UK news/radio 4 at least one more time in the last couple of months, with the plea for funding to investigate and set up trials etc.

Perhaps we could all club together and get a second hand copy of Freeman, Freeman and Kelly's comprehensive paperback on the Ketogenic Diet? Probably a couple of quid on Amazon could save them a lot of going round with the begging bowl.

But at least they are raising the profile of ketogenic diets, which is good...

Thanks for the latest paper BTW. Trying to keep up with your blogs and Emma's is a pretty full time job, 'specially now Emma's being a bit prolific!

Ta,

Peter

Bruce K said...

Peter, good point about the problem being caused by ketogenic diets too high in PUFAs. I have written about this before. Here's a study I found that compares low-carb diet high in PUFAs to similar diet low in PUFAs. They note that the high-PUFA caused significantly more nausea, and that the low-PUFA diet caused low levels of ketosis, implying that saturated fats and MUFAs burn cleaner. I'd be happier with less nausea, but these study authors concluded that having higher levels of ketones was better than not having nausea. Hmmm.

http://jcem.endojournals.org/cgi/reprint/89/4/1641.pdf

Bruce K said...

Peter: "The funny thing is that Kwasniewski doesn't care about PUFA, ratios, EPA etc except to avoid all PUFA expet those present in small amounts in animal fats.... He never tells you why, but he has an uncanny knack of being right!"

I think JK's 100% right. The ratios don't matter. It's more crucial to limit total PUFAs and avoid all the high-PUFA oils. Best oils: coconut, palm kernel, mac nut, cocoa butter, red palm, olive, avocado, hazelnut. Eating a lot of nuts and seeds is a bad idea. Most fats should be from animal sources, free of fiber, and low in PUFAs. As a practical guide, keep SFAs and MUFAs as high as you can, relative to PUFAs.

It should also be noted that there are many alleged cancer remissions in the raw food world. One man, in particular, promotes a diet of raw meat, raw butter, raw eggs, juiced greens, unheated honey, and so on. Aajonus Vonderplanitz is his name. He tells diabetics to eat unheated honey by the cup. I've read that a few doctors used to give diabetics fresh raw honey with great success in treating their disease. We just don't see those studies being done any more. Maybe we should consider the raw and cooked factor. See the article below for many examples of using raw food to treat disease. I think we should consider this when looking at studies that use highly processed refined foods.
http://www.drbass.com/freedownload/files/drbassrecov.pdf

Bruce K said...

"One of my biggest problems is that I feel quite down on Ray Peat after checking three random refs from one of his essays and disagreeing with his interpretation on all three."

You have to read all of his essays to see how the ideas fit together. Even Chris Masterjohn pointed this out. His articles don't stand alone and you have to read all the ones about fats, lipids, oils, diabetes, Vitamin E, alzheimer's, etc. I did not agree with everything he wrote years ago, but I kept studying and reading and experimenting nad came to the conclusion that Ray Peat is right about most things. He should be given as much respect as JK, if not more.

"Now Chris M has reached the same conclusions and I have a great respect for him."

Chris didn't agree with Ray just a few months ago when I was debating the issues, and pushing references at him. One of the crucial studies that is often cited (Burr and Burr) does not prove PUFAs are essential at all. It proves that a synthetic diet is necessary to cause any EFA deficiency. The food which animals are fed in studies increases their need for nutrients, as Chris notes. And I have been saying that to him months before he wrote the article. The EFA studies never taste natural food that are low in PUFAs. They're all based on highly processed oils, refined carbohydrates, and purified proteins, etc. Ray Peat's ideas are going to catch on, because he's the one who's right about PUFAs and the people pushing fish oil, flax oil, and canola oil are simply wrong.

Chris said...

Here is a new one:

Conclusions: Rapidly absorbed carbohydrates are associated with postmenopausal breast cancer risk among overweight women and women with large waist circumference. Carbohydrate intake may also be associated with estrogen receptor–negative breast cancer.

from the new American Journal of Clinical Nutrition

Bruce K said...

Chris: "Conclusions: Rapidly absorbed carbohydrates are associated with postmenopausal breast cancer risk among overweight women and women with large waist circumference."

This conclusion is too broad, based on cohort data. They really need to clarify what rapidly absorbed carbs they studied. I suspect those women ate lots of wheat / flour products, refined sugar, corn syrup, etc. The results might be quite different if they studied potatoes, ripe fruits, root vegetables, comb honey, etc. I bet honey has a high glycemic index and glycemic load, but when I ate a lot of unheated honey I lost weight and my overall health improved. The key may be to eat foods as close to their natural state as possible.

Chris said...

Bruce - I take your point.

Here is another related study:

http://www.ajcn.org/cgi/content/abstract/87/6/1793?etoc

Magda said...

Hi Peter,
I am very happy to find your blog. i was high fat dieter for several years following Kwasniewski method until I came to live in London (7 years ago)
i staretd to eat pretty ordinary diet that would be called healthy by most authorities. the results are putting on 2 stones and developing IBS and I am worried I may cause myself even more harm. I would like to get back to healthy high fat eating but it seems that I cannot get right food - I do not know what hight fat would be based on what i can purchase in average big supermarket ( as I am used to small farmers produce and unavailable cuts of animals ). Seems that amimals when you give them choie now what to eat, tribal communities will regard fat animal as most precious but neatly cut pieces of lean meat seem to be the only option here. Can I get unprocessed animal fat here? Could you share with me some ideas as per what your menu looks like. I would very much appreciate it.
Thank you
Magda

Peter said...

Hi Magda,

There are a couple of posts entitled "What do I eat" and several starting with "Food" which give some ideas of how I work through supermarkets.

The beef dripping in the UK (I buy Brittania brand) is refined but has no preservative or hydrogenation. This converts lean meat to fatty meat. Of course butter does exactly the same thing and I drink a great deal of cream. Eggs are pretty much the same world wide too. Even in Sainsbury's you can pick through the pre packaged belly pork to find the fattiest...

Unprocessed animal fats need you to find a butcher who will order it specially for you. Ask for raw suet. Some will even mince it for you which makes the rendering much easier. They will order you a whole ox heart too, but you must have the whole heart, no one else will buy it!

Hope that helps. Butter and cream are so easy, especially if you are OK with casein and lactose.

Peter

Calvin said...

Hey Peter,

I'll keep this comment specific to yours "I feel quite down on Ray Peat after checking three random refs from one of his essays and disagreeing with his interpretation on all three. I actually purchased a couple of Peat's books back in the early 90's b/c someone (also from Eugene) recommended them. Anyway, he has a few interesting ideas, but for the most part it's a bunch of crapola. And like you I tried following up on his references--most are dead ends, not even related to the subject at hand, or if so I came away with totally different interpretations too. That said, I keep seeing his name quoted time-and-again as a health expert--hello? Anyway, just my two cents to add to the pot.

Cheers,

Calvin

Peter said...

Hi Clavin,

Nice to have the confirmation. Interestingly there are some posts on PUFA and cirrhosis coming up...

Peter