Before I get into the meat of this blog I want to extend an invitation to you to help me celebrate my sixth year of cancer survival next month, July 2017 by sharing your stories of survival with me. I would love to have the privilege of sharing your story on my social media, through my blog, and on my podcast with other survivors. Please email your story to Laura@LauraLummer.com, and if your are interested in sharing your story in person on my podcast, please include that in your email as well because I would love to have some of you sharing through your own voice, on my show next month.
I truly believe that many women need to hear that one story that connects with them and helps them to believe that they can get through the struggle that often accompanies breast cancer survival. That story could be the one that you have to share. Let’s join our voices and create more support for other survivors in doing so. I’m looking forward to receiving some stories about not only how you survived, but how you thrive now. Tell me what changed in your life. Did you pursue a dream that you wouldn’t have if you had not gone through the experience of breast cancer, or do you have a different outlook on life now? I’d love to hear so once again please email your stories to me at firstname.lastname@example.org
All right let’s get into talking about a LCHF or low-carb high-fat diet otherwise known as a ketogenic diet. Before we get too deep into this I do want to acknowledge that as breast cancer survivors, many of us have special needs or continue to take prescription medications. I’ve shared in previous podcasts and blogs about my own experience with having very high levels of insulin, glucose, cholesterol and high blood pressure following treatment and especially when I was on tamoxifen.
It’s important for me to remind you that I am not a doctor or a registered dietician, although I spend a lot of time researching, reading and ensuring that the information that I’m putting out to you is valid and comes from professional, educated and credentialed resources it’s important that you always put your health and safety first. So please do your research, follow-up with your doctor on anything that you read here, especially if you’re on medications or have metabolic conditions that are under, or require medical supervision like heart disease or type two diabetes.
History of Ketogenic Diets
In my last blog, which was part one of this series on managing weight after breast cancer treatment, I wrote about the struggle I went through and all of the different avenues and resources that I exhausted while trying to manage my weight after treatment. Which was the first time in my life that I have been faced with this difficult challenge.
I also wrote about how I had seen people around me experiencing great successes with a low-carb high-fat diet, but I really had a hard time wrapping my mind around eating high-fat and being healthy. Also, I’ve never been a big fan of the so-called “diet” I’ve always been an advocate of balanced eating and moderation. Or at least what I perceived as balanced. But, I do try to keep an open mind to other options. I started to do some research into the ketogenic diet because I wanted to lose weight, but I also wanted to be sure that it was safe in the sense that it would not increase my risk of cancer recurrence.
What I discovered was that there are multiple versions of a ketogenic diet. One version is a low-carb high-fat diet (LCHF) and the other is a traditional ketogenic diet. The ketogenic diet includes up to 90% of its calories from fat. Whereas a low-carb high-fat diet is more of a modified Atkins diet.
The Atkins diet recommends 50% to 60% of calories come from fats versus the LCHF diet which recommends more than 75% of calories coming from fat sources. Atkins also includes more protein than the ketogenic diet or LCHF diets which recommend keeping protein intake between 20-25% of total calorie intake and then adjusting it downward as needed for weight loss. This is because, these diets are primarily concerned with controlling levels of insulin and glucose, and higher intakes of protein can cause more of an insulin release.
By no means am I criticizing the Atkins or any other type of diet, I’m just offering this comparison to help you get a better understanding of what the low-carb high-fat or ketogenic diet actually is.
One of the first resources that I was fortunate enough to come across when I began looking into the ketogenic diet was a researcher that I referred to in last my blog, Dr. Dominic D’ Agostino. Listening to interviews with him led me to other excellent resources, which led me to the surprising discovery that the ketogenic diet has been around since 1921, when it was discovered that this diet worked exceptionally well for children who suffered from epileptic seizures.
When children with epilepsy were put on a ketogenic diet the majority of them completely recovered and stopped having seizures. After a period of time, this diet fell out of fashion as more pharmaceutical drugs were developed to control seizures, even though many of these drugs did not have nearly the same success rate that the ketogenic diet did.
The Keto diet for the treatment of epilepsy was resurrected in the 1990s when James Abrahams, the writer of many movies you’re probably familiar with including Airplane, The Naked Gun, and Scary Movie Four to name a few, was searching for help for his young son, Charlie, who had severe epilepsy.
His search lead him to Johns Hopkins where he became acquainted with a dietitian who recommended the ketogenic diet for Charlie. Even though all the drug therapies Charlie had been subjected to in the short span of his 11-month life had failed to manage his condition, the ketogenic diet succeeded. Eating this way allowed Charlie to get off of the drugs he was taking to manage his seizures, recover from epilepsy and live a normal life, even though his original prognosis was that he would live a life of seizures which would result in progressive mental retardation.
James was amazed at the results of the ketogenic diet and at the same time, angry with the medical institutions that didn’t give this information freely to so many people suffering from epilepsy. He was passionate about getting information about the ketogenic diet out to other parents that were in his desperate situation. He started the Charlie Foundation to spread the word and educate other people who desperately needed help for their epilepsy or for their epileptic children. He also wrote, directed and produced the 1997 movie, “First Do No Harm” featuring Meryl Streep. This was the story of an elliptic child whose life was changed by the ketogenic diet.
Since starting the Charlie Foundation, the ketogenic diet has been found to benefit many other conditions including Parkinson’s disease, ALS, cancer, Autism, Traumatic brain injury, and type two diabetes As a result, the name of the foundation has been changed to the Charlie Foundation for Ketogenic Therapies in an effort to continue to promote the studies and trials of the ketogenic diet across the spectrum of these diseases. I highly recommend checking out their very informative website for information dietary plans and recipes.
I could go on for a long time about the science of a ketogenic diet as there’s a ton of science out there and it seems that more studies are popping up all the time. However, today we’re going to focus on how the ketogenic diet may support cancer patients and cancer survivors and improve our odds of survival. First, I’ll give you 5 key pieces of information you should know about ketogenic diets, and then I will give you five tips on getting started with a ketogenic plan.
5 ways Ketogenic Diets Benefit Breast Cancer Survivors
1. Cancer cells need glucose to grow and survive
In 1923, near the time that the benefits of the ketogenic diet and were discovered for epilepsy, a German biochemist named Otto Warburg, publicly stated his hypothesis that cancer was a metabolic disease. Meaning something gone wrong in the body is the root cause of cancer and rather than it being caused by genetics, which was the accepted theory at that time. What Warburg discovered was that cancer cells used a different way of creating or accessing energy than normal cells. Cancer cells use a process called cellular fermentation even if there was oxygen present for them to use, which is what healthy cells would go to first. Fermentation requires glucose or blood sugar to be present. In fact when cancer cells do not have access to glucose they often die. This process of cancer dying in the absence of glucose to this day is called the Warburg effect.
We all know that chronically high blood sugar is something we want to avoid. However, there’s also a common understanding that you must have a certain level of blood sugar or glucose in order to function. And that’s true, but when there’s not a lot of glucose in our blood we can use ketones for energy instead. When our body is using ketones for the majority of its energy rather than glucose we are said to be in ketosis.
It is important to distinguish that ketosis and ketoacidosis are two very different conditions. One is quite dangerous and the other quite safe. When we are in ketosis we are using the energy of the ketone bodies that our liver is making. When a person, usually a type two diabetic, is in ketoacidosis their system has become very acidic, their body is producing ketones, but just as their body has become resistant to insulin and is not able to correctly use blood glucose for energy, the energy from the ketone bodies is also not being used, so it builds up in the blood is filtered out by the kidneys and found in the urine. It’s important to realize that saying you’re in ketosis is not something to be afraid of.
Another situation in which your body produces ketones for energy is when you’re in a fasted state. At this time your body accesses your stored fat and your liver makes ketone bodies for energy.
2. LCHF/ Ketogenic diets keep glucose low and reduce insulin response
The bottom line here is that following a ketogenic diet helps to keep blood sugar and insulin levels low in the body. The is a benefit to cancer patients and survivors because cancer cells cannot use ketone bodies to create energy, to live, or to multiply. When our body is making ketones and we are using them for energy more than glucose, studies show that cancer cells don’t have the food necessary to grow and multiply. In a situation where people are currently being treated for cancer, this can be a supportive therapy for chemotherapy or radiation and in fact, tremendous success is being found using both fasting and a ketogenic diet in while patients are in treatment.
Dr. Jason Fung, Author of the “Obesity Code unlocking the secrets of Weight Loss”, is a kidney specialist in Canada, an advocate of the ketogenic diet and of intermittent fasting. Dr. Fung talks in his lectures and in his books about how important it is to keep the insulin response low so that our bodies don’t become insulin resistant which then leads to us having high blood sugar. It’s also commonly known that insulin encourages fat storage, I mean that’s its basic job, to store energy in the body. The more carbohydrates we eat, the higher our blood sugar goes, insulin we secrete, and the fatter we get. Let alone the fact that the higher our blood sugar is, the more fuel that’s just floating around in our body eligible to be picked up by cancer cells.
3. LCHF/ Ketogenic diets reduce metabolic syndrome and risk of diabetes
Metabolic syndrome is a cluster of conditions that increase your chance of heart disease and your risk of becoming a diabetic when they occur together. Metabolic syndrome is a step in the progression of the development of diabetes. The progression may begin with chronically high blood sugar, resulting in weight gain and metabolic imbalances.
If you have at least three of the following conditions occurring at the same time, you are considered to have metabolic syndrome:
- A waist conference for females larger than 35 inches (89 cm), or for men, greater than 40 inches (102 cm)
- Chronically high triglyceride levels
- Low levels of high-density lipoprotein (HDL cholesterol) Which is less than 40 mg/dL in men, and less than 50 mg/dL in women.
- High blood pressure, consistently 130/85 or higher.
- Fasting blood sugar greater than 100 mg/dL or higher.
On a ketogenic diet, studies have shown that all of these conditions are improved in most people. Additionally, most people experience a decrease in waist circumference pretty quickly after following a ketogenic diet. This is significant for more than just your favorite bathing suit, abdominal fat is the most dangerous place to carry around extra body fat when it comes to increasing your risk of disease. (It’s also the first place that body fat loves to accumulate after menopause.)
4. LCHF/ Ketogenic diets reduce cravings and hunger
There’s an ongoing debate as to whether people lose weight on a ketogenic diet because they eat less, or because they metabolize fat differently than carbohydrates (maybe both). In my experience and the experiences of those around me, the high amount of fat in the diet leaves you feeling so satisfied that you really do eat less. You don’t constantly feeling the need to graze throughout the day. As you become more adapted to eating this way you literally lose the cravings for sugar and sweets.
5. LCHF/ Ketogenic diets Improve Brain Function
For cancer survivors who underwent chemotherapy as a part of their treatment, chemobrain is no joke. The American Cancer Society (ACS) states on their website that even though the direct cause of chemobrain is uncertain the results are real and can include:
- Memory lapses
- Trouble concentrating
- Trouble remembering details
- Trouble multi-tasking
- Feeling disorganized, slowed thinking and processing of information
- Trouble remembering common words or difficulty completing a sentence
ACS also states that these symptoms can last for months to years after treatment.
Although I looked for research on a ketogenic diet specific to chemo brain I didn’t find any, however I did discover many other studies on ketogenic diets and cognitive impairments. One study, published in March 2016 by the Annals of the New York Academy of Sciences. This report said that part of the problem in Alzheimer’s disease is the brain’s lack of ability to properly use glucose as fuel. However, this report states that clinical trials have shown that increasing ketone availability to the brain through nutritional ketosis has a beneficial effect on cognitive outcomes in Alzheimer’s disease and other cognitive impairments.
How to start a Ketogenic diet
A traditional ketogenic diet, otherwise called a strict ketogenic diet, is a 4 to 1 ratio, with fat being four times that of your calories for carbohydrates and protein combined. You can imagine that that’s challenging for some people, not only to begin to cut carbohydrates back that low but also to increase fat by that much. There is also the option of a moderate ketogenic diet would keep the carbohydrate intake between 20 and 50 g per day.
If you’re not one for calculating percentages, there are several online tools that can assist you in creating a ketogenic food plan. One that is particularly simple and yet thorough is called the Keto diet buddy. Just enter your information like height, weight, age, gender and this website will calculate your goals at a maintenance level, for a moderate calorie deficit, and for a large calorie deficit. It’s pretty cool and it even has an app that you can put on your phone. I use My Fitness Pal and then which shows my macronutrient intake in a little pie chart. I recommend finding a tool that’s easy for you to understand and use. There are lots of resources out there and new ones are popping up all the time as this diet becomes more well-known.
I don’t want to turn a blind eye to the very real challenge that our society faces with sugar addiction. Thinking of eating a ketogenic food plan could cause a bit of panic in some of us because it means going through that emotional struggle of detaching from sugar. It’s important to understand that a ketogenic diet is not something you do halfway. You can’t be taking in large amounts of fat and eating carbohydrates and sugar at the same time so it’s really something that you have to commit to. Once your body adapts to eating this way, you can have a treat now and then, if you even still have a desire for it but you have to cut out the sugar when you increase the fat.
Simple steps to getting started:
1. Eat Whole Foods- One of the first steps that you have to take in beginning ketogenic the plan is to get the processed food out of the house. If food comes in boxes or bags when it shouldn’t it has had things added to it to keep it preserved and fresh for a longer period of time than it could in its natural state. You’ll find sugars in sausages, sauces, salad dressings and other places that you might not expect so please check labels look for sugar, high fructose corn syrup, cane sugar, maltose, dextrose or sugar by any other name and steer clear of those products. This includes eating processed or fake low carb foods. Focusing on eating vegetables, meats, cheese, dairy products, eggs, nuts, and other natural foods.
I do just want to qualify something here because I’ve had this question from many people and I want to clarify that fruits and vegetables are carbohydrates. We have vilified the word carbohydrate so much that whenever we say it, people think of bread, donuts, cookies and that’s not always the case. Fruits and vegetables, beans and legumes are carbohydrate foods but they’re also rich in phytonutrients, vitamins, minerals, and fiber. All of that is important for a healthy digestive system and many other functions in our body. So, don’t be afraid of fruits and vegetables because they’re carbohydrates just be mindful of how many eat and how sensitive your body is to any or all carbohydrates
2. Don’t fear fat– We have been so programmed to fear fat that even when we are given free rein to consume it, we struggle to get our mind around the fact that it’s OK to eat. A ketogenic diet is not a high-protein diet, which is the first thing people tend to go to. It’s a moderate protein diet so you want to keep the protein intake between 20% and 25% of your total calorie intake. I’ll give you an example of this. The other night while having dinner with my sisters, who are all following a ketogenic diet with a lot of success, I was helping one of them calculate the amount of nutrients she was eating in the My Fitness Pal app. When we saw that her fat intake was below 60% she was a little surprised, but as we reviewed what she had been eating, a lot of the foods were much higher in protein than fat. She was ordering a ribeye steak and a side of vegetables for dinner, so I had her order an extra side of drawn butter and some blue cheese crumbles to put on top of those veggies and that steak. Sounds delicious right? It was! So slather on the butter and don’t be afraid of cheese. Obviously, if you’re lactose intolerant you’ll work around the dairy and if you’re vegan you have many beautiful oils to choose from as well. On my last podcast show page, I even posted a vegan ketogenic cookbook along with other resources that you could reference for ideas.
3. Get a cookbook or sign up for a website that’s focused on a ketogenic diet- It’s a very simple diet to follow but make sure you have an understanding of how it works. Many people see quick weight loss when starting a ketogenic diet and then they plateau. If that happens, it’s important to know that you have options like drinking more water, reducing the amount of your protein intake, exercising a little more, and maybe adding more fat. I recently discovered a fantastic resource, the Dietdoctor.com. This website is beautiful, simply laid out, and contains interviews with physicians and specialists that can answer and address all of the concerns that you might have about eating a high-fat low-carb diet. It has delicious recipes, and if you choose the membership option it’s free for 30 days and then only nine dollars a month.
I went with the nine dollar a month option because you can choose all the meals you like and it prints out a grocery list for you which is awesome! I also love to learn and there are courses and interviews with tons of valuable information on this website. Whether you cook or you don’t cook, or you’re concerned that giving up sugar is going to be too much, there are all kinds of options and articles on this website to help you make an informed decision.
4. Be aware of the Keto flu- A common experience people have when they begin a ketogenic lifestyle and they’re transitioning from using glucose as their primary source of fuel in the body to using ketones, their body goes through an adjustment period and they can feel pretty crummy. Common side effects can include leg cramps, fatigue, constipation and lack of endurance. This is often called the keto flu. I personally experienced a challenge in getting through my workouts for about two weeks, and then surprisingly I showed up in the gym one day and felt like wonder woman. That’s when I knew that I had made it past the adaptation point. So be patient with this way of eating, and consider, being more gentle with yourself for the first couple of weeks as you’re adapting. Instead of intense workouts, take some walks, do some restorative yoga and give your body time to adjust as you eliminate refined carbohydrates from your diet. You may notice that your body flushes fluid very rapidly and you have to pee a lot! Keto flu symptoms can be related to this loss of fluid and can often be remedied by becoming more hydrated, adding salt to your food, or drinking sugar-free electrolyte beverages.
5. Find a community or a buddy for support.- I highly encourage you to find somebody to begin this new lifestyle with. If you have children or a partner at home that will support you in this do it together. It’s fun to experience the results and try out the new delicious foods together. They’re also communities like my Facebook page where survivors can share their experiences and successes. Having support can make the whole transition a lot easier and help you stick to the ketogenic lifestyle when you’re at home or even when you’re out.
Be patient with yourself
Remember, we are all different and going through cancer treatment affects our DNA and the way that we respond to many different things. So be patient with yourself. Although I lost several inches and 10 pounds in the first two months that I followed this way of eating, my sisters and my husband have all lost a lot more weight than me. It’s important not to compare to others because I know that my body has been through a lot of stressors that their bodies have not and I’m really grateful for the success that I am seeing and for the difference that I’m experiencing in energy, the lack of hot flashes, joint pain, and fatigue.
I hope this introduction to the ketogenic diet has inspired a little bit of curiosity in you and that you’ll check out some of the resources that I have posted on my website. You can also email me at email@example.com. I’m always looking for information that I can put out there to be the go-to resource for other cancer survivors and I really believe that the ketogenic diet has a tremendous amount of benefit to offer all of us.
Look for me on Facebook at Laura Lummer, on Instagram @TheBreastCancerRecoveryCoach and become part of our community of survivors who share wisdom and support with each other.
Until next time,
Let Your Lifestyle be Your Medicine,
Interested in working one on one with Laura? Email her for fees and availability.