Cancer as a Metabolic Disease - Keto, mTOR, Fasting and Autophagy
This article breaks down the carbohydrates for you, so you don't have to!
With the growing awareness of cancer as a disease of metabolism, comes a growing awareness that in order to suppress cancer from progressing, we need to slow its metabolism down in order to starve it, weaken it and then hopefully kill it.
Metabolism is simply defined as, how something gets and uses fuel.
Substrates are substances that act as the main ingredient to make the fuel and Metabolites are products that are produced as a result of the process of turning those ingredients into fuel.
There are many metabolic pathways that cancers can hijack but the primary pathway is through glucose/sugar metabolism . All carbohydrates are actually sugar so when I hear people telling me they have cut sugar completely out of their diets but they had toast for breakfast and pasta for dinner, I facepalm!
We need to widely educate ourselves and loved ones on what carbohydrates are and how they impact the body and our health. We are getting sicker, the younger populations are getting cancer and it’s mostly preventable.
If we educate ourselves, then we can share that with others and help them learn too.
Always with compassion and not judgement
‘when we know better, we do better’ -M.Angelou
Let’s break those carbs down!
Carbohydrates are just long sugar chains. Here is a diagram to demonstrate how that might look. Glucose = sugar. Yep, the same kind as the white stuff you get at the store!
Glucose−Glucose−Glucose−Glucose−Glucose−Glucose−Glucose−Glucose
Less-healthy examples of complex carbohydrates include bread, pasta & rice (white and brown); oats, muesli and white potatoes. They are less healthy because they are either grain based or they have very little nutritive value to compensate you for the bang of detrimental sugar they hit your body with.
Healthier complex carbs are in beets, sweet potato and some fruits as these tend to (but less so if they are not organically farmed) have more nutrition in them, especially if they are wild or home grown and organic.
The above long glucose chain is actually a ‘complex carbohydrate’ because your body is going to need to take an amount of time to break that chain up into individual sugars. Old-nutrition ‘pro-grain’ food pyramids, used to say that this was beneficial to us due to the slow release of carbohydrates but we now know that we both, don’t need an external source of carbohydrates to thrive (as long as we eat enough fat), and that carbs/sugar are the primary fuel for cancer.
A simple carbohydrate would instead, look like this:
‘Glucose’ or ‘Glucose-Glucose’
This simple carb, doesn’t need to be split in the body, it’s already a simple sugar and can jump straight into the blood to be used for fuel, or raising your blood sugar and being stored, if you don’t actually need that much fuel in that moment.
What happens in the body when you eat sugar?
Typically when we eat carbohydrates we get a sugar hit, either an instant one if we have been scoffing the cookies and soda or a slower climb if we had a wholewheat pasta meal.
That sugar hit comes about because our blood sugar levels rise which can be dangerous if levels get too high. So the pancreas takes action and throws out insulin to bring the blood sugar levels back down again. The liver is also working hard at this point, storing sugar as fat in tissues and converting it for energy needs.
A point about energy. If you are sitting at your desk or lounging about while tucking into those cookies, there is going to be a very different metabolic impact on you overall than if you get out on your bike or go for a long cycle straight after. The way that energy from the food is sequestered or stored, is heavily impacted by your level of activity. Eating carbs and sitting still is going to put a heavy burden on your body, quite literally!
Continued sugar stress on the pancreas will cause your pancreatic beta cells (which do all the blood sugar regulating) to get very weary. After all they have been working so hard in a way they haven’t evolved to. This can lead eventually to Type 2 diabetes.
Cavewoman Kate didn’t sit around watching TV with cookies and soda to keep her company, she was working, raising the cavekids and gathering food. Paleo Pete was off hunting for his tribe, he wasn’t sinking beers and scoffing chips and chocolate bars! and that’s the problem ….
We still have Stone Age genes but we aren’t in a stone age environment any more. Our genes express best health in stone-age conditions (minus the man-eating tigers & bears of course).
Insulin is the hormone that the pancreas releases into the body when our blood sugar levels get too high, to bring that blood sugar down. Insulin is a growth hormone and is a major factor influencing cancer as well as obesity (which increases oestrogen production and of course, type 2 diabetes).
mTOR
We have two major metabolic pathways in the body, mTOR and AMPK. These pathways cannot be switched on together at the same time.
If mTOR is on, AMPK is off.
If AMPK is on, mTOR is off.
Put simply, mTOR is for growing (think anabolic, bodybuilding) and AMPK is for breaking stuff down and cleaning up waste (think catabolic, clean up job).
Can you guess which pathway cancer likes?
You’ve got it! The GROWTH pathway. mTOR is the pathway that drives the cancering process including angiogenesis. Angiogenesis is how cancers signal to the body to have small blood vessels created that channel the fuel for cancer to help make tumours (sugar is the main fuel and there are others like amino acids and fats, which I promise I will get to, but sugar is the biggie).
So what puts us in this mTOR state?
Glucose does!
(Yes so do amino acids, but that is when we eat protein to excess and a great reason why you might want to work with a nutritional therapist privately, to ascertain your own individual needs for protein so that you aren’t routinely over or undereating protein. ) aaand back to glucose…
The solution?
As I say to people who suffer with stress and anxiety, it’s all well and good to have your Magnesium/Valerian/L-Theanine supplement or whatever you are using, to bring down that anxiety but the absolute best thing you can do..? Is to avoid the stress triggers in the first place? (where humanly possible)
Switching the cancer pathway mTOR, off permanently is out of the question, because without it, yes the cancer would die, but you would disappear right along with it! We need both AMPK and mTOR pathways, operating at different times of the day to live. We need a little growth and we need a little rest and repair.
In order to demonstrate a solution to this, maybe we need to go back one little step and think about what a typical American diet might look like. (I asked AI for help here so don’t shoot the messenger…)
A typical US diet
7am Breakfast (the most important meal of the day - or is it?) ‘Healthy’ breakfast consists of wholegrain cereal with dried fruit & orange juice, with a token banana chopped on the cereal. Usually eaten on the go. (Stress)
10am feeling peckish? - A cookie with a coffee (Blood sugar dysregulation)
1pm - Regular sandwich - a tuna melt (with token lettuce leaf) soda, chips, chocolate. Eaten at a work desk, which means no rest and digest either. (Stress)
(Afternoon slump… another cookie perk-me-up?)
7pm - Dinner Sushi, Pizza, Mac n Cheese, Burger, Spaghetti Bolognese (Carb heavy, to combat the blood sugar drop and energy slump over the afternoon)
8-11pm Evening - snack foods, chocolate bars, chips, leftovers, nibbles, alcohol, soda… while watching a movie or TV to relax. In effect coasting through the evening on a carb high, leading to more blood sugar dysregulation overnight and feeling famished in the morning due to a morning hypo (low blood sugar).
Welcome to the blood sugar rollercoaster…
‘The crazy ride your body is desperate to get off!!’
I know that this doesn’t reflect everyone’s diet and that many of you reading this will be many steps ahead and have probably been eating pretty well at least since you started to learn more about cancer as a metabolic disease, but I am making a general point here. The point is that the average person, is eating from the moment they wake, to the moment they sleep. Some are even waking up for a midnight snack. This puts them in mTOR…. ALL THE TIME!
Continuous growth!
It’s no wonder cancer rates are rising and sadly we are seeing sharp rises in the younger populations too which somewhat nullifies the argument that rising cancer rates are solely attributable to our aging population.
So, we’ve uncovered a few problems…
Sugar is the primary fuel of cancer
Sugar/glucose drives mTOR
mTOR activation means cancer growth
In a typical modern diet and lifestyle, people spend almost their entire day in mTOR.
The Ketogenic Diet & Intermittent Fasting
Keto starves the body (and therefore cancer) of glucose
This is why the ketogenic diet is so effective against cancer, starving it of the primary fuel it uses to grow.
I will write more in the future about the ketogenic diet, we are just at the beginning of this journey together through the cancer process and all the lovely supplements, drugs and therapies that might serve you along the way.
The ketogenic diet (KD) though is shown in study after study to be an effective companion to your medical oncology treatment. It helps chemotherapy to work better , reduces side effects and improves quality of life.
Intermittent Fasting puts you in AMPK (and gets you out of mTOR)
In the 1990s a scientist called Yoshinori Ohsumi, discovered autophagy. The word autophagy, literally means self-eating and refers to the clean up and recycling of waste materials in the body, to be excreted or used in different ways. Dysfunction in autophagy is associated with cancer and other metabolic diseases. Intermittent fasting beyond around 12-13 hours activates the AMPK pathway (the opposite of mTOR) and the body goes into autophagy.
I generally feel that around 13-16 hours is pretty optimal for most people to fast each day, but speak with your own Naturopathic Doctor about that. It’s also pretty manageable when you run it alongside a nicely constructed ketogenic diet because in keto, you don’t get those blood sugar rollercoaster, spikes and dips. There is no ‘Hangry’ when you eat the right amounts of fat on keto. It’s great to experience that nice, steady and even energy through the day and in that state, intermittent fasting comes easily. If you have found intermittent fasting hard in the past, you may have just had the wrong diet!
You can have tea, coffee (no milk, and keep it organic), herbal tea and water in your fasted window but nothing else. It’s a great time to thank your body for the miraculous creation that it is and enjoy your down time. Visualise your body doing that clean up job and getting out debris, the dead cells, fighting cancer and recycling waste.
Use your time to read, walk or rest, if you can. Some people enjoy exercising in their fasted window.
Always speak with your primary healthcare provider before you take any supplements or embark on any new diet or exercise regime.
Disclaimer
This information is provided for educational and informational purposes only and does not constitute the provision of medical advice or professional services. This information does not replace medical care or recommendations from a physician familiar with you, your health and laboratory data, or who is actively providing you with medical treatment. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition.
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At 61, I have essentially been following the path of this article for about a year. The key for me at the beginning was to identify where all the glucose/sugar was in my diet and reduce it completely, gradually leading to a low carb diet. I then started to incorporate intermittent fasting and eventually multi-day fasting and have been able achieve high therapeutic levels of ketosis on a periodic basis.
The mistake many make, as I did in the past, is to go low carb/keto, and/or fast, too soon or too fast and not gradually identify and eliminate the addiction to sugar, and the associated blood sugar rollercoaster you accurately describe, that modern standard diets cause in nearly all of us.
I also recommend adding coverage on quality sleep if you can. Most general practitioners are unaware of the prevalence of sleep disorders such as undiagnosed sleep apnea. Even if they are, they are also unaware of the substantial hormone disruptions such disorders can cause. These hormone disruptions can also support the generation and proliferation of certain cancers in predisposed genetic and epigenetic environments.
Really nice article and a great summary, Amanda. I agree that the ketogenic diet has some potential to impact cancer metabolism, but in my experience over the past decade, it’s incredibly hard for people to stick with long-term—especially when you have a family and social life to juggle. I think you’re spot on about intermittent fasting and cutting down on refined carbs. That, combined with fiber-rich fruits and whole foods, seems like a much more sustainable approach for most people.