(Pictured left to right: Dawn Lemanne, MD, MPH; Glenn Sabin; Executive Director of the American Nutrition Association, Michael Stroka, JD, MBA, MS, CNS, LDN.)
Integrative oncologist and n of 1 co-author Dawn Lemanne, MD, MPH, and I were recently recognized at the 58th Annual Conference of the American College of Nutrition in Alexandria, Virginia.
The conference theme was Disrupting Cancer: The Role of Personalized Nutrition. I was presented with the college’s Communications and Media Award for the book: n of 1, and the blog at glennsabin.com, for ‘outstanding media contributions promoting nutrition science’. Dr. Lemanne was presented with the college’s Stanley Wallach Award for her ‘significant contributions to the advancement of the therapeutic role of nutrition in cancer treatment’.
After the awards were presented, Dr. Lemanne and I remained on stage for a spirited one-on-one discussion, followed by an engaging Q&A with the audience. Here is the entire video.
During the conference, I had an opportunity to hear investigator Thomas N. Seyfried, PhD, author of Cancer as a Metabolic Disease, present his theory on the cause of cancer, and speak about his pioneering research on the ketogenic diet, along with calorie restriction, and intermittent fasting as an adjuvant therapy for those going through chemo and/or radiation.
Dr. Lemanne’s lecture, which followed Seyfried’s, discussed more on the science, and how she translates these clinical findings for her patients at Oregon Integrative Oncology.
I am intrigued by these early findings and their potential clinical implications. As a matter of fact, I have been experimenting with intermittent fasting (17-20 hours) for the last few months, supplementing with amino acids and electrolytes, working out with cardio and weights in a fasted state, to reshuffle my body composition.
The impact on body composition has been remarkable: I can see a shift in fat to lean muscle mass. I wish I had measured my body fat at baseline, but at the time had no idea if I could stick to what seemed like a tough regimen. I neither lost nor gained weight—even though I consumed about the same calories as before—but recognize the short-term nature of the experiment.
But I have digressed…
Nutrition science is rapidly advancing, but clinical nutrition in general is still one of the most confusing areas of health, with differing opinions regarding the best approaches to preventing cancer, supporting active treatment, ensuring durable remissions or periods of disease-free progression, and overall survival.
This post does not attempt to unpack the medical literature for nutritional science relating to cancer. That would be a long piece, and I am not the best qualified to do this unpacking. Instead, I will share my personal approach to food-based nutrition as a 26-year cancer ‘thriver’.
Within the first couple of years after being diagnosed with chronic lymphocytic leukemia (CLL), I radically altered my diet. I changed from an avid carnivore, ingesting copious amounts of meat products and processed foods, sprinkled with occasional veggies, to what now might be best described as a Mediterranean diet—with a couple of caveats.
I eat a ton of veggies—a rainbow of colors; heavy on the cruciferous family—especially broccoli, Brussels sprouts, cabbage, bok choy, and cauliflower. I eat only sprouted grains and brown rice. The only animal protein I consume is fish, rich in omega-3 fatty acids. I mostly stick with cold water swimmers like salmon, halibut, and sardines.
(Disclosure: I am a lifelong Marylander, home of the famous Chesapeake Bay blue crab. I readily admit that I gorge on these crustaceans at least a half-dozen times each summer. Not the healthiest choice, I know, but I will never give up hard shell crabs; the psychological and nostalgic connections are too valuable.)
Integrated into my diet are tofu and tempeh; fermented foods like sauerkraut; beans, legumes, nuts, and seeds; and lots of spices.
Sugar is completely eliminated from my diet, with exception of an occasional indulgence in 85 percent dark chocolate. I sometimes use agave, stevia, or molasses. When dining out, I always ask about sugar content because it seems to be in everything, even at vegan restaurants. It’s a mainstay in Chinese food. Most often dishes can be prepared without sugar, so it’s worth asking.
I do not eat processed foods or anything high glycemic (white or whole wheat bread, white rice, white potato) that quickly convert to sugar and spike insulin. The only dairy I consume—a few times each year, typically with my kids while we watch a football game—comes in the form of a pizza: real cheese, white flour and all :).
The vegetable oils I consume are primarily extra virgin cold pressed olive oil, and organic coconut oil.
This is the way I have eaten for a quarter century. I have been largely successful with this food routine—not a diet, per se, simply an accepted part of my everyday lifestyle that supports my body… and mind.
To wash all this down, I exclusively drink reverse osmosis (RO) filtered water. Each day, I aim for one-half ounce of water for every pound of bodyweight. Admittedly, this is hard to keep up with. (And yes, I do wake up at least twice in the night to pee.)
Are other water types such as alkaline, distilled, mineral, oxygenated, or distilled better than reverse osmosis? Perhaps. Some believe that demineralized water (RO) is often on the acidic side, and unless you supplement with minerals, which I do, it can lead to loss of bone mass. For now I am sticking with RO water, but will continue to research other options, and I encourage others to do the same.
Have I been tempted to change my nutrition regimen to ketogenic, 100% raw (veggies), Gerson’s Therapy, macrobiotic, and many other dietary approaches that may support my underlying disease? Not especially, but I read what I can, particularly peer-reviewed, published papers. I try to keep up with live and recorded lectures from nutrition leaders about new approaches based on nutrigenomics and a host of other methods driving the dawn of personalized cancer nutrition.
The ketogenic diet is compelling, generally regarded as safe, and may be appropriate to integrate into your cancer care plan. The human case reports and theory regarding the origin of cancer as a mitochondrial metabolic disease are worthy of consideration.
The role of genetics and genomics influences nutrition science and informs personalized clinical nutrition for cancer patients and survivors. Specifically, nutrigenetics: how your body responds to nutrients based on your genetics; and nutrigenomics: how nutrients affect your body’s expression of your genes.
One Size Does Not Fit All
This is because we are each an n of 1.
I will continue on the path I am on, and will coach survivors in this way of eating.
Animal studies and early clinical evidence, mostly in the form of case reports, are intriguing. They inform on ketogenic diet with intermittent fasting, and/or calorie restriction, for specific diseases such as glioblastoma multiforme (and other types of brain cancers).
I continue to encourage folks to engage an experienced dietician or an integrative oncologist such as Dr. Lemanne to learn more about personalized approaches for their particular situation.
There may not be a one-size-fits-all rule for what to eat as it relates to cancer, however…
An intelligent, balanced approach to cancer prevention, creating an inhospitable environment for active cancer, and to ensure long-term survival, includes:
- eating low on the food chain by consuming lots of cleanly-sourced plants, fruit and vegetables across a rainbow of colors;
- carefully choosing moderate amounts of animal protein;
- avoiding simple carbohydrates;
- staying away from anything processed or in a box;
- remaining hydrated with clean water.
The dietetic world is often confusing, conflicted, and complicated. But it is indisputable that nutrition is a major health determinant, and that poor nutrition is a leading cause of cancer. Investing in well-researched information, and receiving guidance from a well-trained expert in cancer nutrition science and clinical care, will allow you to discover what best fits your unique needs.
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