What Intermittent Fasting Is Not
It can be easier to understand intermittent fasting but talking about what it is not.
- It does not restrict water intake: Water, as well as beverages that do not have calories such as calorie-free soda and water drinks, tea, and coffee are generally allowed.
- It does not define what foods should be eaten or not eaten.
- It does not restrict intake of medications or supplements.
- It does not define or restrict the number of calories eaten while not fasting.
Potential Role And Mechanisms In Treatment Recurrence And Prevention
Intermittent fasting, especially “time-restricted feeding” or “prolonged nighttime fasting” has become very popular, and questions about its potential role in both cancer prevention and treatment have been raised. Early evidence suggests that this strategy has the potential to improve the effectiveness of treatments and reduce side effects, but thus far, only a limited number of studies have been done. With regard to breast cancer, there is evidence that prolonged nighttime fasting may lower the risk of recurrence, a risk we are learning can remain for decades after treatment.
We will take a look at some of the studies that have been done, the potential mechanisms by which it may affect cancer cells, and the potential risks and side effects. Anyone who is living with cancer should talk with their oncologist before considering any dietary regimen, including intermittent fasting.
Water Fasting Is The Ultimate Therapy To Eliminate Cancerous Tumors
When a person reaches one plus keto level, it indicates that they are out of fat. If they go below this level, it means that they have moved from fasting to starving. Dr. Lodi cautions that it is crucial to consult with certified healthcare professionals before, during and after a water fast.
He added, When starvation occurs, the body will consume its own muscles and its organs, so people never want to go into starvation. Thats why it is critical to know the difference and be under medical supervision while on an extended fast.
Water fasting has been linked to several health benefits including promoting autophagy, which is the process wherein old parts of the cell are broken down and recycled. Autophagy can help prevent cancer cells from thriving. Research has also found that water fasting can help lower blood pressure and the risk of chronic diseases like diabetes and heart disease.
Specifically related to cancer, studies have found that water fasting can help fight cancer by decreasing insulin resistance as well as inflammation levels. Fasting is also beneficial in managing obesity and type 2 diabetes, which are risk factors for cancer. It also boosts the immune system to empower the body as it fights off cancer cells.
Find out more about An Oasis of Healings renowned comprehensive cancer care program which incorporates healing modalities, like water fasting, to help the body replace cancer cells with new healthy cells.
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Discussion And Clinical Implications
Clinical research evaluating the potential of STF is still in its infancy and more research is needed as the exact mechanism and effects are not established yet. Remaining questions are: is STF clinically effective in patients with solid tumors, in which tumors is STF effective, which markers are useful for prediction and monitoring of efficacy, what is the optimal length and timing of STF and refeeding, is STF safe in all patients, what is the optimal composition of an FMD, how can we increase patientâs compliance?
Patients at risk for malnutrition or cachexia may not be candidates for STF, as it may be unsafe to further limit nutrient intake in these patients for even a short time . However, notably, in preclinical setting caloric restriction showed even preservation of muscle strength in cancer cachexia . Therefore, robust clinical trials are needed to establish the safety and efficacy of FMD in patients at high risk of cachexia.
Close monitoring of patients by nutritionists with expertise in fasting may be needed to increase compliance in future studies and to prevent patients unacceptable weight loss. Moreover, in our opinion, STF or FMDs should only be applied in the context of clinical research in patients with cancer until there is robust evidence for their safety and benefits.
Types Of Fasting Strategies
Fasting and other dietary interventions are categorised based on the duration of fasting, as shown in Table .
Table 1 Categories of fasting and other diet intervention methods
The most common strategy is short-term fasting , a technique that involves zero-calorie intake and ranges from 24 to 72h. Some reports state that STF may be carried out for extended periods .
Intermittent fasting is another way to limit nutrient intake. IF techniques require a 70% energy restriction every other day, and patients consume only 500700cal two consecutive days a week . The IF strategy has been associated with a reduction of cancer onset and found to prolong lifespans, without the presence of chronic weight loss . Periodic fasting is a modification of the IF strategy, in which patients under PF are subjected to fasting or fasting-mimicking diet ) between 2 to 21days .
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What Looks Most Promising For Intermittent Fasting In Terms Of Fighting Breast Cancer
If intermittent fasting turns out to be a successful fat-loss strategy that improves metabolic health, we could potentially harness these effects to reduce the risk that breast cancer will come back after treatment. We know that metabolic disturbances, like too much insulin and blood sugar, increase the risk of breast cancer recurring. By reducing fat and insulin levels, intermittent fasting could help reduce that risk. Other dietary strategies may prove useful in this as well.
Join a panel of MSK experts on October 14 as they discuss how breast cancer is affected by nutrition and exercise.
Successful fat-loss strategies may also help make treatments work better. For instance, we often give steroids with cancer treatments in order to reduce the side effects of chemotherapy. But the steroids also drive up insulin levels, which we dont want. Diets that keep insulin in balance may help maintain the benefits of the steroids while reducing the drawbacks.
In terms of reducing the risk for developing breast cancer in the first place, its very difficult to design a research trial because there are so many factors that contribute to the development of breast cancer. A lot more long-term research would need to be done before we could make any firm conclusions.
Types Of Intermittent Fasting
Subtypes of intermittent fasting include:
- Prolonged nighttime fasting: This regimen is most commonly studied with respect to cancer, and involves simply extending the period of time between dinner and breakfast. This likely was the “normal” diet eaten by our ancestors in the past, when eating was not as convenient as it is today. A common regimen is the 16/8 method, in which food is eaten between 12 noon and 8 p.m. .
- Time-restricted feeding: This can be the same as prolonged nighttime fasting, and simply defines the hours during which food can be eaten and hours of fasting.
- Short-term fasting: There are a number of varieties of short-term fasting. For example, in alternate-day fasting people alternate between days with no restrictions and days that roughly 25% of average calories are consumed. With whole day fasting, people usually eat normally five days per week, and consume either no calories or 25% of average daily intake two days per week.
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Intermittent Fasting And Cancer Recurrence
Cancer recurrence is not only feared by many people who are diagnosed with early-stage tumors, but a leading cause of death. For example, the majority of women who have stage IV breast cancer were initially diagnosed with early-stage disease and later had a metastatic recurrence. Once breast cancer becomes metastatic, the average life expectancy is only three years, though some people live much longer.
Recent studies highlighting that the risk of breast cancer recurrence does not decrease after five years for women who have estrogen receptor-positive breast cancer has highlighted the need to address ways of reducing the risk of recurrence. In fact, women with hormone-positive breast cancer are more likely to have a recurrence after five years than in the first five years following diagnosis.
A 2016 study looked at the role prolonged nighttime fasting might play in breast cancer recurrence. Over 2,000 women who had been diagnosed with early-stage breast cancer between 1995 and 2007 were evaluated. It was found women who had a short duration of nightly fasting were 36% more likely to experience a breast cancer recurrence than those who had a nighttime fasting duration of more than 13 hours.
Prolonged nighttime fasting may be a simple way to reduce the risk of breast cancer recurrence.
Autophagy And Cancer Therapeutics
Because autophagy can inhibit tumor development or favor tumor growth, progression, invasion and treatment resistance, researchers proposed that autophagy modulation could be a new therapeutic strategy in the treatment of some malignancies :528-42, http://dx.doi.org/10.1038/nrc.2017.53.,4949. Galluzzi L, Bravo-San Pedro JM, Levine B, Green DR, Kroemer G. Pharmacological modulation of autophagy: therapeutic potential and persisting obstacles. Nat Rev Drug Discov. 2017 16:487-511, http://dx.doi.org/10.1038/nrd.2017.22.,5050. Fulda S. Autophagy in Cancer Therapy. Front Oncol. 2017 7:128, http://dx.doi.org/10.3389/fonc.2017.00128.).
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Obesity Adiposity And Cancer Risk And Prognosis
Obese cancer survivors are not only at risk for poorer cancer prognosis, but they also have increased risk of diabetes and cardiovascular, liver, and kidney disease, among many other adiposity-related clinical conditions.- Therefore, there is an urgent need to improve cancer care beyond novel therapeutics by elucidating the effects of diet, exercise, and weight management in cancer prevention and treatment.
Things You Need To Know About Intermittent Fasting And Breast Cancer
Sure, Intermittent Fasting may be all the rage in Hollywood but that doesnt mean its for everyone, especially if youre facing a breast cancer diagnosis and/or treatment. With limited scientific information out there, it might be challenging to make an informed decision about whether IF is right for you. So, we spoke to some experts to help shed some light on IF.
WHAT EXACTLY IS INTERMITTENT FASTING ?
Intermittent fasting is a dietary pattern that involves consuming little to no calories for an extended period of time. According to Jill Shainhouse, a naturopathic doctor who is trained in naturopathic oncology says the most popular fasting to eating ratio is 16:8. That means the fasting period should last around 16 hours followed by eight hours of normal caloric intake. The easiest way to do this is to finish eating by around 8 or 9 P.M., skip breakfast, and resume eating at 12 or 1 P.M. the following day.
ARE THERE STUDIES ON IF AND ITS EFFECT ON BREAST CANCER PATIENTS?
She explains that since our bodies are adapted to eat during the day and sleep at night eating at abnormal times can cause misalignment with the bodys circadian rhythms. Circadian misalignment has been linked to an increased risk of many cancers, including an increased breast cancer risk among shift workers.
WHAT ARE THE BENEFITS OF INTERMITTENT FASTING?
ARE THERE ANY NEGATIVE SIDE EFFECTS TO IF?
FINAL THOUGHTS ON IF AND BREAST CANCER
FOR MORE STORIES ON FOOD AND NUTRITION, .
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Rodent Studies Of Fasting
Because water-only fasting for > 48 to 60 hours is deadly in most strains of laboratory mice, FMDs that can be administered over many days have been developed and tested, with promising results in both mice and humans. These diets are low in protein and carbohydrates, high in unsaturated fat, and provide between 10% and 50% of calories of normal ad libitum intake. In mouse breast cancer and melanoma models, mice underwent 48 to 60 hours of fasting or a 96-hour FMD. The FMD consisted of 1 day of low-calorie broth, vegetable medley powder, olive oil, and essential fatty acids followed by 2 to 4 days of low-calorie broth powders and glycerol. The FMD alone or in combination with chemotherapy was shown to decrease tumor progression as effectively as short-term starvation. The FMD in combination with doxorubicin was found to promote CD3-positive/CD8-positive tumor-infiltrating lymphocytes, a marker of favorable therapeutic response.,
Study Design And Patients
This is a randomized, controlled, observer-blind study. Eligible patients from 11 Dutch centers had histologically confirmed diagnosis of HER2-negative, stage II/III early breast cancer, adequate bone marrow reserve , adequate liver function range, ALAT and/or ASAT 2.5× UNL, Alkaline Phosphatase 5× UNL), adequate renal function , normal cardiac function, a WHO performance state 02, age 18 years, BMI > 19kgm2, absence of diabetes mellitus, absence of allergies for FMD content, and signed informed consent. The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Leiden University Medical Center in agreement with the Dutch law for medical research involving human subjects.
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Could Intermittent Fastingslow Cancer
Early studies of intermittent fasting for breast cancer are underway to see if it slows tumor growth and saves lives.
We live in an age of ever-more complicated and technologically advanced solutions for treating or preventing cancer. Immunotherapies, gene therapies, and radiopharmaceuticals are enormously exciting and very expensive areas of research and development. But even as we race to pursue these possibilities, is there something simple we could be doing in parallel?
Jennifer Ligibel thinks there could be a hack that doesnt involve major expense. She may not recommend intermittent fasting for her breast cancer patients, but the oncologist and Harvard professor says shes well aware of the fact that lots of people are trying it anyway. And she, like them, wants to know whether it will improve outcomes for people with breast cancer. She found eager recruits for her exercise and intermittent fasting trial, which is currently underway.
Many people that we approach are very excited about the idea of trying this because theyve read a lot about some of the observational evidence suggesting that longer overnight fasts are associated with lower risk of breast cancer, she says, noting the evidence suggests fasting can help prevent breast cancers initial development, as well as preventing recurrences. Fasting might slow the diseases progress, too.
The data we were getting were so striking that it made sense to try it myself.
This is not about weight loss
Diet And Cancer Prognosis: Randomized Clinical Trials
The ongoing Breast Cancer Weight Loss Study will help to determine whether weight loss after breast cancer treatment can improve prognosis. However, additional questions will remain, including how such changes may impact treatment efficacy if implemented earlier and whether macronutrient and/or micronutrient dietary modifications can potentiate the effects of weight loss on cancer prognosis, not only for breast cancer but for many other common cancers.
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Fasting Strategies And Clinical Trials
The importance of metabolism in cancer progression indicates that dietary habit is a huge factor in cancer outcomes . Therefore, various fasting techniques have been developed to exploit the nutrient dependency of cancer. Most fasting durations are usually short-termed, ranging from 24 to 72h. The following sections outline the types of fasting strategies and the preliminary observations obtained from ongoing clinical trials.
The Science Behind Fasting And Cancer
Weight loss is just one benefit of intermittent fasting for a normal healthy adult. Recent animal studies and a few preliminary human trials have shown a decrease in risk for cancer or a decrease in cancer growth rates. These studies indicate this may be due to the following effects from fasting:
- stem cells triggered to regenerate the immune system
- balanced nutritional intake
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Reactive Oxygen Species And Dna Damage
Chemotherapeutic agents inflict oxidative stress and DNA damage upon healthy cells, which are underlying mechanisms of toxicity . STF dampens oxidative stress in healthy cells by down-regulating metabolic rate and increasing scavenging of reactive oxygen species , which may contribute to DSR . As serum glucose levels decrease during STF, fatty acids serve as the main energy source. Beta-oxidation of fatty acids produces ketone bodies, which can be used as an alternative/additional fuel. Ketone bodies can also activate pathways involved in protection against ROS . Moreover, STF presumably activates DNA repair processes in healthy cells . For example, in mice fasted for 24âh before high dose infusion of etoposide, less DNA damage was seen in small intestinal stem cells 3âh after the infusion compared to mice who ate ad libitum. As 1.5âh post-treatment DNA damage was similar, DNA repair was likely more efficient in healthy cells due to STF .
In contrast, tumor cells exhibit increased ROS production if chemotherapy is combined with STF in vitro . In breast cancer cells cultured in low glucose medium or serum of fasting mice, a 20-fold increase in DNA damage was seen in response to chemotherapy, as compared to cells cultured in regular medium or in serum of ad libitum fed mice .
Dr Valter Longo Fasting Mimicking Diet Improves Breast Cancer Treatment
The most powerful medicine is the medicine from within. Dr. Valter Longo
Its been two and a half years, since my last interview with Dr. Valter Longo, and today hes back to share some exciting updates on his ongoing research, specifically on fasting to improve cancer treatment.
Valter Longo PhD is the author of the book, The Longevity Diet, and one of the foremost researchers in the world on fasting, immune system regeneration, and longevity.
Dr. Longo and colleagues also developed the Fasting Mimicking Diet, a 4-5 day, plant-based, calorie-restricted diet, which is used clinically under the name Xentigen and is available to consumers under the brand name ProLon.
In this new interview, Dr. Longo talks about three new studies published in Nature on the impact that a Fasting Mimicking Diet has on cancer cells and cancer treatment. These studies found:
-Breast cancer patients who did a four-day Fasting Mimicking Diet around each chemo cycle had the same amount of side effects as the control group doing chemo, but without taking an additional drug to reduce side effects. The FMD group had a five times better response to chemo than the non-FMD group. They were more likely to experience 90-100% tumor loss and they had far less long-term immune cell damage.
-The Fasting Mimicking Diet combined with IV vitamin C worked better than vitamin C alone.
-Hormone therapy ER+ with FMD caused increased tumor regression and reversed treatment resistance.
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