If we’ve learned nothing else from how researchers and nutrition professionals are beginning to re-examine recommendations that were set in stone for the past thirty years, we should at least take away that no one knows everything. I am a passionate proponent of critically thinking about science and public policy, especially around healthcare. It surprises some people I’ve met in “alternative diet” communities, or groups supporting alternative approaches to cancer treatment, that I am skeptical of just about everything. If I haven’t been clear, let me say that I absolutely do not advocate turning down recommended standard care for cancer. I just think that there are holes in our healthcare management system, and that diet and lifestyle approaches deserve a place in the treatment strategy. I do, however, also support every individuals right to decide what is the best approach for them and their family; I think that to do this, you need access to good credible information. Given that, you should follow your own light.
There’s a quote I like that says “unquestioned beliefs are not beliefs, but superstitions”, attributed to Jose Bergamin. I think this was probably said in reference to religion or politics, but I it’s suitable in reference to diet and lifestyle dogma as well. I think critically questioning information is the key to separating what is true, or at least plausible, from pucky. Given that, this week I undertook a little web research to read what opponents of the ketogenic diet and its value in cancer management might have to say. This is an exercise that I think is important when you find any new claim or information – go out and read both sides of the issue. Look at the sources the information is coming from. Then decide for yourself.
There is a growing body of credible evidence that low carbohydrate and high fat diets are useful in managing epilepsy, for weight loss, and for managing diabetes and many other disorders. The evidence is thinner for cancer management, that much cannot be debated. In my reading, I found an article written by David Gorski entitled “Ketogenic Diet Does Not “Beat Chemo for Almost All Cancers“”, published on Science Based Medicine. In my opinion, this is a well-thought out critique of the claims of Dr. Seyfried regarding the utility of ketogenic diets in cancer management. Dr. Gorski’s key points, in short, are:
1) The basis of the theory behind why ketogenic diets might limit tumour growth is plausible and the historical research of Dr. Otto Warburg, a Nobel Prize winning biochemist, is sound.
2) There are currently some very strong claims being made about the value of this approach by Dr. Seyfried and others working in the field, without equally strong human clinical research in support of these claims.
3) All of the published research studies in this area to date are in rodent models; Gorski provides a short summary of the “current state of the art”.
4) Some anecdotal reports have been published regarding the use of the ketogenic diet in human cancer patients, but they are not well-designed clinical trials; Gorski also summarizes these and outlines what he sees as weaknesses in them.
5) There are, however, some clinical trials currently ongoing that will provide more data; Gorski highlights four trials to watch.
6) It cannot be overstated that with so little real human clinical data, we are not likely at a point where we can say with any confidence that a dietary approach like this can or should replace chemotherapy or other standard of care treatments. I fully agree with this.
If you’re prepared to open your mind to the other side of the argument, I encourage you to read this article. I don’t disagree with much that is presented, and I think it employs a good analytical approach to examining the current state of the research. Put on your thick skin, because it’s also pretty detached, and the comments are downright strident. I did record my own perspective before the comments were closed, and other readers pointed out that my perspective is just one more anecdotal case, and that one person’s perspective doesn’t really count in science. This is a true, if harsh, reality.
All of that said, the only way knowledge ever advances is if thinking people study ideas that are plausible in order to prove or disprove them. And while one person’s story doesn’t really prove or disprove anything, I’m still one person who has to make choices. In order to make those choices, I think it’s responsible to examine opinions on both sides of any issue.