13 ms·

Fasting improves chemotherapy results and protects from side effects: study

355 points by alz 6y ago

deleted 6y ago
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deleted 6y ago
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nabla9 6y ago
I wonder how much the effect is slowing metabolism relative to cancer cells.
- wombatmobile 6y ago
  Fasting has been practiced for millennia, but only recently studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity in part by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions. -- Longo and Mattson https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/
abledon 6y ago
If you have to provide a simple (ELI5, if you mention one scientific word their eyes rollup into their skull etc..) way to view how fasting 'controls' the cancerous growth in the body... sadhguru makes an easily digestible concept of 'crime' in the body [1]. [1] https://www.youtube.com/watch?v=JWnyTJ96upw https://www.youtube.com/watch?v=JWnyTJ96upw
- ramblerman 6y ago
  ELI5 means break down the science into simple concepts that a 5 year old could understand. Not here is some Deepak Chopra figure to explain it to you in voodoo
chipaca 6y ago
In mice.
- markus92 6y ago
  Have you clicked on the link? It's a result from an RCT in women with locally advanced breast cancer.
  - cinntaile 6y ago
    In his defence the abstract starts by talking about mice, which is a bit confusing. Sure they talk about patients as well but it's not immediately clear that mice can't be considered patients. If you read on it becomes clear though!
    - markus92 6y ago
      The title saying it's a multi-centre phase 2 trial makes it extremely clear. You don't do those in animals.
- gwd 6y ago
  On the contrary. It worked in mice, so they tried it on humans; turns out it works in humans too.
- eperfa 6y ago
  The first sentence was misleading to me as well (it does refer to mice, but only as a "was also effective on mice" sense), but the study was done on humans.
Cro_on 6y ago
If there were ever a panacea, it would be fasting. The more tight and widespread the research becomes, the more that we prove what humanity has known anecdotally throughout civilisation. From being a Roman cure for epileptic seizures, through the integral practice in most religions, and to the 21st century where we start to prove that it increases both healthspan and lifespan. I find it quite interesting that something so simple, which practically anybody can do, can have such a positive effect on one's life. You are literally healing and regenerating yourself by doing nothing! And instead of compounding medical bills you actually save money! Thank you modern science for validating my no longer fringe medical beliefs :)
- mmhsieh 6y ago
  while on fasts, you get an energy level and mental clarity that has to be felt to be believed. everyone should try it at least once.
  - Cro_on 6y ago
    i like to persuade people by having them imagine an isolated tiger who hasn't eaten anything in a week. by force of nature their sense of smell, hearing, etc. must all be heightened so as to ensure their survival.
    - milquetoastaf 6y ago
      So you just say a bunch of bullshit...ok
    - SketchySeaBeast 6y ago
      But that's because they are incredibly hungry and food focused, at that point they don't care about taking part in other activities and just want food. That tiger would definitely not be the sort I'd care to be around.
      - Cro_on 6y ago
        understandably! it will no longer be thinking: human animal, could be dangerous.. but a tiger has evolved to be an apex predator, and not much else. our predatory speciality is more about leverage than brute force, or scavenging rather than hunting. so i think the logic still applies that cognition can be improved in a way that is beneficial to modern humans. resourcefulness implying that resources are found / conjured when they appeared to be lacking?
luxurytent 6y ago
What are the recommended ways to fast? I did intermittent fasting for about 5 months to shed 25lbs. It likely contributed, but I was also laser focused on dropping.
- samhh 6y ago
  I've found 20:4 successful only as a means of preventing me from eating too much; prior to IF I'd habitually graze throughout the day. It's basically a diet where you don't have to think that much about what you eat (you should a bit, still, obviously).
- valar_m 6y ago
  I've been doing intermittent fasting for 5 weeks as of today and in that time have lost 22 pounds. I have more energy and have noticed a generally heightened sense of well-being (though perhaps as a result of the weight loss and improved appearance). I am doing 18:6, so I generally eat from 12pm to 6pm. During that time I typically eat two meals, and one or two small snacks. I try to eat pretty healthy, but there have been plenty of times in the past 5 weeks when I've just pigged out at Waffle House. I still have lost significant weight. I have two major recommendations: first, drink tons of water. I try to drink about 16oz of water every hour. Besides hydration, it helps a lot with hunger. You will get hungry at times. For me it isn't every day - some days it's easy to stay on track. Others, it's tough. When you're feeling hungry, chug water. It really helps. (tip: try sparkling water to change things up if you get sick of regular flat water). Second, I recommend using an app to track your fasting. Mine was free and tracks your start and end times for fasting and tells you how long until your fasting period is over. It also lets you track your weight, and even water drinking progress if you want. Last thing - the hardest day of fasting, by far, is the very first day. After that, it will get easier. ETA another tip: If you're doing it for weight loss, don't weigh yourself every day. Your weight will fluctuate a pound or two from one day to the next, and even throughout the day. It can be demoralizing to fast for a day and then the scales tell you that you're up a pound. Instead, weigh yourself maybe twice a week, and always near the end of your fasting period.
wdroz 6y ago
I wonder if a regular keto diet would work. In the study they use the term "fasting mimicking diet".
eperfa 6y ago
Looks like this study was initiated/sponsored by this company, specifically testing the effectiveness on what they call Fasting Mimicking Diet. https://l-nutra.com/pages/fasting-mimicking-diet https://l-nutra.com/pages/fasting-mimicking-diet If I understand correctly this is a low-calorie diet, which is easier to follow than a strict water-only diet, but they claim it is equally effective. They recommend it also for healthy individuals, 5 days a month. Does anyone have experience with it?
- wtetzner 6y ago
  Just from personal experience, I've found that fasting is actually easier that something like a fast-mimicking diet. Maybe there's something physiological going on, or maybe it's just psychological, but I find it much harder to eat a little bit than to just not eat. Then when I do get to eat, I can eat enough to feel satisfied.
  - abledon 6y ago
    drinking light vegetable broth?
- BillyTheKing 6y ago
  I do actually, did it twice this year one week in January and then again during lockdown during the last week of March I think. I heard about it from the guy who came up with it, he wrote a book about the merits of a Mediterranean plant-based diet (with the occasional fish, but no meat) that resonated quite well with me, since it's easy to implement and also really delicious - I mean there isn't really all that much that go wrong with eating vegetables, some bread and pasta, nuts, olive oil, and fish (also had the welcome side-effect to reduce my meat-consumption to pretty much zero now) Anyway, so after I switched my diet I decided to give his FMD a go and was pleasantly surprised - it's pretty tough, the second and third day were the worst for me, I was just incredibly hungry (and honestly speaking I did'n really achieve any mental clarity during those days), just went on a ton of walks. But I felt I gained a lot of mental strength following that experience, it was easier for me change eating or drinking habits simply because this exercise of control over your most basic need really provides you with a boost of confidence. You obviously also lose a lot of weight (around 4kg per week) and I've lost even more since then, maybe 20kg since the beginning of the year (though that's a combination of sport, this pescatarian Mediterranean diet, but probably also those 2 fasting sessions). I plan on doing it again, though I want to try out 'real' water fasting next time. I think this is a great starting-point into fasting, though.
feralimal 6y ago
Or perhaps, fasting is the cure, and can even undo the harm from chemo!
- 0-_-0 6y ago
  If I'm reading this correctly, the "harm from chemo" to the person was about the same, but the "harm from chemo" to the cancer was much more significant in the fasting group.
  - feralimal 6y ago
    Yes. But there are alternative healing ideas that fasting and juicing in themselves can cure cancer.
    - SketchySeaBeast 6y ago
      Wouldn't that be relatively easy to find evidence for? We could look at the change in cancer of Muslim communities during Ramadan?
      - feralimal 6y ago
        Well, there are lots of types of fasting. Juice or water or nothing. Skipping a meal, or not eating solid foods for 3 months. IMO not eating during the day but then eating a lot at night might not be the best type of fast. But even so, it would be interesting to see numbers anyway.
      - newen 6y ago
        Ramadan is not really fasting these days. Most people do feasts every day (or something close to every day) on Ramadan when the sun goes down.
    - SeanLuke 6y ago
      Extraordinary claims require extraordinary evidence. Please provide your extraordinary evidence. Ideally in the form of multiple strong, well-vetted and well respected studies in peer-reviewed journals. Otherwise I'll presume you're full of it.
givan 6y ago
Fasting also has excellent results for treating many illnesses including mental ones. There is a documentary that covers two clinics that offer fasting as a treatment and scientific research in this area. https://www.youtube.com/watch?v=t1b08X-GvRs https://www.youtube.com/watch?v=t1b08X-GvRs
lawlorino 6y ago
Since this is likely to attract a lot of fasting practicioners to the comments I want to ask - I've occasionally tried out fasting or severe calorie restriction in the past but I always seem to get dizzy, weak and shaky in the first 24 hours and have to give up. This seems like a normal physiological response to be honest, how are people either avoiding or coping with this?
- dcolkitt 6y ago
  I've been doing some variant of intermittent fasting for about 8 years now. Of course, I'm not always consistent. There have been days, weeks or even months when I'm not disciplined. At least in my experience, the sense of hunger is extremely tuned to one's internal clock. The body seems to absolutely know at what time of day it expects to eat. If I go a long time and never eat before 6 PM, I won't feel even a tinge of hunger until the evening. If I go on vacation, and eat lunch for a week, then the next day I'm ravenous by 12 PM. The hardest thing about fasting is the transition. Once you've got a pattern, your body seems to pretty much just adjust and it becomes just as normal and effortless as eating breakfast, lunch and dinner. I say that because a lot of people try out fasting for a few days, suffer enormously and decide that the juice isn't worth the squeeze. Whereas I think if you get over the transition hump, most will find it's not nearly as bad as it seems to be when you first start out. One technique that I think makes for a smooth transition is a modified version of partial fasting. To start, instead of completely abstaining during the fast window, restrict yourself to vegetables and berries. Don't touch the higher caloric density foods like meats, dairy, and starches inside the fast window. Truth be told, this probably isn't that bad a diet just to stay on forever, because it ups vegetable consumption so much. But if your goal is full fasting, it's a good way to make a full transition. Your body's internal clock starts getting used to much lower calories consumption in the fast window, but you don't have to feel like you're starving.
- wtetzner 6y ago
  I think it's pretty normal. I don't know for sure, but it's possible that it's more or less the same effect as keto-flu. Make sure that you get plenty of water and electrolytes. Also, if 24 hours is too much, you can try intermittent fasting, and do 16 to 20 hour fasts.
tyingq 6y ago
Interesting. Though cancers that force you to fast, like stomach or esophageal cancer don't have great 5 year survival rates.
- kevinmchugh 6y ago
  That's what I keep thinking. One wrinkle here is that the calorie restricted days are those leading up to chemo, which were the only days my dad (who had esophageal cancer) could eat very much. How could we know if this was survivorship bias? What if the folks who can best comply with the calorie restrictions are those who are already in a good state?
  - blithedale 6y ago
    Their "better response rate" touted at the top ignores the 2/3 of women who couldn't carry out the assigned FMD. When you fold back in those 2/3 of people on that arm, the response rate is the same: "The overall pCR rate was 11.7% and did not differ between the two groups (10.8% in FMD group versus 12.7% in control group; OR 0.830, 95% CI 0.282–2.442, P = 0.735)."
markus92 6y ago
Interesting study with, as always, a lot of caveats. The most we can take from this is that it's worth to study more, the effect is existing but not extreme. I don't get the submitted title here claiming that it protects from side effects. The study does not mention this at all, just that the side effects are similar despite omission of dexamethason in the fasting arm of the trial - it increases appetite, so makes sense to omit it if you want any reasonable compliance rate. As with any fasting and dieting study, compliance is moderate at best. In this study, only 33% of patients were compliant for at least 4 cycles of chemotherapy, out of 12 cycles total. Most of them were compliant with at least once cycle though. Overall, we need some more research on this in a larger trial. This paper is a call for funders to do just that - the trial ended prematurely due to needing to include more patients but there was a lack of funding to do so. I'm currently doing research on a similar patient population, so open to answer any questions.
- cellularmitosis 6y ago
  Do you have any info as to which fasting schedule is most effective?
  - markus92 6y ago
    Unfortunately that is far outside my expertise. The study here used a diet that is supposed to mimick the effects of fasting by having a low calorie/protein diet. In the discussion, they say the effects on a growth factor can be measured in blood plasma after 48 hours of fasting, or 48 hours of this diet. My layman guess is that the best schedule is probably the one you can adhere to.
    - teraku 6y ago
      If it's a low protein diet, couldn't the lack of certain aminoacids which promotes cell growth (and by that, also cancer growth) also aid slowing cancer? Layman here, just popped into my mind.
      - brodouevencode 6y ago
CamelCaseName 6y ago
Correct me if I'm missing something, but this isn't the type of fasting most people in the thread are talking about. In the study they say "FMD" or "Fasting mimicking diet", in particular, Xentigen (ProLon?), which is sold by L-Nutra. These are "healthy plant-based meals". [0] [0] https://l-nutra.com/pages/prolon-nutritional-information https://l-nutra.com/pages/prolon-nutritional-information
- projektfu 6y ago
  At approximately 200 calories per day for 3 days.
scott31 6y ago
> Fasting improves chemotherapy results Does it mean more deaths or less?
Yizahi 6y ago
I'm not doubting the results (yet), but I just can't understand how is this possible. Chemotherapy basically damages host cells, with a lot of collateral damage. It already can cause all sorts of digestive tract problems and weight loss among other things. And now they propose to cut energy intake even more. How is this beneficial I can't understand.
- inglor_cz 6y ago
  Chemotherapy is tuned to kill cells that divide. Cancer cells happen to divide a lot, but sometimes normal healthy cells do too. (Not all of them.) Thus they become collateral damage along the cancerous ones. Hence nausea and other unpleasant effects. If you can persuade the normal healthy cells to hunker down and stop dividing for a while, the killing effect of the drugs will concentrate on the cancerous cells alone. This is what fasting is expected to achieve. It is not alone in this regard, anything that inhibits mTOR (e.g. rapamycin) should in theory have similar effect.
  - Yizahi 6y ago
    Got it, thanks for explanation
- projektfu 6y ago
  The idea, as far as I understand it, is that fasting makes cells more quiescent and less likely to undergo mitosis. But cancer cells cannot respond the same way and continue dividing, causing more specific uptake of chemo drugs that damage cells during mitosis. Fewer bystanders get damaged.
temptemptemp111 6y ago
No; this is the opposite of the truth. Food, with its nutrients, protects from the toxicity of "chemotherapy." Just look at the studies showing Vitamin C as protective & synergistic with chemotherapy. Those should cast doubt upon this; not the other way around. "Nature" is clearly corrupt.
jungletime 6y ago
If this turns out to be true, then the practice through the centuries, of a "Religious Pilgrimage" might be effective too. Walking all day, with little food, would put someone in a calorie deficit, combined the stress of extraneous exercise might trigger cell death in cancer cells. Perhaps, completely changing one's environment. Example going from a city to live in a forrest, might also trigger different genetic pathways, and awaken the immune system. Many narrative stories have this pattern of someone getting sick and retreating, going into nature, in pursuit of fresh air or sunshine.
valuearb 6y ago
Reproducibility crisis.
ideals 6y ago
If you aggressively fast on chemo you must must must take vitamins. Have seen personally what can happen when one does this without supplementing and have a result of low levels of thiamine which is lethal and has life long effects when it isn't.
vmchale 6y ago
Did not expect this.
mensetmanusman 6y ago
Wish fasting was a part of our culture more regularly. With almost half of America now obese, we are seeing the downside of ignoring good diet as COVID devastates those suffering from obesity and diabetes.
maerF0x0 6y ago
EDIT: I had a misled belief. Here's a better source: https://www.cancer.org/treatment/treatments-and-side-effects/complementary-and-alternative-medicine/marijuana-and-cancer.html https://www.cancer.org/treatment/treatments-and-side-effects... Ignore below... Wasn't the whole impetus for getting "medicinal" marijuana for the snacking? Seems like someone is talking out both sides of their mouth. Nonetheless glad to see additional evidence for fasting's multiple benefits.
- bitdizzy 6y ago
  The use of marijuana for chemo patients is to manage the extreme nausea that accompanies the treatment. It's not about the munchies per se.
  - maerF0x0 6y ago
    Noted, thank you
throw5543245 6y ago
> Essentially, fasting causes a switch in healthy cells from a proliferative state towards a maintenance and repair state. Is this autophagy? In this interview with Dr. Eileen White, Chief Scientific Officer at the Rutgers Cancer Institute, she mentions that certain types of cancer cells can actually use the effects of autophagy to survive. https://peterattiamd.com/eileenwhite/ https://peterattiamd.com/eileenwhite/
perl4ever 6y ago
In case anyone else, like me, saw "pCR" and didn't know what it meant, I believe that it means "pathologic complete response". Not "polymerase chain reaction" which is all you get by googling. It's really unfortunate people use overloaded acronyms like this without a definition.
voisin 6y ago
If you read “Tripping over the Truth: The Metabolic Theory of Cancer”[0], the fundamentals of this are discussed quite extensively. Highly recommended for anyone interested in both fasting and cancer. [0] https://www.goodreads.com/book/show/23496164 https://www.goodreads.com/book/show/23496164
caymanjim 6y ago
Cancer needs sugar. One of the primary ways they detect cancer is via a PET-CT with a radioactive glucose tracer. It lights up where glucose uptake is the highest. This article talks about starving cells going into defensive repair mode, but also about how energy-hungry cancer cells are. I had cancer (lymphoma) and did three years of chemo (mostly maintenance/preventative, as it was wiped out in the first couple months). I actually gained an enormous amount of weight, because the steroids I was on (and all the weed I smoked) made me ravenously hungry. If I end up in that situation again, I'm going to make a concerted effort to dramatically reduce my calorie intake, and in particularly carbs, because I've read a lot about the potential benefits of starving the cancer out.
- agumonkey 6y ago
  A young biology researcher pitched in to explain the warburg factor in tumors, he made a long paragraph explaining the oh so twisted metabolysm of cancerous cells. The amount of counter intuitive disruptions that mechanically benefited the tumoral tissue was .. almost impressive.
  - faeyanpiraat 6y ago
    Could you give examples?
    - agumonkey 6y ago
      I forgot but let me try: - cancerous cells often break the mitochondria forcing cell into a secondary respiration mode - they also trigger vascular growth but chaotically - since the cell is in this alternative respiration, they don't need normal arteries to get energy so the chaotic arterial network they grow is not a problem - IIRC this network also impedes chemotoxins to reach the cell as fast as normal cells - if you starve your body from sugar, you'll hurt the normal cells (which are in full respiration mode) while the cancerous will keep their metabolysm It was a bunch of things like this but when you take distance, you have a dysfunctional cell that somehow is setup to construct a near perfect bed of survival in his own destructive processes.. it's almost smart.
blithedale 6y ago
ARGH. ARGH ARGH ARGH. Almost no one reads these papers when stuff like this gets posted on HN. And there is shameful statistical fuckery afoot in this paper. People are only repeating the hype statistics at the top of the paper. Their "pathological response" rates touted at the top of paper only come from the 1/3 of women able to actually carry out the diet. This is the "per-protocol" language in the abstract. An honest evaluation here would be "intention to treat" and analyze chemo responses in every assigned to each arm. And they do that evaulation, but bury it later in their paper. Turns out when you account for the 2/3 of women who can't do that fasting, there's NO DIFFERENCE in response rate: "The overall pCR rate was 11.7% and did not differ between the two groups (10.8% in FMD group versus 12.7% in control group; OR 0.830, 95% CI 0.282–2.442, P = 0.735." Argh...
- blithedale 6y ago
  A lot of people might think "Ah, well, fasting is clearly effective for the 1/3 that are able to carry it out, just gotta make sure you have the willpower to be the 1/3." But hold on. Slow down. There's a good chance the "women who fasted had better chemo responses" story completely REVERSES cause and effect. Here's how: WOMEN 1 - Has indolent biology, slower growing tumor than your average breast cancer at this stage. - Symptoms: Less pain, neuropathy, less swelling, tumors not affecting distant organs as much WOMEN 2 - Has aggressive biology, faster growing tumor than your average breast cancer at this stage. - Symptoms: More pain, neuropathy, more swelling, tumors begin to affect distant organs So ask yourself: Which women is more likely to be able to follow a strictly regimented diet? Clearly WOMEN 1.
  - blithedale 6y ago
    This is like making people with cancer do an Ironman triathalon. People about to enter hospice and pass on in a few weeks are gonna be way less able to complete it than someone who has months left to live. But all you've done is stratify your patients. The triathalon doesn't make anyone live longer.
- markus92 6y ago
  That's absolutely right and it's a major problem of this study. There is one caveat though, in the most common ER+ breast cancer, radiological response is more predictive of survival than pCR. And in this study, they do observe a better radiological response in the fasting group, even when looking at ITT (though just barely significant).
resoluteteeth 6y ago
I haven't read the article yet but I just want to point out something that may be fairly important to understand here: chemotherapy drugs target cellular division. This means that if fasting slows down cellular division in normal cells but not cancer cells, it could make the chemotherapy drugs able to target the cancer cells more selectively than normal. However, this would not necessarily translate into anything relating to situations in which chemotherapy drugs are not being taken.

355 points by alz 6y ago

deleted 6y ago

[deleted]

deleted 6y ago

[deleted]

nabla9 6y ago

I wonder how much the effect is slowing metabolism relative to cancer cells.

wombatmobile 6y ago
Fasting has been practiced for millennia, but only recently studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity in part by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions. -- Longo and Mattson https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/

abledon 6y ago

If you have to provide a simple (ELI5, if you mention one scientific word their eyes rollup into their skull etc..) way to view how fasting 'controls' the cancerous growth in the body... sadhguru makes an easily digestible concept of 'crime' in the body [1]. [1] https://www.youtube.com/watch?v=JWnyTJ96upw https://www.youtube.com/watch?v=JWnyTJ96upw

ramblerman 6y ago
ELI5 means break down the science into simple concepts that a 5 year old could understand. Not here is some Deepak Chopra figure to explain it to you in voodoo

chipaca 6y ago

In mice.

markus92 6y ago
Have you clicked on the link? It's a result from an RCT in women with locally advanced breast cancer.
- cinntaile 6y ago
  In his defence the abstract starts by talking about mice, which is a bit confusing. Sure they talk about patients as well but it's not immediately clear that mice can't be considered patients. If you read on it becomes clear though!
  - markus92 6y ago
    The title saying it's a multi-centre phase 2 trial makes it extremely clear. You don't do those in animals.
gwd 6y ago
On the contrary. It worked in mice, so they tried it on humans; turns out it works in humans too.
eperfa 6y ago
The first sentence was misleading to me as well (it does refer to mice, but only as a "was also effective on mice" sense), but the study was done on humans.

Cro_on 6y ago

If there were ever a panacea, it would be fasting. The more tight and widespread the research becomes, the more that we prove what humanity has known anecdotally throughout civilisation. From being a Roman cure for epileptic seizures, through the integral practice in most religions, and to the 21st century where we start to prove that it increases both healthspan and lifespan. I find it quite interesting that something so simple, which practically anybody can do, can have such a positive effect on one's life. You are literally healing and regenerating yourself by doing nothing! And instead of compounding medical bills you actually save money! Thank you modern science for validating my no longer fringe medical beliefs :)

mmhsieh 6y ago
while on fasts, you get an energy level and mental clarity that has to be felt to be believed. everyone should try it at least once.
- Cro_on 6y ago
  i like to persuade people by having them imagine an isolated tiger who hasn't eaten anything in a week. by force of nature their sense of smell, hearing, etc. must all be heightened so as to ensure their survival.
  - milquetoastaf 6y ago
    So you just say a bunch of bullshit...ok
  - SketchySeaBeast 6y ago
    But that's because they are incredibly hungry and food focused, at that point they don't care about taking part in other activities and just want food. That tiger would definitely not be the sort I'd care to be around.
    - Cro_on 6y ago
      understandably! it will no longer be thinking: human animal, could be dangerous.. but a tiger has evolved to be an apex predator, and not much else. our predatory speciality is more about leverage than brute force, or scavenging rather than hunting. so i think the logic still applies that cognition can be improved in a way that is beneficial to modern humans. resourcefulness implying that resources are found / conjured when they appeared to be lacking?

luxurytent 6y ago

What are the recommended ways to fast? I did intermittent fasting for about 5 months to shed 25lbs. It likely contributed, but I was also laser focused on dropping.

samhh 6y ago
I've found 20:4 successful only as a means of preventing me from eating too much; prior to IF I'd habitually graze throughout the day. It's basically a diet where you don't have to think that much about what you eat (you should a bit, still, obviously).
valar_m 6y ago
I've been doing intermittent fasting for 5 weeks as of today and in that time have lost 22 pounds. I have more energy and have noticed a generally heightened sense of well-being (though perhaps as a result of the weight loss and improved appearance). I am doing 18:6, so I generally eat from 12pm to 6pm. During that time I typically eat two meals, and one or two small snacks. I try to eat pretty healthy, but there have been plenty of times in the past 5 weeks when I've just pigged out at Waffle House. I still have lost significant weight. I have two major recommendations: first, drink tons of water. I try to drink about 16oz of water every hour. Besides hydration, it helps a lot with hunger. You will get hungry at times. For me it isn't every day - some days it's easy to stay on track. Others, it's tough. When you're feeling hungry, chug water. It really helps. (tip: try sparkling water to change things up if you get sick of regular flat water). Second, I recommend using an app to track your fasting. Mine was free and tracks your start and end times for fasting and tells you how long until your fasting period is over. It also lets you track your weight, and even water drinking progress if you want. Last thing - the hardest day of fasting, by far, is the very first day. After that, it will get easier. ETA another tip: If you're doing it for weight loss, don't weigh yourself every day. Your weight will fluctuate a pound or two from one day to the next, and even throughout the day. It can be demoralizing to fast for a day and then the scales tell you that you're up a pound. Instead, weigh yourself maybe twice a week, and always near the end of your fasting period.

wdroz 6y ago

I wonder if a regular keto diet would work. In the study they use the term "fasting mimicking diet".

eperfa 6y ago

Looks like this study was initiated/sponsored by this company, specifically testing the effectiveness on what they call Fasting Mimicking Diet. https://l-nutra.com/pages/fasting-mimicking-diet https://l-nutra.com/pages/fasting-mimicking-diet If I understand correctly this is a low-calorie diet, which is easier to follow than a strict water-only diet, but they claim it is equally effective. They recommend it also for healthy individuals, 5 days a month. Does anyone have experience with it?

wtetzner 6y ago
Just from personal experience, I've found that fasting is actually easier that something like a fast-mimicking diet. Maybe there's something physiological going on, or maybe it's just psychological, but I find it much harder to eat a little bit than to just not eat. Then when I do get to eat, I can eat enough to feel satisfied.
- abledon 6y ago
  drinking light vegetable broth?
BillyTheKing 6y ago
I do actually, did it twice this year one week in January and then again during lockdown during the last week of March I think. I heard about it from the guy who came up with it, he wrote a book about the merits of a Mediterranean plant-based diet (with the occasional fish, but no meat) that resonated quite well with me, since it's easy to implement and also really delicious - I mean there isn't really all that much that go wrong with eating vegetables, some bread and pasta, nuts, olive oil, and fish (also had the welcome side-effect to reduce my meat-consumption to pretty much zero now) Anyway, so after I switched my diet I decided to give his FMD a go and was pleasantly surprised - it's pretty tough, the second and third day were the worst for me, I was just incredibly hungry (and honestly speaking I did'n really achieve any mental clarity during those days), just went on a ton of walks. But I felt I gained a lot of mental strength following that experience, it was easier for me change eating or drinking habits simply because this exercise of control over your most basic need really provides you with a boost of confidence. You obviously also lose a lot of weight (around 4kg per week) and I've lost even more since then, maybe 20kg since the beginning of the year (though that's a combination of sport, this pescatarian Mediterranean diet, but probably also those 2 fasting sessions). I plan on doing it again, though I want to try out 'real' water fasting next time. I think this is a great starting-point into fasting, though.

feralimal 6y ago

Or perhaps, fasting is the cure, and can even undo the harm from chemo!

0-_-0 6y ago
If I'm reading this correctly, the "harm from chemo" to the person was about the same, but the "harm from chemo" to the cancer was much more significant in the fasting group.
- feralimal 6y ago
  Yes. But there are alternative healing ideas that fasting and juicing in themselves can cure cancer.
  - SketchySeaBeast 6y ago
    Wouldn't that be relatively easy to find evidence for? We could look at the change in cancer of Muslim communities during Ramadan?
    - feralimal 6y ago
      Well, there are lots of types of fasting. Juice or water or nothing. Skipping a meal, or not eating solid foods for 3 months. IMO not eating during the day but then eating a lot at night might not be the best type of fast. But even so, it would be interesting to see numbers anyway.
    - newen 6y ago
      Ramadan is not really fasting these days. Most people do feasts every day (or something close to every day) on Ramadan when the sun goes down.
  - SeanLuke 6y ago
    Extraordinary claims require extraordinary evidence. Please provide your extraordinary evidence. Ideally in the form of multiple strong, well-vetted and well respected studies in peer-reviewed journals. Otherwise I'll presume you're full of it.

givan 6y ago

Fasting also has excellent results for treating many illnesses including mental ones. There is a documentary that covers two clinics that offer fasting as a treatment and scientific research in this area. https://www.youtube.com/watch?v=t1b08X-GvRs https://www.youtube.com/watch?v=t1b08X-GvRs

lawlorino 6y ago

Since this is likely to attract a lot of fasting practicioners to the comments I want to ask - I've occasionally tried out fasting or severe calorie restriction in the past but I always seem to get dizzy, weak and shaky in the first 24 hours and have to give up. This seems like a normal physiological response to be honest, how are people either avoiding or coping with this?

dcolkitt 6y ago
I've been doing some variant of intermittent fasting for about 8 years now. Of course, I'm not always consistent. There have been days, weeks or even months when I'm not disciplined. At least in my experience, the sense of hunger is extremely tuned to one's internal clock. The body seems to absolutely know at what time of day it expects to eat. If I go a long time and never eat before 6 PM, I won't feel even a tinge of hunger until the evening. If I go on vacation, and eat lunch for a week, then the next day I'm ravenous by 12 PM. The hardest thing about fasting is the transition. Once you've got a pattern, your body seems to pretty much just adjust and it becomes just as normal and effortless as eating breakfast, lunch and dinner. I say that because a lot of people try out fasting for a few days, suffer enormously and decide that the juice isn't worth the squeeze. Whereas I think if you get over the transition hump, most will find it's not nearly as bad as it seems to be when you first start out. One technique that I think makes for a smooth transition is a modified version of partial fasting. To start, instead of completely abstaining during the fast window, restrict yourself to vegetables and berries. Don't touch the higher caloric density foods like meats, dairy, and starches inside the fast window. Truth be told, this probably isn't that bad a diet just to stay on forever, because it ups vegetable consumption so much. But if your goal is full fasting, it's a good way to make a full transition. Your body's internal clock starts getting used to much lower calories consumption in the fast window, but you don't have to feel like you're starving.
wtetzner 6y ago
I think it's pretty normal. I don't know for sure, but it's possible that it's more or less the same effect as keto-flu. Make sure that you get plenty of water and electrolytes. Also, if 24 hours is too much, you can try intermittent fasting, and do 16 to 20 hour fasts.

tyingq 6y ago

Interesting. Though cancers that force you to fast, like stomach or esophageal cancer don't have great 5 year survival rates.

kevinmchugh 6y ago
That's what I keep thinking. One wrinkle here is that the calorie restricted days are those leading up to chemo, which were the only days my dad (who had esophageal cancer) could eat very much. How could we know if this was survivorship bias? What if the folks who can best comply with the calorie restrictions are those who are already in a good state?
- blithedale 6y ago
  Their "better response rate" touted at the top ignores the 2/3 of women who couldn't carry out the assigned FMD. When you fold back in those 2/3 of people on that arm, the response rate is the same: "The overall pCR rate was 11.7% and did not differ between the two groups (10.8% in FMD group versus 12.7% in control group; OR 0.830, 95% CI 0.282–2.442, P = 0.735)."

markus92 6y ago

Interesting study with, as always, a lot of caveats. The most we can take from this is that it's worth to study more, the effect is existing but not extreme. I don't get the submitted title here claiming that it protects from side effects. The study does not mention this at all, just that the side effects are similar despite omission of dexamethason in the fasting arm of the trial - it increases appetite, so makes sense to omit it if you want any reasonable compliance rate. As with any fasting and dieting study, compliance is moderate at best. In this study, only 33% of patients were compliant for at least 4 cycles of chemotherapy, out of 12 cycles total. Most of them were compliant with at least once cycle though. Overall, we need some more research on this in a larger trial. This paper is a call for funders to do just that - the trial ended prematurely due to needing to include more patients but there was a lack of funding to do so. I'm currently doing research on a similar patient population, so open to answer any questions.

cellularmitosis 6y ago
Do you have any info as to which fasting schedule is most effective?
- markus92 6y ago
  Unfortunately that is far outside my expertise. The study here used a diet that is supposed to mimick the effects of fasting by having a low calorie/protein diet. In the discussion, they say the effects on a growth factor can be measured in blood plasma after 48 hours of fasting, or 48 hours of this diet. My layman guess is that the best schedule is probably the one you can adhere to.
  - teraku 6y ago
    If it's a low protein diet, couldn't the lack of certain aminoacids which promotes cell growth (and by that, also cancer growth) also aid slowing cancer? Layman here, just popped into my mind.
    - brodouevencode 6y ago

CamelCaseName 6y ago

Correct me if I'm missing something, but this isn't the type of fasting most people in the thread are talking about. In the study they say "FMD" or "Fasting mimicking diet", in particular, Xentigen (ProLon?), which is sold by L-Nutra. These are "healthy plant-based meals". [0] [0] https://l-nutra.com/pages/prolon-nutritional-information https://l-nutra.com/pages/prolon-nutritional-information

projektfu 6y ago
At approximately 200 calories per day for 3 days.

scott31 6y ago

> Fasting improves chemotherapy results Does it mean more deaths or less?

Yizahi 6y ago

I'm not doubting the results (yet), but I just can't understand how is this possible. Chemotherapy basically damages host cells, with a lot of collateral damage. It already can cause all sorts of digestive tract problems and weight loss among other things. And now they propose to cut energy intake even more. How is this beneficial I can't understand.

inglor_cz 6y ago
Chemotherapy is tuned to kill cells that divide. Cancer cells happen to divide a lot, but sometimes normal healthy cells do too. (Not all of them.) Thus they become collateral damage along the cancerous ones. Hence nausea and other unpleasant effects. If you can persuade the normal healthy cells to hunker down and stop dividing for a while, the killing effect of the drugs will concentrate on the cancerous cells alone. This is what fasting is expected to achieve. It is not alone in this regard, anything that inhibits mTOR (e.g. rapamycin) should in theory have similar effect.
- Yizahi 6y ago
  Got it, thanks for explanation
projektfu 6y ago
The idea, as far as I understand it, is that fasting makes cells more quiescent and less likely to undergo mitosis. But cancer cells cannot respond the same way and continue dividing, causing more specific uptake of chemo drugs that damage cells during mitosis. Fewer bystanders get damaged.

temptemptemp111 6y ago

No; this is the opposite of the truth. Food, with its nutrients, protects from the toxicity of "chemotherapy." Just look at the studies showing Vitamin C as protective & synergistic with chemotherapy. Those should cast doubt upon this; not the other way around. "Nature" is clearly corrupt.

jungletime 6y ago

If this turns out to be true, then the practice through the centuries, of a "Religious Pilgrimage" might be effective too. Walking all day, with little food, would put someone in a calorie deficit, combined the stress of extraneous exercise might trigger cell death in cancer cells. Perhaps, completely changing one's environment. Example going from a city to live in a forrest, might also trigger different genetic pathways, and awaken the immune system. Many narrative stories have this pattern of someone getting sick and retreating, going into nature, in pursuit of fresh air or sunshine.

valuearb 6y ago

Reproducibility crisis.

ideals 6y ago

If you aggressively fast on chemo you must must must take vitamins. Have seen personally what can happen when one does this without supplementing and have a result of low levels of thiamine which is lethal and has life long effects when it isn't.

vmchale 6y ago

Did not expect this.

mensetmanusman 6y ago

Wish fasting was a part of our culture more regularly. With almost half of America now obese, we are seeing the downside of ignoring good diet as COVID devastates those suffering from obesity and diabetes.

maerF0x0 6y ago

EDIT: I had a misled belief. Here's a better source: https://www.cancer.org/treatment/treatments-and-side-effects/complementary-and-alternative-medicine/marijuana-and-cancer.html https://www.cancer.org/treatment/treatments-and-side-effects... Ignore below... Wasn't the whole impetus for getting "medicinal" marijuana for the snacking? Seems like someone is talking out both sides of their mouth. Nonetheless glad to see additional evidence for fasting's multiple benefits.

bitdizzy 6y ago
The use of marijuana for chemo patients is to manage the extreme nausea that accompanies the treatment. It's not about the munchies per se.
- maerF0x0 6y ago
  Noted, thank you

throw5543245 6y ago

> Essentially, fasting causes a switch in healthy cells from a proliferative state towards a maintenance and repair state. Is this autophagy? In this interview with Dr. Eileen White, Chief Scientific Officer at the Rutgers Cancer Institute, she mentions that certain types of cancer cells can actually use the effects of autophagy to survive. https://peterattiamd.com/eileenwhite/ https://peterattiamd.com/eileenwhite/

perl4ever 6y ago

In case anyone else, like me, saw "pCR" and didn't know what it meant, I believe that it means "pathologic complete response". Not "polymerase chain reaction" which is all you get by googling. It's really unfortunate people use overloaded acronyms like this without a definition.

voisin 6y ago

If you read “Tripping over the Truth: The Metabolic Theory of Cancer”[0], the fundamentals of this are discussed quite extensively. Highly recommended for anyone interested in both fasting and cancer. [0] https://www.goodreads.com/book/show/23496164 https://www.goodreads.com/book/show/23496164

caymanjim 6y ago

Cancer needs sugar. One of the primary ways they detect cancer is via a PET-CT with a radioactive glucose tracer. It lights up where glucose uptake is the highest. This article talks about starving cells going into defensive repair mode, but also about how energy-hungry cancer cells are. I had cancer (lymphoma) and did three years of chemo (mostly maintenance/preventative, as it was wiped out in the first couple months). I actually gained an enormous amount of weight, because the steroids I was on (and all the weed I smoked) made me ravenously hungry. If I end up in that situation again, I'm going to make a concerted effort to dramatically reduce my calorie intake, and in particularly carbs, because I've read a lot about the potential benefits of starving the cancer out.

agumonkey 6y ago
A young biology researcher pitched in to explain the warburg factor in tumors, he made a long paragraph explaining the oh so twisted metabolysm of cancerous cells. The amount of counter intuitive disruptions that mechanically benefited the tumoral tissue was .. almost impressive.
- faeyanpiraat 6y ago
  Could you give examples?
  - agumonkey 6y ago
    I forgot but let me try: - cancerous cells often break the mitochondria forcing cell into a secondary respiration mode - they also trigger vascular growth but chaotically - since the cell is in this alternative respiration, they don't need normal arteries to get energy so the chaotic arterial network they grow is not a problem - IIRC this network also impedes chemotoxins to reach the cell as fast as normal cells - if you starve your body from sugar, you'll hurt the normal cells (which are in full respiration mode) while the cancerous will keep their metabolysm It was a bunch of things like this but when you take distance, you have a dysfunctional cell that somehow is setup to construct a near perfect bed of survival in his own destructive processes.. it's almost smart.

blithedale 6y ago

ARGH. ARGH ARGH ARGH. Almost no one reads these papers when stuff like this gets posted on HN. And there is shameful statistical fuckery afoot in this paper. People are only repeating the hype statistics at the top of the paper. Their "pathological response" rates touted at the top of paper only come from the 1/3 of women able to actually carry out the diet. This is the "per-protocol" language in the abstract. An honest evaluation here would be "intention to treat" and analyze chemo responses in every assigned to each arm. And they do that evaulation, but bury it later in their paper. Turns out when you account for the 2/3 of women who can't do that fasting, there's NO DIFFERENCE in response rate: "The overall pCR rate was 11.7% and did not differ between the two groups (10.8% in FMD group versus 12.7% in control group; OR 0.830, 95% CI 0.282–2.442, P = 0.735." Argh...

blithedale 6y ago
A lot of people might think "Ah, well, fasting is clearly effective for the 1/3 that are able to carry it out, just gotta make sure you have the willpower to be the 1/3." But hold on. Slow down. There's a good chance the "women who fasted had better chemo responses" story completely REVERSES cause and effect. Here's how: WOMEN 1 - Has indolent biology, slower growing tumor than your average breast cancer at this stage. - Symptoms: Less pain, neuropathy, less swelling, tumors not affecting distant organs as much WOMEN 2 - Has aggressive biology, faster growing tumor than your average breast cancer at this stage. - Symptoms: More pain, neuropathy, more swelling, tumors begin to affect distant organs So ask yourself: Which women is more likely to be able to follow a strictly regimented diet? Clearly WOMEN 1.
- blithedale 6y ago
  This is like making people with cancer do an Ironman triathalon. People about to enter hospice and pass on in a few weeks are gonna be way less able to complete it than someone who has months left to live. But all you've done is stratify your patients. The triathalon doesn't make anyone live longer.
markus92 6y ago
That's absolutely right and it's a major problem of this study. There is one caveat though, in the most common ER+ breast cancer, radiological response is more predictive of survival than pCR. And in this study, they do observe a better radiological response in the fasting group, even when looking at ITT (though just barely significant).

resoluteteeth 6y ago

I haven't read the article yet but I just want to point out something that may be fairly important to understand here: chemotherapy drugs target cellular division. This means that if fasting slows down cellular division in normal cells but not cancer cells, it could make the chemotherapy drugs able to target the cancer cells more selectively than normal. However, this would not necessarily translate into anything relating to situations in which chemotherapy drugs are not being taken.