8 ms·

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

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
      Don't cancer cells also require massive amounts of glucose to survive?
      - foobiekr 6y ago
        I think you are referring to the Warburg effect: https://en.m.wikipedia.org/wiki/Warburg_effect_(oncology) https://en.m.wikipedia.org/wiki/Warburg_effect_(oncology)
    - unishark 6y ago
      The explanation in the article is sort of along those lines, if cancer cells' inability to switch to a protective state is due to their faulty programming always keeping them in a growth mode: "Essentially, fasting causes a switch in healthy cells from a proliferative state towards a maintenance and repair state. Malignant cells, in contrast, seem to be unable to enter this protective state because of oncoprotein activity, and therefore fail to adapt to nutrient scarce conditions. Instead, fasting deprives proliferating cancer cells of nutrients, growth and other factors, which renders them more sensitive to cancer therapy and increases cell death"
- deleted 6y ago
  [deleted]
- rladd 6y ago
  This is what they mean by fasting mimicking diet, and includes the schedule: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(15)00224-7 https://www.cell.com/cell-metabolism/fulltext/S1550-4131(15)...
  - RSchaeffer 6y ago
    Why make people search instead of quoting the relevant section? "The human fasting mimicking diet (FMD) program is a plant-based diet program designed to attain fasting-like effects while providing micronutrient nourishment (vitamins, minerals, etc.) and minimize the burden of fasting. It comprises proprietary vegetable-based soups, energy bars, energy drinks, chip snacks, chamomile flower tea, and a vegetable supplement formula tablet (Table S4). The human FMD diet consists of a 5 day regimen: day 1 of the diet supplies ∼1,090 kcal (10% protein, 56% fat, 34% carbohydrate), days 2–5 are identical in formulation and provide 725 kcal (9% protein, 44% fat, 47% carbohydrate)." "Subjects in the FMD cohort consumed the provided experimental diet consisting of 3 cycles of 5 continuous days of FMD followed by 25 days of normal food intake."
keithwarren 6y ago
My wife is Stage 3, ++- (43 yo) and half way through the taxol phase of an ACT regimen; she is progressing well but I know she has the discipline to do a fasting diet if we thought it would help. Any thoughts on starting this mid-way through the treatment?
- eperfa 6y ago
  Absolutely not a doctor, so no way qualified to give professional advice, but the article states that not everyone followed the diet during all treatments, so they included all patients who complied at least during half of the cases, and the positive results are based on this extended group. This, and the suggested mechanism of why they think the method works, would lead me to believe that it makes sense to try it. Wish you & your wife strength and all the best.
- Funes- 6y ago
  Try it. My mom (she left us last year at only 53, unfortunately) and I did intermittent fasting (>=16 hours), and ate a super clean and mainly ovolactovegetarian diet for most of her illness. Her life expectancy was only six months, with breast cancer and methastasis; she endured six years. Do anything you can to help her be healthy. Diet is of extreme impoortance.
  - deleted 6y ago
    [deleted]
- wonder_er 6y ago
  I'm not a doctor, but after reading Tripping Over the Truth: The Metabolic Theory of Cancer [0] I'd strongly suggest she start fasting, or, far better, order yourself a copy of the book (epubs available for purchase/torrent) and read it, decide for yourself. There are a lot of resources listed in the book for people who have cancer. I'm trying to get people to read the book. Average people, for sure, but also people on boards of research institutions. I wrote this to one of them: https://josh.works/mike-clayville-can-have-a-huge-impact-on-cancer https://josh.works/mike-clayville-can-have-a-huge-impact-on-... [0] https://www.goodreads.com/book/show/23496164-tripping-over-the-truth https://www.goodreads.com/book/show/23496164-tripping-over-t... The ideas contained in the book are explosive, with profound implications. It's a riveting read.
alz 6y ago
You may be right, but the reason I put that in the title was because it begins by siting a bunch of other research evidencing that “short-term fasting ...can protect healthy cells against a wide variety of stressors, including chemotherapy”, because in the trial they were able to omit dexamethasone with no negative effects, and because “chemotherapy-induced DNA damage in T-lymphocytes“ was “significantly curtailed”
NewOrderNow 6y ago
I started fasting every Monday for multiple reasons: reduce caloric intake, the recent studies on reduction of cancer growth (family history cancer and heart issues), and optimizing brain functions. What are some of the downsides to doing this?
- yurishimo 6y ago
  Hello! Long time faster here (lost over 80lbs in about 9 months with basically zero exercise). One potential downside to steady regimented fasting _when combined_ with caloric restriction, is a decrease in your basal metabolic rate (BMR). Our bodies are very good at adapting to "the new normal" and will optimize itself to function on the fuel you give it. This is true in both directions. If you eat less, your body will learn to live on less, and if you eat more, eventually your body will ramp up to try and burn more energy to try and reach an equilibrium. When fasting, it's important to keep your caloric intake up during brief eating windows. Otherwise, your body will adjust, and when you stop fasting, the slightly increased caloric intake will cause you to gain weight before your body readjusts to the new normal. Many fasting theorists suggest that fasting at random intervals is the best strategy for weight loss without reducing BMR. If your body is used to burning 3000 calories a day just to keep you alive, it can't ramp down those cells immediately so it needs to instead convert stored fat to energy and burn that instead. These aren't fasting specific, but oftentimes in the western world, we begin fasting as a means to an end (weight loss) and often combine it with other dietary changes, like eating less/healthier. The other downside is literal starvation or the development of an eating disorder, but those are pretty obvious. I saw a low-budget documentary on YouTube[0] a couple of weeks ago talking about "fasting retreats" in Russia and now parts of Europe that are seeing great results with patients water fasting for 2+ weeks. They're treating everything from Diabetes to arthritis and dementia. Pretty cool stuff. Personally, I definitely have seen the light and will likely continue fasting regularly in some form the rest of my life. Since I just turned 26 last month, that's going to be a while! I'm currently half way through a 72 hour fast and feeling great. Just had a cup of coffee and some electrolyte spiked water this morning. I still have about 50 pounds to lose but I'm hopefully for my future now and I'm a lot healthier. [0] - https://www.youtube.com/watch?v=t1b08X-GvRs https://www.youtube.com/watch?v=t1b08X-GvRs
late_groomer 6y ago
"Importantly, DNA damage in T-lymphocytes was less in patients who received the FMD in combination with chemotherapy compared to those receiving chemotherapy while on a regular diet" Does this not qualify as a protective effect?
blithedale 6y ago
I'm not convinced the 2/3 dropout rate of the FMD didn't simply select for people with less aggressive tumors, given that the Intention-To-Treat analysis found no difference in response rate, and that this paper is telling a nice story that actually happens to reverse cause and effect. Basically, this? HAS AGGRESSIVE TUMOR ---> CANNOT DO THE FMD HAS SLOW-GROWING TUMOR ---> ABLE TO MAINTAIN FMD Since you're researcher in this field and I'm just a weirdo who likes watching scientists argue on Twitter, I'll ask: Anything you can see in the paper that would give a clearer picture regarding possible bias that might have snuck in?
- markus92 6y ago
  That could very well be a possibility and something that researchers need to address if they wish to investigate this effect a bit further. We can make some educated guesses based on the supplemental table 3. Looking at the staging, grading, tumortype and the hormone receptor status, there don't seem to be any significant differences between the compliant and non-compliant groups. We know that those are the most important factors in assessing how aggressive a breast tumor is, with distinct treatment options and overall survival. So based on this information, I'm inclined to say the cause/effect is not reversed. Of course, there could be some factors determining aggressiveness and response to chemotherapy that we do not know yet. Unfortunately I'm not in regular patient contact so can't say a whole lot about typical side effect profiles of chemotherapy, but I've heard some anecdotal evidence that for patients treated with immunotherapy, the more severe the side effects, the better the response.
  - blithedale 6y ago
    Thanks for clarifying comments here, much appreciated. I have to think my initial comment was overly harsh as well, given Supplement 3. I think all I can say is that it may be possible for this issue to affect their data once they have OS stats accumulated in five years, but it was unlikely to do anything to yield differences in adherence with these kinds of patients over this kind of follow-up length.
- late_groomer 6y ago

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
    Don't cancer cells also require massive amounts of glucose to survive?
    - foobiekr 6y ago
      I think you are referring to the Warburg effect: https://en.m.wikipedia.org/wiki/Warburg_effect_(oncology) https://en.m.wikipedia.org/wiki/Warburg_effect_(oncology)
  - unishark 6y ago
    The explanation in the article is sort of along those lines, if cancer cells' inability to switch to a protective state is due to their faulty programming always keeping them in a growth mode: "Essentially, fasting causes a switch in healthy cells from a proliferative state towards a maintenance and repair state. Malignant cells, in contrast, seem to be unable to enter this protective state because of oncoprotein activity, and therefore fail to adapt to nutrient scarce conditions. Instead, fasting deprives proliferating cancer cells of nutrients, growth and other factors, which renders them more sensitive to cancer therapy and increases cell death"
deleted 6y ago
[deleted]
rladd 6y ago
This is what they mean by fasting mimicking diet, and includes the schedule: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(15)00224-7 https://www.cell.com/cell-metabolism/fulltext/S1550-4131(15)...
- RSchaeffer 6y ago
  Why make people search instead of quoting the relevant section? "The human fasting mimicking diet (FMD) program is a plant-based diet program designed to attain fasting-like effects while providing micronutrient nourishment (vitamins, minerals, etc.) and minimize the burden of fasting. It comprises proprietary vegetable-based soups, energy bars, energy drinks, chip snacks, chamomile flower tea, and a vegetable supplement formula tablet (Table S4). The human FMD diet consists of a 5 day regimen: day 1 of the diet supplies ∼1,090 kcal (10% protein, 56% fat, 34% carbohydrate), days 2–5 are identical in formulation and provide 725 kcal (9% protein, 44% fat, 47% carbohydrate)." "Subjects in the FMD cohort consumed the provided experimental diet consisting of 3 cycles of 5 continuous days of FMD followed by 25 days of normal food intake."

keithwarren 6y ago

My wife is Stage 3, ++- (43 yo) and half way through the taxol phase of an ACT regimen; she is progressing well but I know she has the discipline to do a fasting diet if we thought it would help. Any thoughts on starting this mid-way through the treatment?

eperfa 6y ago
Absolutely not a doctor, so no way qualified to give professional advice, but the article states that not everyone followed the diet during all treatments, so they included all patients who complied at least during half of the cases, and the positive results are based on this extended group. This, and the suggested mechanism of why they think the method works, would lead me to believe that it makes sense to try it. Wish you & your wife strength and all the best.
Funes- 6y ago
Try it. My mom (she left us last year at only 53, unfortunately) and I did intermittent fasting (>=16 hours), and ate a super clean and mainly ovolactovegetarian diet for most of her illness. Her life expectancy was only six months, with breast cancer and methastasis; she endured six years. Do anything you can to help her be healthy. Diet is of extreme impoortance.
- deleted 6y ago
  [deleted]
wonder_er 6y ago
I'm not a doctor, but after reading Tripping Over the Truth: The Metabolic Theory of Cancer [0] I'd strongly suggest she start fasting, or, far better, order yourself a copy of the book (epubs available for purchase/torrent) and read it, decide for yourself. There are a lot of resources listed in the book for people who have cancer. I'm trying to get people to read the book. Average people, for sure, but also people on boards of research institutions. I wrote this to one of them: https://josh.works/mike-clayville-can-have-a-huge-impact-on-cancer https://josh.works/mike-clayville-can-have-a-huge-impact-on-... [0] https://www.goodreads.com/book/show/23496164-tripping-over-the-truth https://www.goodreads.com/book/show/23496164-tripping-over-t... The ideas contained in the book are explosive, with profound implications. It's a riveting read.

alz 6y ago

You may be right, but the reason I put that in the title was because it begins by siting a bunch of other research evidencing that “short-term fasting ...can protect healthy cells against a wide variety of stressors, including chemotherapy”, because in the trial they were able to omit dexamethasone with no negative effects, and because “chemotherapy-induced DNA damage in T-lymphocytes“ was “significantly curtailed”

NewOrderNow 6y ago

I started fasting every Monday for multiple reasons: reduce caloric intake, the recent studies on reduction of cancer growth (family history cancer and heart issues), and optimizing brain functions. What are some of the downsides to doing this?

yurishimo 6y ago
Hello! Long time faster here (lost over 80lbs in about 9 months with basically zero exercise). One potential downside to steady regimented fasting _when combined_ with caloric restriction, is a decrease in your basal metabolic rate (BMR). Our bodies are very good at adapting to "the new normal" and will optimize itself to function on the fuel you give it. This is true in both directions. If you eat less, your body will learn to live on less, and if you eat more, eventually your body will ramp up to try and burn more energy to try and reach an equilibrium. When fasting, it's important to keep your caloric intake up during brief eating windows. Otherwise, your body will adjust, and when you stop fasting, the slightly increased caloric intake will cause you to gain weight before your body readjusts to the new normal. Many fasting theorists suggest that fasting at random intervals is the best strategy for weight loss without reducing BMR. If your body is used to burning 3000 calories a day just to keep you alive, it can't ramp down those cells immediately so it needs to instead convert stored fat to energy and burn that instead. These aren't fasting specific, but oftentimes in the western world, we begin fasting as a means to an end (weight loss) and often combine it with other dietary changes, like eating less/healthier. The other downside is literal starvation or the development of an eating disorder, but those are pretty obvious. I saw a low-budget documentary on YouTube[0] a couple of weeks ago talking about "fasting retreats" in Russia and now parts of Europe that are seeing great results with patients water fasting for 2+ weeks. They're treating everything from Diabetes to arthritis and dementia. Pretty cool stuff. Personally, I definitely have seen the light and will likely continue fasting regularly in some form the rest of my life. Since I just turned 26 last month, that's going to be a while! I'm currently half way through a 72 hour fast and feeling great. Just had a cup of coffee and some electrolyte spiked water this morning. I still have about 50 pounds to lose but I'm hopefully for my future now and I'm a lot healthier. [0] - https://www.youtube.com/watch?v=t1b08X-GvRs https://www.youtube.com/watch?v=t1b08X-GvRs

late_groomer 6y ago

"Importantly, DNA damage in T-lymphocytes was less in patients who received the FMD in combination with chemotherapy compared to those receiving chemotherapy while on a regular diet" Does this not qualify as a protective effect?

blithedale 6y ago

I'm not convinced the 2/3 dropout rate of the FMD didn't simply select for people with less aggressive tumors, given that the Intention-To-Treat analysis found no difference in response rate, and that this paper is telling a nice story that actually happens to reverse cause and effect. Basically, this? HAS AGGRESSIVE TUMOR ---> CANNOT DO THE FMD HAS SLOW-GROWING TUMOR ---> ABLE TO MAINTAIN FMD Since you're researcher in this field and I'm just a weirdo who likes watching scientists argue on Twitter, I'll ask: Anything you can see in the paper that would give a clearer picture regarding possible bias that might have snuck in?

markus92 6y ago
That could very well be a possibility and something that researchers need to address if they wish to investigate this effect a bit further. We can make some educated guesses based on the supplemental table 3. Looking at the staging, grading, tumortype and the hormone receptor status, there don't seem to be any significant differences between the compliant and non-compliant groups. We know that those are the most important factors in assessing how aggressive a breast tumor is, with distinct treatment options and overall survival. So based on this information, I'm inclined to say the cause/effect is not reversed. Of course, there could be some factors determining aggressiveness and response to chemotherapy that we do not know yet. Unfortunately I'm not in regular patient contact so can't say a whole lot about typical side effect profiles of chemotherapy, but I've heard some anecdotal evidence that for patients treated with immunotherapy, the more severe the side effects, the better the response.
- blithedale 6y ago
  Thanks for clarifying comments here, much appreciated. I have to think my initial comment was overly harsh as well, given Supplement 3. I think all I can say is that it may be possible for this issue to affect their data once they have OS stats accumulated in five years, but it was unlikely to do anything to yield differences in adherence with these kinds of patients over this kind of follow-up length.
late_groomer 6y ago