Miriam Kalamian, EdM, MS, CNS

Ketogenic Diet for Cancer

Date Aired: October 27, 2017

Episode Description

Based on the mounting evidence supporting the benefits of ketogenic diet therapies, Dr. Kalamian gives information and guidance on how the ketogenic diet fits into the new paradigm of metabolic therapies for cancer. She is driven by her passion from her own positive experience in using the ketogenic diet for her young son (who had cancer), Beyond starving cancer cells, she describes the impact that the diet has on the metabolism of cancer cells. More importantly, she discusses the nuts and bolts of adopting the ketogenic diet and how to incorporate it into one’s lifestyle. The benefits of other diets and forms of fasting are discussed`


Is an adjunct tx

Ketogenic Diet

  • Carbs:
    • 10–23 grams per day (less than 5 % total calories in adults)
    • this is 25 grams per day for an adult
    • she likes to keep total carbs at 12
    • non starchy vegetables, nuts seeds
    • no legumes, gains added sugar in he beginning
  • protein:
    • enough protein to meet needs (10 %)
  • Fat:
    • rest is fat (85 % )
      • Butter ghee heavy whipping cram, sour cream
      • MCT, coconut oils raise ketone levels
        • Half of coconut oil is lauric acid
          • Anti bacterial and antiviral
          • Not as good as MCT for the ketogenic diet
        • No evidence that saturated fats are that problematic especially on a ketogenic diet when are burning  gat
      • She uses bulletproof coffee to extend am fast with MCT and coconut oils
      • Dairy fats do not generate insulin response
        • Protein in cottage or whey in yogurt will stimulate an insulin response
        • Skim milk is worse
  • Fasting over night
    • Have a 12 hour or so window over night of not eating
    • Narrow eating window but it is hard to compress fats down to small window
  • Don’t lose weight too rapidly
    • Don’t want to lose one more pound per week for women
    • 2 pounds per week for heavy men)
    • Fat loss dumps toxins into body which can be too hard on liver
      • This feeds the wrong pathways

Effects of  Ketogenic Diet

  • Stay in ketosis
  • The ketogenic diet makes a shift from glucose centered to fat centered diet
    • Use ketones as fuel rather than glucose
    • Body can do this because have to have fuel for the brain.
    • Most people find increased mental clarity on the ketogenic die
    • Lowers the availability of glucose available to cancer cell
      • Cancer cells use glucose for metabolism
      • Is good for brain tumour
      • Don’t know if it is good for all cancers
      • Meal timing and meal composition does suppress the cancer pathways
  • Blood glucose level stays the same so total level of glucose is not lowered by limiting carbohydrate intake
    • If don’t get glucose through diet, liver will make glucose for needed body functions

Mechanism of Ketogenic Diet

  • When raise insulin raising and another anabolic hormone as well and are suppressing what lever is trying to do
  • As people age, glucose metabolism in brain decreases; ketone metabolism does not decrease in the brain with age
  • Cancer cells use glucose for fermentation: Cancer cells need a lot of glucose and create lot of lactic acid which is shuttled out of the cell
  • This lactic acid creates acidity – the perfect environment for the cancer cells
  • Ketones enter mitochondria and are used there for energy and do not create as much reactive oxygen species
  • Ketones produce fare less reactive oxygen species
  • Ketones enhance efficiency of canter treatments while reducing the toxicity
  • Ketone have neuron therapeutic effect (e.g., is effective in epilepsy)
    • Ketones lowers inflammation in brain, protects rain cells
  • Cancer cells can’t use ketone but hey can use glutamine
  • Cancer cells increase glucose transporters and the insulin receptors on the cell when
  • Ketogenic diet takes cancer cells favourite fuel (glucose) from them and limits glutamine found in meat
  • Cancer cells lack ability to survive in nutrient deprivation
  • A break down of muscle cells of dying cells release glutamine in to the body


Atkins Diet

  • 20 grams carbohydrates per day
  • there is no limit on protein no encouragement to eat fat
  • goal is weight loss not impeding cancer

Paleo diet

  • They already rely on whole foods
  • Is a good option for children
  • Allows starchy vegetables
  • They eat a lot of protein which can interfere to ketone
    • Excess protein can generate a glucose response
    • Excess protein stimulates the mTORR pathway
      • Necessary to stimulate protein synthesis in muscle
      • Promotes cancer progression through anabolic growth

Plant Based Diet

  • In ketogenic diet are eating little protein
  • Are a lot of anti nutrients in plant as a defense: a lot of people have difficulties with this

Mediterranean Diet

  • 40 % fat
  • Reduce saturated fat
  • High quality olive oil, nuts seeds good
  • May be appropriate early in life
  • Is not that food for cancer treatment and for older as we layer on metabolic issues
  • Are still glucose dependent

Alkaline diet

  • Fermenting sugar pushes lactic acid out of the cell which is acidic and toxic.
  • Acidity in body closely regulated: can’t change this
  • We can change urine and saliva pH
  • Believes alkaline water is misguided

Vegan diet

  • Can do ketogenic diet on vegan diet
  • Egan diet is best for those who are vegan for ethical reasons otherwise this is too complicated


  • Liver and kidney disease
  • Thyroiditis start at a higher carbohydrate rate (25 – 30 g)
    • The ketogenic diet affects thyroid hormones in beginning of diet
    • Is a temporary disruption in amount of thyroid stimulating hormone due to competition of enzymes
  • Cardiac Disease
    • not a contradiction
    • HDL, LDL cholesterol goes up
    • Triglycerides go down
    • But perhaps the real risk factors for heart disease number and size of small LDL practices, Triglycerides/ HDL and endothelial dysfunction improve
  • Underweight Patients
    • Add a starchy vegetable to one meal to get an insulin response
    • Meal timing
    • Adding specific amino acid
  • If no gall bladder
    • Had been advised to not eat fats
    • Use a slower transition; no fast

For normal people

  • 30 -50 grams carbs per day
  • daily intermittent fasting
  • she maintains ketosis
  • boosts ketosis with MC, coconut oil, newer ketone supplements

Other Useful Therapies

  • Hypobaric oxygen hypothermia create reactive oxygen species but do not damage neigbhouring cells as cancer chemotherapy