Q&A: Diet during Cancer Treatment

Q:  What do you know about ketogenic and/or paleo diets? My sister is going that route during her cancer treatments. Any advice or recipes?

A:  Thanks for the great question.  I faced questions similar to this when I was working with cancer patients in the hospital.

First, ketogenic and paleo diets are two separate things, but they are related.  The simplest way to compare them is a ketogenic diet is an extreme form of the paleo diet.  But it goes a little deeper than that.

I previously reviewed the paleo diet for general health and weight loss here.  A paleo diet is a type of low-carb diet, focusing on meat, fish, fruits, vegetables, eggs, and plant-based oils.  You avoid grains, potatoes, legumes, salt, and refined or processed foods.

A ketogenic is more specific than just a low carbohydrate diet.  It is a very low carbohydrate diet that is high in fat and moderate in protein.  Compared to the typical paleo diet, it would be higher in fat and lower in carbohydrates and protein.  A truly ketogenic diet can have some beneficial effects in certain conditions, but can also have consequences on the body and should never be followed without consulting with a physician and dietitian first.

Why do people follow these diets during cancer therapy?  It is well documented that cancer cells LOVE glucose.  They rely on it for energy to divide and do all of their cancer damage.  So, people figure they can help fight the cancer by eating fewer carbs.

While this idea makes sense, it does have a slight problem.  ALL of the cells in your body rely on glucose to survive, especially your brain.  Your body isn’t going to know to only give the glucose you are eating to your brain and not give it to the cancer cells.  In fact, cancer cells can be hoarders and not share the glucose with the parts of your body you want to get it, like your brain, muscles, etc.  So it may not actually work to stop the cancer.

With that being said, there is some promising research into ketogenic diets as an additional therapy along with chemo or radiation for some people.  This research is in the very preliminary stages however.

I always recommend caution for cancer patients in following any diet, and even more so for a diet as extreme as a true ketogenic diet.  Part of this is just because of all the side effects of the treatments they are receiving.  Cancer patients feel sick, tired, have nausea/vomiting/diarrhea, can get severe sores in their mouth or throat, and the list just goes on.  Many of the foods people can tolerate at those times would not be allowed on a low carb diet:  mashed potatoes, jello, juice, yogurt, ice cream, and Ensure or similar supplements.

Nutrition is very important during cancer therapy, and you don’t want to box yourself into a corner that makes getting those nutrients harder.  Weight loss is a bad course to begin during cancer treatments, so you need to get those nutrients in somehow.  I recommend a general, healthy diet.  Focus on fruits, vegetables, lean proteins and dairy, and whole grains, all in moderation.  And when symptoms make that hard, you eat what sounds good to get you through.

If she wants to follow those diets, I would recommend she talk to a dietitian at her cancer center and her doctor.  And if it isn’t working for her, make sure she knows she isn’t failing herself if she has to stop.  Cancer treatment is hard.  Don’t make it too much harder with complicated diet regimens.

I hope that helps.  Thanks for the question!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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