In principle, there are few chronic diseases that are more easily preventable than cancer.
Cancer as a Metabolic Disease, Chapter 19.
At the beginning of 2014 I started to get involved in CrossFit after decades of not really doing any exercise but biking and snowboarding. I discovered quite quickly how unfit I was and made rapid improvements.
This led fairly quickly to thinking more about what I was eating. If I was spending a bunch of time to get fitter then I should probably spend some time figuring out where the energy was coming from. What I used to eat was essentially any crap that was available.
There’s a strong paleo bias in the CrossFit community. Paleo essentially means eating roughly what you were evolved to eat. The thinking is that it’s been a short time since pre-agrarian society existed and before farming we ate one set of things. After farming, we eat another set of things. Actually a radically different set of things from before farming.
The timeframe is evolutionarily very short. The theory is that we evolved to eat what we as a species ate before farming, and we haven’t evolved to eat the food we get in post-agrarian society. In fact, it takes about an order of magnitude longer for DNA to show some meaningful adaptation than the time we’ve had since someone invented farming.
Paleo led me to learning the three basic food groups: Carbs, protein and fats.
When I grew up, I was taught that fat was bad. It turns out that this isn’t really true. I was taught that carbs are good. Sadly that too doesn’t really have any truth to it.
Even more mind-blowing to me were the results of actually trying calories-in calories-out. This is the myth that if you balance the amount of calories you eat with the amount you burn you can gain or lose weight. It’s scary, but that’s not actually really true either.
You can read about all this in Why We Get Fat and many other books.
Reading that book led to some other interesting things. It turns out Japanese women don’t really get breast cancer. Japanese immigrants to the US do, but if they emigrate back it goes away again. That rules out genetics as the major factor.
Now I don’t know about you, but I was taught that cancer was caused by DNA mutation. A photon comes in from the sun and breaks some DNA, or a virus does the same thing, or some oxidant does it. The broken DNA somehow causes a bunch of gene signaling that results in cells replicating out of control.
I was floored by the lack of actual evidence for this.
Now, what happens when you have some large metastatic cancer? The current technology is to give you a dose of radioactive glucose. Then you’re put in a large machine that detects that radiation (positrons as it turns out) and with a lot of computation will spit out three-dimensional images of where the radioactive glucose is.
Where is the glucose? It’s at the tumor sites. Think about that for a second.
The resolution of these machines is sub-centimeter (from memory I think it’s 7mm). So what happens if we do a biopsy and find a few cells but it’s not big enough to image or doesn’t have a clearly defined border so we can rip it out in surgery? Basically we irradiate you and kill everything. We hope that normal cells will rejuvenate back and that the cancer cells won’t survive. Unfortunately irradiating you has a lot of downsides which I won’t list, but are essentially horrific. Okay I’ll list one ironic side-effect, which is cancer.
This got me interested. Why was the glucose at the tumor sites?
It turns out someone was thinking about that and got a Nobel Prize for figuring out some of it in 1931. The theory is that cancer cells have broken respiration and are only able to ferment sugar for energy. This neatly (perhaps too neatly) ties a few things together.
First, that women in Japan aren’t eating bucket loads of sugar like we do in the US. If they aren’t eating all that sugar, and cancer requires sugar, then you’d expect cancer incident rates to be lower. Second, it explains why essentially no progress has been made treating cancer in the last 40+ years since going after DNA wouldn’t be the right thing to go after.
But wait. You saw Jurassic Park where they had a bunch of gene sequencing devices and Thinking Machines supercomputers. What if we took a group of people with the same type of tumor and sequenced the DNA in there. We should discover similar mutations – even the same mutations – in these different people. Then we could target those genetic malfunctions using some space age drugs and stop the cancer.
It turns out that people have been trying exactly this. The problem is they haven’t been finding any common genetic flaws and therefore, the entire working model we have of how cancer works might simply be wrong. That ties in nicely with making no progress in a few generations.
So if it isn’t DNA, what is it? Mitochondria. They supply energy to cells and even have their own DNA. It’s fascinating that mitochondria are inherited from your mother, which is interesting since it means a different set of evolutionary pressures will apply.
It’s worth taking a break from cancer for a second. If you go look at the data you’ll see an explosion of all kinds of other things in the world of chronic disease. Diabetes, Alzheimers, Parkinsons and lots more.
What about MS? Here’s something truly scary: It looks like MS is curable by essentially eating vegetables:
Dr. Wahl also has a few books out you can go find. So if thinking deeply about mitochondria can save someone from MS, what about those other things?
Well T2 diabetes is your inability to control blood sugar. It turns out that by not eating sugar you can essentially cure T2 diabetes. What about Alzheimers and Parkinsons?
There’s another great book there: Grain Brain. It turns out, again, that not eating sugar helps a lot. This idea that we end up old and get all these conditions, somehow left up to fate, just isn’t really true. What you eat and how you exercise will essentially preclude you from getting any of these things.
And none of this is particularly new. There was a book in the 80’s that’s been rereleased called Pure, White and Deadly. 50 years before that, Warburg was getting his Nobel.
So this made me think, is it too late for me? Growing up I had cereal with sugar for breakfast and an all-round cheap low-fat… Oh let’s also mention eating fat doesn’t make you fat, in fact it’s incredibly good for you… and high-carb diet.
After much more reading I got to Cancer as a Metabolic Disease. This guy decided to give a bunch of mice brain tumors and then deny them sugar to see what happened, and the result is a $130 cancer textbook examining everything from Warburg onward, up to and including treatment propositions.
We can skip back to diet again, where we left off on paleo. Paleo is essentially a low-carb diet which means no sugar. If you go look, it’s kind of interesting to see what health problems paleo people had (think: polio) and how we’ve solved most of them. Since they didn’t have sugar they didn’t get tooth decay, people have dug up their bones and figured that out.
What happens with very low carb diets? You go in to ketosis. The reddit keto community have a great FAQ all about it. It turns out you have this other way of fueling your body when you don’t have any sugars or things to metabolize in to sugars.
This again is interesting since if you were on planet earth ten thousand years ago then periods without food were a normal occurrence. Dr. Seyfried, and others, proposition is that without sugar cancer cells are put under a lot of stress and they die. How do you deny that? Well don’t eat sugar, or simply don’t eat. There’s a third way to simulate not eating, which is to put yourself in to ketosis. You should spend some time on /r/keto and see how people do on the ketogenic diet. It’s insane.
This is a graph (from Seyfried’s book) of the glucose and ketones in someones blood over 30 days while they eat a ketogeneic diet. Essentially the glucose goes down and the ketones go up in a compensatory manor so you don’t keel over and die.
By extrapolating out from mice models, Seyfried suggests that fasting for a week per year or a few 2-3 day fasts should kill the dysplastic cells you have. Your blood should look like the above graph but with the time axis shortened down from 30 to 7 days. And as it turns out, there’s already a lot of evidence that fasting is good for you.
So I tried it. I managed to get 3.5 days in. The problem was my timing. Let me say upfront I felt fine, actually great for the whole 3.5 days. But I chose to do it just before going on vacation for my birthday with a bunch of stressful driving and screaming kids. That was sub-optimal. At the 3.5 day mark I had some slight heartburn, got pissed off, and had a cookie.
The fascinating thing is how food craving feels. Having a ham sandwich in front of me felt just the same as having a chocolate cake or a beer sitting there. I expected some major difference there since surely chocolate is a treat and a beer is alcohol (and sugar). It was really strange to have the same episodic emotions over plain food.
During the period I recorded my blood sugar and ketone levels with one of these meters. Diabetics will be familiar with them. You lance your fingertip and squeeze to get some blood. Then dip a test strip to the blood and the machine magically spits some numbers out. You can see the numbers in this spreadsheet.
The problem is that the meters are pretty crappy. The readings are only roughly 20% accurate and the ketone strips (which are ten times as expensive as the glucose strips) have a relatively narrow reading band. The error on them is good enough for diabetics but not really for what I wanted. I also recorded blood pressure with one of these things.
You can see the glucose stay about the same and the ketones jump up on day 3. I think the glucose is problematic for two reasons. One, the accuracy of the device is roughly the same as the drop I should see, so it’s easy to hide it in the noise. Two, Seyfried warns about having anything but water. He talks about subjects having decaf tea and I was drinking gallons of decaf coffee.
If you look, I lose 2+lbs per day too.
The main barrier to fasting is simply self-discipline in the face of food everywhere. That’s why lots of people go on retreats to do it. You’re perfectly capable of fasting and obese people can fast for months on just water. Go look it up.
So I’m starting another fast again today without decaf coffee this time.
Here’s another video, longer and with more technical detail:
I don’t have a medical degree and I’ve glossed over a lot of detail in all this. I can’t summarize all these great books but hopefully just enough to get you interested. What can you do?
- Stop eating sugar. You’ll be amazed at the grocery store trying to find things that don’t have added sugar. Practically everything you pick up will have added sugar, under some name like “evaporated beet juice” or “dextrose” or whatever. Really, go see.
- Read. Get the books I’ve mentioned from the library or amazon, and here’s a recent good documentary to watch. It’s more than not eating sugar, but that appears to be a good start. It will be maybe 50 hours of time invested, but it’s a lot cheaper than getting cancer or some neurological malfunction. If you’re anything like me, educated by the government and charities, what you learn will blow your mind.
- Find a community. I highly recommend /r/keto as a starting point. It’s a place to ask questions and learn from others experience.
- Try to find some contradictory evidence. I’ve been trying, there doesn’t seem to be a lot out there that’s very defensible. Remember, people don’t change their minds, they just die and get replaced by new minds.