Transcript
WEBVTT
00:00:00.232 --> 00:00:02.391
We're talking fasting today, aren't we?
00:00:02.488 --> 00:00:02.939
Yeah.
00:00:03.141 --> 00:00:04.982
and you just had dinner, so this is appropriate.
00:00:05.323 --> 00:00:21.259
yes, I, yeah, we were recording late for us because I wanted to get, um, some pad Thai for my supper because I like to eat early so that I have a nice gap between my last meal of one day and my first meal the next day.
00:00:21.498 --> 00:00:26.509
So do you actually look at your watch, note your time and say, okay, tomorrow morning I'm gonna have breakfast after a certain hour?
00:00:27.018 --> 00:00:41.868
Well, I like to kind of finish eating by 6:00 PM I mean, like, I'll round it up, I'll round it up to 6:00 PM so then I can eat after seven tomorrow, cuz I do 13 hours, at least 13 hours.
00:00:41.868 --> 00:00:43.848
Sometimes I get busy and I do 14.
00:00:43.848 --> 00:00:44.058
But
00:00:44.359 --> 00:00:44.719
All right.
00:00:44.749 --> 00:00:46.639
So we're gonna talk about that in this episode.
00:00:46.848 --> 00:00:52.668
Fasting during treatment, after treatment, what it entails, who should do
00:00:52.698 --> 00:00:53.268
how long
00:00:53.929 --> 00:00:54.259
Yeah.
00:00:54.319 --> 00:00:55.459
is it safe?
00:00:56.088 --> 00:00:58.969
Um, yeah, fasting in cancer, that's what we're talking about.
00:00:59.389 --> 00:01:00.588
And of course, as always, we'll hit.
00:01:01.548 --> 00:01:02.988
Contraindications for it too.
00:01:02.988 --> 00:01:04.338
So when you shouldn't be doing it,
00:01:04.713 --> 00:01:05.948
Yes, absolutely
00:01:06.161 --> 00:01:07.210
who shouldn't be doing it?
00:01:07.260 --> 00:01:10.197
So should we get into it or are we gonna, do our music right now?
00:01:10.436 --> 00:01:11.277
Cue the music.
00:01:12.573 --> 00:01:16.364
I'm Dr Tina Kaczor and as Leah likes to say I'm the science-y one
00:01:16.555 --> 00:01:19.225
and I'm Dr Leah Sherman and on the cancer inside
00:01:20.197 --> 00:01:24.066
And we're two naturopathic doctors who practice integrative cancer care
00:01:24.326 --> 00:01:26.277
But we're not your doctors
00:01:26.436 --> 00:01:30.456
This is for education entertainment and informational purposes only
00:01:30.674 --> 00:01:34.965
do not apply any of this information without first speaking to your doctor
00:01:35.162 --> 00:01:40.981
The views and opinions expressed on this podcast by the hosts and their guests are solely their own
00:01:41.290 --> 00:01:42.881
Welcome to the cancer pod
00:01:59.346 --> 00:02:05.478
So in preparing for this episode on fasting, I just now thought to myself, what?
00:02:05.478 --> 00:02:10.248
I didn't look up the term fast, like F A s T.
00:02:10.278 --> 00:02:11.929
Why do we even call it that?
00:02:12.139 --> 00:02:12.769
I don't know.
00:02:12.799 --> 00:02:13.998
I don't know the answer to this question.
00:02:14.179 --> 00:02:15.498
through the magic of the internet.
00:02:15.829 --> 00:02:16.729
I'm gonna look it up.
00:02:17.118 --> 00:02:18.544
Don't you think it's an interesting term?
00:02:18.544 --> 00:02:20.323
Like from a linguistics perspective,
00:02:20.502 --> 00:02:21.432
Oh yeah, for sure.
00:02:21.432 --> 00:02:22.032
Yeah.
00:02:22.213 --> 00:02:23.234
it's an odd term.
00:02:23.516 --> 00:02:30.926
Well, being that fasting has been around since like the days of Hippocrates, Yeah, I wonder when the term fast came about.
00:02:31.377 --> 00:02:34.227
So this is just the first thing that popped up on the Google.
00:02:34.227 --> 00:02:38.546
So you know it's gotta be true Fast is derived from the Anglo-Saxon word.
00:02:38.757 --> 00:02:39.776
I don't know how to say this.
00:02:40.026 --> 00:02:49.747
F A E S T, which means firm or fixed the practice of going without food at certain times was called fasting from the Anglo-Saxon fasten
00:02:50.062 --> 00:02:50.451
Oh,
00:02:50.984 --> 00:02:52.213
to hold oneself from food.
00:02:52.424 --> 00:02:53.653
That was from True North,
00:02:53.729 --> 00:02:54.149
okay.
00:02:54.508 --> 00:02:55.079
They should know.
00:02:55.274 --> 00:02:57.044
is, yeah, there you go.
00:02:57.538 --> 00:03:02.098
True North is a clinic that's dedicated to water fasting, among other things.
00:03:02.183 --> 00:03:02.674
Yeah.
00:03:02.679 --> 00:03:07.157
We'll probably talk a word or two about them, or at least about the water fasting.
00:03:07.162 --> 00:03:09.526
So yeah, that's where that came from.
00:03:09.556 --> 00:03:14.016
And yeah, fasting has been around since, I mean, the days of the Bible.
00:03:14.271 --> 00:03:25.128
Yeah, I think we've been recording it since then, but I think it was a natural process when we were hunter gatherers and we didn't have food, we fasted, not voluntarily, but we went without food.
00:03:25.408 --> 00:03:25.679
Right.
00:03:25.679 --> 00:03:27.419
I was thinking kind of voluntary fasting.
00:03:27.419 --> 00:03:43.466
Like I know growing up, Jewish, you know, the fast at Yom Kippur, it's a, from sundown till sundown, so it's a, you know, kind of not that long of, I mean relatively, not really that long of a fast, especially cuz sleeping is involved during part of it.
00:03:43.731 --> 00:03:44.812
that's the best part.
00:03:44.812 --> 00:03:56.385
We're gonna talk about that kind of the time-restricted eating id idea, is a type of intermittent fasting, but we're gonna talk about that and why it's a good idea to fast while you sleep.
00:03:56.762 --> 00:03:58.651
because it's easier cuz you're sleeping,
00:03:58.956 --> 00:03:59.657
it sure helps
00:04:00.521 --> 00:04:02.042
It helps you not be hungry
00:04:02.387 --> 00:04:03.497
for most people.
00:04:03.497 --> 00:04:03.676
Yeah.
00:04:03.676 --> 00:04:06.977
I, you know, there's always a few people who have to get up in the night and snack.
00:04:06.977 --> 00:04:09.106
I've had those patients who are like, I must do this.
00:04:09.180 --> 00:04:17.500
it's always an indication that there's something off in their biology, in their, you know, metabolism, in their circadian rhythm or in their digestion.
00:04:17.670 --> 00:04:22.680
So I just wanna throw that out there cuz I think there's always a few people who are like, yeah, but I have to eat.
00:04:23.083 --> 00:04:27.038
and that might not be the person to fast until they figure out what's going on.
00:04:27.137 --> 00:04:33.858
in my mind, if they're like, no, I have to wake up in the middle of the night to eat something, then I will be like, no, maybe we rethink that.
00:04:34.307 --> 00:04:39.197
But I don't really talk a lot about fasting with my patients right now since I don't really talk about diet.
00:04:39.197 --> 00:04:41.483
I mean, I talk a little bit, but, Okay.
00:04:41.752 --> 00:04:56.995
So the history of fasting, we kind of, I don't know, I didn't delve too deep into it, but yes, I know that it was, way back in days of your that they did it as well as at those like those health spas, sanatoriums, I'm sure they did fasting then.
00:04:57.505 --> 00:05:07.387
we didn't look up to see exactly what the indications were in the times of Hippocrates to fast for medical reasons, but yeah, religions have, religions have been doing it for millennia.
00:05:07.663 --> 00:05:08.153
Yeah.
00:05:08.392 --> 00:05:08.603
Yeah.
00:05:08.603 --> 00:05:11.423
All the major religions have some fasting component
00:05:11.617 --> 00:05:14.228
the major, all the major religions are doing it
00:05:15.173 --> 00:05:16.252
That's totally vogue
00:05:18.367 --> 00:05:25.718
So, but in terms of cancer, why would somebody consider fasting?
00:05:26.463 --> 00:05:29.677
like what's the ultimate goal with fasting in cancer?
00:05:29.843 --> 00:05:35.963
Well, it depends if we're talking about during treatment time or post-treatment, I suppose.
00:05:36.088 --> 00:05:37.127
Let's start during.
00:05:37.463 --> 00:05:56.632
Okay, so during treatment time, the easiest way to imagine this is that generally speaking, this isn't always the case, but a lot of times cancer cells are dividing at a more rapid pace and they need all of the fuel and all of the components that normal cells need.
00:05:56.663 --> 00:05:59.723
So they need carbohydrates, they need protein.
00:06:00.098 --> 00:06:07.507
They need fat and they need that because they keep producing new cells, which are made of those components, and they need the energy to do that.
00:06:07.778 --> 00:06:13.598
So they're, they're similar to normal cells, but they're going, going, going, and they're not stopping because they're cancer cells, so they don't know when to stop.
00:06:13.958 --> 00:06:25.627
If you fast normal cells in the body while you're fasting, normal cells in the body will sense that, and they will slow down their processes.
00:06:26.137 --> 00:06:28.958
They'll say, oh, there's a calorie deficit.
00:06:29.257 --> 00:06:39.877
Let's go into, I'll use the word hibernation, for lack of a better term, So they, they slow down and they say, oh, fuel is minimal, food is minimal.
00:06:39.877 --> 00:06:44.077
Let's all dial this back and not proliferate as much as we normally would.
00:06:44.108 --> 00:06:46.327
Let's not chew up as much energy as we usually would.
00:06:46.687 --> 00:06:48.487
Of course, your brain has to have its energy.
00:06:48.728 --> 00:06:50.528
Your heart still has to have energy, so it still has.
00:06:51.583 --> 00:06:58.252
Chugging along your cells are still doing their thing, but many cells in the body know enough to tamp down their normal processes.
00:06:58.492 --> 00:07:01.192
Cancer cells do not have that capacity.
00:07:01.192 --> 00:07:24.173
So what we're relying on is what was dubbed by, uh, a researcher who's famous in this realm, vaulter Longo down in LA um, the differential stress response so that you take advantage of the fact that normal cells will react one way and cancer cells don't have the ability to react as normally to the lack of calories.
00:07:24.177 --> 00:07:35.872
So if you do it during chemotherapy or during a treatment that's supposed to destroy the cancer cells, the idea here is that the normal cells slow their processes down while the cancer cells keep doing their thing.
00:07:35.872 --> 00:07:43.737
And because chemotherapy in particular targets rapidly dividing cells, you end up killing those cells more selectively.
00:07:43.767 --> 00:07:46.168
So you should have less side effects from the treatment.
00:07:46.677 --> 00:07:47.307
That's the idea.
00:07:47.608 --> 00:07:57.531
so you're sensitizing the cells, the cancer cells, to, to take up more chemo or be more responsive, or to be more dead from chemo.
00:07:57.771 --> 00:07:58.401
yeah, yeah.
00:07:58.401 --> 00:07:59.125
In a complete
00:07:59.130 --> 00:08:06.771
be to be more dead, woo, more dead to become targets, to become better targets for the chemo.
00:08:06.831 --> 00:08:07.370
Yes.
00:08:07.430 --> 00:08:13.742
So in a complete oversimplification, your normal cells know enough to duck and cover and the cancer cells do not.
00:08:14.160 --> 00:08:18.932
They're going underneath the desk to take a little nappy nap because they aren't getting their snack.
00:08:18.932 --> 00:08:20.312
and the cancer cells are like, what?
00:08:21.033 --> 00:08:27.502
The cancer cells are like throwing paper at each other and having a party and.
00:08:28.533 --> 00:08:29.822
Woo, look what's coming.
00:08:29.822 --> 00:08:31.593
Here comes the chemo, let's drink it up.
00:08:31.593 --> 00:08:32.102
That kind of thing.
00:08:32.822 --> 00:08:33.993
That's my analogy.
00:08:33.993 --> 00:08:34.442
I like it.
00:08:34.702 --> 00:08:34.913
Yeah.
00:08:35.092 --> 00:08:35.482
Pretty much.
00:08:36.722 --> 00:08:49.773
yeah, so, and there is some thought that with like, you know, short-term fasting around treatment, it could possibly reduce some of the side effects that come about, like nausea and vomiting.
00:08:50.342 --> 00:08:56.763
so that, you know, that was kind of appealing when the idea was introduced to me by my oncologist.
00:08:57.628 --> 00:08:58.118
Yeah.
00:08:58.118 --> 00:09:04.962
That it's reason to do it during treatment is because it lowers a lot of the side effect profile of the chemotherapy that's being given.
00:09:05.113 --> 00:09:19.624
Is it, it's also supposed to encourage from when I'm remembering from like the ProLon packaging, it encourages cells to, to kill themselves, like when they need to, which wasn't happening necessarily before.
00:09:19.756 --> 00:09:24.317
and that's how cancer forms is because your cells don't recognize that something's wrong and they don't off themselves.
00:09:24.706 --> 00:09:32.486
And so the idea behind fasting is that it promotes kind of the, the cells cleaning themselves up.
00:09:32.981 --> 00:09:33.866
Mm-hmm.
00:09:33.868 --> 00:09:33.869
Mm-hmm.
00:09:34.100 --> 00:09:36.139
The whole idea of autophagy, you mean?
00:09:36.711 --> 00:09:37.220
Yeah.
00:09:37.639 --> 00:09:37.970
Mm-hmm.
00:09:38.720 --> 00:09:42.379
autophagy is a process that is a normal cellular process throughout the body.
00:09:42.379 --> 00:09:44.450
We have autophagy happening.
00:09:44.750 --> 00:09:46.820
Autophagy is the destruction of cells.
00:09:46.820 --> 00:09:50.269
There's different types of autophagy, so I'll just leave it at that one word.
00:09:50.629 --> 00:09:59.168
And it's spelled, it looks like when it's spelled, it looks like auto Fiji, P H A G y, autophagy, but it's, um, autophagy.
00:09:59.677 --> 00:10:01.201
So, so now you, now, you know,
00:10:02.341 --> 00:10:02.942
Now I know.
00:10:03.331 --> 00:10:08.522
Now you know why I was avoiding saying the word Autophagy.
00:10:08.822 --> 00:10:11.581
it also can do things like improve insulin resistance.
00:10:12.032 --> 00:10:17.804
that's another, that's another reason why someone would do it during treatment and after.
00:10:17.839 --> 00:10:18.168
Yeah.
00:10:18.168 --> 00:10:22.861
And through some fairly intricate mechanisms that we will not go into.
00:10:23.461 --> 00:10:32.491
high insulin leads to resistance, um, of the chemotherapy or the radiation therapy or even some immunotherapy.
00:10:32.491 --> 00:10:35.912
So high insulin is not a good thing during treatment time.
00:10:36.062 --> 00:10:37.501
It's not great afterwards either.
00:10:37.861 --> 00:10:40.682
There's many reasons, but, um, it does lead to a direct.
00:10:41.004 --> 00:10:42.889
resistance to killing the cancer cells.
00:10:42.889 --> 00:10:48.139
So, yes, on that note, we definitely wanna keep the insulin at the lower end and fasting.
00:10:48.139 --> 00:10:48.620
Does that,
00:10:48.796 --> 00:10:54.383
So anything else on why somebody would fast during treatment?
00:10:54.383 --> 00:10:55.552
I don't think of weight loss.
00:10:55.552 --> 00:10:59.123
I know after treatment people are like, oh, I do it for, you know, weight loss.
00:10:59.123 --> 00:11:03.109
And I think it's, the jury's still out as to whether or not that's really, effective.
00:11:03.739 --> 00:11:12.139
Um, but I don't encourage anyone who wants to do it during treatment for weight loss that that's not, that's not the goal.
00:11:12.349 --> 00:11:16.548
And I think if you fast appropriately, you won't lose weight.
00:11:17.089 --> 00:11:19.609
Yeah, I think, uh, depends where you start.
00:11:20.028 --> 00:11:23.629
I think it depends on how much excess adipose you have to start with.
00:11:23.808 --> 00:11:30.589
Because some of these fasting diets will eat to weight loss because you're just taking in so many less calories and your body has to get the fuel somewhere.
00:11:30.798 --> 00:11:36.538
there was one done in the last year or two that showed when people went on a fasting mimicking diet, they certainly lost weight.
00:11:36.629 --> 00:11:40.958
And that was despite the fact that they put them on a regime to do exercises to build muscle.
00:11:41.071 --> 00:11:44.841
But wouldn't the exercise also contribute to the weight
00:11:45.243 --> 00:11:46.932
it was resistive exercise.
00:11:46.937 --> 00:11:51.572
So the idea was that they were, they were, try it wasn't aerobic or, um, cardio,
00:11:51.581 --> 00:11:52.860
But you could still lose weight
00:11:53.092 --> 00:11:53.253
exercise,
00:11:53.640 --> 00:11:54.451
exercising, right.
00:11:54.826 --> 00:11:55.905
I guess so yeah.
00:11:55.905 --> 00:11:58.186
The idea of resistive exercise is to build muscle.
00:11:58.336 --> 00:12:01.666
But yeah, I can just tell you that this one study was very careful.
00:12:01.666 --> 00:12:03.916
Um, they were, everybody in it was monitored.
00:12:04.255 --> 00:12:05.630
but across the board, people.
00:12:05.975 --> 00:12:10.926
Lost weight with every fasting mimicking cycle that they did.
00:12:10.926 --> 00:12:15.399
So they did it, during their treatment time, during their chemotherapy time, or whatever treatment they were getting.
00:12:15.399 --> 00:12:18.759
In this particular study, there were all sorts of different, treatments that people got.
00:12:18.759 --> 00:12:29.698
There was immunotherapies, there was radiation, there was even some biological agents, this didn't select just for chemo, but they did do, fasting mimicking diet, which we'll talk about more in detail.
00:12:30.208 --> 00:12:32.729
But a fasting mimicking diet is low calorie.
00:12:32.744 --> 00:12:39.019
and it intentionally deprives the person of certain amino acids and it keeps the carbohydrates low.
00:12:39.075 --> 00:12:42.674
um, F M D fasting mimicking diet is what we, what we say.
00:12:43.095 --> 00:12:47.129
but yeah, across the board, that was the one issue with it was that, was that it it led to weight loss.
00:12:48.068 --> 00:12:48.623
Mm-hmm.
00:12:48.623 --> 00:12:50.000
which is fine to an extent.
00:12:50.120 --> 00:12:51.530
You just can't get it down too, too low.
00:12:51.561 --> 00:12:51.801
Right.
00:12:51.801 --> 00:12:53.071
You don't want it the body composition to
00:12:53.130 --> 00:13:01.941
I, yeah, I mean, again, it depends on, um, the type of cancer, the stage of cancer and, the treatment that the person's getting.
00:13:02.600 --> 00:13:07.250
So that kind of could lead us to what would the contraindications be of fasting.
00:13:07.490 --> 00:13:07.880
Yeah.
00:13:07.910 --> 00:13:15.628
You know, some cancers are notorious for leading to a tendency to lose muscle mass.
00:13:16.317 --> 00:13:20.437
the loss of muscle mass, as you know, is called sarcopenia.
00:13:20.918 --> 00:13:28.577
And After a certain amount of muscle loss, your immune system suffers, So it leads to an immune depressed state.
00:13:28.998 --> 00:13:46.048
But some cancers, especially stage four cancers, and cancers that affect the upper GI tract in particular, lung cancer, a lot of the times they all lead to the sarcopenia, sarcopenic state if they go too far, if it's a progressive disease and we're talking late stage disease.
00:13:46.678 --> 00:13:51.962
Generally, those are the patients that probably are not suited to be fasting.
00:13:51.993 --> 00:14:04.253
We really don't want someone going without calories who is already prone to losing muscle mass and losing weight to the point where it can lead to, um, system failures.
00:14:04.432 --> 00:14:06.413
So I would put the top of the list.
00:14:06.413 --> 00:14:08.062
Lung cancers, GI cancers.
00:14:08.243 --> 00:14:08.903
Who else?
00:14:09.383 --> 00:14:10.942
Anyone who has a low bmi.
00:14:11.393 --> 00:14:11.883
Yeah.
00:14:11.883 --> 00:14:15.863
I think if you're going into your treatment already, malnourished.
00:14:16.292 --> 00:14:18.412
or at risk of malnourishment.
00:14:18.532 --> 00:14:26.359
like you're saying, like GI cancers, if somebody has to, have a feeding tube placed, maybe because they're getting radiation to the esophagus.
00:14:26.749 --> 00:14:30.688
Um, yeah, anything like that I think would be, a contraindication.
00:14:31.349 --> 00:14:31.859
Definitely.
00:14:31.864 --> 00:14:33.869
Anyone who has a history of eating disorders,
00:14:35.188 --> 00:14:43.589
and on that note, I will tell you some of the toughest patients I've seen over time are the people who don't know that they are underweight.
00:14:44.698 --> 00:14:51.813
Um, so in that category of, of patients where, I think they shouldn't fast, but they think they're normal weight.
00:14:51.813 --> 00:14:53.234
But I'm looking right at them.
00:14:53.234 --> 00:14:55.903
I can see they, to me look underweight.
00:14:56.203 --> 00:15:01.033
Then you put'em on the scale and their body mass index indicates 18 or less.
00:15:01.543 --> 00:15:05.624
They are underweight by definition, but they don't see it.
00:15:05.864 --> 00:15:14.663
Um, that's actually the hardest folks for me to talk out of doing fasting, cuz I'm already worried about them, even though they might've been this weight their entire life and they're used to it.
00:15:15.071 --> 00:15:17.140
I'm like, no, I don't think you should be losing more weight.
00:15:17.321 --> 00:15:21.341
I think I find that to be like the toughest subcategory of patients that I see in the situation.
00:15:21.341 --> 00:15:24.071
Most people who are underweight, who have lost weight are like, yes, I agree.
00:15:24.076 --> 00:15:24.581
I'm underweight.
00:15:24.581 --> 00:15:25.331
I don't wanna do this.
00:15:25.870 --> 00:15:27.071
You know, it doesn't feel right.
00:15:27.130 --> 00:15:33.640
But people who have, basically body dysmorphia, you know, they see something different in the mirror than what I see as a clinician.
00:15:34.120 --> 00:15:37.120
That's a tough, that's a tough group to stop from fasting for me.
00:15:37.441 --> 00:15:58.900
And when I fasted, which I've talked about in several episodes, um, my oncologist at the time was conducting, I believe it was a phase two clinical trial, with women with early stage breast cancer, and he was looking at their labs and looking at, um, IGF one and all these other, you know, different labs.
00:15:59.081 --> 00:16:09.355
I wasn't part of that trial, but he said, if you're interested in fasting, and his concern was, I was thin and I did not, my weight did not change throughout treatment.
00:16:09.985 --> 00:16:12.385
Um, because when I wasn't fasting, I was still eating.
00:16:12.385 --> 00:16:13.556
I never lost my appetite.
00:16:13.556 --> 00:16:16.880
I didn't have nausea or anything to interfere with, my eating.
00:16:17.600 --> 00:16:19.880
So, um, but that was his concern.
00:16:19.880 --> 00:16:23.270
And his concern also was with my taking the steroids.
00:16:23.990 --> 00:16:26.600
that I don't know, something about my weight and the steroids.
00:16:26.600 --> 00:16:27.471
I can't remember what it was.
00:16:27.801 --> 00:16:30.471
But, um, yeah, and I did have broth.
00:16:30.471 --> 00:16:31.850
When I had my infusion.
00:16:32.221 --> 00:16:32.500
Mm-hmm.
00:16:32.660 --> 00:16:33.380
have broth.
00:16:33.831 --> 00:16:36.551
So, so you did fast during chemotherapy,
00:16:37.130 --> 00:16:43.941
I fasted starting 24 hours before and then for 24 hours after, up to 24 hours after,
