Feel Better, Live More with Dr Rangan Chatterjee - What Everyone Needs To Know About Cancer with Professor Thomas Seyfried #385

Episode Date: September 19, 2023

When I started medical school in 1995, we were taught that one in four people was likely to develop cancer in their lifetime. Today, that statistic has changed to one in two – a rapid rise that can���t be explained by genetics. But if our modern diet and lifestyles are the cause, we have more control than we might think. That’s the message my guest, Professor Thomas Seyfried, has worked tirelessly to prove and communicate over his four decades as a cancer researcher. Professor Seyfried is a professor of biology, genetics and biochemistry at Boston College, Massachusetts, and author of more than 150 peer-reviewed publications, as well as the 2012 book Cancer As A Metabolic Disease. Through his research, and in this conversation, he sets out to explain how it’s a malfunction in our mitochondria – the energy powerhouses in each of our cells – that’s at the root of every cancer he’s studied. Normal-functioning mitochondria, he explains, use oxygen to make energy. In cancer, this process is disrupted. Cancer cells cannot use oxygen, so they fall back on a primitive form of energy creation known as fermentation.   It follows then, explains Professor Seyfried, that if we can somehow stop this fermentation process, then cancer cells will die. Cancer uses glucose and glutamine to fuel fermentation. While we don’t want to block glutamine, as it has other uses in the body, we can drastically lower our glucose levels to stop driving cancer growth. We discuss some of the ways in which we can start doing this – for example, using specific low-carb diets and nutritional ketosis. Professor Seyfried also talks us through his ground-breaking ‘metabolic therapy’ protocols for treating cancer – sometimes, alongside conventional treatments like chemotherapy and radiotherapy. Professor Seyfried has spent decades researching and proving a metabolic cause for this devastating disease. This a compelling and optimistic conversation, packed with actions we can all take to reduce our risk not just of cancer, but all the chronic conditions driven by metabolic disruption. CAUTION: This podcast discusses ketogenic diets and water-only fasting. Always consult a qualified healthcare practitioner before making any drastic changes to your diet or before going for prolonged periods without eating. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Show notes https://drchatterjee.com/385 DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

We have a lot of tools for managing cancer. It's just that we haven't been using them in the correct way or understanding the concepts of evolutionary biology to enhance the success of the treatments that we already have. It's not that complicated. All the cancers that we know are fermenting to get energy. Hyperglycemia is an accelerant to rapid tumor growth. The higher the blood sugar, the faster the tumor grows.

The lower the blood sugar, the slower. Once you know that, then the path to long-term management without toxicity becomes obvious. Hey guys, how are you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee, and this is my podcast, Feel Better, Live More. Today's conversation is all about cancer. Now, the first thing I want to say is that I understand that cancer can be a very scary word and that all kinds of complex emotions can come up when we hear it. But I do believe we need to talk about it more. Not only that, I think we urgently need to be broadening out the conversation around cancer and hearing from a diverse group of scientists

and researchers. You see, when I started medical school back in 1995, we were taught that one in four people would develop cancer. Today, that number has gone up to one in two, a rapid rise that simply cannot be explained by genetics. But if our modern diet, lifestyles and environments are the cause, we actually have a lot more control than we might think. That's the message my guest today has worked tirelessly to prove and communicate over his four decades as a cancer researcher. communicate over his four decades as a cancer researcher. Professor Thomas Seyfried is a professor of biology, genetics and biochemistry at Boston College, Massachusetts, and he is the author of more than 150 peer-reviewed publications, as well as the 2012 book, Cancer as a Metabolic Disease. Now we begin our conversation by exploring how the changes of the past 50 years have contributed to increased rates of cancer. Contaminants in the atmosphere, low quality foods

and the lack of exercise can all be seen as insults to our bodies that over time can result in the development of many different chronic diseases including cancer. Now Professor Seyfried explains how it's a malfunction in our mitochondria that's at the root of every single cancer he studied. Normal functioning mitochondria, he explains, use oxygen to generate energy. Cancer cells, however, cannot use oxygen even in the presence of oxygen. And so they fall back on a primitive form of energy creation known as fermentation. It follows then that if we can somehow stop this fermentation process, then cancer cells will die. And in our conversation, Professor Seyfried explains some of the ways in which we can start doing this. For example, using specific low-carb diets and nutritional ketosis.

He also talks us through his groundbreaking metabolic therapy protocols for treating cancer, sometimes alongside conventional treatments like chemotherapy and radiotherapy. Please note that we do talk about ketogenic diets and water fasting in this episode and I really need to highlight that everyone, especially anyone who already has a cancer diagnosis, should really consult a qualified healthcare professional before making any drastic changes to their diet. Professor Seyfried has spent decades researching and proving a metabolic cause for this devastating disease. This is a compelling, optimistic and inspiring conversation that is packed with actions we can all take to reduce our risk, not just of cancer, but of all the chronic conditions driven by disruption. Almost 30 years ago, I started medical school in Edinburgh in Scotland. And I still

remember sitting in the anatomy theatre being told by one of our professors that one in four of us at some point in our lives were going to get cancer. And I remember being shocked. This was back in 1995. I looked around thinking, wow, one in four. Now I know as things stand today, that rate has gone up to one in two of us are going to get cancer at some point in our lives. So Professor Seyfried, you've been studying cancer for decades now. In your view, what's going on? Well, thanks. Well, you know, in any kind of a disastrous situation, there's never one thing that could be responsible for the rise in a particular disease. I think that there are many factors that come together to account in part for this worldwide epidemic of cancer, where most people that study

epidemiology have now considered the view that it's just a matter of time before cancer overtakes heart disease as the number one killer of people in various countries. So what, what's going on, uh, when you consider that our ancestral, uh, groups of people, are ancestral groups of people. Cancer was extremely rare in tribes and different populations that live by their standard ways, ways that were common to those folks for centuries. All of a sudden now, we have this explosion within the last, say, 50 or 70 years, an explosion of cancer. And a lot of it has to do with our Western civilization, diet and lifestyle. We have more contaminants in the atmosphere. We have less exercise and we have far more foods that are poorly nutritious and provide high amounts of carbohydrates. I think you put all

this together because there's a direct correlation between the obesity epidemic and cancer, a correlation between the obesity epidemic, cancer, and type 2 diabetes. You put all this together, Alzheimer's disease, all these chronic diseases are on an increased trajectory. So clearly, it's linked to a change in diet and lifestyle over the last 50 to 70 years where we're really starting to see this increase. Even when we said the anti-smoking campaign here in the United States in the 1990s, smoking was a major cause of lung cancer and other cancers. But now with the reduction of smoking, we're still seeing this relentless increase. And obesity now is replacing smoking as a number one or a major risk factor for the

development of cancer. So I think it's a lot of factors coming together, increasing our susceptibility to developing tumors in various organ systems. It's really interesting. One of the ways in which we get trained as Western medical doctors, of course, is that these different diagnoses, these different illnesses are completely different diseases. We say things like, oh, you know, this increases your risk of type 2 diabetes. And if you have type 2 diabetes, it increases your risk of another condition called Alzheimer's disease. And what's really interesting hearing you talk about what's happened in the last, well, my question was the last 20,

30 years, but you broaden it out to 50 to 70 years, is that it's not just cancer that's going up. As you say, we know that chronic disease is going up, type 2 diabetes is going up, Alzheimer's is going up, cancer is going up. And I know you have very much been trying to get the message across to people for many decades now that cancer is a metabolic disease. So clearly, these things are not quite as separate as they might initially seem. That's absolutely right. And metabolic homeostasis, which is the absolute functioning of our cells in the appropriate way, organ cells, it's called metabolic homeostasis. When you're basically a very healthy person, you're in metabolic homeostasis.

So what's happening is our bodies are falling out of metabolic homeostasis as the result of a variety of insults largely from the environment, diet, and lifestyle, and these kinds of things. from the environment, diet and lifestyle and these kinds of things. But when you look back and say, what is responsible for maintaining metabolic homeostasis? And it comes back to our mitochondria within the cells, the organelle that ultimately is responsible for the metabolic homeostasis within individual cells and within the body as a whole. So this organelle, when it becomes corrupted or dysfunctional, can manifest this problem in many different ways, cardiovascular disease, type 2 diabetes, cancer, Alzheimer's disease, depending on the tissue and the cells of the individual. In cancer, we know for sure

that every major cancer that I have studied has defects in the number, structure, and function of the mitochondria. And this then causes the cells to fall back on a primitive form of energy, which is fermentation, and that leads to dysregulated cell growth. So I have a very clear idea of the origin of cancer and how to manage it. The ramifications of these to, say, other chronic diseases, we always find a mitochondrial connection. It may not be always the same as what we see in cancer. Yeah. Well, let's just go initially to something you mentioned at the start of this conversation,

which is when we look at these kind of indigenous populations, we don't see cancer. Now, some people may be thinking, okay, but how much are we examining these people? How much are we scanning these people? So do we know for sure that actually they don't have rates of cancer or is it just that we haven't found it? So I wonder if you could just address that right at the top. Yeah, well, that's a good question. But when we read the work of the humanitarian physician, Albert Schweitzer, he definitely knew what cancer was. He examined 40,000 Africans living in their natural ways looking for cancer, and he didn't find it. So he absolutely knew.

In other cases, with the Inuits of Alaska and the Arctic Circle, some British physicians reported that cancer was very, very rare. But I don't think it was done as comprehensively as what Albert Schweitzer did in the African populations. But others have looked as well. And they kind of concur what Schweitzer had seen. In general, human populations that lived according to traditional ways had a much lower incidence of cancer than those same populations that shifted to diet lifestyle. For example, the Inuits.

I had the opportunity to visit the medical school at Thunder Bay, Canada, where they service the medical problems of the Canadian Inuit population. And the Inuits now are raked with diabetes, cancer, dementia, which their ancestral populations never had. So clearly, it's the change in diet and lifestyle that's largely responsible for the onset of these chronic diseases, including cancer. I've heard you say in a previous interview that our bodies are actually very resistant to cancer. And I've been thinking about that a lot over the past few days, that despite all the insults that are coming into our bodies, especially these days, although the rates are high, you could make the case that the rates should be even higher.

So I guess when you say our bodies are incredibly resistant to cancer, what do you mean by that? Well, I think when we live traditional lives like the primitive folks and traditional ancestral groups traditional ancestral groups not getting cancer or having very low rates of cancer. I think when we have the right diet and lifestyle, I think it becomes much more difficult for cancer to develop. And a kind of an example of this was there was a study done some years ago with, I think they were macaques, some sort of a monkey from South America or one of these places. And they rubbed carcinogen, 20-methylcholanthrene is a known carcinogen. And they rubbed it on the arms of these monkeys for 10 years and inject them with

it and everything else. And they didn't get a single case of cancer from these. And they concluded that, well, these monkeys are not good models for cancer. But the monkeys were eating their diet. They were living in their natural environment. And they were quite resistant. The alternative experiment, which was never done, is why don't we give these monkeys high carbohydrate diets, really change their diet and lifestyle, and then do these kinds of experiments. And I think that members of our ancestral groups having the correct exercise, diet, and lifestyle, even when exposed to carcinogens, would have a much lower risk. So when you take folks that are now not exercising, getting obese, you have them exposed

to a variety of chemicals within the food systems, the type of poor nutrition. I think even though we have a lot of resistance in our body to cancer, we're really bashing down those walls of resistance by the diet lifestyles that we're taking. Yeah. I really like that example because I think it goes beyond cancer for me into all these chronic diseases. We can scare ourselves these days if we go online, if we read about the toxins, the pollutants, the air pollution, the diesel fumes.

It can be really, really scary to think, well, what can I do? I'm going to be exposed to so much of this. But what you just explained there is really the approach I take with myself and with my patients, which is very much, okay, well, what can you do? Okay, what are the things you have control over? What can you do in your own house? And the more good things you can do, the more of a buffer you create, the more strong these foundations become to then resist the attack

and the onslaught from the modern worlds. As someone who's been studying cancer for decades now, do you think that's a kind of fair analogy? Oh, I think it's a really good analogy. I think, but it's hard, you know? It is hard. We are confronted now with food sources in abundance. Our exercise levels are far, far lower than they were when we evolved as a species.

Um, you know, this, this whole way we live sitting in traffic in front of computers, um, with minimal exercise, uh, chowing down on, on, on poorly nutritious, high carbohydrate foods. I mean, over years, you know, little kids, kids can do this, uh, because your body is strong and healthy, but man, you do that for 30 years and it just, it just, you know, it crushes you down. Yeah. And so it's a combination of all these exposures and the lifestyle that we have. And it's, it cuts across racial and different groups. different groups. I mean, it clearly it's, it's a common, it, once that Western diet lifestyle enters into a population, all of a sudden you see the onset of these chronic diseases. It's very clear. So, so that never existed previous. So you can know, you know what it is, but what in the

diet and lifestyle specifically is responsible for one of these chronic diseases, you know, as you said, they're all linked in one way or another. And that linkage, in my mind, has to do with the way we generate energy within ourselves and the consequences of what happens to the body through this chronic assault year in and year out, decade in, decade out. Yeah, we're going to get into the details here because I think it's really important. And I think certainly for longtime listeners of my podcast, I think, I hope there's a real awareness that actually the way we live our lives, the choices we make, the behaviours we engage with each and every day, over time they

build up and they increase our risk or decrease our risk of getting sick in the future. But we haven't spoken about cancer that much on the show so far, which is one of the reasons why I wanted to speak to you. And I think you've already so far spoken about concepts that people are familiar with, but possibly not familiar with when looking at cancer. What I mean by that is, just as type 2 diabetes doesn't happen overnight, you don't just wake up one morning, go to the doctor, get your HbA1c at 6.8 and go, oh wow, I don't know what happened. I've just got type two diabetes. No, things were going on in your life for maybe five to 10 years that was building up, building up, building up. And now you've crossed that threshold. Can we say cancer adopts a similar kind of model that, you know, you get the diagnosis at some point, but things have been building up for a period

of time. I wonder if you could just expand on that and help us understand how one actually develops it in the first place. Yeah, well, you're right about that. I mean, it doesn't happen. You don't go to sleep looking healthy at night, wake up with a big tumor on your lung or your kidney or something like this. tumor on your lung or your kidney or something like this. I mean, these things, when you have something that can be obvious now and detected by pathological report or non-invasive imaging, I mean, there's got to be a large number of dysregulated cells in that mass before you actually see it with,

with some diagnostic tool. But, you know, when I, when I wrote my book on cancer, Albert Szent-Gyorgyi, who was a Nobel prize recipient, did work on vitamin C. He called, he called this cancer thing thing an oncogenic paradox. How is it possible that so many different provocative agents could elicit a dysregulated group of cells in a particular organ or part of the body in a common way? What is the common pathophysiological connection among all the provocative agents? We know carcinogens. They call chemicals that cause cancer as carcinogen. This is a chemical that has been determined to cause cancer. So we refer to

these chemicals as carcinogens. We also know that we have certain viral infections like hepatitis C, papillomaviruses, and some of these other kinds of carcinogenic viruses. They produce cancer. We also know radiation can produce cancer. We also know that chronic inflammation can produce cancer. We know that intermittent hypoxia can produce cancer in certain cells. What is the common pathophysiological mechanism by which all this happens? We know that there are certain inherited genes in our body. These are called secondary risk. They're not primary risk factors, but in the right environment, they will elicit cancer like the Liefraum-Menny syndrome. You have the BRCA1 mutations for breast cancer. So a woman might get breast cancer for having a BRCA1 mutation. They might get breast cancer from a clogged milk duct. They may get cancer from systemic inflammation. But when you look at it

under the microscope, the pathological report, they say, oh, you have breast cancer. So what was the origin? Why one woman, why all these women that would have various kinds, they might all have different provocative agents that elicited the common path. Now, what the common pathophysiological mechanism is to all cancers is a chronic disruption of energy metabolism in the mitochondria of the cell, followed by a compensatory fermentation. Now, let me break that down because this is what Otto Warburg initially said. He just didn't connect all the dots like we have. He said cancer elicits from chronic damage to the ability of a cell to generate energy from oxygen. So we know that all of the cells in our body use oxygen to generate ATP, which is the

currency of energy in our body, adenosine triphosphate. Okay. So you and I are breathing, we're talking because the air that we breathe in has oxygen in it. Oxygen serves as the acceptor of electrons, which allows the mitochondria to produce vast amounts of energy. And the waste products are CO2 and water of oxidative phosphorylation. All of our cells in our body, the majority of cells except red blood cells, are using this process so that we can remain alive. What happens in the cancer cell? Over time, that organelle, that process becomes corrupted or deficient in some way. But as Wernberg said, if you disrupt oxidative phosphorylation or energy through oxygen too acutely, the cell will die and you'll never get a cancer from a dead cell. So whatever causes the cancer, whatever the provocative agent does, it doesn't do it

acutely, it does it chronically. And by chronic disruption of oxidative phosphorylation, it allows the cell to replace oxidative phosphorylation with the ancient pathways of fermentation. oxidative phosphorylation with the ancient pathways of fermentation. The fermentation pathways is energy without oxygen. And all the cells on our planet existed in using fermentation before oxygen came into the atmosphere. And that was about 2.5 billion years ago. So the cancer cell adapts to a fermentation metabolism as a way to compensate for the chronic disruption of oxidative phosphorylation. Interestingly enough, that same organelle, the mitochondria, controls the cell cycle. It allows the cell to remain in a quiescent, differentiated state.

And as that organelle becomes corrupted over time, the transition to fermentation causes the cell to lapse into the default state, which is proliferation. So in this, all of the cells on our planet were highly proliferative, dysregulated cell growth before oxygen came into the atmosphere to form metazoans and more complicated, complex organisms. So the cancer cell is doing nothing more than falling back on ancient pathway, living as if it were in the absence of oxygen. And that's what cancer cells do. They can absolutely survive without oxygen. They don't use oxygen anymore. So they're living without oxygen, anaerobosis as Warburg called it, their life without oxygen. Even when oxygen is present, the cancer cell is still fermenting. So now you know what this cell is. Yeah, it's so interesting. So let's just unpack a little bit of what you just said. First of all, you said that, I guess, or my interpretation is that there are infinite numbers of insults that

we can have on the human body. And with respect to cancer, it can be from pollution, from radiation, from whatever it might be, we can have these insults. But whatever those insults are, for us to get a diagnosis of cancer, there is a specific abnormality in mitochondrial function which occurs. At that point, the cancer cell is no longer utilizing oxygen to make energy, it's doing it using fermentation products. And you're saying that, so if we go down that logic, is it fair to say then that cancer is not really the diagnosis, cancer is a symptom, it's a symptom of problems in the mitochondria? Yes, exactly. You're actually right. And then

Warburg had said this, and at that time, he only knew about glucose fermentation, lactic acid fermentation, because ATP synthesis through oxidative phosphorylation is highly, highly efficient. So you can generate 32 to 36 ATP molecules for one mole of oxygen consumed. But fermentation is a very inefficient system. So what is the raw material to generate fermentation? Yes, glucose, but the glucose can only generate a couple of ATP relative to the vast number from oxidative phosphorylation. So in order to make up the difference in energy, you have to take in

massive amounts of glucose in order to replace the energy that you would have gotten from, that the cell would have received from oxidative phosphorylation. So consequently, the transporters for the sugar glucose are massively upregulated on the surface of cancer cells. And this is one of the reasons why you can detect tumors using PET scanning, positron emission tomography. You can see cancer because it's sucking down so much glucose. But what we have found, and Warburg did not know, we have also discovered that these same tumor cells also ferment the amino acid glutamine. So they can use glutamine in the absence of oxygen in a fermentation mechanism.

So the two fuels, the glucose and the glutamine, are the two predominant fuels for fermentation. So once you know this, once you know that these tumor cells are dependent on non-oxidative energy, which is called fermentation, energy without oxygen, what generates... Listen, without energy, which is called fermentation, energy without oxygen, what generates, listen, without energy, nothing can grow, period. Energy is absolutely essential for life. So if the cancer cell is using a different type of energy metabolism, what is it? It's fermentation. Wow. Okay, great. What are the fuels that are driving the fermentation? Well, one of them is glucose, as Warburg said, and the other one is glutamine, as we have now found as the second major fermentable fuel in these tumor cells. And these two fuels work together, driving all of the necessary processes for rapid development,

rapid proliferation, and for the constant dysregulated growth. DNA, RNA, protein synthesis. The glutamine has the nitrogen and carbons to make new DNA and RNA. The glucose has the carbons for fatty acids and proteins. And these two fuels are driving the beast. And then the other thing you need to know is that they can only use fermentable fuels. Fatty acids and ketone bodies are non-fermentable fuels. They cannot be used by tumor cells, but they can be used by normal cells that have normal mitochondria. So the solution to the cancer problem is simultaneously targeting the fermentation metabolism of the cells, which is the glucose and glutamine, but by transitioning the body over to ketone bodies, which allows the normal cells

in the brain and all of the organs to function, and fatty acids for the liver. Tumor cells can't use fatty acids in ketone bodies. So the solution to the cancer problem is very simple. You have to simultaneously target the fermentation while transitioning the body over to fuels that cannot be fermented. And this now puts massive pressure and kills the tumor cells without toxicity. Wow. I mean, it's so clear when you say it like that, because look, if you were not medical, right? If you knew nothing about cancer and the pathophysiology, but you knew that, hey, listen, a cancer cell cannot use oxygen. Even if oxygen is around, it doesn't use oxygen to generate energy. It can only use glucose and glutamine, right? If that's all you you knew you told a child that i reckon a child would say okay well let's not give the body any more glucose or glutamine if that's what cancer cell feeds on

let's stop it right now that may be overly simplistic but it kind of sounds like that's the conclusion from what you're saying yeah Yeah. Well, I think you can't stop the glutamine because it's a non-essential amino acid and it's the most abundant amino acid in our body. It plays a massively important role in our gut, our immune system, the urea cycle. So glutamine, they call it a non-essential amino acid, but for cancer, it's an absolutely essential amino acid. You can use diet and lifestyle to lower blood sugar for sure, but you need drugs that will interrupt the glutamine pathway, the glutaminolysis pathway, essentially. So we use a combination of diet and repurposed drugs in what we developed called the Press Pulse

Therapeutic Strategy for Managing Cancer, where we bring the body into a state of very low glucose, high ketones, and then we hit the surviving tumor cells with drugs that can target and disrupt the glutamine pathway. But we pulse it. We don't do it very, we pulse it. We don't do it too aggressively. Knowing the value of glutamine for the normal physiological function of our body, you can't go after glutamine aggressively

because you're going to harm the body. So you have to know the biology. You have to really understand biology, evolutionary biology to manage cancer. And once you understand that like you said it's quite it's not that complicated uh once you break down uh the issues so um once you understand the issues and dissect them i mean yeah there's you have to know about energy metabolism and you have to know about a variety of these things for sure but once once you know that, then the path to resolution, the path to long-term

management without toxicity becomes obvious. You mentioned oxygen, making energy in the presence of oxygen or making energy, well, in the presence of oxygen, but without utilizing oxygen. And I think a lot of the public have heard about aerobic exercise and anaerobic exercise. So they understand, I think, a lot of people will remember from biology class at school, that when your body's utilizing oxygen, you can do certain forms of exercise. But if you push up the intensity and let's say you're playing football or doing lots of high intensity sprints, that at some point you go to anaerobic, where actually you're generating energy no longer using oxygen or not exclusively using oxygen.

For people who are thinking about that, can you help us understand, is there a similarity there between what you're saying about cancer and the difference between aerobic and anaerobic exercise? Just taking a quick break to give a shout out to AG1, one of the sponsors of today's show. Now, if you're looking for something at this time of year to kickstart your health, I'd highly recommend that you consider AG1. AG1 has been in my own life for over five years now. It's a science-driven daily health drink with over 70 essential nutrients to support your overall health. It contains vitamin C and zinc, which helps support a healthy immune system,

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with their first order. But until the end of January, they are doubling the five free travel packs with their first order. But until the end of January, they are doubling the five free travel packs to 10. And these packs are perfect for keeping in your backpack, office or car. If you want to take advantage of this limited time offer, all you have to do is go to drinkag1.com forward slash live more. That's drinkag1.com forward slash live more. Yeah, well, I think that's really an important point. With the sprinting, you build up lactic acid because the muscles are working at such an

incredible speed that the amount of oxygen delivered to the tissue in the blood is not enough to keep the muscles working through an aerobic mechanism. But the muscle can generate tremendous energy using anaerobic short periods of time. For short periods of time, your muscles can burn energy through anaerobic mechanisms, which is taking in massive amounts of glucose and getting energy. Now, as soon as the muscle stops contracting, you're breathing oxygen so that the muscle can recover ATP synthesis through oxidative phosphorylation. But when they were in that sprinting condition, they were dumping out lactic acid, which,

and this was how they found the Cori cycle, Saul and Gertie Cori that received the Nobel Prize, when the muscles were dumping out massive lactic acid into the bloodstream from this very active activity, the lactic acid would go bloodstream from this very active activity, the lactic acid would go to the liver and the liver would conjugate the lactic acid back into a glucose. Two lactic acids were reconfigured into glucose molecule to replenish the blood sugars. Now, muscle is very interesting because muscle conserves it. Muscle does not share glucose with other organs. This is a very interesting thing. And it's an evolutionarily conserved adaptation.

So muscle stores energy in the form of glycogen. You have glycogen in your muscles. And that energy, that can be broken down very quickly for rapid energy. But muscle does not share glucose with any other organ, mostly. And that's because when a lion would chase us, we better damn well have enough energy in our muscles to run away. Because if you're sharing your energy with some other organ, you're not going to be able to run as fast when the lion chases you. So clearly, the conservation of energy within muscles is an evolutionary adaptation for

survival. Liver, on the other hand, will store glycogen, and that glycogen in the liver can be shared. In fact, it's shared mostly with the brain. And as we stop eating, blood sugar goes down. Glycogen is mobilized largely from liver, which can then subserve the function of the brain. Brain burns a lot of glucose. On the other hand, if the glycogen stores, that's why it takes about 36 hours after you stop eating for the glycogen stores in the liver to be depleted. And then all of a sudden we then mobilize energy out of the adipocytes in our body and the adipocytes release the fatty acids back into the bloodstream. Those fatty acids go

to the liver and the liver makes ketone bodies, water-soluble breakdown products of the fat, which can then provide the brain the energy for the brain. So we are an unbelievably sophisticated machine that we have these different organs and different populations of cells that can be flexible in how they generate and use energy. The cancer cell, on the other hand, is trapped. It's linked only into a fermentation energy. So knowing that this cell is massively limited in its capability of survival, we now have strategies.

We can take advantage of knowing how the body works to eliminate and kill cancer cells without toxicity. Once you understand evolutionary biology and systems physiology, you now know the strategies for managing cancer. Through the lens of evolution, you mentioned before oxygen came into the atmosphere and before we evolved into being multicellular, those single cells would generate energy through the process of fermentation, which is what cancer cells do. So is the cancer cell then moving towards a more primitive form of energy production? Yeah, you're actually right. I mean, we can't say the cells before oxygen came into the atmosphere as cancer cells,

because cancer cells developed from cells that were differentiated. They were part of the society of cells. However, they share a common energy mechanism. They ferment. They ferment. And fermentation before oxygen came into the atmosphere was the way all cells got energy, was a fermentation mechanism. And they would ferment whatever carbohydrate or whatever amino acid would be in the environment. And interestingly enough, it was called the alpha period of life on Earth, as St. Georgi called it. All of the cells at that time had dysregulated cell growth. They were unbridled proliferation, and they would proliferate like crazy until the fermentation

fuels in the environment dissipated, and then they would die. Cancer cells are the same. They will survive as long as there are fermentable fuels in their micro environment. And when you remove the fermentable fuels in their micro environment, they die very quickly, just like cells did in the old days. The old days, let's put it this way, in the time before oxygen. But their behavior is very, very similar. And when you say cancer cells look very primitive, like when you look at cancer under a microscope, I mean, it's just a massive pile of cells in all different dysmorphic stages. very undifferentiated compared to the normal cells of the organ from which they arose. But the commonality is that the cancer cell is surviving on fermentation because its oxidative phosphorylation is defective. The cells before oxygen came into

the atmosphere had no mitochondria. Mitochondria were a fusion between two different organelles, two different organisms, an organism that could capture the oxygen and use it for energy. So we had this symbiotic, and that led to the formation of metazoans, which are multicellular organisms of which we are, all metazoans, multicellular. You couldn't have multicellularity until you were able to capture the energy from oxygen in the fusion hybridization between these different organisms. So the cancer cell is simply using the heirlooms of energy metabolism from the past to grow in a dysregulated way. And that dysregulated growth will continue

as long as the cancer cell has access to fermentable fuels in the microenvironment. So our way of managing cancer is simply to restrict the availability of to fermentable fuels in the microenvironment. So our way of managing cancer is simply to restrict the availability of the fermentable fuels in the microenvironment using both diet and specific drugs, and then using the normal cells of our body to out-compete and digest and destroy the cancer cells. It's unbelievable. When you really understand the mechanisms and the strategies involved, you can get very excited about that. Well, it's absolutely fascinating to hear how we've evolved, how we get energy, and then what happens to that cancer cell and how it reverts back to actually maybe the oldest form,

the oldest way that we have of generating energy. The cancer cell is utilizing that. So that's really, really interesting. I want to talk a little bit about genes and genetics because we hear a lot of things. In the media, let's say over the last 10 years, there's been a growing awareness of BRCA1 and BRCA2 and how that potentially can increase the risk of things like breast cancer or ovarian cancer by 50% to 80%, depending on which study you read.

Now, I'd love to know your thoughts on that, but I'd also love to know just more broadly about this relationship between genes and cancer. I have heard prominent oncologists in the UK, professors, say things like, we are born with the genetic codes for cancer within our cells, but they're kept locked in place by suppressor genes. And then something happens, whether it be from carcinogens in the diet or the environment or whatever we're exposed to. And then what happens is that genetic material becomes rearranged. And once it becomes rearranged, those cells no longer stop growing and they become cancerous and they spread. So that's a viewpoint I've heard. What is your view on that? And I guess more broadly,

where did genes fit into this whole conversation around cancer? Yeah. Well, of course, that's the basis for the somatic mutation theory here in the United States. National Cancer Institute, on their website, they say cancer is a genetic disease caused by mutations in specific genes, tumor suppressor genes and proto-oncogenes and these kinds of things. And this leads to a dysregulated cell growth. And this is the dominant consistent view we have right now, the somatic mutation theory, where the mutations arise randomly in a population of cells, which then leads to a disorder of the cell cycle and the proliferation.

But you have two different kinds of genes. You have those inherited in the germline, and you have those that are acquired through various insults in the environment. When you mentioned about BRCA1, that's an inherited mutation that contributes to a greater risk for breast cancer. And when you look at what does the BRCA1 mutation do, it disrupts oxidative phosphorylation in the mitochondria. The most prominent inherited mutation is the P53 mutation in the Lee-Fraumeni disorder syndrome. You have about 80% to 85% penetrance of that gene, leading to ovarian cancer, breast cancer, brain cancer. There's a variety of cancers that are linked to the Li-Fraumeni.

The Li-Fraumeni encodes a protein in the electron transport chain of the mitochondria, cytochrome C oxidase 2. So what these inherited mutations are doing, and we went through all the inherited mutations, and all of the inherited mutations, risk factors, damaged mitochondria in a particular way, putting them on the path to destabilized energy metabolism and a consequent fermentation metabolism. So the inherited mutations are what we call secondary risk factors, not primary risk factors. Because in order for an inherited mutation to be a primary

cause of a disease like the presenilin mutation in Alzheimer's disease, that's 100% associated with the development of Alzheimer's disease. There is no cancer gene-linked, germline-linked mutation that is 100% associated with the onset of a particular cancer. So we call those secondary risk factors, just like being exposed to a carcinogen. If you inherit a mutation in BRCA1 or one of these, your risk for the development of cancer is certainly higher, but it's not 100%. Now, in somatic mutations, this is where a cell in the body will randomly accumulate mutations, some of which will then lead to destabilized growth. So where do the somatic mutations come from? And they come from destabilized energy metabolism in the mitochondria. How does that happen? So ROS, reactive oxygen species, are a byproduct

of dysfunctional oxidative phosphorylation. So the oxygen that the tumor cell is taking in is not being used efficiently for ATP synthesis, but rather is throwing out these radicals, these reactive oxygen species. What do they do? They cause mutations in the DNA. They lead to the mutations in the DNA. So the mutations that we see in cancer are largely downstream epiphenomenon of the damage to oxidative phosphorylation, forcing the cell into a fermentation metabolism, leading to acidification of the microenvironment, which further damages the nuclear genome. So that most of what we see in cancer, the genetic mutations, are largely downstream

epiphenomena of the damage to oxidative phosphorylation. So they're not causes, they're effects of this whole process. Okay, so let's just get this really clear. So because a lot of people will have absorbed the idea that cancer is genetic. And of course, there's been a conversation online for, I would say, at least 10 years about what a woman might want to do if they have one of these BRCA mutations. And I think there's some very prominent examples of women having prophylactic operations, removing both breasts to try and ensure that they don't get breast cancer in the future. And I definitely want to get your perspective on that and your view

on these kind of procedures. But the big picture I'm getting from what you're saying is that, look, these genes may increase the likelihood that you are going to develop cancer, but they're not 100%. They're not deterministic genes fully. Yeah, we call them risk factors. It's a risk factor, right? It's a risk factor. It's a risk factor, right? It's a risk factor. But if you make significant modifications to your diet, your lifestyle, your environment, the amount of stress you're under, all kinds of things that you try your best to significantly change your environment, you can then also significantly decrease your risk of developing that cancer, even if you have the gene. Yes, you are absolutely correct. So you have, I guess, at least two choices.

If you are detected to have the BRCA1, let's just use that, but there are several other genes that this would also apply to. But the BRCA1, because some women have done prophylactic removal of breasts and ovaries and things like this to reduce their risk for getting cancers in those organ systems, or recognizing that they would have this risk factor, how would they reduce the probability of that inherited mutation causing cancer? And you're absolutely right. Cancer cannot occur if the mitochondria in the cell remain healthy. And how do you keep mitochondria in your cell healthy? By exercise and enhancing ketogenesis. How do you do that? Well, you can do water-only fasting. You can do a variety of diets

that will reduce glucose and elevate ketones. Ketones are a super fuel for mitochondria. They reduce reactive oxygen species, the damaging byproducts of respiration. So ketones can significantly reduce damage to mitochondria, allowing that organelle to function in a highly precise manner for long periods of time. So yes, diet and exercise in the right foods,

in the right context, could take the risk of a hereditary mutation that we would say 50% chance of getting a cancer with that mutation. You could reduce that down massively. I don't know to what extent because the studies haven't been done in the correct population. But we do know that we can significantly, just as you said, you can significantly reduce your risk knowing that you can't get cancer without, you get cancer from

damaged respiration, protect the mitochondria, and the risk will go down. Look, I'm all for informed consent, like real informed consent. So you tell a patient what all the options are. And of course, a patient is entitled to do what they want, right? They're entitled to do what they want with their own body. But what I'm passionate about, why I work so hard on this show each week is to help give people information. So actually they're empowered to know, well, actually there are some options here. There are some options. Now someone may say, I don't want to take that option. Fine. Informed consent to me means, or one part of it is giving people all the options. So if you have been diagnosed

with epilepsy, as well as the anti-epileptic drugs, if there's good evidence, as there clearly is, that ketogenic diets can be of use, and in some people can be transformative, surely you should also be told that at the same time. Now you may go, well, I don't want to do a ketogenic diet. It's too difficult. It doesn't fit my life. Fine. You're entitled to make that decision, but you kind of need to be given that choice if we're going to be evidence-based, if we're truly practicing informed consent, right? Yeah, absolutely. I was on those decision committees when I was a member of the Epilepsy Society of America.

I was the society's representative to the corporations on this whole thing. And, you know, the ketogenic diet developed from Wilder in 1921, only when he realized that many of these intractable seizures could be modified significantly with water-only fasting. But water-only fasting is only good for a certain period of time, and you have to eat something. So what he found was that when you water-only fast, blood sugar goes down, ketones go up. Is there a diet that can do what water-only fasting could do? And that was the ketogenic diet. It was managing a lot of different seizures in children. It works in adults, but it's the children. The problem is with kids is that when they have a blown seizure or they have absence seizures or whatever, it disturbs the parents tremendously. And the parents have control

over the child's diet at what they're doing. So in order to avoid seeing your child writhing on the floor and foaming, they would say, okay, you're going to stay strict on this diet because I don't want to see you seize. In the 1930s, certain drugs became available that would also stop seizures. And obviously it was much easier to take the drug than to adhere to a kind of a rigid diet. The problem with these drugs is long-term, they have very adverse consequences. And then in the 1990s, mid-1990s, Jim Abrams, a movie producer from Hollywood, his son Charlie had this terminal kind of epilepsy where he was actually dying. And then he contacted folks at the Johns Hopkins Medical School in Baltimore, the late John Freeman, who was one of the few guys left that like to study

ketogenic diets. And they rescued Charlie from his condition. They made a movie out of it, First Do No Harm, was the movie with Meryl Streep, a friend of Jim Abrams, made this movie, which then brought tremendous attention back to this ketogenic diet because it had fallen by the wayside. When I was at Yale University in New Haven, Connecticut, I wanted to do a project on ketogenic diet internal support. And the people in the neurology department and the medical school in general said, ah, ketogenic diets, nobody's interested in that stuff anymore. So my grant was just like, oh no, no more. So when one of my students came to me in the late nineties, when I was here at Boston college and said, Hey, there's a, there's a meeting in Washington, in Seattle, Washington on ketogenic diets, spearheaded by Jim Abrams, because his son,

Charlie did so well in this ketogenic diet. He wanted to bring the concept to the world that this ketogenic diet should be resurrected as a non-toxic management for epileptic seizures. So I told him I see that nobody's interested in ketogenic diets. She said, oh, please send me anyway. So I sent her out there. She came back. Oh my God, you can't believe how powerful the diet is. Everybody's so excited about this diet for epilepsy.

So we started working on ketogenic diets because we had the best animal models of epilepsy, just like humans with Epsom seizures and all this kind of stuff. And we started to see, wow, this diet does work on the animal models as well. And I said, we published all these papers and everything. And I said, wow, what's the mechanism of action? I know you got to lower glucose and elevate ketones. Well, we were doing research on cancer at the same time, looking at angiogenesis, which is the vascularization of the tumor cells.

So when we put the epileptic mice on calorie-restricted diets that lowered blood sugar and elevated ketones, we knew from Warburg, I said, what the hell, Warburg? He said, you lower blood sugar and you can manage cancer. So we started to move the diets that we were using to manage epilepsy in the mice onto our cancer models, which are the best models that we, spontaneous models of cancer in the mice. And lo and behold, we said, holy crap, these calorie-restricted diets knock the hell out of angiogenesis. When everybody's getting excited about angiogenesis, you can completely manage angiogenesis with these diets. And, you know, Napoleon Farrar and all these other guys that were making all these anti-angiogenic immunotherapies and stuff, and a lot of them don't

work and they cause the cancers to be worse. But when you start using metabolic therapy, so after we saw that, and not only that, we started killing these cancer cells through a variety of different mechanisms, okay? And then we said, oh, we should be shifting, shifting our power away from the,

we actually had two parallel programs, metabolic management of epilepsy and metabolic management of epilepsy and metabolic management of cancer. But of course, folks from England and the United States got together and they wrote up a clinical trial. They said, well, we can't believe epilepsy, managing epileptic seizures with ketogenic diets. There's no clinical trials. Well, Dr. Cross from England and our group here at Johns Hopkins got together and they wrote up a really nice publication showing a clinical trial that ketogenic diet absolutely can manage a variety of epileptic seizures in children. So you'd say to yourself, well, like you said, well, then we should use this. But no, they'll only do ketogenic diet for managing seizures only after your expensive

drugs don't work. Then you'll do that. But we've all argued that you should be doing metabolic therapy for epilepsy first. If that doesn't work, maybe you can consider low dose drugs. But they still have it reversed. In the cancer field, the stuff right now, what I'm saying is predominantly unknown. People have no clue that you can manage cancer in a very similar kind of way, obviously with certain differences. But now that's the

situation. So the argument is, well, we can't use metabolic therapy for cancer because there's no clinical trials to prove it, despite the fact that the science is rock solid to support why you should do that. So that's the conundrum that we have right now, is that no one on the planet has yet, and we can't do a clinical trial yet because the people needed to do that aren't trained. And you need to know what to do and how to do it. And we're working on that right now. So as soon as we have our treatment protocol, we'll be able to move into the cancer field with the same intensity as we did in the epilepsy field to manage the epileptic seizure. So it's an evolving situation with parallel studies, knowing how the brain works under the ketosis issue and all of these different kinds of things

coming together to know how to enhance the health and vitality of your normal cells without harming the body. I know I said an awful lot in a very short period of time. No, I mean, you're clearly very passionate about this and with good reason. How long have you been studying cancer for now? Well, I studied cancer for probably 40 years, but it was not in the way to manage the disease. I studied cancer like 90% of the people studying cancer. We do research on some aspect of cancer. Like I was doing glycolipids. We were looking at all the different abnormalities in glycolipids in cancer cells. So it had nothing to do with actual design to manage the disease. Of course, everybody in their papers, everybody, many, many people put it, oh, this information

could potentially be important at some future point or whatever. But it wasn't a direct assault on the management of the disease where you can actually see an observable outcome in someone that would be riddled with a stage four cancer. Okay, how would understanding the glycolipid dysregulation in that person with a stage four cancer in a very short period of time lead to a management strategy? And the answer was none. And that's the majority of people signaling cascades and looking at this and looking at that. I mean, you can do that for the next 150, 200 years and you're not going to have any impact in the clinic. So the idea is how are you going to make your research impactful to

the person dealing with a stage four cancer today. We've used the word cancer a lot during this conversation so far. And of course, there are lots of different types of cancer. You can differentiate them depending on location in the body, brain, pancreas, prostate. Of course, the different pathological types of cancers as well. So when we say cancer, do we need to be a bit more specific about what we're talking about? Or would you state based upon your research that actually all of them are fundamentally the same? There is a problem with respiration. There's a problem with generating energy in the mitochondria. Just help us understand that, if you will. Yeah, well, that's really so important because we were all led to believe, and we still are pounded by information saying we have a therapy for your specific kind of cancer. You hear this all the time. Breast cancer

is different from colon cancer, different from brain cancer, different from bladder cancer, different from the leukemias. You hear this all the time. And that's based, again, on the somatic mutation theory of cancer. When you start to look at the mutations in all these different cancers, they're all quite different from each other. They're different from each other within the same type of cancer, within the same tumor, you'll find all kinds of different mutations. But all of the cells, now what I did, I went back and I said, well, if all the cancers that we know are fermenting to get energy, that says there's some commonality between them. go through historical records on ultra histology, the way electron microscopy, ultra structure of the cells in a cancer. So I would look at lung cancer, breast cancer, colon cancer, pancreatic cancer, bladder cancer, blood cancers, and I was looking for a commonality.

And that commonality was abnormalities in the number, structure, and function of mitochondria in all of the major cancers. And that's what I found. And in the concepts of evolutionary biology, structure determines function. This is a well-established concept. Structure determines function. If the structure of the organelle that generates energy through oxygen is abnormal, the function of that organelle will be diminished in some significant way, leading to an alternative energy, which would be fermentation. So when I went back and looked at all of the major cancers, I found abnormalities in all of these different cancers. And then that would lead to the explanation

that they would all need to have fermentation in one way or another. And that leads to the concept that if they do ferment, there's only two fuels that they can ferment, which is glucose and glutamine. And we know every major cancer is dependent on glucose and glutamine fermentation. So it comes right back to the,

yes, they look different under the microscope. They look different in their genomic profiles. But metabolically, they're all very, very similar and will respond quite effectively to a singular strategy of metabolic therapy. The ketogenic diet or certainly the presence of ketones in the body is now, you know, the research is accelerating so fast. We're seeing benefits, potential benefits of ketones in neurodegenerative disease, in Alzheimer's, in mental illness, in cancer, of course, in weight loss. And it's really interesting,

weight loss. And it's really interesting, isn't it, that how can this one fuel source or potentially this one diet, ketosis, and of course, there's many ways to get into nutritional ketosis, but it's very interesting to me how this could potentially have a wide variety of different benefits for a wide variety of seemingly different conditions. Now, let's look at this methodically. Yeah, you're right. You're absolutely right. I mean, okay, let's go back to our Paleolithic ancestors. All right. So for thousands and thousands of years, for thousands and thousands of years, we were in a state of ketosis, mainly because food was not available. Carbohydrates were certainly very limited to seasonal situations. So our ancestors, we were always in a state of therapeutic ketosis. We know that in the aboriginal populations not only was cancer rare diabetes was rare cardiovascular disease was rare alzheimer's was never heard of or rarely discussed or rarely identified

as some all of these things that we see that you've just mentioned, are linked to mitochondrial function. So ketones, as I said, as my late good friend Richard Veach from the National NIH, ketones are a super fuel. They allow the health and vitality of our mitochondria. They allow our mitochondria to remain very, very healthy. our mitochondria, they allow our mitochondria to remain very, very healthy. So when you talk about all of these different linkages for all these different diseases, it all comes back to energy metabolism. And we didn't have all of these chronic diseases when we were existing in the Paleolithic period. We had other things that would kill us, like infections, bacterial infection. We had other things that would kill us like infections, bacterial infection. We didn't have antibiotics, falls, arthritis. You would have a variety of things that would limit your

capability of longer-term survival, but cancer, dementia, cardiovascular disease, all of these kinds of things were not there or very, very rare. So when you say ketogenic diet, it's actually, you got to be very careful because it's not necessarily a ketogenic diet. It's the state of being in therapeutic ketosis. And a ketogenic diet can put you in therapeutic ketosis. But many of these so-called ketogenic diets are not done correctly. People go out, eat too much of it. They don't do it the right way it's

nutritionally imbalanced i mean but uh but the bottom line the the underlying theme here is nutritional ketosis prevents chronic diseases that's a really interesting point there right so if we're going to talk about as i hope we get to during this conversation nutrition and cancer and the link between it and you've covered bits get to during this conversation, nutrition and cancer and the link between it. And you've covered bits of it throughout this conversation so far. A lot of people will talk about, and there's lots of N equals one studies, there's lots of anecdotes of people saying that, I got a cancer diagnosis and it caused me to stop and look at everything in my life. And I changed dramatically

my lifestyle. I started to meditate. I lowered stress. I stopped traveling all the time for work. I went on a keto diet, for example, and my cancer never came back, or whatever it might be. You hear that a lot with a ketogenic diet, and of course that can be practiced in many different ways. But you also hear people saying that if they radically change their diet to plant-based diets. There's many case studies out there that I've heard, or certainly people reporting. Now, it's really interesting to me. So I'm trying to put it all together and go, well, okay, to me. So I'm trying to put it all together and go, well, okay, what Thomas just said was that it's not necessarily a ketogenic diet. It's the state of ketosis. So I guess what I'm trying to get to, a plant-rich diet will have lots of polyphenols within it. And I know there's been

quite a few studies showing the benefits of polyphenols in terms of their role as signaling molecules and what they can do for cancer risk. Given what you know about cancer, how do you put these two things together where some people say they revolutionize their health with a keto diet, other people will say that they've done it with a plant-based diet. How does that sit with you when you think about cancer? Before we get back to this week's episode, I just wanted to let you know that I am doing my very first national UK theatre tour. I am planning a really special evening where I share how you can break free from the habits that are holding you back and make meaningful changes in your life that

truly last. It is called the Thrive Tour. Be the architect of your health and happiness. So many people tell me that health feels really complicated, but it really doesn't need to be. In my live event, I'm going to simplify health and together we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life, and I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to drchatterjee.com forward slash tour and I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change.

Now journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better decision making and reduce symptoms of anxiety and depression. It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships. There are of course many different ways to journal and as with most things it's important that you find the method that works best for you. One method that you may want to consider is the one that I outline in the three-question journal. In it, you will find a really simple and structured way of answering the three most impactful questions

I believe that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes, but the practice of answering them regularly will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much it has helped them and how much more in control of their lives they now feel. Now, if you already have a journal or you don't actually want to buy a journal, that is completely fine. I go through in detail all of

the questions within the three-question journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal, or click on the link in your podcast app. Yeah, well, I think those are important points. And you know, we don't have answers to all of that yet. I know Kelly Turner wrote a book on called Radical Remission. And in her book on these cancers that you've just mentioned, like some people just do something different and cancer goes away. She kind of cataloged all the different kinds of things that were linked to so-called radical remissions. And a large amount of it had to do with a dramatic

change in diet and lifestyle, whether you were a carnivore going through a vegan or a vegan going through a carnivore. It seemed as though there were radical changes in diet and lifestyle that these remissions. You have to realize the cancer cell is a cell hovering near death all the time because it can't get energy efficiently. So it has to depend upon the fermentation fuels in the micro environment. And whenever you change the whole physiology of your body, you are creating all the, we evolved as a species to survive under incredible stresses in our environment, whether it's cold, hot, food, absence, food abundance, or whatever it was. Rick Potts of the Smithsonian Institution described it as our flexibility in survival. Cancer cells can't do that. They're very limited. So when you have these radical changes in your body going from one state to another,

sometimes the tumor cells just simply cannot handle the change in some people making these radical changes. So you don't have a very good clinical trial or a sophisticated approach to say, you know, what is responsible for the elimination of your cancer by this radical change? All we know is the tumor cells up and died and they disappeared and you're now healthy. In the movie that's coming out, the documentary film called Cancer Revolution by Brad and Maggie Jones. Brad is a professional documentary filmmaker and his wife, Maggie, who contacted me, she had stage four breast cancer that metastasized to her

brain. She went on one of these radical keto changes and her cancer disappeared and she's still doing very, very well. But they've collected a lot of these N of ones, a lot of these people that you just mentioned and put them in the movie. And they're all, the faces are there and I'm a survivor, I'm a survivor, one after another, after another. And she's collecting more and more of these individuals that had stage four cancers of a broad range, lung cancer, brain cancer, colon cancer, breast cancer, and they're all alive. What is it about this? And there's no comprehensive clinical trials on this because how would you design such a clinical trial to look at some sort of a radical change in your diet and lifestyle? There's a lot of variables

that have not yet been pinned down that we should need to focus on. And this is the whole thing with using ketogenic diets for managing cancer. What kind of ketogenic diet? That's why we developed the glucose ketone index calculator. We published this. And what it does is it allows any patient, healthy or sick, to know whether they're going to be in a state of maximal metabolic homeostasis. And it's a meter, you can buy it on Amazon, the Keto Mojo meter, and you take a drop of blood and you can measure with one stick your blood sugar and with another stick your blood ketones. And if you can get the ratio down to 2.0 or below, you are going to be in a state of metabolic homeostasis. And that really puts tremendous pressure on cancer cells, homeostasis. And that really puts tremendous pressure on cancer cells, diabetes, all of these varieties. In other words, you're bringing yourself back to a state of metabolic homeostasis with a

quantitative measure to let you know when you're there. Okay. I want to talk about that. I just want to finish off from the previous question about keto diets, plant-based diets. Another way I was thinking about it as you were talking is that if we develop cancer, based on everything we've said so far, I think it's fair to say that there's something going on. You have been receiving a variety of inputs, whether out of choice or not out of choice, whether you're aware of or whether you're not aware of, but whatever's happened, your current environment has resulted in you developing cancer, right? We don't know maybe what exactly it was, but it was multiple signals from your environment and lifestyle. So if you then undergo radical environmental and lifestyle change,

If you then undergo radical environmental and lifestyle change, I'm not saying no matter what, but if you're significantly making changes so the environment in which the human body is now existing is fundamentally different, well, it kind of stands to reason that in some cases, depending on how advanced that cancer is, depending on the type, it stands to reason that, yeah, in some people, the environment has shifted and you're no longer getting the inputs, so cancer cells are no longer sort of growing and proliferating, right? Does that sound like a reason? You're absolutely correct.

Especially if you catch it early. Yeah. Many people, not all people, many people are first diagnosed with cancer. They never knew, Oh gee, I just diagnosed with cancer. How do you feel? I feel great. Uh, it's at that stage, uh, where the body is pretty healthy other than you have a growing tumor somewhere where you can do this radical change and blast out these, uh, marginalized and blast out these cancer cells. The problem, the problem is many cancer, many folks who are diagnosed with cancer,

immediately without any alternative thinking or recognized, they go in for toxic poisons and radiation. And what happens is that undermines the health vitality of the rest of the cells in the body, making them less capable of challenging the vitality of the rest of the cells in the body, making them less capable of challenging the vitality of the existence of these tumor cells. So then I get so many people contacting me who have failed every kind of a cancer treatment, and the cancer is still growing, and now they want to do one of these metabolic therapies. And their bodies are rigged. They're emaciated. They have all kinds of adverse effects and all kinds of stuff.

And now you're going to ask your body to go through this tough, radical change to try to eliminate. They should have been doing that at the very beginning. Not to say it can't happen, because when you have, sometimes you get a stage four diagnosis, you're still in pretty good health. Oh, I got stage four diagnosis. Okay, well, great. Now you do metabolic therapy to pound out those cancer cells. Not to say that we can't use radiation and chemo, but they would be used in a very strategic way, in very low doses at the right time, at the right setting, but not massive poisoning at the beginning of this disease.

That is such a key point, because I really think that that message has to come through loud and clear, which you're not necessarily saying that we shouldn't be using some of these modern advances like chemotherapy or radiotherapy. What I think you're saying, as you've just pointed out there, is essentially that, look, let's get involved with the metabolic side of things right at the start. And I'm guessing you're going to say that in some people, that may be sufficient. In others, it's going to reduce the size. It's going to allow some cancer cells to die off so you can be a bit more targeted and use lower doses of chemotherapy or radiotherapy, right? Absolutely. Absolutely. We have seen that ourselves. You shrink the tumor down and make it extremely vulnerable.

Now you can come in with, say, one of these therapies, more modern therapies, at a lower dose in a more strategic way to finish off the cancer survivors that the metabolic therapy wasn't able to kill. Because one thing is going to be in common. When you pare down, the cancer cells are all kinds of, as you said, they're all genetically different from each other. They're all fermenting, but they're all genetically different from each other. But when you pare them down, the survivors of metabolic therapy will have something in common. And that commonality makes them extremely vulnerable now to some sort of metabolic therapy will have something in common. And that commonality makes them extremely vulnerable now to some sort of targeted therapy because all the cells are going to have the same target on them. So that's the strategy. So in other words, we have a lot

of tools for managing cancer. It's just that we haven't been using them in the correct way or understanding the concepts of evolutionary biology to enhance the success of the treatments that we already have. Yeah. We kind of need to embrace this approach more, not going either or. It's like, well, why can't you do both? Why can't we do both? But we're not. But going back to what I said at the start, that I started medical school in 1995, I started medical school in 1995, right? We were taught how to diagnose and we were taught to treat with pharmaceuticals. End of, right?

That is literally what we were taught. And again, that can be very useful for certain conditions, but there's a big piece missing there, right? So the training needs to evolve. I honestly don't feel it has evolved even now, almost 30 years on. Well, you're 100% correct. And what we know, we base it on the science. I mean, I do the experiments here in the lab. I have the best animal models for cancer. So we know what it's doses, timing, and scheduling.

This is not what we call sexy science. This is just knowing how to manipulate the tools that you have to the maximum efficiency. And then we can translate that directly to patients in the clinic. When I have all these, my physician colleagues, they're coming to me and they say, wow, you can't believe how powerful this stuff is when you do it the right way. Our group in Istanbul, Turkey are using metabolic therapy with conventional treatments and they're using far lower doses and the outcomes are so much better. So this is an evolving process right now, but I agree a hundred percent. We have to do, we have to know the tools that we

have, what will work the best, and how to blend the system. But we're not doing that. We're not doing that at all. I have all this information. I publish all these papers. We do all this kind of stuff. And then when the cancer patient goes to their oncologist, no, there's no evidence to support that. If it were really true, I would have learned it in medical school. Well, we'll get into that because I've got a few things to share about that. Let's go to that glucose ketone meter that you mentioned. That sounded really interesting, right? So you're measuring the ratio between glucose in your blood and ketones. Is that right? Yes. Now, if you were to take, you live in, I think, Boston,

if you were to go out into the center of Boston and pick the first 10 people who passed you on an average street downtown on a Saturday afternoon, what do you think the glucose ketone ratios would be in that population, typically? I know exactly what they would be because we've done these. typically i know exactly what they would be because we we've done these okay okay not to guys walking through the streets but to the students and they're at the university here so we can all of us we test uh it's about 50 to 60 sometimes 70 hold on hold on so 50 is that to one so it's basically yeah so so it's um you would have glucose levels. Well, you can do, normally your glucose levels would be, let's say, 100 milligrams per deciliter. What does that come out to be?

You have to divide that by 18, and that gives you the millimolar ratio. What is that, 4.5 or something like this? And the ketone value in millimolar would be 0.1. So you divide the 4.5 by 0.1 or one of these kinds of things. Okay. You come up with a value about 50. I have all the numbers. It's about 40 to 50 times higher based upon that.

Yeah. Okay. So then you stop eating. Like when we did the water-only fasting here with the students, it takes about four days. And then you start to see the ketones rise and the glucose drops. So because you stop eating, once you stop eating, you're not bringing glucose back into your system.

The only way you're going to get glucose now is through the process of gluconeogenesis, where your body will make glucose from breaking down proteins. And also you mobilize the fats. And most of these are called triglycerides. So the two glycerol backbones could be conjugated to make one glucose molecule. But the majority of the fats are going to be used to make ketone bodies. So the ketones are going to gradually increase in your bloodstream. And then glucose gradually goes down. And you come to a ratio where the ketones and the glucose are about the same, similar

millimolar or in your blood, or the ketones are higher in millimolar than the glucose. Therefore, you get numbers below one. And that becomes super healthy. So did you say before you want to get to two or below? Well, for killing cancer cells, for sure. But for just general health, yeah, you can get down to five or even like my good friend, Dom D'Agostino from University of South Florida. He's always in ketosis, right? He's always in this kind of a state. He's like one of these paleolithic guys, you know, he likes to eat the alligators and squirrels. I mean, it was one of these kinds

of guys. He's always like living, he's like living the paleolithic. I really like Don's work and I'm hopefully going to try and get him on the show later in the year. And he shared, well, we'll get to this maybe later, but he did share one of his colleagues, I think, in a mouse model where they had GBM glioblastoma. Yeah, it was our model. It was your model. Yeah, and actually, by using ketosis and radiotherapy, there was like full remission, I think, from recollection. It was hyperbaric oxygen, hyperbaric oxygen. It's hyperbaric oxygen, hyperbaric oxygen.

We use hyperbaric oxygen as an alternative to radiation because both radiation and hyperbaric oxygen kill cancer cells by increasing reactive oxygen species. So ROS. So if I can kill, but the hyperbaric oxygen doesn't work until it doesn't work well until you bring your blood sugar down and your ketones up. So once you put the pressure on the cancer cells, then you put patients in hyperbaric chambers once they're in a state of ketosis. And then you start killing cancer cells by the same mechanism that radiation does, but without harming the rest of the body. That's why it's beautiful.

Yeah. So back to the glucose-ketone meter for a second, right? So the average person on the street who's maybe not paying attention to their diet may have a 50 to 1 ratio, right? You're saying that if you have cancer and you want to kill cancer cells, you want to get down to at least 2 to 1, ideally lower, right? Yeah, 2.0 or below. 2.0 or below. So that's a huge change. Now, I don't know if you know this or not, but someone, let's say, like many people these days to try and put their type two diabetes into remission of following low carb diets. And I guess, you know, low carb can mean so many different things, but to many people, it's when they keep their carbohydrate intake under 50

grams of carbs per day. Some people would use that as their definition. But of course, I'm aware there's a huge variety there. If someone was having around 50 grams of carbs a day and on a low-carb diet, what might you imagine their glucose to ketone ratio to be? Well, it's certainly going to be lower than what, than it was before. You could use this meter, this, uh, we published the calculation and the, uh, the company that makes Keto-Mojo, um, put a chip in the meter. So you just push the button. It gives you the ratio right off the bat. So patients can, can always monitor, uh, their GKI.

We call it the glucose ketone index, their GKI. Do you do it yourself? I do it occasionally. I I'll, I'll, uh, some guy will tell me, oh, I got this keto drink, so I'll not eat for about 18 to 20 hours. I'll take my GKI, find out what it is, stop eating for it, and then chug his little drink, do some exercise, come back and measure it again and determine whether or not I'm going in the right direction. And sometimes it does work. And do you have a feeling? Because I guess we can talk about treatment, and we could talk about prevention, right? So if you have cancer already, we know that there's

been a variety of signals to your body. And for whatever reason now, cancer cells are starting to proliferate. So at that point, you're saying no matter, I think you're saying no matter what the cancer is or the site of it, one of the things you want to be thinking about is trying to reduce these fermentable fuel sources to the cancer, which are glucose and glutamine. And it's easier with diet at least to try and remove that glucose by going into ketosis. So far, so good. Yeah, you're absolutely right. And what George Cahill, who was the head of the Joslin Diabetes Center, passed away a few years ago, he found that the patients who did water-only fasting to 14 to 20 days, the blood glutamine would go down as well. So if you want to push

it that way, and I have, I know personally, several people who have completely eliminated their cancer by just doing water only fasting. Now people, when you tell cancer patients, oh, you got to do, don't, don't eat any food for 21 days or so they'll think you're nuts. So that's why the, the, the keto, uh, like a carnivore only diets only diets, very low in carbohydrates. Vegan diets are a little bit harder because the plants, but we have to use a lot of energy to burn the plants up. We didn't evolve to eat, we were not born, we did not evolve to eat only plants. We're omnivores, we can eat everything. But you're right. So the GKI values will tell whatever person,

Right. So the GKI values will tell whatever person, whether you're a vegan, a carnivore, or whatever, it cuts across all diets. It cuts across everything because it tells you right off the bat, whether I'm in a zone to kill cancer cells, regardless. They always ask me, can I eat this? Can I eat that? I don't know. I said, what does it do to your GKI? Yeah. This is interesting, right? Because we've all got different bodies. We've got different microbiomes, right? We're seeing that with personalized nutrition now that someone can have a banana and their blood sugar can go into their diabetic range. Someone else could have a banana and have a pretty stable blood sugar, right? So I love things that cut through the nutrition wars because ultimately it's like, well, what's going to work for you?

Do we know yet? And I think I'm going to buy one of these glucose ketone meters straight after this conversation. I'd love to know what I'm in. Yeah. In fact, I made the meter for glioblastoma patients with brain cancer because they needed more than anyone. But now I get all these health gurus out there, these guys that are running health clinics and everything. And they're saying, oh, I got a GKI. So obviously it's cutting across the populations. What do you want your GKI at? It's hard to say.

All I know is that when you don't feel well and you feel kind of iffy, don't eat for a couple of days. Whatever was bothering you seems to go away when you start getting super healthy. But if I were to have cancer, having written the protocol to treat cancer prices with my colleague Thomas Duryea, and we're working on the treatment protocols right now, the first thing you're going to do is you're going to, you're going to take, stop taking carb, or get your GKI down. People say, oh, I don't care how hard it is, that you get it closer to 2.0 or below, below one, you're going to start killing cancer cells. So what we do, because it's such a hard thing, what we do is we, we, we, we take

zero carb diets for about 10 days to see where your GKI is, and you can start to see it stair step down in the right direction. And then from there, you can step off into water only fasting, because the trauma of doing water only fasting, the difficulty of your physiology to do that, like as opposed to going cold turkey, okay, you're going to eat a big meal today. And now for the next five days, you're not going to eat anything. The body goes through, it's almost like trying to break alcohol, nicotine addiction. Yeah. The body, the brain is addicted to glucose.

It's like an addictive agent. So you have to lower that addiction slowly with a zero carb diet. You're still eating, but you're not getting carbs. And then once you're down to a GKI of about five or seven, you jump now into water only fasting. Once you're in that zone of water only fasting, now you can keep a low GKI. That's when we come in with the battery of drugs, these repurposed drugs that hammer the glutamine and further lower the glucose. These tumor cells are toast. They can't handle this kind of a dramatic change in your body. They up and die. And not only that, the body cells compete directly with the tumor cells, starving them even further. And not only

that, it's called autolytic cannibalism. Your body actually goes after the tumor cells and uses them for the fuel for the rest of the cells that are healthy. It's unbelievable. This is evolutionary biology in action. It is absolutely amazing to hear this. It's even more amazing to see it in action. Some people, Thomas, are going to say this is pretty controversial, right? You're talking about stuff that we've got no evidence for, right? You're talking about water only fast. No, we have plenty of it. I have.

No, no, I know you have. I'm just trying to think about what would your critics say? Now, some people will say you need people who are going to lose weight, right? And you need proper weight to fight off this cancer and to deal with the toxic effects of the chemo, right? So for anyone who is thinking that, and I'm sure this has been leveled at you before, what would you say to them? Well, this is again an extremely important point. You know, when you say weight loss, there, why there's two reasons why you would lose weight with a cancer. One is the cachexia, which is the signaling from the cancer cells to the muscles, to dissolve the muscle, to get glutamine for the cancer. So, and the other reason for weight,

because the treatment you're going to be given this poor person is so poisonous. They have a fatigue, diarrhea, nausea, vomiting, all this kind of stuff. This makes you lose weight. You're not hungry anymore. So we want you to take as much carbohydrate back into your body to keep the weight on. So cachexic weight loss and weight loss from poison, this is called pathological weight loss. You're sick as opposed to therapeutic weight loss. When you stop eating, your body gets super healthy. You're not poisoning the body, you're making it stronger and healthier. So that's why depending on the weight of the patient at the time we start the, or my colleagues will start the treatment, we have to design the kind of treatment

that would be appropriate for that individual's body weight. If you have some guy walking into the clinic that weighs 300 pounds and you're worried about him losing weight from the treatment, I mean, this is absurd. This guy with that amount of body weight can blast the hell out of his cancer. So just because he has so much energy stored in his body, the tumor cells won't be able to use the fats that he mobilizes. So you have to use it. You have to understand the difference between therapeutic weight loss versus pathological weight loss.

And the medical establishment hasn't come to recognize these differences yet. So they think weight loss is bad. Yeah, because you're poisoning somebody. You're going to lose weight because you're poisoned. You don't have to poison. The thing of it is, is that once you do metabolic therapy, the amount of drugs that you would need to kill off the tumor cells now becomes so much less. So you're really dealing with an altogether different physiological state. But getting back to your really important point is when the cancer patient goes into the clinic, they should be at least told that there

are alternative options to the treatment plan that we have been indoctrinated to use. So I think, and that's where we have this problem. There is a one size fits all. You either do it my way or the highway. And so many cancer patients email me and say, I asked my oncologist if he could help me do metabolic therapy. And he says, there's no evidence to support that. And I say, well, you got to read the scientific literature and you have to understand the science.

And then you'll know that it works. And what's more important, you're a hundred percent correct. Many cancer patients would love to be participants in their healthcare. They want to know that their actions are also helping them survive. And the traditional cancer treatments we have today takes that completely out of their hands. They just sit there and get radiation, chemo, and whatever they're going to give this patient with the patient absolutely doing nothing. Yeah. I i mean there's so much to unpack there i'm loving my conversation with you i think this is so important we get this message out but one of the frustrations will be i'm sure for some of the listeners or viewers on the back of this is

they'll hear this information and maybe they have cancer or a family member has, and they may go to their oncologist and have this conversation. And chances are this will be shut down and it will be like, I don't know about that stuff. I mean, four years ago, a really close friend of mine, four years ago, a really close friend of mine, his son, I think at the age of maybe six or seven, was diagnosed with an optical pathway glioma. And of course, very scary for your child to have this tumor inside your brain. And initially they started, I think, down the conventional route. I think initially he had a course of chemotherapy. But as my friend started to read up, and he went all in, spent hours a day researching the papers, experts like yourself listening. And he thought, wait a minute, I'm not sure about this. I'm not sure I like what's being offered versus what I think we can do. He has basically for four years, there has been no increase in size at all. And he's done it all. And to be fair, I feel he's done it all through a huge amount of stress. He's taken on to seven days a week,

obsessively research the literature, trying to get help. He's not getting help from his oncologist. He told me recently, he said one of the first things his oncologist said to him was, oh, you're going to do the no sugar thing. Don't worry, in four weeks, you'll be back eating McDonald's. They all are. That that's the first thing which is a pretty um i just don't know why or how a doctor would say that what what even if that's what the doctor believes i'm not convinced that that has any benefit at all uh to saying that to a parent of a child with a tumor i mean what would you say to that well it speaks to a parent of a child with a tumor. I mean, what would you say to that? Well, it speaks to a profound lack of knowledge on the part of the oncology community. And it's not just where you are. I see it all the time here in the States as well. At the Mayo Clinic, which is supposed to be a top-notch medical center. And for certain aspects of medicine, they are. But when it comes to cancer, they're clueless.

One of the people who emailed me said they went to the Mayo Clinic with glioblastoma. And one of the neuro-oncologists there said sugar has nothing to do with glioblastoma. And I said that we were the first to publish a direct association between glioblastoma and the mouse and how fast the tumor, the sugar and how fast sugar could make a tumor grow. And then that was replicated in humans with glioblastoma. Hyperglycemia is an accelerant to rapid tumor growth. And it's been repeated dozens of times. And now it's been shown for almost every major cancer that the higher the blood sugar,

the faster the tumor grows. The lower the blood sugar, the slower. This has been now repeated. And yet for a person treating patients to say that sugar has nothing to do with glioblastoma speaks to a profound lack of knowledge on the part of not only that person, but the entire establishment. Another person you might want to talk to is Pablo Kelly from Devon, England. Pablo chose no radiation, chemo, or steroids to manage his glioblastoma.

He's still alive, almost nine years. August will be nine years. And just explain to people how bad the prognosis is when you have a diagnosis or when you have glioblastoma. It's a brain tumor. It killed John McCain of our country, Ted Kennedy. It killed the President Biden's son, Beau Biden. I did the studies for many, many decades on glioblastoma. The issue is, why is survival for glioblastoma so poor? There's been not a single major advance in 100 years. And I keep pointing this out. In 1925, survival was 8 to 14 months. In 2023, survival is 8 to 17 months. So, I mean, you're talking about no progress in 100 years. And what we have found, what I have found in my research,

is not only is the tumor very bad, it grows rapidly. Radiation treatment frees up massive amounts of glucose and glutamine in the microenvironment. When you irradiate somebody's brain tumor, the head swells, the radiation forces blood sugar into the stratosphere. And not only that, they give you high dose steroids to reduce the inflammation from the radiation, which raises blood sugar even higher. So you're actually contributing a microenvironment rich in the two fermentable fuels that drive the rapid growth of the cancer. I have published this over and over again. And I said, as long as you continue to irradiate the person's brain, you're never going to achieve

a level of success that you would expect. Now, Pablo Kelly rejected radiation. He rejected temozol. He rejected it all and went for metabolic therapy alone. People say, oh, he's only an N of one. Yeah, an N of one. He could be the rule rather than the exception. But to stop the radiation of the brain by radiation oncologists is an absolute essential part. If you want to keep people alive longer, you have to stop irradiating their tumors. And we have a treatment protocol that will hopefully do this. But I tell you, when you're indoctrinated and wrapped into this constant system, it's very hard to break the habits of what you're doing. Yeah, I think that's the problem.

You know, I genuinely believe that all doctors, nurses, healthcare professionals are doing the best for their patients based upon what they've been taught, based on what they know, based upon the current paradigm. And I know you've been shouting from the rooftops trying to shake up this paradigm and go, you know, the other thing to really think about here is that, and I always say this when we're talking about nutrition changes, is that look, like there's very little downside here, right? Improving your diet, whatever that means, depending on what you're doing, whether it's cancer or anything else, there's no downside here, right? Rarely, you know. Well,. Well, that's an interesting point. You'll

hear some of the people in the oncology center said, oh, that ketogenic diet is very dangerous. You're going to get cardiovascular disease or something like this. And I said, what? You got a brain tumor. You got a glioblastoma. And the issue is relative. You're exactly right. Downside. Do you think a metabolic therapy has more downside than toxic radiation and poisonous chemicals? I mean, give me a break. And also what you were saying, Thomas, before is that you could do them both. You could use the metabolic therapy to reduce the cancer size, improve the health of other cells, and then use small targeted doses which have less side effects.

So it's not either or. So Pablo Kelly, you're saying has been alive for what, eight, nine years. Is that right? Yes. Yeah. And he was given nine months to live. Wow. And he said, no, it's all over the English newspapers. There was many... Where did you say he lives? Devon. Devon. Devon. I might try and get a hold of him. Oh, get a hold. He's a character. He can tell you what he did. Now, he's since got married. He has two children.

He would have never had any of this. So if he had followed standard of care, it would have killed him a long time ago. So he was bold. He was bold, though. He really fought against using the standard of care, despite all the dire prognosis that he was given. Thomas, one thing I really want to make sure we make clear, right? You have mentioned how hyperglycemia, so elevated blood sugar levels, is an accelerant for tumor growth, right? And that fits with everything we've been talking about so far, metabolic dysfunction, a problem in the mitochondria, you know, what happens when a

cancer cell is there, it no longer is using oxygen appropriately, it's getting its fuel from fermentable sources, which is glucose and glutamine. So it makes sense when you have a diagnosis of cancer, you may want to reduce sugar, reduce glucose, maybe go into ketosis. But if we shift our lens to prevention, of course, there are many things that can cause cancer. We've already mentioned that diet, lack of exercise, environmental pollutants, carcinogens, whatever it might be. Can we say that sugar is causing cancer? Because I think that's where we really need to be very careful with our messaging, right? There's something to do with our diet as a therapeutic intervention if we have been diagnosed. But what if you are, I don't know,

in your 30s and 40s and pretty well, and you listen to my podcast, you try and stay healthy, try and make small changes, you know, what's the relationship there between sugar and cancer? Well, I think we can never call sugar a carcinogen. We cannot. We cannot. call sugar a carcinogen. We cannot. We cannot. No. Sugar is not a carcinogen. Okay. But sugar creates a systemic inflammation in the body over time. C-reactive protein goes up. Now, how do we know this obesity? The obesity epidemic, which is now becoming worldwide in industrialized societies, the obesity epidemic, is the result of the storage.

You get fat by storing carbohydrates. You don't get fat by eating carbs. That's why you lose weight with a ketogenic diet. You can't store fat. You store carbs as fat. You don't store fat as fat. This is another tremendous misconception, misunderstanding. So we have an obesity epidemic.

Obesity has now replaced smoking as a major risk factor for cancer. How do you get obese? By consuming too much carbohydrate in the diet, especially poorly nutritious carbohydrates, not complex carbohydrates that you see in certain plants and in certain grains, but you get it from consuming those foods that have minimal nutritional value with high levels of processed carbohydrates, high fructose corn syrup and all these kinds of things. They are provocative to becoming obese, elevating blood sugar. Elevated blood sugar is an accelerant to growing tumor. So, so clearly all of these things

come together and it's basically diet and lifestyle. Yeah. We all would like to prevent cancer, but when we have fast food stores on every corner, we have Coca-Cola, we have everything that's in our environment that makes us feel good. We evolved as a species to love sweets. Our brains are geared to love sweets and we have sweets everywhere. So again, it's moderation. We try to do what we can do to moderate our consumption of highly processed carbohydrates, and that will reduce the risk for not only cancer, but a lot of these diseases as well. I think the truth, as I see it, Elise, is that many people are really struggling. They either live in a food desert where they can't get access to decent foods,

they're in poverty, they've had a problematic relationship with food. So I think on an individual level, I think that it's complex as to why so many people are overweight. Certainly that's my experience as a clinician. But I think we can say as a society, we're not really putting this front and center. If government, for example, really wanted to address, frankly, beyond reducing our risk of cancer, reducing our risk of obesity and type 2 diabetes, they could put in place a lot more policies. For example, I don't know, make sure that there's affordable, healthy food for all of the population make sure the food in hospitals and schools is healthy and health promoting rather than health decimating right so i just want to clarify that because i'm sure you would agree oh you're 100

but you know it's an industrial thing. The food industries are extremely powerful. They control politics as well as the pharmaceutical industries. So you have massively powerful industries that thrive on the health problems of the country. And you're right about food deserts and people are stressed out and food makes them feel better. And a lot of that food is full of carbohydrates that puts them at risk for all these different diseases. But the governments could do a better job. But, you know, who are the governments? They're the congressmen, senators, these guys, and they get money from these different industries to run their campaigns. And they're not going to come out and all of a sudden shout that we have to reduce carbohydrates in the diet to make our population healthier. And the drug companies are making money hand over fist on all these crazy drugs that they're giving to people.

But I think it falls on our shoulders ourselves. Now, you're right. I can speak from a different perspective than the poor guy who's living hand to mouth. And his food can only be cheap foods that's poorly nutritious. He can't afford the garden variety of stuff that's more, generally more expensive, grass-fed beef and all this kind of stuff. I mean, so you're caught in between a rock and a hard place. So yeah, these are difficult problems that need to be addressed. And two things I just wanted to finish up on there. As you mentioned earlier on in this

conversation, you can put on weight on a ketogenic diet if you eat too much, right? So I think processed carbs are absolutely, we're eating too much of them. But I think people are losing weight on a whole variety of different diets. I think people are losing weight on a whole variety of different diets. I guess for me, it's a question of what is the whole food-based diet? Because I'm interested in weight loss and health promotion. You can technically eat 500 calories of garbage each day and lose weight. But if you have a whole food-based diet, it's a case of what can you do consistently that's going to help you eat the right amounts. Well, your point is some recently within the last month, I think, some guy

lost 50 pounds eating only McDonald's food. And you say, wow, how is that possible? He would order something and eat only half of it. In other words, he did calorie restriction. Anyway, he lost weight by, just like I said, eating food, but only at half the amount that he normally would eat. He lost weight. He got it. He felt good.

But there was another guy who ate as much as you could get, supersized meals. This was about 10 or 12 years ago. And that guy, within a month, got cardiovascular disease, obesity, and all the other. So again, it's the amount and types of food that you are addressing to keep your body in a state. And I think the key point there to conclude is, look, obesity is a massive risk factor for cancer. That's not trying to shame anyone. That's not trying to have a go at anyone. It's just trying to look at the science and share it.

I think a lot of people do not know that. Yeah, I agree. By you stating that, you have informed whoever's listening that obesity is a major risk factor for cancer. And I think a lot of people aren't aware of that. And I think that statement, getting out in the world, makes people think twice about their weight condition. Professor, it's been a real joy talking to you. I know you've been in this field for many decades now, and you're still banging

the drum. You're trying to get people to see that there's a metabolic cause to cancer, and that maybe we need to re-look at how we view cancer and how we treat cancer. There's plenty more we haven't got to. Maybe I can tempt you for a part two at some point in the future. I'm pretty sure my audience are going to love this conversation. But just to finish off then, for people who've heard that and are inspired to go, okay, I'm with you. I can see how poor metabolism, metabolic dysfunction, mitochondrial dysfunction is going to increase my risk of getting cancer. What can I do right now? I don't have cancer, but I want to reduce my risk of getting it in the future. I wonder if you could share some of your top tips for people as to what they can actually practically do.

Well, I think exercise is absolutely essential. Because bringing oxygen into your blood, having a good blood flow, increases physiological function. If you can reduce the amounts of high carbohydrate foods that you eat with exercise, and occasionally look at your GKI, your glucose ketone index, you're going to ward off not only cancer, but probably type 2 diabetes, cardiovascular disease, and even dementia. So all of these things are linked to a common problem in disturbed metabolic homeostasis. So I think there are definitely things people can do. And it's hard when you're sitting in traffic jams, and then you have to rush up and sit in front of your computer or in an office somewhere.

So all of these things are not consistent with our evolutionary origins. But I think if people have become aware of these things, at least they can, in their own lives, try to adjust their situation to recognize this. And sleep, chronic stress, these sort of things? Well, that's another thing too. Sleeping, you know, good sleep. Yeah, right.

Who wouldn't like to have that? Stress, what do you do for stress? to sleeping, you know, good sleep. Yeah. Right. Who, who wouldn't like to have that? Uh, yeah. Stress. What do you do for stress? You know, I mean, we're all stressed out. People were used to smoke like crazy to reduce stress. Now they stopped smoking and now they got fat and now they got this, they're back in the same spot for a different reason. So, uh, you know, it's just, it's just, um, but, but the point, but the point is, is that all of these things really do make a real difference at reducing your risk of cancer in the future. Yeah, absolutely. And maybe this is just a little teaser for the next time we talk. You mentioned earlier on that intermittent hypoxia is one of the things that can drive the mitochondrial dysfunction.

I wanted to really explain what you meant by that. Did you mean obstructive sleep apnea, things like that? Because you then mentioned exercise as being a way of delivering more oxygen. Right. You know, that's what Warburg even showed that it was intermittent hypoxia that he thought was responsible for the majority of cancers. We've expanded upon that and we've shown the mechanisms by which that can happen. We've expanded upon that and we've shown the mechanisms by which that can happen. So yeah, that's another story. I mean, we've done a lot of research and we recognize these things.

And intermittent hypoxia can be prevented by oxygenation and exercise and eating the right foods. So again, coming back to a similar kind of thing. Well, we'll get to that in our next conversation, hopefully. But just to finish off then, are you hopeful that we can do something different to make an impact in our rates of cancer? Oh, absolutely. I mean, absolutely. And Warburg even said that we could reduce 80% of our cancers, and I believe that. But we have a plan. We know what's going on. We have an understanding of the mechanism by which cancer occurs, and we really understand how we can manage it. The problem is getting that to be adapted in the clinics and the education that requires in the medical schools to train the physician that diet lifestyle issues are really important for managing chronic diseases.

And here is the strategy and, and, and protocols for doing that. And that's, I think will be the future. Well, professor, thank you for your tireless work. Thank you for giving up some time. Thank you for coming on the show. Yeah, very nice. Thank you very much for having me. really hope you enjoyed that conversation do think about one thing that you can take away and apply into your own life and also have a think about one thing from this conversation that you can teach to somebody else remember when you teach someone it not only helps them it also helps you learn and retain the information. Now before you go, just wanted to let you know about Friday Five. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do

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