“Physiologically we’re discovering that not every calorie is equal.”

Dr. Siddahrta Mukherjee, Columbia University Medical Center

Amen. Each gram of fat contains roughly the same calories, yet the nutritional value of fat varies greatly across different saturated fats, in saturated fats versus monounsaturated fats, in omega-3 vs. omega-6 polyunsaturated fatty acids (PUFA), in long-chain PUFAs compared to other PUFAs, and trans fats (natural and industrial).

And just to make things even more complicated, the balance in intakes across different fatty acids has a big impact on health outcomes. See our “Primer on the Fatty Acids in Milk” for more insight.

Cutting-edge science carried out in Mukherjee’s lab suggests that changes in diet capable of lowering insulin levels can reinforce the effectiveness of drug-based therapies treating patients with lymphoma and endometrial cancer.

One of the most common cancer mutations is in an enzyme called PI3K. Cancers stemming from PI3K are proving hard to treat with medications, a shortcoming that is impacting many people since the PI3K enzyme is present in about 40% of breast cancer cases.

During research on a new drug, Aliqopa, Mukherjee’s team noticed that several patients became diabetic, leading to spikes in insulin production. And then, they realized the increase in insulin was reactivating a mutated genetic pathway that was promoting the growth of cancerous cells.

The hope is that a high-fat, low-carbohydrate diet will suppress the production of insulin, and retard the proliferation of the cancer cells enough so that the added impact of the medication will actually trigger remission.

Mukherjee and colleagues have already demonstrated this potential in an animal model, and conclude that dietary interventions may “provide a means to significantly increase treatment efficacy for patients with a myriad of tumor types.”

Other research has shown that cancer cells are disproportionally dependent on the amino acid serine. This is because healthy cells can manufacture their own serine, but cancer cells depend on dietary sources. Cutting protein-based sources of serine in the diet tends to starve cancer cells and enhance the efficacy of drug therapy.

The recognition that diet can help starve or suppress cancer cells opens up a whole new dimension when discussing and defining “nutritional quality.” It drives home the point that people differ in what they need from their food, and that it’s time to abandon the notion that nutritional quality is monolithic.

Sources:

Hopkins Benjamin D et al. (2018). “Suppression of insulin feedback enhances the efficacy of PI3K inhibitors,” Nature.

Hannah Devlin, “Top oncologist to study effect of diet on cancer drugs,” The Guardian, July 9, 2018.