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The Ketogenic Diet and Cancer

The ketogenic diet has been all the rage in the media lately as a potential weight loss diet or as a strategy to reduce cancer cell growth, but is it really safe or evidence-based? I’m about to nerd out with you, buckle up.

Follow my audio guide on WZZM here.

What is the ketogenic diet?

The ketogenic diet (KD) is a high fat, moderate protein, and low carbohydrate diet. Americans generally consume a diet high in carbohydrates (50-75%). The KD diet requires careful calculation to ensure the ratio of fat to protein/carbohydrates is 4:1. When this ratio is achieved, metabolic pathways shift the bodies’ use of glucose as its primary source of energy to fat or ketones (metabolites of fatty acid breakdown). During this process called ketosis, the body starts to metabolize ketones to provide fuel for bodily functions. Examples of high carbohydrate foods that are limited on this diet include sweets, bread, pasta, juice, fruit, and starchy vegetables. Examples of high fat foods that would be included in this diet may be avocado, olive oil, nuts, nut butters, heavy cream, and butter.

This diet has classically been used to treat epilepsy in children and most recently in adults. In regards to cancer, the ketogenic diet has been of particular interest in the treatment of brain tumors, such as glioblastoma multiforme (GBM). However, there has also been interest in its overall treatment of any cancer. Because the brain and cancer cell’s preferred fuel source is glucose, the theory is the KD may alter the metabolism and reduce growth of brain tumor cells and possibly make it more sensitive to treatment (chemotherapy and radiation).


What we currently know

  • The use of the KD diet is safe and feasible as an adjuvant therapy, but requires frequent lab testing and supervision by a dietitian and physician.
  • The KD diet should be administered over at least 3-4 weeks to see any potential benefit or improvement.
  • Quality of life and current tolerance to cancer treatment should be taken into consideration before starting this diet. If a patient is already having difficulty maintaining their weight or sustaining nutritionally, the ketogenic diet may only exacerbate cancer cachexia and an individuals ability to tolerate treatment. A patient’s safety should always be priority numero uno.
  • Animal-based studies and some human studies have shown promising, yet inconsistent results in reduction of tumor growth with the ketogenic diet, especially with brain cancers.

Questions that still need answering-

  • Does every type and subtype of cancer respond the same way to the KD diet? It’s important to remember that not all cells in the body respond the same way and same goes for cancer cells.
  • What’s the exact dosage or ketogenic diet regimen that is most effective? For example, what exact ratio of fat to carbohydrate will be most successful in reducing tumor growth?
  • What are the specific markers or signals that indicate the ketogenic diet is working as it pertains to cancer? In the case of epilepsy, effectiveness can be seen by a patient not having seizures as a result of successful ketosis, however this would be more difficult in cancer. It may require more frequent CT scans and imaging to check on the growth or lack thereof of tumors as a response to the ketogenic diet. With insurance companies already getting a little iffy with providing coverage for reimaging, this may be a challenge.


Other things to consider-

  • Side effects: constipation, fogginess, lightheadedness, and fatigue
  • Better research is needed:
    • Gold standard: Double-blinded, randomized controlled clinical trials
    • Studies specific to cancer type and subtype
  • Good news! Currently, there are several clinical trials and studies ongoing to help address the questions requiring answers.

Takeaway: As an oncology dietitian, I am very excited about the potential of the ketogenic diet being used as a measurable medical nutrition therapy in cancer treatment. But just like any prescription drug or chemo treatment, this needs to have substantial supporting evidence and testing to ensure the treatment is safe and effective. More to come on this topic. Stay tuned…




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Navigating Food Trends

This morning I was on WZZM 13 helping the GR community navigate through the latest food and nutrition trends. The latest trends on the scene include matcha green tea powder, beetroot powder, spirulina, and activated charcoal. But are these foods or products worth your money and which ones may actually be healthy for you? Follow this true or false guide with explanation on which trends are worth your attention. Cheers to evidence-based nutrition advice and hump day!

Check out the WZZM audio guide here!


True or False

Beetroot powder vs. whole beets

Beetroot powder has the same amount of fiber per serving as a whole beet.

True. However this depends on the brand. Because beetroot powder is a supplement, the purity of the product may not be created equal due to lack of FDA regulations. When you are looking for the best beetroot powder, aim for at least 2 grams of fiber per serving (generally 2 tsp-1 Tbsp powder). Try adding the powder to smoothies, baked goods, pasta sauces, salad dressing, dips, and soups.

Activated charcoal for detox diets

Activated charcoal is a healthy and safe way to remove toxins from your body.

False. The use of activated charcoal is most commonly reserved for emergency treatment of severe poisonings. The administration of activated charcoal causes the charcoal to bind to chemicals, foods, drugs, and nutrients in the stomach to prevent being absorbed into the body. In other words, if you are taking this for a healthy diet detox and consuming with healthy food, these healthy nutrients will also not be absorbed. This not only prevents the absorption of the good nutrients that your body needs, but excessive intake can increase your risk of constipation or diarrhea, black stools, or dehydration. Stick to a plant-based diet with an emphasis on fruits and vegetables for the best long-term “detox” diet.


Spirulina is one of the few foods on the planet with a naturally high content of the healthy omega 6 fatty acid, gamma linoleic acid (GLA).

True. Spirulina is a green-blue algae powder that can be added to foods or taken as a pill supplement. Although it is safe to consume for adults, the algae flavor may turn most away. But what it lacks in flavor, it makes up in nutrient composition. Spirulina is packed with protein, vitamin A and K, iron, potassium, GLA, and other antioxidants, such as phycocyanin and zeaxanthin. Preliminary and mostly animal-based studies show promising potential health benefits, such as boosting the immune system, preventing infection and allergic reactions, anticancer properties, and improving liver and eye health. More research is needed to determine the exact impact spirulina has on overall health.

Matcha green tea powder

Matcha green tea may have a higher antioxidant content than regular green tea.

True. Matcha green tea uses the whole tea leaf and grinds it into a powder. This powder is then mixed in with hot water for a frothy tea beverage, ultimately allowing you to consume whole tea leaves. On the other hand, general consumption of regular green tea is the infused water from the leaves instead of whole tea leaf consumption. Matcha green tea leaves grow in shaded areas potentially increasing the chlorophyll content. Matcha green tea also contains l-theanine and epigallocatechin gallate (EGCG), which have antioxidant properties, help fight inflammation in the body, and may improve alertness. Due to lack of scientific evidence specific to matcha green tea, there is no clear indication to drink matcha green tea over regular green tea. Try using in lattes, smoothies, and sweet or savory sauces. It is not recommended to drink more than 2 cups of matcha green tea daily due to its nutrient concentration.



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Coconut Oil: A slippery slope?


A recent report came out from the American Heart Association’s (AHA) presidential advisory board warning against the use of coconut oil and truthfully all I thought to myself was….FINALLY. Don't get me wrong, fats do belong in a healthy diet, but you are wrong to think too much saturated fat is going to keep your heart healthy.

Cardiovascular disease (CVD) is the leading cause of death worldwide, accounting for 1 of every 3 deaths. In regards to reducing risk of CVD, the AHA’s recommendations since 1961 has consistently advised to reduce dietary saturated fat intake. AHA’s recent report took a deep dive into the latest scientific evidence on dietary fats and CVD risk. The conclusion of this report is again consistent with their previous recommendations: keep saturated fat intake to <10% of your total calories and replace saturated fats with mono- and polyunsaturated fats more often. If you have elevated LDL cholesterol levels, recommendations are even stricter and include reducing saturated fat intake to <5-6% of total calorie intake.

With coconut oil containing ~82% saturated fat (even beating butter and lard for saturated fat content), the AHA’s response to using this oil is simple…don’t. A review of 7 controlled clinical trials revealed that coconut oil raised LDL, the bad cholesterol, in comparison with monounsaturated and polyunsaturated oils in all 7 trials. But have no fear. I am here to help! I have an easy guide for how to incorporate oils in a healthy diet.

Check out my news segment with WZZM here for the audio guide.

Key takeaway (if you read nothing else, read this!): Choose monounsaturated and polyunsaturated fats over saturated fats as much as possible. They have been shown to help reduce LDL cholesterol (yay!).

  • Monounsaturated fats: olive oil, safflower oil, sesame oil, avocados, peanut butter, almondsFullSizeRender
  • Polyunsaturated fats: peanut oil, canola oil, soybean oil, corn oil, sunflower oil, walnutsFullSizeRender_1
  • Saturated fats: butter, coconut oil, ghee, palm oil, lard, beef fat, whole fat dairy, lamb, pork, poultry with skinFullSizeRender_2

Serving size: 

  • Oils: 1 TbspFullSizeRender_4
  • Foods rich in oils:
    • Trans fat-free margarine and mayonnaise: 1 Tbsp
    • Salad dressings and peanut butter: 2 Tbsp
    • Avocado: ½ medium or 3 tsp
    • Nuts (peanuts, cashews, almonds, hazelnuts): 1 oz or 3 tsp
  • Average calories per serving: 75-150 calories
  • Daily Oil Allowance: ~2 Tbsp for adultsFullSizeRender_3

Smoke point: the degree to which an oil or fat starts smoking and breaking down. If your oil is heated past it's smoke point, the fat in the oil starts to break down and releases free radicals. These free radicals create unpalatable flavors and promote inflammation in the body. Be sure to use oils based on your cooking methods.

  • Searing, deep-frying, stir-frying: peanut, corn, or safflower oil
  • Salad dressings or sautéing: virgin olive, avocado, or sesame oil

Storage: Oils should be stored in a dry, dark, and cool place away from light, heat, moisture, and air. I know those clear, glass bottles with the special nozzles are tempting to keep as a kitchen counter accessory, but your oils should really be kept away from heat in a dark, dry place so avoid storing it in the cupboard above the stove.

Purchasing: When grabbing your favorite oil from the local grocery store, try to avoid buying in bulk and stick with the smaller containers of oils. The bigger the container, the more likely the oil will have time to go rancid before you finish it. Try to stick with virgin or raw oils to preserve the best flavor. Lastly, there is always the unknown of how long the oil has already been sitting on the shelf absorbing the unwanted fluorescent light at the grocery store. Try to avoid picking the first or second oil on the shelf. Do a little shuffling and pick one farther back in the line protected by darkness of the shelf. This helps to avoid purchasing potentially half-rancid oil without even knowing it.


P.S. Still got a jar of coconut oil sitting around and don't what to do with it now that you've learned it's not the healthiest of fats? It'll make an excellent moisturizer or hair conditioner. So instead of contributing to your bum fat, it will make your bum soft 😉




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Nutrition Facts Label Decoded

With so much information available on food labels, it can be difficult to navigate and figure out what’s really best for your body.

I had a really fun discussion with WZZM 13 news yesterday morning about how to best navigate those confusing food labels and why to be cautious about health claims. Check out the video here!


Marketing of food items affects how we as consumers purchase foods and this proves true with foods that we think are nutritious. A recent study from the Journal of the Academy of Nutrition and Dietetics revealed that individuals were more likely to purchase snacks with health claims even if they are not the most nutritious. Health claims can include organic, low-fat, all-natural, reduced sodium, etc.

In particular, participants in this study were 30% less likely to use the Nutrition Facts label before their purchase if a nutrient content claim was on the front of the package. Although only 10% of participants opted to look at the Nutrition Facts label, those that did were 5 times more likely to choose the healthier option. These results only cement the need for consumers to be their own health advocates and understand how to navigate food labels for healthy foods.

Guide to navigating food labels

Sample Nutrition Facts label:


1. Start with the serving size. Look at the serving size and total servings per container. Then ask yourself, “Am I going to consume more than one serving”? If the answer is yes, then be sure to double the total nutrient numbers (i.e. calories, grams of fat, etc.).

2. The Rule of 3. Know which nutrients to limit and which to get more of. The top three nutrients, fat, cholesterol, and sodium are all nutrients to keep your intake the least of as part of a healthy, balanced diet. However, intake of the right type of carbohydrates, dietary fiber, and adequate vitamins and minerals, such as calcium, are nutrients to make sure you get enough of.

3. Understanding the percent daily value. Knowing that 5 percent DV or less is low and 20 percent DV or more is high is an easy rule of thumb to remember. Always remember to double these percentages as needed if you are consuming more than one serving.

Take away message(s):

  • Don’t depend on health claims to determine the nutrition quality of a food.
  • When in doubt, check the nutrition facts label! I know it can be scary, but by just looking at the nutrition facts label, you are more likely to make a healthier choice.
  •  If this is still very confusing to you, start by shopping the perimeter of the grocery store to increase your probability of purchasing fresh and healthy ingredients.
  • Better yet, focus on using the MyPlate method by filling your plate with nutrient-dense foods, such as fruits, vegetables, whole grains and legumes that don’t need health claims to make them healthy.

MyPlate icon

Have a great Thursday everyone!