43 Comments
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Neil Gyte's avatar

1000% agree Nick. I have a close family member reversing stage 4 cancer with ketogenic diet being the main protocol. It's beyond me how this study could even be written, let alone published

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Nick Norwitz MD PhD's avatar

That’s quite an amazing story. Certainly, ketogenic diets are an area of active investigation in oncology for their incredible therapeutic potential, often in combination with chemotherapy. If anything, the data strongly suggest ketogenic diet can help treat cancer – not cause it.

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Neil Gyte's avatar

Yes, agree Nick. The great thing about this case is no chemo/radiation. Just ketogenic diet, hormone based treatment and some moderate fasting. Hoping to publish a case report when we get the next scan (fingers crossed it's a remission scan!)

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Nick Norwitz MD PhD's avatar

Thanks for sharing! That would be a fascinating case report I’m sure!

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Bill Beers's avatar

Several comments were made regarding keto diet treatment for cancer. That sure beats carb loading in oncology wards we keep hearing about.

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Nick Norwitz MD PhD's avatar

That is true.

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Michelle Hurn's avatar

When my wife was diagnosed with breast cancer, she immediately went on. Therapeutic, ketogenic diet. The surgeon said she was, “The fastest healing patient he had ever seen.” Today she’s cancer free. Shame on these people for false, nonsensical, fear mongering! Thank you Nick for pointing out how flawed this paper is. Lives depend on people knowing the truth!

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Nick Norwitz MD PhD's avatar

That’s awesome about your wife! In this case, it’s an anecdote that’s part of a pattern. I don’t know what’s up with the “study.”

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Amber Rose Pennuto's avatar

I am deeply disappointed every time I encounter fear mongering in the health space. People are struggling to understand how to eat healthy, and nonsense like this only makes things worse. Thank you, Nick, for your earnest efforts to bring light into this space.

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Nick Norwitz MD PhD's avatar

Appreciate it Amber. The silver lining here is the general public has unprecedented access to information & content like this paper will get called out. Academia is only hurting its own brand — And that’s coming from a Harvard and Oxford trained MD PhD.

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CMFasulo's avatar

What people will do to undermine what they don't understand! I would say misleading is grossly understated... Papers such as these are why I get so much grief from mainstream eaters. Don't worry, I'm posting your rebuttal.

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Nick Norwitz MD PhD's avatar

Cheers CMF

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Debbie's avatar

This is one reason I follow you! You know the BS when you see it and I appreciate you passing your knowledge to us.

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Nick Norwitz MD PhD's avatar

Thanks Debbie.

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Terry Sloan's avatar

Excellent article!

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Nick Norwitz MD PhD's avatar

Thanks Terry

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ilaria bertini's avatar

strongly agree

more and more

being able to read accurately data is not a quality of many people

superficially reading brings stupid and dangerous conclusion

let us be with you opening mind in this world

thank you Nick!

waiting your next letter, short or long, for me always enlightening

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Nick Norwitz MD PhD's avatar

Thank you Ilaria. Appreciate your voice and support.

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ilaria bertini's avatar

I would be able to do it loudlier

:)))))))

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Nick Norwitz MD PhD's avatar

You need a megaphone... what's your address ;) (JK -- don't post your address)

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ilaria bertini's avatar

;)

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Marta's avatar

How did this even get through the peer review? The diets were essentially the food pyramid and healthy plate recommendations, not even low-carb, let alone ketogenic. With kcal% averages of 15% protein, 50% carb, 35% fat, the title should be "Standard American Diets Are Associated with an Elevated Risk for All Cancers."

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Nick Norwitz MD PhD's avatar

Indeed “SAD” is. And keto is consistently misrepresented in media — but to this degree after a proposed “peer review” is next-level.

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Vmlh47's avatar
3dEdited

How on earth can anyone be in ketosis eating that many carbs? That’s ludicrous! Was anything, like a blood test perhaps, done to prove they were in ketosis?

I suppose they could be imbibing sufficient amounts of exogenous ketones while imbibing at least 20,000 calories, but really, that’s still a far cry from claiming a ketogenic diet! 🙄

I hope none of these people (can’t really call them researchers) ever find a career teaching math.

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Nick Norwitz MD PhD's avatar

No, there was no confirmation of ketosis. As stated in the post, all that was known about the participants’ diet was reported in a two day retrospective diet survey. There were no biological tests, no prospective diet logging, or anything else of the sort.

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Cat's avatar

How many carbs people eat on a ketogenic diet varies, but this study is completely nonsense. Some people eat 10 or 20 grams of carbs others up to 40 on a ketogenic diet. But 100 grams is definitely not keto, that's low carb; 180 grams isn't even low carb.

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Nick Norwitz MD PhD's avatar

I agree that nutritional ketosis is different thresholds for different people. But calling 181 g of carbs a ketogenic diet is like calling a megalodon shark a guppy fish. It’s ridiculous to the point of being comedic.

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buddhi's avatar

Ridiculous, yes, but more so it is odd. For a Nutrition in Cancer journal it is impossible, unless intentional, thus they've forever lost being termed venerable and prestigious.

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Nick Norwitz MD PhD's avatar

I don’t think this journal is regarded as prestigious. But technically it does come with the stamp of “peer-review.”

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Alex Heyworth's avatar

The only way to know if a diet is ketogenic for an individual is to measure their blood ketones. Having said that, it’s pretty much impossible that a diet with 180 or 300 grams of carbs a day will be ketogenic.

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Nick Norwitz MD PhD's avatar

Yep

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Martin's avatar

At this point, the peer review process itself feels like a scam. What are they reviewing? That the paper doesn't contain mentions of dragons and unicorns? Heck, flat earthers probably produce more sensible experiments. It's completely useless. In IT, if code reviewers let such glaring issues slip by, they'd be scolded by any competent boss within hours.

If I was subscribed to such publications, I'd require a full refund. I can't comprehend how can people accept this garbage.

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Bill Beers's avatar

Maybe they thought Keto was spelled with a hard C for carbs, Ceto.

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Nbm's avatar

Wow thanks for that. Nutrition research is a joke. It should be abolished. What defines a ketogenic diet then? Is it under 20g of carbs per day? Under 50g of carbs per day? Or is it based on the level of carbs that produces ketones in a person? I am unable to prick myself to test ketones - it hurts. So can only use a breath monitor but the breath monitor that I have is biosense and they went out of business so I stopped checking.

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Nick Norwitz MD PhD's avatar

Technically, you do need a blood capillary measurement in confirmation of nutritional ketosis, usually defined by a threshold of levels at or above 0.5 mM. That said, a heuristic some people use is 25 g of net carbs per day or less. There isn’t a strict carb threshold that generalizes across populations.

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Papet Adrien's avatar

I think it is the moment to re read the famous paper of Ioannidis https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124 that most published researched is false positive. It belongs to this crap study, but also to the previous discussed omeg6/3 study.

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Jacqueline Ritacco's avatar

Even a layperson can tell this is very bad science being presented in this article. Please make sure the editor knows we are not happy with this type of sloppy science being published. Thanks.

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Nick Norwitz MD PhD's avatar

I’ve conveyed the consistent sense of disappointment.

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