Macrobiotic Diet Cancer Survival – This article will examine some of the popular diets followed by people with cancer, as well as the positives and negatives. The negative associated with these foods.
More than 48% of cancer patients follow popular diets, including alkaline, paleolithic, ketogenic, vegan and macrobiotic diets, in the hope that they will improve survival and prevent recurrence. These foods have positive characteristics that are consistent with the dietary guidelines proposed by the American Cancer Society (ACS) and the American Institute for Cancer Research (AICR). All diets emphasize eating vegetables, all but the ketogenic diet encourage fruit, and all but the vegan diet limit refined grains and alcohol. Both macrobiotic and alkaline diets meet most ACS and AICR recommendations. The negative aspects of these diets include the scientific basis for their anti-cancer properties, limited evidence that they improve cancer outcomes, the potential for nutrient deficiencies, and the exclusion of food groups with proven benefits for cancer prevention and general health. Furthermore, nutritional counseling can often address nutritional deficiencies and nonadherence to clinical guidelines for cancer care. Clinicians should consider strategies to promote evidence-based dietary changes that promote the positive attributes of popular cancer diets while minimizing the negative aspects.
Macrobiotic Diet Cancer Survival
Among cancer patients and survivors, there is great interest in lifestyle changes, including diet . Both the American Cancer Society (ACS) and the American Institute for Cancer Research/World Cancer Research Fund (AICR/WCRF) have clinical dietary guidelines that apply to cancer patients. These guidelines are a review of evidence-based diets for reducing the risk of cancer and death. A large multicenter epidemiological study has shown that high levels of adherence to the ACS and AICR dietary guidelines significantly reduce cancer incidence, from 17% to more than 50%, depending on cancer location, and reduce cancer mortality by 20% to 30% [4 – 8]
Macrobiotic Health Care Essentials
However, cancer patients and survivors rarely use dietary guidelines to determine their food choices. Instead, a survey of cancer patients and survivors showed that “special diets” such as vegan and macrobiotic diets are one of the most used combination therapies, with 48% of cancer patients or those at risk of cancer, taking their diet. [9–14] In contrast to the ACS and AICR dietary guidelines, there is limited research on the effects of these popular foods on cancer-specific outcomes such as morbidity, mortality, and quality of life. This leaves physicians with a lack of information on how to counsel their cancer patients regarding the use of these foods.
The purpose of this review is to help oncologists gain knowledge about the content, rationale, and science of diets that are popular among cancer patients. Specifically, we look at five of these popular diets: the alkaline, paleolithic, ketogenic, vegan, and macrobiotic diets, using three different frameworks. The first framework is a set of three questions suggested by nutritionist Marion Nestle on how to evaluate any food. These three questions are: 1) “What is it?” 2) “Is this reason reasonable?” and 3) “Does it promote health?”  The second frame is to determine what, if any, scientific evidence supports these popular foods for cancer patients, and the third frame is to determine the extent to which these special foods are consistent with ACS and AICR clinical dietary guidelines.
Proponents of an alkaline diet believe that most cancers are caused by an acidic environment in the body and that the main cause of this hypothesized acidity is an acidic diet (see table).  The Western diet is characterized by a high consumption of animal products and refined carbohydrates with limited consumption of fruits and vegetables, and is therefore considered a highly acidic diet. In contrast, alkaline foods designed to provide more alkaline ions after digestion are rich in fruits and vegetables with limited protein; reduce acid load; And this will help reduce the burden on the acid detoxification system. [17, 18] Proponents suggest that it will increase the pH of the system and its effect can be evaluated by monitoring urine pH. Indeed, a clinical trial in healthy adults comparing an alkaline diet to an acidic diet found that when urine pH increased by 1.02 units, systemic pH increased significantly by 0.014 units, suggesting that urine pH may be an accurate indicator of pH. 
There are only two studies investigating the role of dietary acid load and cancer. A prospective cohort study examined the relationship between bladder cancer risk and urine pH in 27,096 smokers participating in the Alpha-Tocopherol and Beta-Carotene (ATBC) Cancer Prevention Trial. The relative risk (RR) of developing bladder cancer was not significantly related to urine pH (RR, 1.15; 95% CI, 0.86-1.55) when comparing the highest to the lowest urine pH. However, men who smoked more than 45 years were suggested to be at increased risk of having low urine pH (RR, 1.72; 95% CI, 0.96-3.10;
Diet And Cancer
= 0.08). Another small, open-label study examined the use of an alkaline diet in 11 patients with non-small cell lung cancer receiving an EGFR tyrosine kinase inhibitor. While patients had longer median progression-free survival (19.5 months; range 3.1-33.8 months) and overall survival (28.5 months; range 15.4-46.6 months), the control group did not; Therefore, the results are difficult to interpret  . In general, the reasoning behind the alkaline diet is flawed and the evidence is lacking. Despite this, an alkaline diet is consistent with dietary guidelines for cancer patients and survivors. Therefore, it may be suitable for cancer patients, but for different reasons than those given by the sponsor (see picture).
The Paleolithic diet tries to replicate the diet of Stone Age humans by including foods that were available to hunter-gatherers, including fruits, vegetables, nuts, meat, and eggs, while excluding grains, legumes, milk, and all processed foods (see table)  The reasoning behind the diet is based on the idea known as the “difference hypothesis of evolution” that humans have developed over thousands of years with a relatively consistent diet and that chronic diseases such as cancer arise from the consumption of foods that are only after the agricultural revolution, which humans are. Genetically not genetically predisposed to prepare for digestion . Diet advocates believe that human genetics has not changed significantly since the Paleolithic period, which ended about 10,000 years ago, with an understanding of prehistoric diets, and that foods that existed in history are equivalent to modern diets. Each of these hypotheses, however, contradicts the anthropological evidence that there is no single Paleolithic diet; that grains have been cultivated and consumed in Europe for more than 40,000 years; that humans have recently evolved to consume food that is prominent in their environment, as evidenced by the development of lactase resistance in Europe and Africa; and that the food available today has been greatly changed by human agricultural practices and therefore differs greatly from the food available historically. [24-27] In addition, cancer is a disease that often occurs late in life, after a person has through reproductive age. , and thus there is no selection pressure in the population for low cancer incidence.
The evidence for the Paleolithic diet in the prevention or treatment of cancer is limited to two controlled studies. In one study, the highest adherence to the Paleolithic diet compared with the lowest adherence was associated with reduced all-cause mortality (hazard ratio [HR], 0.72; 95% CI, 0.55–0.95;
= 0.03). In a similar study, the odds of colorectal adenoma were lower among those in the highest quintile of the Paleolithic diet compared with disease-free controls (adjusted odds ratio 0.71; 95% CI 0.50-1.02;
Der Letzte Versuch
= 0.02). The Paleolithic diet emphasizes fruits, vegetables, nuts, and seeds while limiting refined carbohydrates, processed meats, and alcohol. However, the diet contradicted the AICR dietary guidelines for being high in saturated fat and low in legumes and whole grains, a combination associated with poor survival in colon cancer . In summary, the Paleolithic diet shares characteristics with other healthy diets, but strict adherence may exclude food groups with proven benefits for cancer prevention and general health (see figure).
The Ketogenic diet is a high-fat, low-carbohydrate, protein-sufficient diet with a 3-4:1 macronutrient ratio of fat to protein to non-fiber carbohydrates. Sixty-five percent or more of calories come from fat, while carbohydrate intake is limited to 20 to 60 grams per day (see table).  This composition of macronutrients forces the body to metabolize lipids more than carbohydrates or proteins, and change the body’s main energy substrate from glucose to ketones. In accordance with the Warburg effect – the phenomenon that cancer cells depend on glycolysis for growth even in the presence of oxygen – indicators of the hypothesis indicate that the growth of cancer cells will be inhibited by switching to ketone metabolism . Evidence suggests that some cancer cells can metabolize ketones less than healthy cells, while other experiments show that some tumor cells can use ketones for energy .
However, recently, preclinical studies indicate that the possible mechanism of ketosis on cancer cells is not based only on the Warburg effect. The range of altered growth, metabolism, and signaling metabolites induced by ketosis can lead to the induction of specific cancer cells of oxidative stress, thereby enhancing the effects of chemotherapy and radiation. [34, 35] Additionally, the ketogenic diet may have a protein-rich effect that preserves muscle mass in the setting of cancer cachexia.  In animal models, ketogenic
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