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SHORT-TERM FASTING DURING

CHEMOTHERAPY
K A I TLYN D I CK SO N
SEA M A R CH C D I ETETI C I N TERN
SI TE: SEA TTLE CA N CER CA RE A LLI A N CE
IN-SERVICE OBJECTIVES
To become familiar with fasting
strategies and perceived benefits
made by media and internet
claims
To review physiology of fasting
and the growth hormone/insulin
like growth factor 1 axis
To explore current research
related to short-term fasting
during chemotherapy
To assess the risk versus benefit
of fasting during chemotherapy https://www.washingtonpost.com/national/health-science/fasting-may-
protect-against-disease-some-say-it-may-even-be-good-for-the-
brain/2012/12/24/6e521ee8-3588-11e2-bb9b-288a310849ee_story.html
the abstinence or limitation
of food, drink or both
Practiced in many cultures and
religions
Fasting allows the body to focus on
energy and cleansing
Health Claims
Anti-aging
Brain health
Reduces inflammation and oxidative
stress
Weight loss
https://patriciadaly.com/intermittent-fasting/
FASTING STRATEGIES 7

Time Restricted Fasting

Intermittent Fasting

Short-Term Fasting

Prolonged Fasting

Fasting-Mimicking Diet
DR. VALTER LONGO 7

Professor at the USC Leonard Davis School of Gerontology


and director of USC Longevity Institute
Creator of the Fasting Mimicking Diet (FMD)
Weight loss
Slowed aging
Leads research on fasting effects on cancer cells during
chemotherapy
Founder of L-Nutra and developer of FMD products
Prolon and Chemolieve
PHASES OF FASTING

http://www.derangedphysiology.com/main/required-
reading/endocrinology-metabolism-and-
nutrition/Chapter%203.1.8/physiological-adaptation-
prolonged-starvation
HUMAN GROWTH HORMONE 7

Produced in anterior pituitary gland


Stimulates lipolysis to provide free fatty
acids and glycerol for energy
Also inhibits insulin induced suppression of
gluconeogenesis
Preserves lean muscle mass and bone
density
Stimulates release of IGF-1 from the liver

https://intensivedietarymanagement.com/how-
do-we-gain-weight-calories-part-1/
GH/IGF-1 AXIS 2,4

IGF-1
High blood levels suppress GH
secretion
Produced in the liver
48% amino acid sequence of
proinsulin
Major regulator of metabolism
Exerts powerful effects on
cellular proliferation and
apoptosis, angiogenesis and
metastasis

http://sageke.sciencemag.org/cgi/content-nw/full/2004/31/re5/F1
DIFFERENTIAL STRESS RESISTANCE EFFECT 5
Changhan L, Safdie F, et al. Reduced Levels of IGF-1 Mediate Differential Protection of Normal and Cancer Cells in Response to Fasting
and Improve Chemotherapeutic Index. Cancer Research. 2010; 70(4); 1564-72
DorffT, Groshen S, et al. Safety and feasibility of fasting in combination with platinum based chemotherapy. BMC
Cancer. 2016. 16:360
DorffT, Groshen S, et al. Safety and feasibility of fasting in combination with platinum based chemotherapy. BMC Cancer. 2016. 16:360
ASSESSING RISK VS BENEFIT

POTENTIAL BENEFITS POTENTIAL RISKS

Induces protective mechanism in heathy cells1 Importance of weight stability during


May reduce side affects associated with chemotherapy
chemotherapy Malnutrition/cachexia/dehydration
May enhance chemotherapy treatment5 Micronutrient deficiencies
Food intake may increase
bioavailability for some drugs
Increased risk for infection
Fasting related symptoms
Non-adherence
Decreased comfort for patient

https://www.dietdoctor.com/intermittent-fasting
REFERENCES

1. Changhan L, Safdie F, et al. Reduced Levels of IGF-1 Mediate Differential Protection of Normal
and Cancer Cells in Response to Fasting and Improve Chemotherapeutic Index. Cancer
Research. 2010; 70(4); 1564-72.
2. Clemmons, David. The relative roles of growth hormone and IGF-1 in controlling insulin
sensitivity.The Journal of Clinical Investigation 2004 Jan 1;113(1): 25-27
3. Dorff T, Groshen S, et al. Safety and feasibility of fasting in combination with platinum based
chemotherapy. BMC Cancer. 2016. 16:360.
4. Jin M, Buck E, Mulvihill MJ. Modulation of insulin-like growth factor-1 receptor and its signaling
network for the treatment of cancer: current status and future perspectives. Oncology Rev
2013. 22;7(1)e3.
5. Lee C, Longo V et al. Fasting vs dietary restriction in cellular protection and cancer treatment:
from model organisms to patients. Oncogene. 2011. 30;3305-3316.
6. Longo V, Mattson M. Fasting: Molecular Mechanism and Clinical Applications. Cell Metabolism.
2014. 19;181-192,
7. L-Nutra. l-nutra.com.Accessed: March 20 2016.
8. Norrelund H, Nair S et al. The Protein-Retaining Effects of Growth Hormone During Fasting
Involve Inhibition of Muscle-Protein Breakdown. Diabetes. 2001. 50(1): 96-104.