The problem I have with the above study / conclusion--is that statistically "heavier" people tend to do well (or better) in their multiple myeloma, than do "thin" folks.
I think this has been studied and reported out by several different researchers/ reviewers for a considerable period of time. ( ie. Fatter folks do Better)
Is this new study tied to considerations of Hispanics only ??
Is there a Genetic difference between this study population and prior studies, which clearly indicate a contrary conclusion ? Is this a "Brown Fat" issue?
Again, the adage "you can find a study that says pretty much what you want", comes to mind.
What are we multiple myeloma'rs to believe ?
Forums
Re: Ketogenic diet and multiple myeloma
There are numerous studies that state obesity is a risk factor in development and progression of MGUS and myeloma. Also you can be non obese and have a high carb diet with increased visceral fat and low adiponectin.
Re: Ketogenic diet and multiple myeloma
Hey, Ron, thank you for the link! It helps to have the link so I can look for other studies by the authors. Wonder if there is any way to control our fatty acid composition if we are thin?
The good news is that my WBC, platelets and ANC were the highest they had been since SCT 27.5 months ago.
Also, I think the biggest step forward for me to be consistent in my food intake is that I joined a calorie counting program where I can print out each day at the end of the day and see the fat grams, protein grams, carb grams, etc. I have a formula where I could put that into my Excel spreadsheet and calculate that I AM eating a ketogenic diet (let me know if you want the formula).
Unfortunately, my kappa free light chains were up to 25.2 mg/L, lambdas were 30.9, and ratio of 0.84. I got sick around January 17 and finally got on antibiotics Monday, so I did not take my Revlimid during that 3 weeks (trying to get healthy again). I will take my Revlimid again tomorrow.
Interesting that both kappas and lambda's both went up because, when I was diagnosed, my kappas were 1060 mg/L and lambdas just 11.9, for a ratio of 89.
I'll study your article, Ron Thanks Cathy
The good news is that my WBC, platelets and ANC were the highest they had been since SCT 27.5 months ago.
Also, I think the biggest step forward for me to be consistent in my food intake is that I joined a calorie counting program where I can print out each day at the end of the day and see the fat grams, protein grams, carb grams, etc. I have a formula where I could put that into my Excel spreadsheet and calculate that I AM eating a ketogenic diet (let me know if you want the formula).
Unfortunately, my kappa free light chains were up to 25.2 mg/L, lambdas were 30.9, and ratio of 0.84. I got sick around January 17 and finally got on antibiotics Monday, so I did not take my Revlimid during that 3 weeks (trying to get healthy again). I will take my Revlimid again tomorrow.
Interesting that both kappas and lambda's both went up because, when I was diagnosed, my kappas were 1060 mg/L and lambdas just 11.9, for a ratio of 89.
I'll study your article, Ron Thanks Cathy
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antelope1225 - Name: Cathy1225
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: May 25 2012
- Age at diagnosis: 55
Re: Ketogenic diet and multiple myeloma
This is my excel spreadsheet analysis of macros and ketones for January 2015.
The formula is:
=product(.9*fat+ .46*protein)/ (.1*fat + .54* protein +1* net carb).
This total should be over 1.5 to keep ketones in right zone. I am surprised how often my actual blood ketones equal the amount expected from formula.
ketones fat protein carbs fiber net formula w
carb net c
1-Jan 139 42 34 9 25 2.35
2-Jan 1.9 112 58 24 11 13 2.30
3-Jan 3.3 139 44 31 12 19 2.57
4-Jan 4.3 122 58 24 15 9 2.60
5-Jan 2.9 120 62 19 10 9 2.51
6-Jan 3.7 146 60 28 10 18 2.45
7-Jan 2.2 137 73 38 19 19 2.18
8-Jan 1.7 130 71 22 7 15 2.26
9-Jan 120 74 24 10 14 2.15
10-Jan 104 55 21 2.7 18.3 2.04
11-Jan 125 79 23 9 14 2.15
12-Jan 2.3 115 61.6 32 13.4 18.6 2.08
13-Jan 3 113 71 19.2 5 14.2 2.10
14-Jan 1.8 133.6 59 11 5 6 2.88
15-Jan 4.2 131 61 19.7 3.6 16.1 2.35
16-Jan 1.7 0
17-Jan 3.1 0
18-Jan 4.2 117 68 26 8 18 2.06
19-Jan 3.2 0
20-Jan 6.1 0
21-Jan 2.2 131 56 23 10 13 2.55
22-Jan 128.5 60 26 10 16 2.34
23-Jan 2.4 142 61 18 6 12 2.64
24-Jan 0
25-Jan 2.9 122 62 21 9 12 2.40
26-Jan 3.1 125 53 17 6.7 10.3 2.66
27-Jan 2.5 0
28-Jan 2.8 130 41 23 11 12 2.88
29-Jan 149 58 18 6.4 11.6 2.78
30-Jan 2.7 135.7 50 21 6.2 14.8 2.62
31-Jan 2.9 130 65.2 24 10 14 2.36
The formula is:
=product(.9*fat+ .46*protein)/ (.1*fat + .54* protein +1* net carb).
This total should be over 1.5 to keep ketones in right zone. I am surprised how often my actual blood ketones equal the amount expected from formula.
ketones fat protein carbs fiber net formula w
carb net c
1-Jan 139 42 34 9 25 2.35
2-Jan 1.9 112 58 24 11 13 2.30
3-Jan 3.3 139 44 31 12 19 2.57
4-Jan 4.3 122 58 24 15 9 2.60
5-Jan 2.9 120 62 19 10 9 2.51
6-Jan 3.7 146 60 28 10 18 2.45
7-Jan 2.2 137 73 38 19 19 2.18
8-Jan 1.7 130 71 22 7 15 2.26
9-Jan 120 74 24 10 14 2.15
10-Jan 104 55 21 2.7 18.3 2.04
11-Jan 125 79 23 9 14 2.15
12-Jan 2.3 115 61.6 32 13.4 18.6 2.08
13-Jan 3 113 71 19.2 5 14.2 2.10
14-Jan 1.8 133.6 59 11 5 6 2.88
15-Jan 4.2 131 61 19.7 3.6 16.1 2.35
16-Jan 1.7 0
17-Jan 3.1 0
18-Jan 4.2 117 68 26 8 18 2.06
19-Jan 3.2 0
20-Jan 6.1 0
21-Jan 2.2 131 56 23 10 13 2.55
22-Jan 128.5 60 26 10 16 2.34
23-Jan 2.4 142 61 18 6 12 2.64
24-Jan 0
25-Jan 2.9 122 62 21 9 12 2.40
26-Jan 3.1 125 53 17 6.7 10.3 2.66
27-Jan 2.5 0
28-Jan 2.8 130 41 23 11 12 2.88
29-Jan 149 58 18 6.4 11.6 2.78
30-Jan 2.7 135.7 50 21 6.2 14.8 2.62
31-Jan 2.9 130 65.2 24 10 14 2.36
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antelope1225 - Name: Cathy1225
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: May 25 2012
- Age at diagnosis: 55
Re: Ketogenic diet and multiple myeloma
Hi all who are interested in my ketogenic diet
I had an appointment with my oncologist yesterday. Cancer numbers about the same – slightly above normal 25.4 mg/L. The most exciting thing was that my kidney numbers had improved significantly - estimated creatinine clearance of 46.17 (estimates my kidneys are functioning at 46%, which is the best since I was diagnosed). My creatinine was down to 1.184167 - which is basically normal.
My oncologist muttered that I was “off the charts”, “out of the box”. I asked what he meant, and he said I was taking basically no Revlimid since I am just 5 mg once a week. He says let's wait 8 weeks before next appointment.
A quick background is that I was diagnosed May 31, 2012 with multiple myeloma and light chain deposition disease. My beta 2 microglobulin was 8.46 on August 16, 2012 after 2 1/2 months of dex, Velcade and thalidomide (International Staging says over 5.5 is Stage 3). I had SCT November 18, 2012, but had no remission - numbers were going up rapidly even with 5 mg Revlimid every other day and then 10 mg Revlimid every other day.
My oncologist told me to keep blood glucose low and steady a year ago and my numbers are about the same after one year of following ketogenic diet.
I still eat about 130 g fat, 60 g protein, 20 g carbs. I also added some vitamins since last appointment. I took 2000 IU D3, 500 mg C, a B complex every other day, calcium and selenium since last appointment.
I had an appointment with my oncologist yesterday. Cancer numbers about the same – slightly above normal 25.4 mg/L. The most exciting thing was that my kidney numbers had improved significantly - estimated creatinine clearance of 46.17 (estimates my kidneys are functioning at 46%, which is the best since I was diagnosed). My creatinine was down to 1.184167 - which is basically normal.
My oncologist muttered that I was “off the charts”, “out of the box”. I asked what he meant, and he said I was taking basically no Revlimid since I am just 5 mg once a week. He says let's wait 8 weeks before next appointment.
A quick background is that I was diagnosed May 31, 2012 with multiple myeloma and light chain deposition disease. My beta 2 microglobulin was 8.46 on August 16, 2012 after 2 1/2 months of dex, Velcade and thalidomide (International Staging says over 5.5 is Stage 3). I had SCT November 18, 2012, but had no remission - numbers were going up rapidly even with 5 mg Revlimid every other day and then 10 mg Revlimid every other day.
My oncologist told me to keep blood glucose low and steady a year ago and my numbers are about the same after one year of following ketogenic diet.
I still eat about 130 g fat, 60 g protein, 20 g carbs. I also added some vitamins since last appointment. I took 2000 IU D3, 500 mg C, a B complex every other day, calcium and selenium since last appointment.
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antelope1225 - Name: Cathy1225
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: May 25 2012
- Age at diagnosis: 55
Re: Ketogenic diet and multiple myeloma
Cathy,
Glad you are doing well. I am now thinking that, along with the low-carb diet, keeping animal protein and dairy reduced in the diet is very important for IGF-1 reduction.
Glad you are doing well. I am now thinking that, along with the low-carb diet, keeping animal protein and dairy reduced in the diet is very important for IGF-1 reduction.
Re: Ketogenic diet and multiple myeloma
Good to see you continue to do well Cathy. This thread is long but I check on it occasionally to see how you are doing.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Ketogenic diet and multiple myeloma
Cathy
You have been very helpful to me in posts on other subjects and I have recently been reading through your posts and progress on this subject. I have begun to cut back on carbs (especially sugars) and plan to make more changes towards the ketogenic diet. It is difficult because I live with a husband who is carb and bread addicted, but I must learn not to make excuses and maintain my own course.
Another thing I have been doing is not eating anything between the hours of 7 pm and 7 am. I feel better and am sleeping better. I think I will extend this fasting period between 14 to 16 hours and see how that goes.
Anyhow, I think you are onto something important here with the ketogenic diet, so please keep posting.
Thanks
You have been very helpful to me in posts on other subjects and I have recently been reading through your posts and progress on this subject. I have begun to cut back on carbs (especially sugars) and plan to make more changes towards the ketogenic diet. It is difficult because I live with a husband who is carb and bread addicted, but I must learn not to make excuses and maintain my own course.
Another thing I have been doing is not eating anything between the hours of 7 pm and 7 am. I feel better and am sleeping better. I think I will extend this fasting period between 14 to 16 hours and see how that goes.
Anyhow, I think you are onto something important here with the ketogenic diet, so please keep posting.
Thanks
-
Melpen - Name: Melissa
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: Feb 5, 2014
- Age at diagnosis: 57
Re: Ketogenic diet and multiple myeloma
Here are some links pertaining to low animal protein intake,and IGF-1 in myeloma and other cancers. Fontana also has studies from 2008 showing decreased animal protein correlation to IGF-1 levels.
L Fontana et al, "Dietary protein restriction inhibits tumor growth in human xenograft models," Oncotarget, Nov 2013 (link to full text of article)
Abstract:
Purpose: Data from epidemiological and experimental studies suggest that dietary protein intake may play a role in inhibiting prostate and breast cancer by modulating the IGF / AKT / mTOR pathway. In this study we investigated the effects of diets with different protein content or quality on prostate and breast cancer.
Experimental Design: To test our hypothesis we assessed the inhibitory effect of protein diet restriction on prostate and breast cancer growth, serum PSA and IGF-1 concentrations, mTOR activity and epigenetic markers, by using human xenograft cancer models.
Results: Our results showed a 70% inhibition of tumor growth in the castrate-resistant LuCaP23.1 prostate cancer model and a 56% inhibition in the WHIM16 breast cancer model fed with a 7% protein diet when compared to an isocaloric 21% protein diet. Inhibition of tumor growth correlated, in the LuCaP23.1 model, with decreased serum PSA and IGF-1 levels, down-regulation of mTORC1 activity, decreased cell proliferation as indicated by Ki67 staining, and reduction in epigenetic markers of prostate cancer progression, including the histone methyltransferase EZH2 and the associated histone mark H3K27me3. In addition, we observed that modifications of dietary protein quality, independently of protein quantity, decreased tumor growth. A diet containing 20% plant protein inhibited tumor weight by 37% as compared to a 20% animal dairy protein diet.
Conclusions: Our findings suggest that a reduction in dietary protein intake is highly effective in inhibiting tumor growth in human xenograft prostate and breast cancer models, possibly through the inhibition of the IGF/AKT/mTOR pathway and epigenetic modifications.
D Chiron et al, "Autocrine insulin-like growth factor 1 and stem cell factor but not interleukin 6 support self-renewal of human myeloma cells," Blood Cancer Journal, June 2013 (link to full text of article)
Abstract:
In this study, we have identified the growth factors supporting myeloma self-renewal in eight myeloma cell lines. All cell lines able to form self-colonies displayed constitutive P-AKT and P-ERK1,2 but not P-STAT3 and did not express CD45, suggesting the presence of an insulin-like growth factor 1 (IGF1) loop. We showed that a blocking anti-insulin-like growth factor 1 receptor (IGF1R) monoclonal antibody (mAb) inhibited colony formation in correlation with IGF1R expression and decreased P-AKT. Imatinib or a blocking anti-stem cell factor (SCF) mAb also inhibited colony formation of two cell lines expressing C-KIT and SCF, and decreased P-AKT. Moreover, the PI3K/AKT pathway inhibitor wortmannin inhibited colony formation. Blocking interleukin (IL)6R did not inhibit colony formation in good agreement with a lack of constitutive P-STAT3. We showed that primary cells frequently co-expressed IGF1R/IGF1 but not C-KIT/SCF or IL6R/IL6, suggesting that in vivo autonomous growth could be possible via IGF1R. Despite their similar role in clonogenic growth and shared signaling pathway, IGF1R and C-KIT had opposite prognostic values, suggesting that they were surrogate markers. Indeed, we showed that both C-KIT and IGF1R prognostic values were not independent of MMSET expression. This study highlights the autocrine role of IGF1 in myeloma cells and reinforces the interest in targeting IGF1R in IGFR1+ CD45+/− patients, such as MMSET+ patients.
L Fontana et al, "Dietary protein restriction inhibits tumor growth in human xenograft models," Oncotarget, Nov 2013 (link to full text of article)
Abstract:
Purpose: Data from epidemiological and experimental studies suggest that dietary protein intake may play a role in inhibiting prostate and breast cancer by modulating the IGF / AKT / mTOR pathway. In this study we investigated the effects of diets with different protein content or quality on prostate and breast cancer.
Experimental Design: To test our hypothesis we assessed the inhibitory effect of protein diet restriction on prostate and breast cancer growth, serum PSA and IGF-1 concentrations, mTOR activity and epigenetic markers, by using human xenograft cancer models.
Results: Our results showed a 70% inhibition of tumor growth in the castrate-resistant LuCaP23.1 prostate cancer model and a 56% inhibition in the WHIM16 breast cancer model fed with a 7% protein diet when compared to an isocaloric 21% protein diet. Inhibition of tumor growth correlated, in the LuCaP23.1 model, with decreased serum PSA and IGF-1 levels, down-regulation of mTORC1 activity, decreased cell proliferation as indicated by Ki67 staining, and reduction in epigenetic markers of prostate cancer progression, including the histone methyltransferase EZH2 and the associated histone mark H3K27me3. In addition, we observed that modifications of dietary protein quality, independently of protein quantity, decreased tumor growth. A diet containing 20% plant protein inhibited tumor weight by 37% as compared to a 20% animal dairy protein diet.
Conclusions: Our findings suggest that a reduction in dietary protein intake is highly effective in inhibiting tumor growth in human xenograft prostate and breast cancer models, possibly through the inhibition of the IGF/AKT/mTOR pathway and epigenetic modifications.
D Chiron et al, "Autocrine insulin-like growth factor 1 and stem cell factor but not interleukin 6 support self-renewal of human myeloma cells," Blood Cancer Journal, June 2013 (link to full text of article)
Abstract:
In this study, we have identified the growth factors supporting myeloma self-renewal in eight myeloma cell lines. All cell lines able to form self-colonies displayed constitutive P-AKT and P-ERK1,2 but not P-STAT3 and did not express CD45, suggesting the presence of an insulin-like growth factor 1 (IGF1) loop. We showed that a blocking anti-insulin-like growth factor 1 receptor (IGF1R) monoclonal antibody (mAb) inhibited colony formation in correlation with IGF1R expression and decreased P-AKT. Imatinib or a blocking anti-stem cell factor (SCF) mAb also inhibited colony formation of two cell lines expressing C-KIT and SCF, and decreased P-AKT. Moreover, the PI3K/AKT pathway inhibitor wortmannin inhibited colony formation. Blocking interleukin (IL)6R did not inhibit colony formation in good agreement with a lack of constitutive P-STAT3. We showed that primary cells frequently co-expressed IGF1R/IGF1 but not C-KIT/SCF or IL6R/IL6, suggesting that in vivo autonomous growth could be possible via IGF1R. Despite their similar role in clonogenic growth and shared signaling pathway, IGF1R and C-KIT had opposite prognostic values, suggesting that they were surrogate markers. Indeed, we showed that both C-KIT and IGF1R prognostic values were not independent of MMSET expression. This study highlights the autocrine role of IGF1 in myeloma cells and reinforces the interest in targeting IGF1R in IGFR1+ CD45+/− patients, such as MMSET+ patients.
Re: Ketogenic diet and multiple myeloma
Wow! I don't usually get any responses to my weird diet 
Eric, Thank you for checking on me. I hope you are doing well too. I always read your posts when I see them and hope the higher dose of Revlimid helps. Have you tried Resveratrol and Curcumin? I have started taking both of those after reading about them.
Ron, I appreciate that you have told me to look into the link between protein and IGF-1 I read your links and looked up some others. The diet I have been eating is about 16% protein, 78% fat and 5% carbs. I may lower the protein a bit more - I usually eat about 2.5 oz protein at lunch and dinner, but I will be careful not to let that creep up. Thanks! I will keep my focus on that. here is a link I found.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673798/
Protein restriction causes reduction in IGF-1.
Hi Melissa. I think of you often and hope you are doing better. It is hard at first to eat this way, but I have been doing it for a year now and I have some fantastic recipes.
My hubby is a very good sport about eating my cooking, but I usually make some rice, noodles or taco shells with his dinner (and just don't eat it), and he likes muffins or hash browns with his eggs. I make him sandwiches for lunch when I have a salad or lettuce roll etc. We have both lost weight even though that is not my focus or my goal.
Eric, Thank you for checking on me. I hope you are doing well too. I always read your posts when I see them and hope the higher dose of Revlimid helps. Have you tried Resveratrol and Curcumin? I have started taking both of those after reading about them.
Ron, I appreciate that you have told me to look into the link between protein and IGF-1 I read your links and looked up some others. The diet I have been eating is about 16% protein, 78% fat and 5% carbs. I may lower the protein a bit more - I usually eat about 2.5 oz protein at lunch and dinner, but I will be careful not to let that creep up. Thanks! I will keep my focus on that. here is a link I found.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673798/
Protein restriction causes reduction in IGF-1.
Hi Melissa. I think of you often and hope you are doing better. It is hard at first to eat this way, but I have been doing it for a year now and I have some fantastic recipes.
My hubby is a very good sport about eating my cooking, but I usually make some rice, noodles or taco shells with his dinner (and just don't eat it), and he likes muffins or hash browns with his eggs. I make him sandwiches for lunch when I have a salad or lettuce roll etc. We have both lost weight even though that is not my focus or my goal.
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antelope1225 - Name: Cathy1225
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: May 25 2012
- Age at diagnosis: 55
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