Low-Carb Diet & ADT

I am always interested in what Dr. Steve Freedland is working on. His study of the effects of a very low carb diet during ADT hasn't appeared in print yet, but the gist is in this interview at the AUA meeting this year:

& here is much the same info from a new interview in Urology Times:


The interesting thing is what didn't happen in the intervention arm:

"In the control group in our study, we saw that at 6 months they gained 1.3 kg, their insulin resistance went up 36%, and they added 11% new fat mass. They experienced the effects that hormones generally have."

"Compared to the control group, rather than going up 36%, insulin resistance went down 4% in the diet group. So we completely prevented insulin resistance from happening."

It's an extreme diet - but ADT is an extreme therapy.


17 Replies

  • "One of the key questions for me is whether eating a lot of fats and cheeses may actually make the cancer grow faster, and there is some literature that suggests this." What to do? Experts say have a low fat diet, others disagree. Limit cheeses or limit dairy or limit certain dairy; it looks like you make your choices depending what you feel comfortable with eating and putting in your body.


    PS: I do appreciate you providing this information to both me and our community.

  • Rich,

    ADT has two big negatives IMO: (a) it has a short mean-time-to-failure, which is very disappointing for those diagnosed at earlier ages, & (b) it causes/worsens the metabolic syndrome [MetS] & shunts many men into an alternative death.

    It is very encouraging that a low-carb diet can prevent MetS, but what else can it do? Does it delay CRPC? Does it extend life?

    The case against "fats" is weak, in that fats are generally lumped together as though interchangeable. In reality, the biological activity of a fatty acid depends on the length of the carbon chain & the positions of any double-bonds. A good example as to the subtlety one finds is in the 18-carbon chains:

    - with no double-bonds, we have stearic acid, which is found in beef fat & is good for making candles. Incidentally, although it is a common saturated fat, it is now recognized as having no negative effects on cardiovascular health.

    - take stearic acid & add a single double bond at the midpoint. This gives us oleic acid (omega-9 because the double-bond is 9 from the end). Oleic acid is thought to be healthy because it is the major fat in olive oil.

    - take oleic acid & add another double-bond 6 from the end (making it an omega-6) & we have linoleic acid [LA]. LA is considered to be bad because it can be converted to arachidonic acid.

    Very small changes, but big differences. Next we have the changes rhat occur in the body. First, the body makes fat from carbohydrate. In the case of the fats I mentioned, the body can convert one to another. In cancer, the ratio of oleic:stearic acid goes up. So much for oleic being healthy. The cancer wants it that way & I don't know how to inhibit it.

    With low-carb diets, fats get burned rather than glucose. With high-carb diets, fats are not burned but are created. Visceral fat stores secrete pro-PCa hormones.


  • Patrick,

    That ws very informative. I will use some of the information to lose excess weight.


  • I am hard pressed to know if I eat little enough carbs. I eat mainly salad bar salads, which can include berries and grapes and salmon(!), and I eat chicken (and beef) in crushed tomatoes cooked in the crock pot, drink coffee - now black. And carbs socially, but I am anti-social. Still I am not sure if I am low enough. Oh and eggs with diced veggies. Need to lose 20.

  • There is a case to be made for a Paleo-like diet that excludes starchy carbs but is high in low-calorie veg. There are just over 100 calories in 1 lb of spinach. Just over 150 for 1 lb broccoli. 118 for red peppers, & so on.

    You can eat a lot of that kind of veg & still be low-carb. & it's nutrient-rich.

  • thx. a little more clarification:

    //NCT01763944 diet is based on the Atkins diet (https://www.atkins.com/how-it-works/atkins-20) phase I, but we emphasize the good fats and good protein that has minimal saturated fat. [from Pao-Hwa Lin]//

  • Hi Patrick,

    I used to eat 2 bagels a day, & cereal with milk, & often some bread or pasta or tortillas or nan or pasta or rice, & sometimes some cookies, etc. And sometimes Swiss Milk Chocolate Ice Cream, with Chocolate Sauce. I ate meats & fish & chicken. Also beans & legumes. With some genetic luck & basketball playing, I stayed at a good weight.

    I cut out the carbs, except some brown rice, & cut out the meat, poultry & dairy. This has been going on for several years. My weight fell to my high school weight. When I got really serious about not "eating white," it dropped to my junior high weight. I don't know if this is related or not, but for the first time in all these years, I'm feeling some fatigue & drowsiness.

    My wife would like for me to gain some weight, & she knows I'm not going to do it on the fruits, veggies, fish, oatmeal, beans, legumes, & soy or coconut milk I eat, even though there are plenty of Asian & Italian sauces & oils included. I now use quinoa pasta to make my anchovy pasta, with spaghetti sauce, garlic & shiitake mushrooms.

    How can I gain weight without trashing my diet, which seems to have helped me live much longer than the oncologists predicted 10 to 13 years ago? I'm willing to consider adding some foods I've given up, if they're not detrimental to my cancer fight.

    Thank you!


  • When looking for nutrition advice Doctors are last on my list. Fats don't make us fat.

  • Nuts?

  • Thanks efsculpt, that's a good suggestion. I've also added coconut & avocado oils.

  • I have been on a low net carb diet for about three years. Less than 100 net carbs per day. I lost about 40 pounds in the first 6 months, and another 10 pounds since. I now weigh less than I weighed 20 years ago. Feel better, more energy, hot flashes less severe. I basically avoid sweets, sugar, pasta, rice, potatoes, bread. Low carb eating comes natural now. I prefer it.

  • well ok!

  • Yikes. I am going to have to research low carb diets. It would seem to rule out just about everything I am used to eating and snacking on. I thought it would be easy to avoid dairy by switching from 1% milk to almond milk. That caused horrible constipation. Soy milk is OK but is it that much better than low fat milk? I am 2 months into an 6 month ADT shot (eligard) so I've been given a wake up call.

  • What was the appeal of low-fat milk? Fat avoidance seems to be at epidemic level in the U.S. If I had a milk craving, I would go for whole milk & limit myself to one cup/day. Ironically, one PCa study that associated 4 servings of milk with aggressive disease, found that this applied only to skim milk.

    Milk has two major smoking guns: (i) bioidentical IFG-I - a growth factor - & (ii) calcium. Excess calcium prevents the kidneys from converting vitamin D to its hormonal form. With skim milk, one gets higher concentrations of IGF-I & calcium.

    Makers of almond milk, in order to compete with actual milk, add, vitamin D ... & calcium. Depending on how much one drinks, the calcium might negate any benefit from vitamin D (cholecalciferol) supplements.

    There are recipes online for making almond milk at home - without the calcium. Alternatively, one can eat the almonds & have a nice beer instead. LOL

    As for soy milk, in my Genistein post I point out that physiological levels, as found in soy food products might spur PCa growth, whereas pharmaceutical doses of genistein inhibit PCa growth. Which is the case for avoiding all soy products other than high-dose genistein caps.

    Best, -Patrick

  • My interest in soy milk is an attempt to battle the side-effects of eligard, namely hot-flashes or in my odd case cold-flashes. I woke up shivering the other night and it was about 76 degF in the room. My milk/soy consumption is limited to what I pour into my cereal bowl -- maybe a cup or so. I have been operating on the general advice to 'limit dairy and red meat' when it comes to PCa. Better advice is probably to avoid sugar and carbs as Dr Freedland espouses.

  • My present mind set: the milk in the cereal bowl is better than the cereal. Maybe toss the milk and eat the bowl?

    And a general question - what makes red meat red? The blood. so is it the blood that is bad, or is that just a way to identify what you mean.

  • Trying black coffee. we'll see how that goes. Reserve the cafe-au-lait for parties.

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