Establishing Metabolic Flexibility in Cancer Patients: Dr. David Jockers

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The Stern Method Podcast Episode 20: Dr. David Jockers

Dr. David Jockers explains what it means to be metabolically flexible, how this relates to ketosis and the tremendous anticancer benefits of the ability to transition into nutritional ketosis.

In This Episode & Article:

  • Dr. Jockers’ own encounter with skin cancer and how taking a step back and a hard look at his life and making the appropriate changes was able to turn it around.
  • What it means to be metabolically flexible and how this in itself almost transcends the keto or no keto argument in the sense that no matter what dietary strategy you choose your body should have the ability to easily transition between fuel sources and if it isn’t, you’ve likely got a problem.
  • The vast array of health and anticancer benefits from time spent in ketosis.
  • Fasting as a key component of ketosis and how it has been used throughout the ages.
  • Specific fasting strategies and how to find out what approach is best for you.

Resources Mentioned:

How Do Metabolic Flexibility, Fasting and Ketosis Relate to Cancer?

As you’ll read below, metabolic flexibility essentially refers to how easily your child is able to go from burning sugar for energy to burning fat. In the case of fasting this comes from their own body fat.

Typically, the younger the child the more inherently metabolically flexible they are. It’s only through years of constant, unrelenting carbohydrate and protein intake day in and day out that we begin to lose this ability and it’s more of a process to get back.

Our natural instinct as parents in today’s society is to get upset when our children don’t feel like eating large meals at predetermined times throughout the day. We can feel like we’re somehow doing something wrong by the very fact that our kids don’t happen to be hungry right then and even be inclined to practically ram the food down their throats whether they want it or not.

Isn’t it amazing though that when they’re able to convince you to let them off the hook without eating that their able to play with their typical amount of high energy for sometimes hours after you thought they needed to eat? This is because kids are much more naturally in tune with this metabolic flexibility than we realize.

Kids eat when they’re hungry. They don’t when they’re not. This is touted by adults that get into intermittent fasting as an amazing revelation in how to live, but to kids they’re just doing what their body tells them.

Kids do like snacks however. And who doesn’t like high empty carbohydrate foods with lots of breads and pastas in them?

When we sit our kids down to these meals of empty calories with continuous snacks in between from the moment they wake up to the moment they go to sleep we quickly begin to chip away at their natural metabolic flexibility and all the anticancer benefits you’ll read about below.

Fasting hands down is also one of the most protective measures one can take against the damage of chemotherapy. I read about this when Ryder was going through chemotherapy and thought that this was just one of those things I would have to pass by because you just couldn’t fast a kid… right?

If I could go back in time there are of course a few things I’d change knowing what I know now and this is certainly one of them. Ryder’s daily lifestyle today does consist of shorter eating windows and longer periods of fasts like you’ll read about below and we are working towards implementing longer term fasts as well.

If you’re implementing the use of an NG feeding tube as we always recommend parents try to do as a way to ensure your kids get the highest quality nutrition with the least amount of uncertainty as to whether or not it’s going to make it into them, controlling the eating time window will become that much easier.

Side note but a related one. Exactly when did the term junk food become interchangeable with what we now think of as kids’ food? Who made the decision that what we think of as a guilty pleasure should be what our kids should eat all day every day?

Don’t we all want “the best” for our kids? Do we really somehow think that mac ‘n cheese paired and chicken nuggets are somehow “the best things” for our kids? A green smoothie is best for us but somehow garbage is what is most nourishing to them?

I could tie just about every article back to how ridiculous it is when oncologists and even hospital “nutritionists” tell parents to just give their kids whatever they want to eat and as much of it as possible, but it’s especially applicable here.

For parents who want more information on how to apply the ketogenic diet to kids, check out the interview and article with MaxLove Project.

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What is Metabolic Flexibility?

According to Dr. David Jockers, metabolic flexibility is essentially the ability to transfer into nutritional ketosis.

Our cells are capable of producing the energy necessary for all bodily functions by burning either sugars or ketones. Sugars are derived from all carbohydrates and protein. Ketones are produced from either dietary fat or our own body fat.

Where metabolic flexibility comes in is how easily our bodies are able to switch between the two fuel sources.

In typical western diets where we are eating high amounts of carbohydrate and protein all day long, our bodies have typically lost the ability to easily switch to burning ketones. The constant flow of sugar neither gives it a reason to burn the dietary fat we take in or our body’s own stored fat.

In times where we are eating a higher source of dietary fat, or optimally where we are going longer periods of time without eating, the body should be able to easily transition to burning ketones for fuel. The more capable our bodies are of smoothly making this transition, the more metabolically flexible we are.

Dr. Jockers also uses the term energy efficient as almost interchangeable with metabolic flexibility. If we’re highly metabolically flexible we will by nature be very efficient users of energy sources, from either sugars or ketones.

Fasting is Key to Metabolic Flexibility

As understanding of nutritional ketosis has begun to catch on, much emphasis has been placed on high fat diets as a way to get into ketosis, but not enough on fasting.

Dr. Jockers points out that our ancestors and great healers of note going back in basically every instance we can find had fasting built into their lives for reasons of spirituality, lack of relative available food, or both.

Hunter-gatherers and even more modern periods of civilization before the very recent advents of the grocery store and refrigerator did not have a continuous food supply and as such went long periods of time without eating. This was fasting by necessity in which the people of these times regularly went into ketosis, running off of their body’s stored energy, when they were not able to walk over to the fridge at any time they liked and make themselves a nice sandwich.

Virtually all religions have fasting as an integral part of the religious lifestyle.

Jesus said certain spiritual enlightenments only come with prayer and fasting. Jesus himself fasted for 40 days and Christians emulate this during Lent and other times of significance to them. People of the Jewish faith incorporate a day-long fast in Yom Kippur. Muslims practice fasting during Ramadan.

Hippocrates said one of the greatest healing miracles is fasting. Plato fasted for reasons he described as better mental clarity and energy efficiency. You get the picture.

So when you think ketosis, don’t just think high fat. Think fasting.

Cancer Cells are Weakened by Fasting and Ketosis

Dr. David Jockers enumerates a multitude of benefits those going through cancer will want to take note of from time spent in ketosis.

The benefit many are aware of is that cancer cells’ primary energy source is glucose and they are unable to utilize ketones. So when blood glucose goes down and ketones go up cancer cells can outright die or become weakened and therefore more easily regulated by the immune system.

Dr. Jockers also notes that in this state not only is blood glucose low but it is actually diverted away from cancer cells and towards regular cells. Cancer cells’ own ability to carry out glycolysis, the means by which they produce energy, is also inhibited.

As if meant to be (it probably was!) on top of cancer cells being weakened by various means by fasting and ketosis, Dr. Jockers states that at the same time white blood cells actually achieve a higher phagocytic index (more killin’ power!).

Epigenetic Anticancer Mechanisms of Fasting and Ketosis

Epigenetics are essentially changes in genetic expression stemming from to our food (or lack thereof in this case) and environment. Many of these changes can be crucial one way or the other to those going through cancer, and Dr. Jockers notes many that come from ketosis.

Dr. Jockers states the presence of ketones will upregulate (increase) the AMPK pathway which signals the body to produce more energy (to run the immune system and other anticancer processes).

The MTOR pathway is a pathway implicated in many cancer and that is downregulated (decreased, which is usually a good thing for this pathway in cancer) while in ketosis.

Cancer cells release VEGF which signals the body to create new blood supply to tumors. Ketosis blocks VEGF.

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How do we Begin Using Fasting and Ketosis?

A fasting approach includes both intermittent and longer term fasts.

Intermittent fasting is a daily practice consisting of eating within a shorter time window than what we consider normal.

A “beginner” length of time for this window might be 12 hours. For example that would consist of finishing dinner at 7:00 PM, abstaining from any further snacking before bedtime, and eating the first meal of the day at 7:00 AM.

An intermediate eating window would be ten to eight hours of eating with fourteen to sixteen hours of fasting. So in the example above the first meal of the day would be pushed back to the 9:00 – 11:00 AM range.

The advanced window is six to four hours of eating and eighteen to twenty hours of fasting. Again, the first meal of the day is simply pushed back to 1:00 – 3:00 PM.

Dr. Jockers notes the length of time you go should be dictated by how you feel. Start slow and if you’re having trouble going longer periods of time without eating, beginning to reduce the amount of carbohydrates you take in while you are eating could be a way to get your body more used to running off of less carbs.

Dr. Jockers also notes that electrolytes in the form of diluted broth or a pinch of healthy salt in water is a great way to keep out energy up during fasting periods without affecting the transition over to ketones.

He actually goes as far as to say that electrolytes are what we get our energy from. Food is used for repair.

Can Vegetarians and Vegans use Fasting and Ketosis?

Dr. Jockers notes that either way, he does not recommend a whole lot of animal protein to anyone, so for most people a vegetarian or vegan ketogenic diet or approach is absolutely possible.

He states that a well formulated diet regardless of whether or not it contains any meat will include a diverse array of vegetables and electrolytes.

Even if someone has read about the Gerson diet and would like to incorporate things like carrot and apple into their protocol, Dr. Jockers will work with them to include it. The person will not be in ketosis immediately after they drink the carrot juice. If they do consume the juice within their short) eating window and then go back to not eating in their extended fasting window (from 16 to 20 hours), they should transition into ketosis before the next time they eat.

Dr. David Jockers DNM, DC, MS is a doctor of natural medicine, functional nutritionist and corrective care chiropractor. He currently owns and operates Exodus Health Center in Kennesaw, Georgia.
He has developed 6 revolutionary online programs with thousands of participants. These programs include E-guides, recipe guides, meal plans and video instructions including “The Sugar Detox,” “The Cancer Cleanse,” “Navigating the Ketogenic Diet,” and “The Digestive Health Restoration Program,” and “The AutoImmune Elimination Program” and the “Super Brain Program.”

Dr. Jockers is a sought after speaker around the country on such topics as weight loss, brain health, functional exercise, natural detoxification and disease prevention. Dr Jockers sees patients at his clinic, Exodus Health Center and he does long-distance consultations by phone or Skype to help customize specific lifestyle plans to help individuals improve performance and beat chronic disease.

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