S1 Ep 6: 'Latest science on the Ketogenic Diet' featuring Patricia Daly BA Hons, dipNT, mBANT, mNTOI

Patricia Daly is a nutritional therapist and ketogenic diet expert, specialising in cancer. Most of us have come across at least the basics of the ketogenic diet, but Patricia is able to provide updates and insights that add new layers to its application. Her own experience in both following and supporting people with the ketogenic diet is invaluable, alongside her collaborations with like-minded health professionals.

Patricia explains about ketones and metabolic flexibility, the potential benefits of a ketogenic diet, when you would avoid a ketogenic diet and useful tests to help you figure this out, and some practicalities along the way.
Patricia first came to the diet when she had cancer herself, and refers to this when describing the “privilege of witnessing the transformation of people who come to me”:

“I started my journey in the boot of the car. I didn’t even know, I didn’t want to know what they were going to do to me. Then I moved to sort of the child seat and then to passenger, until I had enough and started to drive. So that’s basically what I love to see in my clients as well, that’s people leaving from the boot to the driving seat.”


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The IHCAN magazine Podcast is provided for professional education and debate and is not intended to be used by non-medically qualified individuals as a substitute for, or basis of, medical treatment.

Transcript

Speaker 1

Hello, I'm Kirsten, Chick nutritional therapist and author, and I'd like to welcome you to series one of the ICAN Magazine podcast on today's episode. I'm talking with nutritional therapist and ketogenic diet expert Patricia Daily, so hi, Patricia, thanks for joining me on the. My can magazine podcast.

Speaker 2

Yeah. Hi, Kirsten. Thank you so much for. Inviting me. I was really looking forward to speaking with you.

Speaker 1

Likewise, very much so. So you specialise in supporting people on a ketogenic diet for a number of years now, so you're more clued up around this than most people. What made you so interested in the ketogenic approach in the first place?

Speaker 2

Yeah, it's my own, my own story, my own health history. I was diagnosed with ocular Melanoma, malignant Melanoma in the in the right eye in 2008, when I was only 28 years old. And yeah, I'm a by nature very curious. And quite sceptical person as well. But still I I did all the I just did as I was told at the beginning. Did all the. Treatment. I didn't know any. There, but I remember at the end of the first round of I had plaque radiotherapy, which is, yeah, pretty rough plaque stitch to the back of. The eye 2. Channel anaesthetics within four days and just a whole week in hospital, which is quite a trauma for I was very active. I was a a triathlete. I was generally a very healthy person and so it was quite natural for me to ask the oncologist at the end. So what can I do now? I mean, I can't just go home and go back to my banking job. I was financial. Advisor and had a background or have a degree in Economics and Business as well. And for me it was quite clear something's got to change because it's not quite normal to have cancer at the age of 28 and I think I'm now grateful for his answer that he said, Oh no, you know, just go back to your old life. And and that's it. And so I was sort of instinctively, no, this this can't be it. And four weeks later, I actually started studying nutritional therapy. And it's funny How I Met the right people at the right time in the right place. You know, it was really this synchronicity. So I started studying nutritional therapy. Thought I was doing. All the right things. I I did the usual I. You know, ditched most. Meat and animal products went very much the direction of fully plant based and thought I was doing great. I got pregnant. I had my first child will be a bit too short too soon after completing treatment and not even two years. No, actually. 18 months after treatment, I already had my symptoms back. I remembered distinctly when my daughter was five. Sold and I knew something was wrong. I wasn't listened to. Finally, I think about five months later they redid the stands and the tumour was bigger than before. The first time round and so it basically grew from not visible on a scan in January, but I already have the symptoms then to. Almost two centimetres, which is massive for an eye tumour in May. So yeah, not a round of treatment this time home with a breastfeeding baby in tow. Very, very tough time. And and then again I I had started researching metabolic therapies and there was a lot of German literature and Swiss. So I. Was fortunate enough to be able to read the literature in German, and it was this really rings a bell. It really feels like this could be something that. With me and put it to my consultant, he was. No, don't, because there's, you know, there's not enough evidence. It could really sabotage your treatment and fair enough at the time in 2010, it was very, very new. Well, you know when. We look at the history of ketogenic diet it it. Wasn't, but in in in a cancer context. So anyway, I shelved my plans with without forgetting about it, and kept researching it and then it when I had or I was facing another relapse in 2012. So it was like Swiss clockwork every two years I was OK. So that's that. That's it. Now I'm just. Doing it and they, the consultant, suggested Avastin injections and if those would fail then they would take the eye out. So Enucleation was was on the table and and I said please just give me a few weeks. Just let me try. At least I don't have to beat myself up. Afterwards for not trying. And he was very supportive and he said, yeah, totally guess where you're. From and, it was literally within weeks. I mean, the next scan he was. Whoa, the edoema had really reduced. Antigenes had drastically reduced. He was actually, did you go and have a Mastin injections? And and and I think that's one of the neurological effects as well of the ketogenic diet, which now we know. So it can happen that it reduces the the block block vessels feeding the tumour and we could see that we can it's it's brilliant how we can see the tumour environment in my case because it's not a nice place to have a tumour. But from that perspective, it was it was pretty practical without invasive scans to just see what's going on. And so that was in in 2012 and Touchwood that's basically.

Speaker 1

A long time ago now.

Speaker 3

Two. Yeah. Yeah, I I broke that two years ago.

Speaker 1

Breaking the captain, then yeah.

Speaker 3

Exactly and and.

Speaker 2

I always say to to my client. I started so simple because there wasn't all the confusion around it. I just relied on on two books and some recipes I talked to Carol Grainger I. Yeah. The time. Yeah. And she told me about the keto sticks, the urine sticks. I use them beginning. I talked to Tom Dagostino, Tom Seyfried. When they weren't. Busy and you could still talk to.

Speaker 3

Them now it's impossible to.

Speaker 1

Brilliant. Yeah, actually, really, yeah.

Speaker 2

Yeah. So that's basically that was pick starting and because of the the very compelling results I was, yeah, it's it's very evident that I'm researching the heck out of. And see who. Who else could benefit from it? And I think we've come such a long way now in those.

Speaker 1

We really have. And I wanna ask you about some of the research that's kind of emerged along the way and, you know, but for the benefit of anyone who hasn't come across the ketogenic diet. But I mean, most people have heard of the phase, but may, you know, think I'm not really entirely sure what it is. Could you just give us a brief overview? Of what it looks like.

Speaker 2

Yeah, sure. So I mean originally tonic diet was was discovered or ketone bodies were discovered a long time ago in the 1920s, early 1920s or even a little bit before that when doctors realised that epileptic patients. Stopped having seizures when they were sick and when they weren't eating. So they were. Oh, this is interesting. So what happens and that's how it all basically started by OK how can we mimic this fasting state? We can't just. Starve them to death. But how can we feed them in a way that is still mimicking fasting? And that's basically how the ketogenic diet was invented. So it's been around for. 100 years plus and and then? Yeah, it was. It was, you know, quite sort of neglected in my opinion. Research did point into that direction, with Otto Warburg as well. Really digging. And to it all and and getting a Nobel Prize as well for for proving that cell respiration works differently in cancer cells as opposed to healthy cells. So there was all. Those pointers, but then things happened and they were was never picked up again. And ultimately I think what is important to understand is yes. Ketone bodies. Are important and they they certainly at the very beginning they really help, especially protect the brain, but also lots of other cells that are very happily burning ketones and they are a byproduct of a fat burning state. So the liver starts converting free fatty acids as they are. Accumulating when we are also starving or fasting into ketone bodies to make sure, especially the brain or most brain cells, that run happily on ketones are protected. And it doesn't just shut down when glucose isn't readily available. And so it's it's ultimately it's it's been able to tap into our fat metabolism. And I always explain as well our cells when they are healthy and well functioning, they are like a hybrid engine. So we can either move from from petrol to battery very happily without any hiccups. But quite a lot of people, including me and so I can take myself as an example, I wasn't able to go for two to three hours without food. I was even tested for diabetes. Because I had a number of just, you know, collapses in the hospital because I just couldn't keep my my glucose steady. And so I had to regularly eat because for whatever reason, I was always very slim. I was a triathlete and I was just completely glucose focused, so myself were. So programmed to only be able to run on on glucose. And So what we want to achieve is, is really that what we call as well metabolic flexibility, so that our cells, they have all the the resources and the skills to burn both fatty acids and glucose. So these are the main fuels and then of course ketones as well. They are very favoured by the heart muscle as well by certain brain. And I think the the whole brain metabolism has really come to four from recently with, you know, keto for mental health and the absolutely mind-blowing, really amazing benefits that it can have in helping people with bipolar conditions or schizophrenia even, which we always thought.

Speaker

There's no.

Speaker 2

Way we can help these people apart from psychiatric medication. So we are learning a lot about the brain and how important metabolism is for brain cells and how we can help the the brain by having the ketones present. Because I think the important thing as well is. Of the year in in cancer, as I already mentioned, we have effects on antigenic ISIS, possibly through the the ketone bodies as well that are not just fuels, they're also signalling molecules. And that's I find really interesting as well because it can also have an impact on teen expression. And I know that's. At Imperial College, that's. Avidly researched at the moment as well for brain tumour patients and there's a a host of other things. I think one of the main things everybody always talks about glucose, glucose, glucose and yes.

Speaker 1

But this is it. That was. That's when the narrative for ages, isn't it? It's, yeah, it's then it diet because it starves the cells of sugar, which is that, I mean. Yeah, fortunately, the narrative is declining, but it's taking a long while, isn't.

Speaker 2

It it is. Yeah. And I and I think it's all it is ultimately, especially for accountable as all mental health and and probably everything. It's about insulin as well.

Speaker

Thank you.

Speaker 2

And insulin is, I find, is the smoking gun. And if we if we tracked insulin in people a lot more, especially diabetics. We could we could prevent a lot of then full blown health crises, so yeah.

Speaker 3

Like and again I I remember when.

Speaker 2

We published our book, The Ketonic Kitchen, in 2016. We actually we were on the radio debating with the head of research of the Irish Cancer Society. And he came out out with stuff like well. Glucose. What are you even talking about? Glucose. It always bounces back to the level it's supposed to be. And I was. Yes, but at what price? That's the big question. What is the price of these glucose roller coaster? Because we are in the danger zone when when we're too high and when we're too low.

Speaker 3

We want to.

Speaker 2

And it always there's always a cost of homeostasis, of course. So I think that's that's the important thing to understand, yeah.

Speaker 1

So these are these are the repercussions and This is why it's, you know, you've already touched on so many really fascinating aspects of what can happen when you have that metabolic flexibility. I like that term where you can easily switch to producing ketones and fats and using that for for energy. As well or as instead. The the way that plays out, it's it's not like that happens. And then that happens and then that happens with with any biochemical process, there are cascades of impacts that then happen around the body. So we'll probably never get to the bottom of all of its benefits. We, we.

Speaker 2

Don't have to, and ultimately if it wasn't for ketosis we wouldn't be here as a human race because as soon as we we don't have readily, you know, available foods around us, we have to ultimately once our glucose is going down in the blast, once our glycogen stores our. You stop. It's. About 2000, I think about 2000 calories. So it it doesn't get you very far. And then you're sort of OK. There's no more fuel. So what do we do now? And that's when we have to really, swiftly and and elegantly go into fat burning mode. And our ancestors used to do that all the time. Because they were forced to to fast because they didn't always have food. And then sometimes. When seasonally, there were more carbs around, of course there were that the carbs also helped to store fat in the autumn, for instance, in in a you know fairly high carb, high fat context we can store, which is very important for the winter, except that we don't use it up anymore during the winter now. And if it wasn't for. For ketosis and the ability to burn fatty acids or ketones, the brain can't burn fatty acids. They won't cross the blood brain barrier, so that's why ketones are so important. And and it's just also a cleaner way of generating energy. There's less oxidative stress involved, so it's it makes sense to be able to to tap into both when we need it.

Speaker 1

Brilliant. So just to take it right back down to basics. So in the fasting state then what we're doing is we we don't have the the sugars and or the proteins available unless we start breaking down muscle tissue in order to make energy. But we have this body fat that we can tap into. And we can convert some of that into ketone bodies that then we can use.

Speaker

Thank you.

Speaker 3

OK.

Speaker 1

Or if you know and and that's what people are tapping into when they're using ketogenic diets for weight loss as well. But actually if we want to sustain or maintain weight or even put on weight, actually we need to be introducing the fats. Into the diet.

Speaker 2

Yeah, exactly. So fact I always say to my clients, fat is is the buffer. So it really depends on on your goals. So a ketonic diet in terms of the macro nutrients, so the carbs, proteins and fats. It looks completely different depending on your health goals. Depending on where you're starting from, depending your on your genetic blueprint and and on on your lifestyle, full stop. So there are. Lots of factors and and some some ketogenic diets, especially for for weight loss. They look more like high protein. It's because we, yeah.

Speaker 1

Like a lampkins.

Speaker 2

Yeah, but except that we we generally include quite a bit more plants and I do use you know, quite strict carnivore approaches in some cases, but that needs to be again well planned and I don't think. It's it's sustainable for for everyone or I think very few people can make it very sustainable. I'm happy to be proven wrong. And yeah, so I think it, it just needs to be very well designed and especially matched to the goals and what are the health goals and also you I think for fat. Plus, we don't need to chase ketones at all because and that's the the other interesting thing that because I've been on a ketogenic diet for for so long. It's changed so much it changes within my menstrual cycle, it changes within. Seasons, so it's. It's a very I'm I'm very. An intuitive ketogenic eater. And yeah, when? When I when I started off. I used to have. Fantastic ketone levels. I mean, we're sort of up to three millimoles per litre or even higher and my glucose to ketone index would easily be one or lower, which is quite often the goal in cancer patients.

Speaker 3

But what I've.

Speaker 2

Also learned with with myself and also to to clients is that it's it's not going to be sustainable and it's not necessary.

Speaker 3

And even for.

Speaker 2

Epilepsy, especially in children we know quite often we use the ketogenic diet for two to three. Years and then they. Can actually transition in a much more into a. Much more moderate. UM, so I really don't think it's a life sentence or it's a a lifelong treatment. It's it's very it's a very dynamic process and that's sometimes for some people it's hard to get their head around. So this is, this is never gonna end. I'm always going to have to tweak and adapt and.

Speaker 1

Yeah, well, you know, that's how we should be. Well, ideally going to life anyway is tweaking and everything to the environment and what's going on.

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Speaker 1

So how do you initially assess? I mean it's it's the key to diet appropriate for everybody.

Speaker 2

No, there are very clear absolute contraindications, but usually. People know about this. So these can be carnitine deficiencies or carnitine is is incredibly important in shuttling fatty acid. It's into the mitochondria, so if if there's a problem there, the people know about this, they are eternally continental. They're diagnosed at birth or any kind of fat beta oxidation issues as well, so there are very clear absolute contraindications. The ketogenic diet is just out of the question. It's not going to work, and then there's quite a lot of relative contraindications. Where I'm really, I'm very cautious with you initiating the diet in in particular also in. Cancer patients who already have lost a lot of weight, we really need to be very cautious and with them, you know, certain things are are just not going to happen or if somebody has pancreatitis or you know very uh, you know, liver metastasis, liver tumours, a very poor liver function. And you know why block counts? And then there's there's some other relative contraindications also looking at nutrigenomics.

Speaker 1

We get a bit.

Speaker 2

Of a an idea how well someone will be. Bonds and it's more than about managing expectations. I find you know, than just to say, you know, don't expect massive ketone levels and and what I also also find then you know as I just said in the long term block, ketones generally go down because we become so efficient. Not using ketone bodies so they're not hanging around. They're not building up in the blood and we don't.

Speaker

Right.

Speaker 2

Want them to build up in the blood?

Speaker 1

Measuring isn't. Yeah, it can be a bit of a red herring as blood tests off and now. We've always got to put them in context.

Speaker 3

OK.

Speaker 2

Yeah, exactly. And it doesn't mean you're not in ketosis or or in in the therapeutic range. You know I'm unless I I fast, you know, for a long, long time, I really don't have super high ketone bodies, but I'm clearly in in ketosis in terms of my symptoms.

Speaker 1

Yeah, but if somebody starting out, they've just started and they want, you know, do you recommend and measuring ketones in the blood and just making sure they're getting there to begin with?

Speaker 2

Exactly, yeah, definitely. So I think at the beginning or even sort of. The first you. Know 5-6 months. It's very useful to start with the urine sticks. That's very cheap and easy, and that's going to give you a sign that you're producing ketone bodies, but you're not using them, you're peeing them. Out. So we obviously don't want that in the long term. And then in the blot. That's almost like a bit the. Buffet. So we're not quite sure. What's going to happen to to them?

Speaker 3

And then the.

Speaker 2

Acetone you know in in all the the breath measuring too. Rules, which unfortunately aren't very accurate yet or they're accurate for about a month, and then they they're not anymore. So I generally ask my clients to hold off until the technology has caught up, but acetones in the breath reflect. Then what is actually what has been burnt, what has been used. In the energy generation process. So I think that's how generally they are related and also. So you know if if somebody is building up a lot and a lot of ketones in the blood, I'm sort of OK and they're feeling very tired. Let's see what's going on here. And are they? Not being rude.

Speaker 1

The thing isn't. That energy level. So I so often people will say to me, oh, I tried the ketogenic diet but it just felt awful. I was exhausted all of the. It just makes me think, well, you clearly weren't doing it in a way that was providing you with ketones. And there was something wrong with the way that you were doing it. And you you delve. Further, and they've just read a book or an article, and they've kind of reduced their their carbohydrate intake, but they haven't increased anything else. They're not eating much in the way of vegetables. It's, you know, it's just not. It's not being a a proper ketogenic diet. Really. So if you said that's a good measure, energy levels would be one of. The things you'd be looking at.

Speaker 2

It's quite normal at the beginning that.

Speaker 1

Yes, of course.

Speaker 2

People have a little bit of I call it sort of a little bit of. An energy deficit. Because you, especially your brain, is sort of a little bit in this limbo with sort of, oh, there's this new thing, those ketones. What do we?

Speaker 3

Do with them.

Speaker 2

I I should always explain it like like this. You're reducing your block glucose, but then? You you can't compensate. Yes, and and that's not enough to actually, yeah, just provide that that energy that is supposed to come from the ketones in the brain or also the fatty acids. And you have to understand that it's it's quite a shift for ourselves in terms of enzymes and also for. Our digestion the pancreas has to basically change the output of digestive enzymes completely and also the liver has to adapt with bile. Ohh all of a sudden there's a lot more. Uh, fat then? Especially if someone hasn't eaten fat for for decades, and then all of a sudden there's all this fat flooding in, might not be the smartest thing to do. So we need to have the support in place to help people transition and also I think quite often of that dreaded keto flu. It's quite often as well because we are when insulin starts to come down, our kidneys work in a in a different way and they tend to shed fluid. So a lot of weight loss at the beginning is is just fluid loss. And uh and then also in in terms of the electrolytes. So that's a complete. Sort of shift. In electrolyte requirements and they're obviously very important for energy levels. So people who are super tired when initiating it and then not replacing electrolytes, here's your answer. And that's why it is. Quite, you know, it's highly recommended to just have someone to just guide you through it. This is this is what you need to know. This is what you need to be cautious of. These are the potential pitfalls if you feel. Like this do. That, and just all these little troubleshooting helps at the beginning.

Speaker 1

Yeah, so become an expert in it, really, to support that transition.

Speaker 2

Yeah, I think I think that's really important. And and I don't think any any of my clients really have those issues if they do it, you know and I would say it's not a race and you've you know you've been very glucose dependent. Most people who come to me, they're really. You know, they really need to regain that flexibility, and I sometimes read stuff or you just have to exercise more and, you know, muscle is like a metabolic sink and.

Speaker 3

It's well, yeah, but.

Speaker 2

Not if you have a chronic condition. And it's hard.

Speaker 1

Yeah. And you mentioned like the neutral Val test or even just the the metal metabolomics urine test that can actually highlight potential issues with fat metabolism. Do you think that would be a useful thing to add in to help that transition period?

Speaker 2

Yeah. I mean, there's, there's one thing that I definitely I actually do with with every client is testing for nutrigenomics. And so I'm very excited that life code TX they're now specifically create or they have created a panel. To really look at those pathways, especially especially with ketogenesis and ketosis as well, and who has to potentially be cautious or supplement certain you know cofactors as well and I think it is so useful and it is a shortcut and just. Helps personalise and uh and just generally looking at you know what is from a genetic blueprint perspective and that's obviously you know really what's what's happening in the body right now but working towards that how you know if people have the. TCF7S or related to the diabetes gene, they probably can never go to. You know, they they have to be cautious around carbs and they have to, uh, track. And they are at a higher risk of of just not being able to metabolise carbs in in the same way as someone who. Who has? Who doesn't have those variants there? So it's all these things to look at as well or PPA are alpha. If there are variants again, it doesn't mean it's not possible that fasting is just a. Bit harder or. Producing ketones can just be a little bit more of a challenge for these people. And then there's there's lots of other changes that I look at. In fact, metabolism. And based on symptoms. And obviously we can, we can do other tests. Yeah. And neutral. I think organic acids can be quite handy because that look.

Speaker 1

Yeah, yeah, that's what I was thinking of. But absolutely it means it's it's become a lot more popular now. To to look at the the genetics or the what, the genomics in terms of have you, have you ever said somebody actually I've looked at that your nutrigenomics and no, you shouldn't be following a ketogenic diet.

Speaker 2

No, not an absolute, no. So it it really depends on their block. Chemistry if if somebody as well, you know if they are, they have all the signs of insulin resistant.

Speaker 3

And what what are?

Speaker 2

You gonna do otherwise and they can't. You know, they they can't exercise or certain lifestyle factors are just not an option. We have to work with diet so you know they they don't want to or can't fast. What? Else, are we going to? Do so, but it's really about completely. Personalising, especially the the fatty acid intake because we have the majority of our calories usually on a ketogenic diets that are coming from the fat intake. And so being really quite well informed of what? What facts you might be able to metabolise better than others, and that's really quite a a question of of heritage as well. Some people just. They don't do. Well, on on saturated fats and you. Can see it in their biochemistry. As well, and it's just not doing them any favours, and especially with Apoe E4, you know then I'm. I'm really very diligent with fat intake because you don't want them. You know, as they grow older, saturated fats. Can potentially become quite inflammatory, but again you need to test you. You can't just say oh, these are your genes and that's the way it is. So you need to look at their inflammatory markers and just look at the whole, uh, full picture and the family history is often really, really telling, you know, quite often people with apo E. E4. Even just one variant. Yeah, there's really at least three or four people who have dementia or Alzheimer's or Parkinson's. And then I'm sort of OK, now we really need to to be diligent with this and not take any risks and err on the side of caution.

Speaker 1

Yeah, really interesting. So it's brilliant that we're now able to personalise this ketogenic diet so much to people and you know, getting more and more or having access to more and more information about this all of the time. But I like that you're balancing testing with looking at the case history and all of the other.

Speaker 3

Right.

Speaker 1

Trees that we used to. Think as well that you usually.

Speaker 2

Yeah, yeah, absolutely. Yeah, definitely so.

Speaker 1

No, you've got somebody. It's a. It's a go. We can do this. The ketogenic diet is an absolute plus for them and let's get back to that question. We were talking about before a little bit about the benefits of the kids diet. For somebody specifically with a cancer diagnosis. Say, as we were saying before, it's not about starving the cells. The cancer cells of sugar. What is it about?

Speaker 2

Yeah, I think really. One of the main benefits I find, and I see over and over again, is it it, it's insulin and having a better control on insulin and we know that insulin, it's the main anabolic hormone. So it grows things and and obviously also it. It's a director of energy and decides the fate. For macro nutrients, do they get stored? Do they get used? Where do they get used? How do they get used and and obviously insulin is also involved in in other things that are important from a cancer perspective, apoptosis and. All of it it is. It has an impact on so many oncogenic pathways. So that's why I find, you know, just ignoring insulin and not testing it and saying yeah, whatever, because you can have beautiful glucose control because, you know, high.

Speaker 3

You're achieving the.

Speaker 2

Feasible glucose control with high insulin. You know, that's what I was mentioning earlier when we were talking to the head of research of the Cancer Society. I was, yeah. How do you achieve your glucose control? That's always the the the the big question. And I think, yeah, we we did talk talk a little bit about, you know, epigenetics, antigenic, ISIS and UM and there's also in in terms of the the beta oxidation, there's always the question was you know what can fatty what can cancer cells use and they can use fatty acids they can use. Tones. I think cancer cells are so savvy like.

Speaker 1

They're very adaptable themselves, aren't they?

Speaker 2

Yeah, yeah, exactly. But I think it's it's really glucose is and glycolysis is still such a main driver, especially also at cancer initiation and it's the one. Common denominator that is just cancer cells. Just use glucose. At some point we just need to figure out as well. Can we actually test, you know, if they're more glutamine independent, the amino acid or glucose driven? That's also very dynamic. That just depends. Even within the team. So we know that there's so many. The heterogeneity is amazing from genes. But also in terms of the. So it's it's a bit. Sometimes I feel chasing the fuels is is a bit futile. I really like to look at so many you know really just looking at the tumour in at the micro environment as well and optimising that. And yeah, of. Course, then, relying we we have to rely. On something that's. That knocks the tumour on its head because people sometimes ask. So do you regret having radiotherapy? And I was. Aw. No, maybe the second round, but something radical needed to happen. It was such a large tumour. And who knows, if you know if if keto alone or God only knows what else it was that that really helped me. Maybe also a mindset shift. I'm very strong believer as well. In mind, body connexion, but ultimately yeah, we of course we need to take the best of of both worlds and and bring it to. And I think also using you know fasting or if fasting is not possible fasting mimicking so or keto to achieve better treatment results. I think that's a really uh, promising and very exciting field as well. And again, just really tailoring how how that's best. But I think in terms of the the preliminary studies in in human trials, it is definitely. I would say it will have a a clear place, especially with radiation therapy that we do know the presence of ketones and and especially having having that glucose nice and low before radiation. Uh, it it just really it becomes more targeted. The treatment we have less side effects. And and with with chemotherapy we see the same. I mean I've. Had clients who who just couldn't tolerate their treatment, and then we introduced a light fasting regime and and they just found it easier.

Speaker 1

Likewise same here. Been blown away by the massive change.

Speaker 3

Yes, yes.

Speaker 2

Yeah, and and I think that ultimately, you know, even if it's, if it turns out for cancer, that's the main tool. And then afterwards it's all about measuring and and testing. How can you achieve your best glucose control and without relying on on insulin? And and other compensatory mechanisms. And I think ultimately that's really what what is very important and some people do that better with lifestyle interventions. They control their glucose really well, working on. Your sleep stress, it's massive. For some people, I say just forget about the food side. Let's work on that first. That has a much bigger impact and it's amazing when people, some of my clients, they go for the continuous glucose monitor. And one of my clients, she she is a she's a medical doctor herself and she's like God. Patricia I I noticed that work.

Speaker 3

That some people really my glucose just goes up happens that person comes and wants something from me.

Speaker 1

And there's nothing to do with the food. There you go. We're so much more complex than we think.

Speaker 3

Yeah. Yeah, and yeah. And so we said, OK.

Speaker 1

That's fascinating.

Speaker 2

What can we do? Can we we true. So let's just find ways of of managing that stress. Gets the glucose up.

Speaker 1

So also, if somebody's embarking on a ketogenic diet for their for to say they've got a cancer diagnosis, they want to follow a ketogenic diet because they've heard. It's really good. But actually they're finding it really stressful and suddenly life is really miserable.

Speaker 2

Yeah, exactly. Yeah, all about. It's all about the balance, balance and. I I often say, you know, if if actually stress cancels out any of the. Benefits. So yeah, just really have a good think about it. Is it it? It isn't for everyone. And some people find it really hard and they're so emotionally attached to. Food and also one thing I work a lot on with my clients is some people they really come to me and they're literally scared of food. Oh, dairy drives cancer growth. Oh, and meat. Oh, and I read about eggs. And what about this? And I was.

Speaker 1

And they're just eating lettuce leaves, yeah.

Speaker 2

Yeah. And and it's interesting. We have a a really compelling study that shows type 2 diabetics. So they both both groups. The controlled study both groups get exactly the same drink, but one label says this is high glucose. And the other label says. This is low glucose and it's it's sweetened with stevia or whatever so they have it in their head already. What's going to happen to their glucose and exactly that is happening? So in the intervention group that that get the high glucose, they expect, you know, or they all get the same drink with the label, they expect high glucose. And the glucose. In the blood goes up a lot more so. Use your intention. If you're sitting down thinking this is gonna fuel cancer growth, chances are that it is. So we know that scientifically now that it it, it's really important how you perceive. See food lifestyle, what you do.

Speaker 1

Yeah, but again, now I I'm aware that I want to just briefly if you can, because you're offering a programme now with Doctor Wafa Abdul Hadi, who I'd absolutely love.

Speaker

Running out of time.

Speaker 3

I think she's brilliant.

Speaker 2

Yeah. Yes.

Speaker 1

So you're combining your knowledge, your expertise, your enthusiasm and passion and so do you want. To tell us. A little bit about that project.

Speaker 2

Yeah, sure. So we started that in December 21 and uh, just because we we we we have been working together for a while and we realised that there's so much to learn just doing that in one-on-one and you know it people get so much more out of also being in a group while also having of course. Personalised support. That, and that's why we said, yeah, let's just, let's just try it out and uh, really teaching all about what we. Just talked about. And giving people so many tools and teach cheats. And you know, if they want to use apps as well and and really great help to get started. And especially because we all have our blind spots being in a group is so fabulous because sometimes somebody asks a question that you didn't even know you had it and it's relevant for you. And so yeah, it's it's really developed into. We've obviously constantly, we're fine tuning. We just recently added sort of the the individual coaching within the group as well, just for for instance macro questions or looking at blog biochemistry or Neogenomics or whatever people want to have looked at. More in a more personalised way and then in between the sessions they have a whole video library and we always have homework, so there's a bit of preparation people send in their questions and then we get together once a week. For a live session and then these live sessions are for 12 weeks and then the coaching sessions are in between as well. So that's basically.

Speaker 1

Wonderful. That's really supportive, really.

Speaker 2

Yeah, yeah. No, it's working out really well. We were initially, oh, how can we how can we do this in a group? Can we personalise enough? But I think because I. Doing a one-on-one session as well with everyone and we have this personalised coaching and initially people are a bit, you know, I say just share with whatever you want to share. And leave the. Rest for just working one-on-one with.

Speaker 1

Brilliant. Yeah. Welcome to setting that up. That sounds brilliant.

Speaker 2

Yeah, it's great. And we also have a group for it. Just metabolic health now since September, yeah.

Speaker 1

Great. Lovely. Ohh fantastic. So on that set there's. Is there any anything or anyone in the nutrition world right now who is really, really grabbing your attention? This is a question I'm asking everybody.

Speaker 2

Yeah, I think it's definitely Josephine Barberino who is the founder of the the Keto Life Conference and the the future director of the Metabolic Health Centre that she's currently setting up in Switzerland and it's due to open in June 24 and. She's just been incredibly inspiring. I mean, all the people I talked about, you know Tom Seyfried, Tom Dagostino, but also Chris Paul. And you know Georgia UID is is on board. I would comments from from Ireland as well and so many experts from all over the world doctor offer of course as well they shall interest who so she's just managed to gather all these people. Into an amazing conference, and especially creating CME and TPDD. As well acknowledged and endorsed by the Swiss Oncology Association, the Swiss Medical Association, and also in Germany in the states like just all those conventional associations and just getting bringing all these people together, especially also in the mental health. And kidney chronic kidney disease section where conventional medicine really is a bit stuck at the moment. I think it's, it's amazing. And she's just her. Her drive and her passion is so inspiring. Yeah.

Speaker 1

Thank you for that. And finally, what do you love most about? What you do?

Speaker 2

I think it's it's really. Having the privilege to witness the transformation of people who come to me and they're very intimidated, they don't know exactly. They're completely overwhelmed. Really, they they don't know what to do and they've. They're used to just being. Told what to do. And then the poor things come to me and. They need to. Start taking charge and you know being in command of of their own health and just really witnessing that transformation from, you know. A bystander and to to just an active participant and just being really just becoming the boss of their own choices and their own. Bodies. And it's what happened to me as well. I always say. I started my journey in the boot of the car. I didn't even know. I didn't want to know what they were going to do to me. Then I moved to sort of the the child seat and then to passenger until I had enough and started to drive. So that's that's basically what what? I love to see in in. In my clients as well, that's.

Speaker 1

People leaving from the beat to the driving seat.

Speaker 2

Next song.

Speaker 1

Brilliant. Ohh, that's been really really fascinating and enlight. Ling, thank you so much for that.

Speaker 2

Yeah. Thank you so much for giving me the opportunity and I hope to hope to see you and meet you properly. In person at some point.

Speaker 1

Yeah, I'm sure we will. So that was Patricia Daly chatting with me. Kirsten Chick about all things ketogenic and particularly in the field of cancer. I hope you enjoyed listening and have found it's educational and inspiring.

Speaker 4

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