Effect of Intermittent Fasting on Cancer Prevention and Cancer Treatment

Öz

Cancer is one of the leading causes of death both in our country and in the world. For this reason, new searches have been made in the prevention and treatment of cancer in addition to existing treatments. Intermittent fasting, which affects many mechanisms in the human body and includes energy restriction and meal timing, can be preferred for the treatment of many diseases and protection of health, as well as body weight loss. Intermittent fasting can affect many metabolic pathways such as oxidative stress, inflammation, DNA damage and growth factors. This has shown that intermittent fasting can also be used in prevention of cancer and cancer treatment because of its effects such as reduction of chemotherapy side effects and improvement of metabolic parameters. However, it is thought that the decrease in energy intake with intermittent fasting causes weight loss in individuals with cancer, and metabolic and oxidative stress may cause negative effects. It is also reported that there are not enough clinical studies to clarify the relationship between intermittent fasting and cancer. In this review, it is aimed to summarize the current literature on the relationship between intermittent fasting and cancer.

Anahtar Kelimeler

• Cancer
• Tumor
• İntermittent fasting
• Diet

Kanserin Önlenmesi ve Tedavisinde Aralıklı Açlığın Etkisi

Öz

Kanser, hem ülkemiz hem de dünyada en önde gelen ölüm nedenlerinden biridir. Bu nedenle mevcut tedavilerin yanında kanserin önlenmesi ve tedavisinde yeni arayışlara girilmiştir. İnsan vücudunda pek çok mekanizmayı etkileyerek etki gösteren ve enerji kısıtlaması ile birlikte öğün zamanlamasını da içeren aralıklı açlık, günümüzde vücut ağırlığı kaybının yanı sıra pek çok hastalığın tedavisi ve sağlığın korunmasında tercih edilebilmektedir. Aralıklı açlık, temelde oksidatif stres, inflamasyon, DNA hasarı ve büyüme faktörleri gibi pek çok metabolik yolak üzerinden etki gösterebilmektedir. Bu durum aralıklı açlığın hem kanserin önlenmesi hem de kemoterapi yan etkilerinin azaltılması ve metabolik parametrelerin iyileşmesi gibi etkileri nedeniyle kanser tedavisinde de kullanılabileceğini göstermiştir. Fakat aralıklı açlık ile birlikte enerji alımında oluşan azalmanın kanserli bireylerde ağırlık kaybına neden olmasının bununla birlikte metabolik ve oksidatif stres durumunun yaşanmasının olumsuz etkiye neden olabileceği düşünülmektedir. Ayrıca aralıklı açlık ve kanser ilişkisinin netleşmesi için yeterli klinik düzeyde çalışmanın bulunmadığı da bildirilmektedir. Bu derlemede aralıklı açlık ve kanser ilişkisinde güncel literatürün özetlenmesi amaçlanmıştır.

Anahtar Kelimeler

• Kanser
• Tümör
• Aralıklı açlık
• Diyet
• Cancer
• Tumor
• İntermittent fasting
• Diet

Kaynakça

1. 1. World Health Organization. Global Cancer Observatory. Cancer Tomorrow. IARC. https://gco.iarc.fr/tomorrow/en/dataviz/bars?mode=population. (Erişim Tarihi: 20 Mayıs 2022)
2. 2. Torre, L. A., Siegel, R. L., Ward, E. M., Jemal, A. (2016). Global cancer incidence and mortality rates and trends—an update. Cancer Epidemiology and Prevention Biomarkers, 25(1), 16-27.
3. 3. Yıldırım Kahrıman, Ş. (2021). Non-intrinsic cancer risk factors. Experimental Oncology, 43, 290-297.
4. 4. Poirier, A. E., Ruan, Y., Volesky, K. D., King, W. D., O'Sullivan, D. E., Gogna, P., et al. (2019). The current and future burden of cancer attributable to modifiable risk factors in Canada: summary of results. Prev Med, 122, 140–147.
5. 5. Anand, P., Kunnumakara, A. B., Sundaram, C., Harikumar, K. B., Tharakan, S. T., Lai, O. S., et al. (2008). Cancer is a preventable disease that requires major lifestyle changes. Pharmaceutical Research, 25(9), 2097-2116.
6. 6. Grosso, G., Bella, F., Godos, J., Sciacca, S., Del Rio, D., Ray, S., et al. (2017). Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk. Nutrition Reviews, 75(6), 405-419.
7. 7. Güveli, H., Uzsoy, A., Özlü, T., Kenger, E. B., & Ergün, C. (2021). Onkoloji hastalarında tamamlayıcı ve alternatif tıp kullanım sıklığının ve diyet yaklaşımlarının belirlenmesi. Avrupa Bilim ve Teknoloji Dergisi, 21, 307- 312.
8. 8. Kav, S., Hanoğlu, Z., & Algier, L. (2008). Türkiyede kanserli hastalarda tamamlayıcı ve alternatif tedavi yöntemlerinin kullanımı: literatür taraması. Uluslararası Hematoloji-Onkoloji Dergisi, 18(1), 32-38.

9. 9. Patterson, R. E., Laughlin, G. A., Sears, D. D., LaCroix, A. Z., Marinac, C., Gallo, L. C., et al. (2015). Intermittent fasting and human metabolic health. Journal of the Academy of Nutrition and Dietetics, 115(8), 1203.
10. 10. Freire, R. (2019). Scientific evidence of diets for weight loss: different macronutrient composition, intermittent fasting and popular diets. Nutrition, 110549.
11. 11. Tinsley, G. M., La Bounty, P. M. (2015). Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr Rev. 73, 661–674.
12. 12. Harris, L., Hamilton, S., Azevedo, L. B., Olajide, J., De Brún, C., Waller, G., et al. (2018). Intermittent fasting interventions for treatment of overweight and obesity in adults. JBI Database Syst Rev Implement Rep. 16, 507–547.
13. 13. Mazidi, M., Rezaie, P., Chaudhri, O., Karimi, E., & Nematy, M. (2015). The effect of Ramadan fasting on cardiometabolic risk factors and anthropometrics parameters: a systematic review. Pak J Med Sci, 31(5), 1250–1255.
14. 14. Stockman, M. C., Thomas, D., Burke, J., & Apovian, C. M. (2018). Intermittent fasting: is the wait worth the weight?. Current Obesity Reports, 7(2), 172-185.
15. 15. Kolb, R., Sutterwala, F. S., & Zhang, W. (2016). Obesity and cancer: inflammation bridges the two. Current Opinion in Pharmacology, 29, 77-89.
16. 16. Picon‐Ruiz, M., Morata‐Tarifa, C., Valle‐Goffin, J. J., Friedman, E. R., Slingerland, J. M. (2017). Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention. CA: A Cancer Journal for Clinicians, 67(5), 378-397.
17. 17. Gallagher, E. J., LeRoith, D. (2015). Obesity and diabetes: the increased risk of cancer and cancer-related mortality. Physiological Reviews, 95(3), 727-748.
18. 18. Lohmann, A. E., Goodwin, P. J., Chlebowski, R. T., Pan, K., Stambolic, V., & Dowling, R. J. (2016). Association of obesity-related metabolic disruptions with cancer risk and outcome. J Clin Oncol. 34, 4249-4255.
19. 19. Mattson, M. P., Allison, D. B., Fontana, L., Harvie, M., Longo, V. D., Malaisse, W. J., et al. (2014). Meal frequency and timing in health and disease. Proc Natl Acad Sci USA. 111(47), 16647–16653.
20. 20. Wei, M., Brandhorst, S., Shelehchi, M., Mirzaei, H., Cheng, C. W., Budniak, J., et al. (2017). Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease. Science Translational Medicine, 9(377), eaai8700.
21. 21. Salvadori, G., Mirisola, M. G., Longo, V. D. (2021). Intermittent and periodic fasting, hormones, and cancer prevention. Cancers, 13(18), 4587.
22. 22. Harvie, M. N., & Howell, T. (2016). Could intermittent energy restriction and intermittent fasting reduce rates of cancer in obese, overweight, and normal-weight subjects? A summary of evidence. Advances in Nutrition, 7(4), 690-705.
23. 23. Berrigan, D., Perkins, S. N., Haines, D. C., & Hursting, S. D. (2002). Adult-onset calorie restriction and fasting delay spontaneous tumorigenesis in p53-deficient mice. Carcinogenesis. 23, 817-822.
24. 24. O’Flanagan, C. H., Smith, L. A., McDonell, S. B., & Hursting, S. D. (2017). When less may be more: calorie restriction and response to cancer therapy. BMC Med. 15, 106.
25. 25. Onorati, A. V., Dyczynski, M., Ojha, R., & Amaravadi, R. K. (2018). Targeting autophagy in cancer. Cancer, 124(16), 3307–3318.
26. 26. White, E. (2015). The role for autophagy in cancer. The Journal of Clinical Investigation, 125(1), 42–46.
27. 27. Mindikoglu, A. L., Abdulsada, M. M., Jain, A., Choi, J. M., Jalal, P. K., Devaraj, S., et al. (2020). Intermittent fasting from dawn to sunset for 30 consecutive days is associated with anticancer proteomic signature and upregulates key regulatory proteins of glucose and lipid metabolism, circadian clock, DNA repair, cytoskeleton remodeling, immune system and cognitive function in healthy subjects. Journal of Proteomics, 217, 103645.
28. 28. Fettig, L. M., & Yee, D. (2020). Advances in insulin-like growth factor biology and -directed cancer therapeutics. Advances in Cancer Research, 147, 229–257.
29. 29. Brandhorst, S., Choi, I. Y., Wei, M., Cheng, C. W., Sedrakyan, S., Navarrete, G., et al. (2015). A periodic diet that mimics fasting promotes multi-system regeneration, enhanced cognitive performance, and healthspan. Cell Metab. 22(1), 86-99.
30. 30. Kocaturk, N. M., Akkoc, Y., Kig, C., Bayraktar, O., Gozuacik, D., Kutlu, O. (2019). Autophagy as a molecular target for cancer treatment. European Journal of Pharmaceutical Sciences, 134, 116-137.
31. 31. Zhao, X., Yang, J., Huang, R., Guo, M., Zhou, Y., Xu, L. (2021). The role and its mechanism of intermittent fasting in tumors: friend or foe?. Cancer Biology & Medicine, 18(1), 63–73.
32. 32. Raffaghello, L., Lee, C., Safdie, F. M., Wei, M., Madia, F., Bianchi, G., et al. (2008). Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy. Proc Natl Acad Sci USA. 105(24), 8215-8220.
33. 33. Buono, R., & Longo, V. D. (2018). Starvation, Stress Resistance, and Cancer. Trends in Endocrinology and Metabolism: TEM, 29(4), 271–280.
34. 34. Amaravadi, R., Kimmelman, A. C., & White, E. (2016). Recent insights into the function of autophagy in cancer. Genes & Development, 30(17), 1913–1930.
35. 35. Raffaghello, L., Safdie, F., Bianchi, G., Dorff, T., Fontana, L., & Longo, V. D. (2010). Fasting and differential chemotherapy protection in patients. Cell Cycle, 9(22), 4474-4476.
36. 36. De Groot, S., Vreeswijk, M. P., Welters, M. J., Gravesteijn, G., Boei, J. J., Jochems, A., et al. (2015). The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study. BMC Cancer, 15, 652.
37. 37. Bauersfeld, S. P., Kessler, C. S., Wischnewsky, M., Jaensch, A., Steckhan, N., Stange, R., et al. (2018). The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study. BMC Cancer. 18(1), 476.
38. 38. Vernieri, C., Fucà, G., Ligorio, F., Huber, V., Vingiani, A., Iannelli, F., et al. (2022). Fasting-mimicking diet is safe and reshapes metabolism and antitumor immunity in patients with cancer. Cancer Discovery, 12(1), 90-107.
39. 39. Lee, C., Raffaghello, L., Brandhorst, S., Safdie, F. M., Bianchi, G., Martin-Montalvo, A., et al. (2012). Fasting cycles retard growth of tumors and sensitize a range of cancer cell types to chemotherapy. Sci Transl Med. 4(124), 124ra27.
40. 40. Zorn, S., Ehret, J., Schäuble, R., Rautenberg, B., Ihorst, G., Bertz, H., et al. (2020). Impact of modified short-term fasting and its combination with a fasting supportive diet during chemotherapy on the incidence and severity of chemotherapy-induced toxicities in cancer patients-a controlled cross-over pilot study. BMC Cancer, 20(1), 1-14.
41. 41. De Groot, S., Lugtenberg, R. T., Cohen, D., Welters, M., Ehsan, I., Vreeswijk, M., et al. (2020). Dutch Breast Cancer Research Group (BOOG). Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial. Nature Communications, 11(1), 3083.