Bonus: Dr. Colin Champ – The Caveman Doctor

Jonathan: Hey everyone welcome back to another bonus Smarter Science of Slim podcast. Very, very excited about today’s guest he is an individual who..man I tell you if there are more people like this, I think we would be in a really good place. He is a super intelligent and passionate guy who’s thinking outside of the box but also working on the inside of the system which is really important. He studied at MIT, he was a chemical engineer and then went on – he’s a very, very lazy guy – went on to get his MD and now he is an assistant professor and practicing physician at the University of Pittsburgh Medical Center where he specializes in cancer research. Does a bunch of oncology work and in his copious amounts of free time he also has the wonderful blog Cavemandoctor.com where he applies simple logic to complex health issues. Dr. Colin Champ welcome to the show.

Colin: Thanks a lot. Thanks for having me. I’m really, really thrilled to be here.

Jonathan: Well Colin, before we dig into cancer and protein, one of which is my favorite topics and another one which makes me sad – and you can probably guess which one is, how did you…so you went the “traditional” route and then you were disappointed with what you found and you decided to venture out a bit on your own. Can you tell us a bit about that story?

Colin: Sure. When I started medical school I assumed I would be an orthopedic surgeon or pediatrician primarily because those are the only two physicians that I encountered in my life so I assumed that’s just what I would go into. I went away from that, I got into the cancer field. I love, as weird as it sounds; I love the field of cancer. The patients are amazing, they’re great. They just want to be better and it’s a very rewarding job but I was very much into nutrition, diet and exercise during my college years and I really got away from that during med school because what worked for me and what worked for my clients in the gym was vastly different than what I was taught in medical school. I kind of went away from that, it really just left a lot of confusion in my head; went into the cancer world and then brought me right back. There is such an integral link between diet, exercise, staying slim and cancer so the two really go hand in hand.

Jonathan: Colin what were those biggest disconnects you saw between your actual experience, both personally and professionally, as well as your underlying understanding of biology and how cancer works and what you were being taught to teach people in terms of diet and exercise – what were the biggest areas of discrepancy there?

Colin: Through my own self-experiments and through my clients in the gym and my friends in college and beyond, I found that minimizing carbohydrates is a quick way to gain weight, which meant eating more fat, potentially eating more protein. I also found that chronic type exercise, pounding of the joints, long distance running – those kinds of things, more often ended up in injury as opposed to health. Yet, when I went through medical school it was a lot of very anti-fat message, all fat was really bad for you, all fat lead to everything from gaining fat to diabetes to cancer and carbohydrates where the key whether that be grains, wheat, pasta even white bread and we pushed more of a jogging type message in college as well. A lot of chronic exercises and it just didn’t really jive with what I personally knew and what I knew from my friends. Then I was…like I said, I kind of wasn’t sure which way to go because you assume what your thought in medical school is the ultimate in what’s right. It’s nice people like you out there and others are dispelling those myths that were thought in medical school. I think now were hitting a point where were righting the wrongs.

Jonathan: Certainly promising news. And Colin one thing I want to dig in to specifically with you, because you are uniquely qualified to talk about this as a practicing oncologist and someone who I believe based on your very nice picture on your website, you graduated from medical school fairly in the relatively recent past and therefore are up on the most recent research. Is that accurate?

Colin: Yes, that’s right.

Jonathan: Or is just that this lifestyle has been so good to you that you just look really, really young, not that I am very old myself. But anyway, people like to talk about fat and protein and when we talk about caveman Paleo ancestral lifestyles and then sometimes people who may be less friendly to that lifestyle play a “trump card” which is; that’s fine protein causes cancer and we have definitive studies that show that protein causes cancer and to the extent that you can eliminate protein from your diet, you will eliminate your chance of getting cancer. Do you have anything to add to that conversation?

Colin: Yes, I think like all things in life it’s a balance. If you’re not eating one thing you’re eating something else so it’s always a question of what is that something else. I heard a very prominent cancer researcher, one of the most prominent cancer researchers in the US who runs a major cancer center, giving a talk on this. Someone asked him a similar question and he basically said, “In terms of [indiscernible 05:44] of different foods that cause cancer, the question is: Does carbohydrates? – Yes very much. Does protein? – Yes may be not as much, but yes and Does fat? – No” Taking does three things into consideration, everyone has to eat all three of those macro-nutrients so I don’t think any diet that eliminates any one of those in its entirety is going to 100 percent guarantee you’re not going to get cancer. In terms of what the data actually shows is if you’re going to minimize one of the three, I think carbohydrates would take a larger stand than protein per say and definitely than fat.

Jonathan: What is the underlying “science” that is sometimes thrown out, in terms of protein? Is it, well triggers IGF-1 and that cause cancer to grow? So can you go a couple of clicks deeper as to…

Colin: Sure.

Jonathan: …explain why carbohydrate maybe the most offensive and fat is the least and protein is the middle.

Colin: Yes. And I think you hit the nail on the head that stimulating the IGF pathway, the insulin pathway, it’s an anabolic process which is why protein is great in that regard because you eat protein, you get bigger muscles its anabolic as opposed to catabolic which breaks down muscle. But anything that stimulates cellular growth and anything that’s anabolic can also stimulate cancer whether that’s going to stimulate cell growth anytime the cells are growing. A little too much growth is basically cancer which is happening all the time in everyone and usually we fix the problems, sometimes we don’t.

Looking at a polarized view at the IGF pathway, carbohydrates stimulate that quite a bit more than protein which is interesting because a lot of push back I get with my dietary recommendations people always bring up, well protein causes cancer. These are generally groups that are pushing a high carbohydrate diet. I think carbohydrates are a little more stimulating than that regard. The other pathway is – not to get science heavy here, is mTOR. This is a pathway where we have hundred thousand dollars drugs that we attempt to block this pathway and that is a pathway that protein can stimulate as well. These are reasons why you may not want to go too overboard on the protein.

Then also what really set protein and cancer causing on the map was a lot of the casein studies by T. Colin Campbell. Casein is a protein found in milk and he found that on a surface that a high casein diet in individuals exposed to a toxin of the liver caused liver cancer. Now this is not a very straightforward study and some of the rats got low protein in the beginning, high protein at the end. Some of the rats got high protein at the beginning and low protein at the end so it’s very contrived and it is important to note those rats that got low protein died a lot more than the high protein rats. Once again it leaves my head spinning. I don’t know maybe high protein causes cancer more but it cause more death. Do we have actually want that?

Jonathan: Well Colin, one of the…again I’m not an MD nor a PhD so I don’t want to oversimplify things due to my ignorance but I’ve always seen when I read this research that protein is a little bit analogous to water. Protein to your body is a little bit analogous to water to your garden, meaning the more you water your garden the more things are going to grow. And I say things. Like weeds could grow too, if weeds are in your garden if you water if more it’s going to grow more but that doesn’t mean the answer to having a beautiful garden is to stop watering it. It seems like protein is the same way, both through the mTOR and IGF pathways where protein stimulates growth and if you eat it stuff grows. The things that are already growing will grow faster and if you don’t eat it you have sarcopenia and nothing grows and you can’t move in your 70. Is that a reasonable take on things?

Colin: I think that’s a great take on things. Not only does it make things grow but it helps to repair things that are broken which you need to do to live a long and prosperous life.

Jonathan: And that’s when it comes to a long and prosperous life, you mentioned the mTOR pathway and I know there’s actually a lot of really exciting research with the mTOR pathway and protein and amino acid leucine and just the idea of you said, repair and the need for us to repair and to stimulate the ability for our body to generate new cells and to repair it and that only protein – in particularly specific amino acids which are mostly found in animal sources of protein – facilitate that. Is that accurate?

Colin: I think that is accurate. Exactly what you get at, limiting protein could affect the entire garden whereas there’s other ways to prune those weeds out and that’s intense exercise, intermittent fasting, intermittent ketosis, there’s other ways to stay healthy overall while getting rid of the weeds.

Jonathan: Is that a more macro point? Because even we sometimes hear about a very high carbohydrate diet doing certain things and if you provide your body with insufficient nutrition like a slow march towards death is maybe not…its slow so it’s going to slow everything, it’s going to slow your mental function, it’s going to slow the growth of cancer but it just slows you down. It puts the breaks on your entire body. Is that a one way to think about it or…?

Colin: Yes. That’s what we have to add in animals that show that, the recent data in monkeys that’s been published in Nature hasn’t shown such a great correlation but if we extrapolate from the animal data yes, if you severely calorie restrict yourself, less than 1500 or so and severely protein restrict yourself, you may live longer and to each his own. It’s not really the way I would like to live. If that’s going to give me six months you can have them.

Jonathan: I forget who it was but they said something like, “Anyone who talks about adds years to the end of your life, well make sure you’re not compromising that middle third of your life.” To live from a 112 to 115, I’m not sure those last three years are going to be that good anyway.

Colin: Exactly, exactly.

Jonathan: Colin, what are your thoughts on in a lot of these studies specially the monkey studies you mentioned and caloric restriction, often there’s a false dichotomy placed upon diets that are high in plant based, anti-toxin free but high vitamin mineral substances like vegetables and low fructose fruits. We’re given a false dichotomy saying that if you eat nutrient-dense plant foods, you have to be a vegetarian and you can’t eat animal foods versus an approach where you eat nutrient-dense animal foods and nutrient-dense plant foods and how much of these like caloric restriction studies are really just because in one group they had more nutrient density. How much of it is attributable to the lack of calories versus the abundance of essential nutrients?

Colin: Exactly that’s a great point. I actually published a paper on this same topic about two weeks ago which are getting at. There’s such an issue with semantics right now with in the whole calorie restriction community. What is calorie restriction? What are you actually restricting? If you look, there’s studies at the turn of the century showing that if you calorically restrict mice they will have a decreased incidence of cancer but when you take a closer look these mice are eating an 80 percent corn grain type diets so it’s a very poor diet to begin with and when your cutting 30 percent that back, is it the calories or is it the poor source of carbohydrates that your restricting?

If you look at one of the professors that did a lot of these studies, Tenenbaum, he actually wrote on this and it’s been lost in the cancer community where he said, “The greatest decrease in incidence of cancer was not from restricting calories alone, it was only when you restricted carbohydrates and replaced them with fats.” What’s happening there is you probably taken away a lot of these nutrients sparse carbohydrate sources like corn or what not you’re exchanging them for more nutrient-dense sources and exactly that your providing more vitamins, your providing more other nutrients here so this is where the waters gets muddied very fast, there’s so many things at play here, it’s really hard to say what’s going on. And every group with some sort of agenda says, “Oh it’s because of this or it’s because of this or it’s because of that.”

Jonathan: What have you seen Dr. Champ – because I’ve heard a lot of talk about promising research when an individual does is in any phase of cancer treatment and cancer’s ability to grow or thrive on glucose versus on ketones? Can you tell us a little bit more about this?

Colin: Sure. The metabolic difference between cancer cells and those of our normal cells is basically that they…whether oxygen is present or not they rely on a process called glycolysis which is turning of conversion of sugar directly into energy. Whereas our normal cells if there’s no oxygen present, say if your lifting weights or running sprints you feel that burn and that’s basically called glycolysis as well. Its turning sugar into lactate, lactic acid but when oxygen is present we have mitochondria which is much, much more efficient than the process called glycolysis and mitochondria can turn anything from sugar to fat to energy. Basically one of the big differences between cancer cells and normal cells is they do not have this ability so they need to rely on sugar.

We have a good way of exploiting this via what’s called a PET scan, which is when we give radioactive sugar, you inject it to a cancer patient and then you put then under a CT scan and the cancer cells light up like Christmas lights because they take in so much sugar. There’s been a push – and this is actually nothing recent, it’s been tried almost 50 years ago but there’s been a push to put people on what’s called a ketogenic diet which is basically a 80 to 90 percent fat diet, very minimal protein and even less carbohydrates. This is a method of getting ketones out which are sources that likely cancer cells cannot use whereas normal cells can.

I’ve been open to this with my patients, I promote it via my website and I promote it via my talks but it has not been proven yet in human patients. It has been shown in mice to have some amazing result but it has not been proven yet but an interesting tidbit basically for patients that have brain tumors, the higher their blood sugar is the worse they do, the shorter they live. This is exactly hitting on what you said, the more sugar that’s around the more these cancer cells are going to feast on it. I’ve had a handful of patients undergo ketogenic diet and interestingly enough there blood glucose level drops on average below 90. So patients in the studies show that those that the blood glucose below 90 lived the longest. We’re hoping, were putting our patients in this category.

Jonathan: Fascinating, fascinating and certainly the idea of eating radioactive sugar is one that is interesting to me because I’m curious if I could become a hyperactive superhero if I did that enough.

Colin: Unfortunately its very low radiation doses so it has not turned anyone into a superhero as of yet.

Jonathan: Dang it!

Colin: We’ll keep trying.

Jonathan: Spiderman just going crazy. Colin what would be your prescription for…forgive the pun, to someone who wanted to eat in a way that would minimize their likelihood of cancer while maximizing their quality of life right now, because as we talked about those things might maybe mutually exclusive?

Colin: I think saying exactly what I do, the prescription myself, is keeping the amount of carbohydrates low and by low definitely lower than what our mainstream health resources have recommended, keep those low. I think keeping the fat, the majority of my diet is fat and then the middle ground is as you pointed out very nutrient-dense green leafy vegetables and some berry type fruits. I think diet wise that makes sense. Then periodic intermittent fasting, I think is a great way to prune up those weeds that you spoke of in our cells to basically cause our cells to recycle some of the lesser needed parts. I think intermittent carbohydrates restriction, getting your body into the ketosis in case there are any of those cancer cells in there that are going to thrive on sugar it’s a good way to starve to them and then another thing is just being very active overall, your baseline activity high, walking around a lot and then having periodic intense, whether its sprinting or lifting heavy weights, these are all ways to turn on a process called autophagy which gets rid of those weeds in the cells.

Jonathan: Colin, last question is how do you deal with – this is what you do day in and day out and it is not the party line – how do you continue to stream up current? Do you get tired? How does that work?

Colin: It’s tough. There’s a dichotomy right now between what you read on the internet and what you hear on the hospital. Diet and nutrient has really not been an integral part of medicine for the last 30 years of so. But people are willing to change, its coming back and as long as you say something and can support it with data people can’t argue. It’s also very nice too when you’re the one making the data. When I can say this is what I did, this is my data, this is what it shows – argue with that, then people start listening. I think a lot of these aspects of cancer care are going to start out crossing party lines into the hospital setting.

Jonathan: Very, very exciting news. Colin what’s next for you?

Colin: I have a couple clinical trials I’m trying to get through, continue to publish my work on diet and nutrition and I should have my ketosis paper out soon for cancer patients that underwent a ketogenic diet during treatment for brain tumors.

Jonathan: Well listen, it was very, very exciting stuff and as you can tell Colin is busy at work and let’s do all that we can to support him, check out his work – it’s fabulous. His name is Colin Champ, MD and you can read more about him at cavemandoctor.com. Colin, thank you so much for joining us today.

Colin: Thanks a lot for having me I really appreciate it.

Jonathan: Listeners I hope you enjoyed today’s show as much as I did and please remember this week and every week after, eat smarter, exercise smarter and live better. Chat with you soon.