Alternative Diets (Appendix B Green Book)

Question 1

What is the proposed mechanism of action of the Alkaline Diet?

Answer 1

It is based on the premise that modern diets cause acidosis and acidosis causes diseases. Proponents claim that an alkaline diet improves digestion and absorption and that acid in the body cells destroy minerals leading to disease. They also believe that cancer cells thrive in an acidic environment but not in an alkaline environment and cancer results from improper food combinations.

Question 2

General description of the Alkaline diet?

Answer 2

Proponents believe the alkaline diet changes the body’s pH to the alkaline range needed to fight disease and maintain health. Some versions recommend moderate diet changes, encouraging a plant based diet that excludes meats, sugars and processed foods. Some recommend 80% alkaline foods and 20% acid forming foods. The Acid-Alkaline Association (AAA) suggests 10 levels to the diet with 10 being the most restrictive consisting of raw, vegan foods.

Question 3

What are considered Alkaline foods on the Alkaline diet?

Answer 3

vegetables, low sugar fruits, and legumes

Question 4

What are considered Acid foods on the Alkaline diet?

Answer 4

Beef, poultry, dairy, eggs, coffee, sugar, and alcohol

Question 5

What are additional diet guidelines on the Alkaline diet?

Answer 5

Avoid eating carbohydrates and acid foods at the same time, avoid eating concentrated protein and carbohydrate at the same time, and avoid eating two concentrated proteins at the same time.
Do not consume protein with fats or acids,
Eat only one concentrated starch per meal,
Avoid melons,
Don’t drink milk with any other foods (if dairy is consumed at all),
Drink 2+ quarts of water per day,
Use water alkalizer to raise the pH of the water

Question 6

What are possible side effects of the Alkaline diet?

Answer 6

As the diet becomes more restrictive, it becomes difficult to consume adequate energy and protein and increases risk of nutrient deficiencies.

Question 7

What does the science say about Alkaline diets?

Answer 7

An alkaline diet can change urinary pH, but will not significantly change blood pH. If the kidneys are functioning normally, the body should maintain pH balance regardless of diet. There are no scientific studies to support the effectiveness or safety of the Alkaline diet.

Question 8

Other Alkaline diet considerations.

Answer 8

Water alkalizer are expensive.
The diet requires significant and difficult changes.
It may lead to nutrient deficiency.
In general, plant based diets and minimizing processed and sugary foods are healthy and adequate without the unnecessary complication of the Alkaline diet.

Question 9

Should the RDN recommend the Alkaline diet?

Answer 9

no

Question 10

What is a general description of the Bill Henderson Protocol?

Answer 10

Based on the Budwig diet.
Raw fruits and vegetables, gluten-free whole grains, legumes and cottage cheese and flaxseed oil mixture.
Up to 46 vitamin and herbal “superfoods” supplements (antioxidants, barley grass, beta-glucans).
2/3-1 c cottage cheese with 6-8 Tbsp flaxseed oil every day.

Question 11

What is the proposed mechanism of action of the Bill Henderson Protocol?

Answer 11

Based on the belief that cancer is caused by lack of oxygen to the cells, a weakened immune system, excess acidity and toxicity secondary to tobacco, alcohol and asbestos.
The intent is to increase alkaline foods in order to increase body pH.
The protocol claims to improve cell oxygenation.

Question 12

Food groups excluded on the Bill Henderson Protocol?

Answer 12

meat, dairy (except cottage cheese), gluten, processed foods, sugar, and alcohol.

Question 13

Potential nutrition side effects of the Bill Henderson Protocol?

Answer 13

May be limited in calories, protein B12, iron, zinc, calcium and iodine.
6-8 Tbsp flaxseed oil may lead to diarrhea and may enhance effects of blood-thinning medication.

Question 14

What does the science say about the Bill Henderson Protocol?

Answer 14

There is no evidence that this diet is safe and effective.

Question 15

Should the RDN recommend the Bill Henderson Protocol?

Answer 15

No.

Question 16

General Description of the Budwig Diet?

Answer 16

A vegetarian diet encouraging natural unrefined foods. The cornerstone of the diet is a blend of cold-pressed flaxseed oil (45-50 g) and quark cheese (a German cottage cheese) which is then used to make “Budwig muesli” which is eaten at breakfast and lunch (6-7 Tbsp flaxseed oil total)
Eat 8 times a day of allowed foods.
Diet combined with breathing exercises and enemas.
Essiac tea is encouraged.
One class of wine or champagne daily is allowed.

Question 17

Foods allowed on the Budwig Diet?

Answer 17

Natural unrefined foods including whole grains, organic fruits, organic vegetables, juice, nuts, potatoes, certain cheeses from naturally grass-fed herds, oleolux (a spread made from cold-pressed flaxseed oil, coconut oil, garlic and onions), green tea, saukraut and sauerkraut juice. Kelp and seaweed are also allowed.

Question 18

What foods are excluded on the Budwig Diet?

Answer 18

Ready made meals and processed foods, peanuts, animal fats, trans fats, hydrogenated fats, margarine, eggs, meat, fish, seafood, poultry, processed meat (sausage, etc), sugar, refined foods (white flour, cakes, pastries, etc.) and other sweets except a small amount of honey, unfermented soy products (tofu) and dairy products (other than cottage cheese).

Question 19

What are possible side effects of the Budwig Diet?

Answer 19

This diet may be low in energy, protein increasing the risk for weight loss and cachexia.
Increased risk for deficiencies of B12, D, iron, zinc, calcium and iodine.
Large flaxseed intake may result in bloating, gas, diarrhea and constipation.
Flaxseed oil may enhance the effect of blood thinning medication and increase bleeding time and decrease platelet aggregation.

Question 20

What does the science say about the Budwig Diet?

Answer 20

There is no scientific evidence to support the effectiveness and safety of this diet. No clinical trial have been published in peer-reviewed journals.

Question 21

Should the RDN recommend the Budwig Diet?

Answer 21

No.

Question 22

General Description of the Gerson Therapy?

Answer 22

Organic, plant based diet that includes raw juices and natural supplements.
Coffee enemas are recommended.
15-20 lbs of fruits and vegetables daily.
Drinking up to 13 glasses of juice per day (from carrots, apples, green leafy vegetables).
Multiple dietary supplements including B12, thyroid hormone, pancreatic enzymes, potassium, etc.
No sodium. No fat except for flaxseed oil.

Question 23

What is the proposed mechanism of the Gerson Therapy?

Answer 23

Claims to detoxify the body, return potassium to tissues and cells, reduce sodium in tissues and tumors, and treat the liver to “restore the body’s ability to restore itself.”

Question 24

Possible side effects of the Gerson Therapy?

Answer 24

Increased risk for protein-energy malnutrition and hyponatremia, coma (secondary to hyponatremia), dehydration, and colitis from frequent enemas.
May develop mouth sores.
May cause flu-like symptoms, anorexia, weakness, dizziness, cold sores, intestinal cramping, diarrhea and vomiting.

Question 25

What vitamins are deficient in the Gerson Therapy?

Answer 25

Deficient in B12, D, iron, calcium, zinc, and iodine.

Question 26

Which patients would have a particularly hard time with the Gerson Therapy?

Answer 26

Individuals with gastro-intestinal cancers and head-neck cancers (d/t high fiber and may cause mouth sores, limiting oral intake).

Question 27

Origin of the Gerson Therapy?

Answer 27

Originally developed to self-treat headaches, Max Gerson, MD, recommended it for tuberculosis in the 1930’s. The Gerson Institute is a nonprofit in San Diego.

Question 28

What does the science say about the Gerson Therapy?

Answer 28

There are no randomized clinical trials conducted on this diet.

Question 29

Should an RDN recommend the Gerson Therapy?

Answer 29

No.

Question 30

General description of the Gonzalez Regimen?

Answer 30

Individualized program (10 basic diets with 95 variations) considered metabolic therapy that consists of dietary supplements (up to 150 pills per day), extracts of animal organs (as a source of pancreatic enzymes) and coffee enemas twice daily.

Question 31

What is the proposed mechanism of action of the Gonzalez Regimen?

Answer 31

Proponents believe that toxins from processed foods, pesticides, preservatives and pollutants cause cancer. This program is considered metabolic therapy.

Question 32

What are the possible side effects of the Gonzalez Regimen?

Answer 32

Side effects vary depending on individual recommendations.
Coffee enemas can cause electrolyte imbalances and increase risk for colitis and infections. (Death from coffee enemas have occurred).

Question 33

What are the supplements associated with the Gonzalez Regimen?

Answer 33

Vitamins, minerals, amino acids, trace elements, electrolytes, animal extracts, digestive aids (pepsin) and pancreatic enzymes) - may be up to 150 pills per day.
Also, animal glandular products (primarily or pancreatic enzymes).

Question 34

What does the science say about the Gonzalez Regimen?

Answer 34

There is no benefit from this regimen. One study actually found QOL and survival time was better with conventional chemotherapy compared to the Gonzalez Regimen.

Question 35

Should the RDN recommend the Gonzalez Regimen?

Answer 35

No.

Question 36

General description of the Livingston-Wheeler Therapy?

Answer 36

75% raw fruits and vegetables supplemented with megadoses of vitamins and minerals and digestive enzymes and antibiotics.
Includes a bacilli Calmette-Guerin (BCG) vaccine derived from each patient’s own blood or urine.
Coffee enemas, lemon juice or hot water.

Question 37

Proposed mechanism of action for the Livingston-Wheeler Therapy?

Answer 37

Based on the belief that the bacterium Progenitor cryptocides initiates cancer, which grows unless stopped by the immune system.
It is described as an ‘immune-boosting cancer prevention program.”

Question 38

Foods allowed on the Livingston-Wheeler Therapy?

Answer 38

Vegetarian diet made up of 75% raw fruits and vegetables.

Question 39

Foods excluded on the Livingston-Wheeler Therapy?

Answer 39

poultry, meat, eggs, milk, sugar, processed foods, food additives, alcohol, caffeine and fluoridated water.

Question 40

What are the possible side effects of the Livingston-Wheeler Therapy?

Answer 40

If the vegetarian diet is not done correctly, the diet may be deficient in B12, D, iron, zinc, calcium, iodine, and protein.
Coffee enemas can lead to electrolyte imbalances, dehydration, malabsorption and death.
Malaise, aching and fever have been reported on this therapy.

Question 41

What does the science say about the Livingston-Wheeler Therapy?

Answer 41

The link between Progenitor cryptocides and caner has never been confirmed, nor has the bacterium’s existence been confirmed.
BCG vaccine has been found ineffective.
There is no scientific evidence supporting the effectiveness or safety of this plan.

Question 42

Should the RDN recommend thee Livingston-Wheeler Therapy?

Answer 42

No.

Question 43

General description of the Macrobiotic Diet?

Answer 43

An adaptation of the traditional Japanese diet to promote a balance of yin and yang (balancing the body, mind and spirit).
Several versions exist allowing fish on occasional all the way to a vegan diet.
Specific cooking methods and utensils are recommended.
No microwave or electricity is used to cook food.
Food is chewed until fluid (50 times)

Question 44

Foods allowed on the Macrobiotic Diet?

Answer 44

40-60% organically grown whole grains
20-30% locally grown vegetables
5-10% beans and bean products
5% soup prepared with beans, miso and vegetables
nuts, seeds, fruits and fish on occasion

Question 45

Foods excluded on the Macrobiotic Diet?

Answer 45

Some vegetables (nightshades, potatoes, tomatoes, eggplant, peppers), dairy, eggs, processed foods, refined sugars, and meats

Question 46

What are some possible side effects of the Macrobiotic Diet?

Answer 46

May be deficient in energy, vitamins B12, D, iron, zinc, calcium, iodine and possibly protein.
Inadequate calareis may result in weight loss, loss of lean body mass and cachexia.

Question 47

What does the science say about the Macrobiotic Diet?

Answer 47

It has not been evaluated in a randomized clinical trial.

Question 48

What should the RDN do with someone who wants to follow the Macrobiotic Diet?

Answer 48

Provide education and counseling to help adopters of this diet meet current cancer-prevention and nutritional guidelines.

Question 49

Should the RDN recommend the Macrobiotic Diet?

Answer 49

No.

Question 50

General description of the Raw Food Plan?

Answer 50

A raw food plan includes uncooked foods prepared with no animal products, dairy, or eggs. Foods consumed have not been processed in any way from their natural state.

Question 51

Foods allowed on the Raw Food Plan?

Answer 51

75% fruits and vegetables (emphasis on carrots, cabbage, green asparagus, broccoli, red beets, beet tops, cauliflower)
Seaweed, sporuts, seeds, beans, whole grains and nuts.
Sprouting and dehydrating foods is common.
Some limit vitamin K vegetable sources.

Question 52

Foods to be avoided on the Raw Food Plan?

Answer 52

Meat, dairy, eggs.

Question 53

What are the possible side effects of the Raw Food Plan?

Answer 53

Deficiencies in B12, D, iron, zinc, calcium, iodine, and possibly protein.
Raw food increases risk of low bone mass.

Question 54

What vitamin should the RDN recommend for patients following the Raw Food Plan?

Answer 54

B12, D, and calcium.

A nutrition assessment is important d/t the risk of nutritional deficiencies.

Question 55

What does the science say about the Raw Food Plan?

Answer 55

Studies are limited and there is no evidence that this diet is effective for cancer treatment.