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Concerted Action for Complementary and Alternative Medicine Assessment in the Cancer Field (CAM-Cancer) www.cam-cancer.

org Project initiated under the European Commission 5th Framework Program Quality of Life, now hosted by the National Information Center for Complementary and Alternative Medicine in Troms, Norway. Scientific Co-ordinator Barbara Wider contact@cam-cancer.org.

Written by Luc Geeraert and the CAM-Cancer Consortium. Updated August 21, 2013

Budwig diet
Abstract and key points
The Budwig diet consists of a lacto-vegetarian regimen that has at its core a mixture combining flaxseed with cottage cheese or quark. The Budwig diet is a lacto-vegetarian regimen featuring flaxseed combined with cottage cheese or quark. A benefit of the Budwig diet in the prevention or treatment of cancer is not supported by clinical evidence. The Budwig diet has a low risk profile.

According to Budwigs theory, the combination of polyunsaturated fatty acids derived from flaxseed with sulfhydryl-containing proteins from the cottage cheese or quark can reverse the progression of cancer by re-oxygenating damaged tissues and reestablishing normal cell growth. This theory is not supported by scientific evidence. No clinical trials or documented case reports on the Budwig diet are available in the peer-reviewed scientific literature. Therefore, a benefit of the Budwig diet in the prevention or treatment of cancer is not supported by evidence. As a general diet, the Budwig diet is likely to be safe.

What is it?
Description
The Budwig diet is described in several books written by Johanna Budwig 1-5, three of which 3-5 have been translated into English. The Budwig diet principally consists of a lacto-vegetarian regimen involving fruits and vegetables, whole grains, nuts, and the special Budwig core mixture of freshly ground flaxseed and low-fat cottage cheese or quark. Refined sugars, meat, fish, hydrogenated and animal fats, distilled alcohol, caffeine, refined flours and grains, preservatives, processed foods, and smoking are prohibited. According to the Budwig diet, foods should be fresh, preferably organic and eaten raw when possible, or lightly cooked.

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History/provider(s)
In the 1950s, the German chemist Johanna Budwig developed a diet with at its core a special mixture of polyunsaturated fatty acids derived from flaxseed combined with the sulfhydryl-containing proteins found in cottage cheese or quark 5,6. According to Budwig, the mixture can restore normal functioning of damaged cells by re-oxygenating damaged tissues, as well as reestablishing normal cell growth 6.

Claims of efficacy
Budwig claimed a high success rate for treating cancer using her approach, although she did not provide any scientific proof, statistics or independent cohorts to back up her claim. Today there are numerous websites and blogs promoting this diet. These sites include testimonials claiming the Budwig diet to be successful in reversing most types of cancers. However, the testimonials are nearly always untraceable to source, inconsistent in quality, and contain pitfalls such as short follow-up times, subjective endpoints, concurrent conventional treatment, etc. and are hence unreliable.

Mechanism(s) of action
Budwig developed a theory that cancer would be caused by immature and incomplete cell growth, or incomplete mitosis, due to failing plasma development and impaired vesicular breathing 3,6. Of crucially importance in this mechanism would be two biological compound classes: polyunsaturated fatty acids and sulfhydryl-containing proteins. The electron-rich polyunsaturated fatty acids would be prone to docking on the electron-poor sulfhydryl groups of the proteins, anchoring fat en protein metabolism, which would be a key event in oxygen intake and orderly mitosis. In this theory, disturbance of the balance between both would lead to cancer development. Moreover, Budwig alleges that commercially processed fats and oils play an important role in damaging cells. The special mixture of polyunsaturated fatty acids derived from flaxseed and the sulfhydryl-containing proteins found in cottage cheese or quark, which is at the core of the Budwig diet, is claimed to be able to restore normal functioning of damaged cells by re-oxygenating damaged tissues, as well as reestablishing normal cell growth. However, the above theory was based on preliminary aspects from her basal fatty acid research and is not supported by later scientific findings in vivo; e.g., at the time, nothing was known about the fact that omega-3 fatty acids are essential nutrients, or about the importance of the exact position of the double bonds in the polyunsaturated fatty acids. Freshly ground flaxseed, which is at the core of the Budwig diet, is a rich source of dietary lignan and of plant-based omega-3 fatty acids, which have both been related with anti-cancer properties 7,8. The evidence for an anti-cancer effect of flaxseed is mainly resulting from in vitro and animal studies. In humans, flaxseed was found to lower tumor biomarkers in patients with prostate cancer or breast cancer. More clinical research must be performed to ascertain whether flaxseed is useful in cancer prevention or treatment. As a lacto-vegetarian diet, the Budwig diet incorporates many of the phytochemical-containing foods that

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are considered part of good nutrition for the prevention of cancer 9-11.

Prevalence of use
No clear data is available on the prevalence of use, although the Budwig diet is especially popular in the United States and Europe. There is a Budwig chat group at the Yahoo cancercure website 12. Video instructions for preparing the Budwig meals are available online 13.

Cost(s) and expenditures


The costs for pursuing the Budwig diet at home are average or below average since staples such as meat, fish, alcohol, sugars, refined flours, processed foods, margarine, and butter are prohibited. These are substituted by organic vegetables, whole-grain products, cottage-cheese or quark, and flaxseed. The cost for following a Budwig cure at a specialized clinic, however, can run up to several thousand euros.

Does it work?
No clinical trials or documented case reports have been published, in the peer-reviewed scientific literature, on the Budwig diet for cancer prevention or treatment. Hence, the anti-cancer claims for the Budwig diet are not supported by clinical evidence.

Is it safe?
Adverse events
Mild, reversible bloating or laxative effects have occasionally been reported with flaxseed (not flaxseed oil); adequate fluid intake must always be foreseen to avoid any possibility of fullness or bowel obstruction 15. Containing plant-based estrogen (phytoestrogen), flaxseed (not flaxseed oil) may rarely exert hormonal effects. There have also been some reports of allergies, and scattered reports of drug interactions/interference for flaxseed and flaxseed oil, in particular with tamoxifen.

Contraindications
Flaxseed is not recommended in pregnant or lactating women as there is insufficient human data.

Interactions
Oral drugs should be taken one hour before or two hours after flaxseed (not flaxseed oil) to prevent decreased absorption.

Warnings

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Patients choosing to follow the Budwig regimen as a general diet should be regularly monitored by their physicians, as lacto-vegetarian diets can lead to an increased risk of vitamin B12 deficiencies and possibly certain mineral deficits 14.

Citation
Luc Geeraert, CAM-Cancer Consortium. Budwig diet [online document]. http://www.cam-cancer.org/CAM-Summaries/Dietary-approaches/Budwig-diet. August 21, 2013.

Document history
Assessed as up to date in August 2013 by Barbara Wider. Summary first published in May 2012 by Luc Geeraert.

References

1. Budwig J. Das Fettsyndrom. Auflage 4A. Freiburg i. B.: Hyperion Verlag; 1996. 2. Budwig J. Krebs, ein Fettproblem. Richtige Wahl und Verwendung der Fette. Freiburg i. B.: Hyperion Verlag; 2000. 3. Budwig J. Cancer: The Problem and the Solution. Nexus GmbH; 2008. 4. Budwig J. Flax oil as a true aid against arthritis, heart, infarction, cancer and other diseases. 3rd Edition. Vancouver: Apple Publishing; 1994. 5. Budwig J. The oil protein diet cookbook. Vancouver: Apple Publishing; 1994. 6. Budwig J. Cytostatic or cytodynamic treatment of cancer. Hippokrates. 1956;19:605-612. 7. American Cancer Society [Internet]. Atlanta, Georgia, USA: the Society c2012 [updated 2011 October 14; cited 2012 February 6]. Available from: http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVi 8. Memorial Sloan-Kettering Cancer Center [Internet]. New York, NY, USA: the Center; c2012 [updated 2011 August 17; cited 2012 February 6]. Available from: http://www.mskcc.org/cancer-care/herb/flaxseed 9. Liu RH. Potential synergy of phytochemicals in cancer prevention: mechanism of action. J. Nutr. 2004 December;134(12 Suppl):3479S-3485S. 10. de Kok TM, van Breda SG, Manson MM. Mechanisms of combined action of different chemopreventive dietary compounds: a review. Eur. J. Nutr. 2008 May;47 Suppl 2:51-59. 11. Doyle C, Kushi LH, Byers T, Courneya KS, Demark-Wahnefried W, Grant B, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006 November-December;56(6):323-353. 12. The Cancer Cure Foundation [Internet]. Westlake Village, CA, USA: the Foundation [cited 2011 June 21]. Available from: http://www.cancure.org/budwig_diet.htm 13. Budwig-videos.com [Internet] San Francisco, CA, USA: the Website; c2000-2011. [cited 2011 June 21]. Available from: http://www.budwig-videos.com 14. Craig WJ. Nutrition concerns and health effects of vegetarian diets. Nutr. Clin. Pract. 2010 December;25(6):613-620. 15. Basch E, Bent S, Collins J, Dacey C, Hammerness P, Harrison M, et al. Flax and flaxseed oil (Linum

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15. usitatissimum): a review by the Natural Standard Research Collaboration. J. Soc. Integr. Oncol. 2007 Summer;5(3):92-105.
Legal notice The present documentation has been compiled by the CAM-CANCER Project with all due care and expert knowledge. However, the CAM-CANCER Project provides no assurance, guarantee or promise with regard to the correctness, accuracy, up-to-date status or completeness of the information it contains. This information is designed for health professionals. Readers are strongly advised to discuss the information with their physician. Accordingly, the CAM-CANCER Project shall not be liable for damage or loss caused because anyone relies on the information.

Please visit the CAM-Cancer website for more information about the project: www.cam-cancer.org

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