The Warburg Hypothesis

 "All science is all too human." 

—Hans Fischer

Our story starts in 1914 alongside a bright, young soldier in the First World War by the name of Otto Warburg. A talented equestrian and decorated cavalry solider in the Prussian Horse Guards, he receives a letter from a family friend -- by the name of Albert Einstein -- urging him to return to his position at the Kaiser Wilhelm Institute for Biology. Einstein says in his letter, "I hear that you are one of Germany's most talented younger biologists of great promise." Einstein's remark was not mere polite flattery, as Otto Warburg went on to win the Nobel Prize in Medicine in 1931 for the "discovery of the nature and mode of action of the respiratory enzyme." Moreover, "the great number and magnitude of his discoveries [sic] rank him as the most accomplished biochemist of all time." (Encyclopedia.com). He was nominated 47 times for a Nobel Prize over the course of his career.

For our current purposes, Warburg's most interesting work involves the respiration of tumor cells versus the respiration of healthy cells. Warburg himself gives the best explanation of the momentous implications of his research in a speech to 1966 Nobel Laureates.

"Cancer, above all other diseases, has countless secondary causes. But, even for cancer, there is only one prime cause. Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar. All normal body cells meet their energy needs by respiration of oxygen, whereas cancer cells meet their energy needs in great part by fermentation."

Later in his speech he proposes an action item for this information: "To prevent cancer it is therefore proposed first to keep the speed of the blood stream so high that the venous blood still contains sufficient oxygen; second, to keep high the concentration of hemoglobin in the blood; third, to add always to the food, even of healthy people, the active groups of the respiratory enzymes; and to increase the doses of these groups if a precancerous state has already developed. If, at the same time, exogenous carcinogens are excluded rigorously, then much of the endogenous cancer may be prevented today." (more on this later)

Finally, he concludes, "These proposals are in no way utopian. On the contrary, they may be realized by everybody, everywhere, at any hour. Unlike the prevention of many other diseases, the prevention of cancer requires no government help, and not much money... Nobody today can say that one does not know what the prime cause of cancer is. On the contrary, there is no disease whose prime cause is better known, so that today ignorance is no longer an excuse for avoiding measures for prevention. That the prevention of cancer will come there is no doubt. But how long prevention will be avoided depends on how long the prophets of agnosticism will succeed in inhibiting the application of scientific knowledge in the cancer field. In the meantime, millions of men and women must die of cancer unnecessarily." (Emphasis mine)

Essentially, Warburg's point of view is that there are all kinds of carcinogens in the world and instead of trying to fight each one individually, we should focus on feeding healthy cells what they truly need instead creating a ripe environment for cancer to thrive. Furthermore, because we know of this significant difference in how healthy cells are fueled versus how cancer cells are fed, we should target this unique cancer metabolism in order to cure cancer.

The next logical question is of course, what should one eat in order to properly feed healthy cells (and thus prevent cancer)? You may have guessed from the whole "sugar fermentation" that cancer cells preferred source of fuel is glucose. Glucose is a simple sugar that is created by our bodies after breaking down carbohydrates in the food that we eat. Too much glucose wreaks havoc on our bodies in many ways: diabetes, heart disease, Alzheimer's, cancer, and many other diseases all have growing bodies of research on the role of glucose and insulin (the hormone that breaks down glucose) in their development.

The Warburg hypothesis is just the beginning of the story of how nutrition can be used as a medical tool to cure and prevent disease. Next time, we'll take Warburg's research one step further and learn about an alternative source of cellular energy called ketones.