Health Care Professional Information

Common Name

Budwig Protocol, Flaxseed Oil Diet, Linseed Oil Diet, Flax-oil and Cottage-Cheese (FOCC) Diet, Oil-protein Diet, Variations: Cellect-Budwig Protocol, Bill Henderson Protocol

Clinical Summary

Developed by Dr. Johanna Budwig in the 1950s, the Budwig diet is an unproven cancer treatment featuring multiple daily servings of flaxseed oil and cottage cheese. It is often combined with procedures such as coffee enema in alternative cancer treatment regimens. Budwig believed that cancer was caused by the lack of polyunsaturated fatty acids, and that a combination of flax oil and cottage cheese would improve cellular function.
The diet consists of a mixture of flax oil and cottage cheese as well as vegetables, fruits and juices. It prohibits consumption of sugar, animal fats, shellfish, processed foods, soy and most dairy products, and encourages daily sunbathing (1).
Although Budwig had written books and papers to provide anecdotal evidence and biochemical mechanism of the diet, no clinical trials have been published in any peer-reviewed medical journal. Polyunsaturated fatty acids, like omega-3 found in flaxseeds, have been shown to exert anticancer activities (2) but there is no evidence that such diet has any benefit in preventing or treating cancer in humans. Whereas a balanced diet consisting of vegetables and fruits can be beneficial for general health, restricted diets may increase risk of nutritional deficiencies (3). High levels of sun exposure can result in increased risk of sunburn and skin cancer (4).
Budwig diet is not recommended by most mainstream cancer treatment centers.

Food Sources

Organic flaxseed combined with low-fat cottage cheese.

Purported Uses
  • Cancer prevention
  • Cancer treatment
Constituents

Organic flaxseed oil (unsaturated fatty acids: linolenic, linoleic acids) combined with low-fat cottage cheese

Variation Diets:
Bill Henderson Protocol: Flaxseed oil/cottage cheese mixture along with supplements such as barley grass, baker's yeast, multivitamins, and green tea (5).
Cellect-Budwig Protocol: Cellect powder along with Budwig diet (6).

Mechanism of Action

Dr. Budwig developed her diet based on the hypothesis that cancer is caused by reduced uptake of oxygen by cell membranes in the absence of omega-3 fatty acids such as linolenic acid (7). While metabolic changes such as increased aerobic glycolysis and fatty acid synthesis occur in cancerous cells, (8) the role of omega-3 fatty acids in the pathogenesis and treatment of cancer is still under investigation (2). The polyunsaturated omega-3 fatty acids in flaxseed oil have been shown to decrease levels of pro-inflammatory cytokines, Tumor Necrosis Factor (TNF) alpha and Interleukin-1 beta (9). Omega-3 fatty acids also demonstrated anti-neoplastic properties by increasing intracellular reactive oxygen species and decreasing pro-tumorigenic prostaglandins (2). Flax oil supplements increased total phospholipid fatty acid content in erythrocytes, (10) but the implication of this finding in cancer treatment is unknown. Flaxseed supplements also inhibit proliferation of human prostate cancer (11) and inhibit breast cancer growth in vitro by down-regulating growth factors and by increasing p53 expression (12). Furthermore, whole flaxseed contains lignans, phytoestrogens which may also have anti-neoplastic properties and exert hormonal effects (13).
Budwig believed that combining cottage cheese and flaxseed oil allowed for better availability of essential fatty acids through the plasma membrane, allowing for improved aerobic cellular respiration (1). The effect of cottage cheese consumption on the bioavailability of omega-3 fatty acids has not been studied. Processed fats, saturated fats, animal fats, processed foods and sugar are prohibited in the Budwig diet because they are thought to interfere with oxygen uptake and cellular respiration. Epidemiological studies show that people who consume lacto-vegetarian diets have lower incidence of gastrointestinal cancer compared to non-vegetarians (14) (15), although these studies indicate association rather than causation.
An animal study showed that greater tumor regression occurred in mice treated with Trastuzumab therapy plus Flax-oil as compared to those treated with Trastuzumab alone (16).
The Budwig Diet also encourages sun exposure or tanning in belief that sun light would activate the electrons in the oils (17). However, the clinical benefits have yet to be demonstrated in scientific studies.

Warnings
  • Delaying or avoiding medical treatment can have serious consequences.
  • Restricted diets may result in nutritional deficiencies.
  • Flaxseed has weak estrogenic effects. Patients with hormone-sensitive cancers should use with caution.
Contraindications
  • Bleeding Disorders: Animal studies indicate that flaxseed oil increases bleeding time and platelet activating inhibitor-1, and decreases platelet aggregation (19).
  • Pregnancy: An animal study found that a diet high in flaxseed during pregnancy can increase risk of breast cancer in the offspring (23).
Adverse Reactions
  • Lactovegetarians may be at greater risk for vitamin B12 deficiency (3).
  • Excessive sun exposure and tanning beds can increase risk of melanoma and skin cancers (4).
  • Adverse events associated with flaxseed consumption include gastrointestinal discomfort such as gas, bloating, constipation, stomach ache and frequent bowel movements (18).
Herb-Drug Interactions

Drug interactions for the Budwig Diet have not been investigated.

Drug interactions for flaxseed supplementation include:
Anticoagulant/Antiplatelet drugs: flaxseed may increases bleeding time decrease platelet aggregation (19).
Antidiabetic drugs: Lignans in flaxseed may lower fasting glucose levels (20).
Ketoprofen: Flaxseed may decrease the absorption of ketoprofen (21).
Metoprolol: Flaxseed may decrease the effects of metoprolol (21).

Literature Summary and Critique

There have been no formal in vitro, animal, or clinical studies on the Budwig Diet to date. Flaxseed oil supplementation alone has been studied in vitro, in animals, and in limited clinical studies.

Dosage (Inside MSKCC Only)
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References
  1. Dr. Johanna Budwig Diet. 2013. http://www.budwigcenter.com/anti-cancer-diet.php. Accessed 11/13/2014.
  2. Cockbain AJ, Toogood GJ, Hull MA. Omega-3 polyunsaturated fatty acids for the treatment and prevention of colorectal cancer. Gut. Jan 2012;61(1):135-149.
  3. Antony AC. Vegetarianism and vitamin B-12 (cobalamin) deficiency. The American journal of clinical nutrition. Jul 2003;78(1):3-6.
  4. Ayala F, Palla M, Di Trolio R, et al. The role of optical radiations in skin cancer. ISRN dermatology. 2013;2013:842359.
  5. Mannion C, Page S, Bell LH, et al. Components of an anticancer diet: dietary recommendations, restrictions and supplements of the Bill Henderson Protocol. Nutrients. Jan 2011;3(1):1-26.
  6. Cellect-Budwig Diet http://www.cellectbudwig.com/index.php. Accessed 11/13/2014.
  7. Budwig J. Cytostatic or cytodynamic control of cancer. Hippokrates. Oct 15 1956;27(19):605-612.
  8. Zhao Y, Butler EB, Tan M. Targeting cellular metabolism to improve cancer therapeutics. Cell death & disease. 2013;4:e532.
  9. Holm T, Berge RK, Andreassen AK, et al. Omega-3 fatty acids enhance tumor necrosis factor-alpha levels in heart transplant recipients. Transplantation. Aug 27 2001;72(4):706-711.
  10. Barcelo-Coblijn G, Murphy EJ, Othman R, et al. Flaxseed oil and fish-oil capsule consumption alters human red blood cell n-3 fatty acid composition: a multiple-dosing trial comparing 2 sources of n-3 fatty acid. The American journal of clinical nutrition. Sep 2008;88(3):801-809.
  11. Demark-Wahnefried W, Polascik TJ, George SL, et al. Flaxseed supplementation (not dietary fat restriction) reduces prostate cancer proliferation rates in men presurgery. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. Dec 2008;17(12):3577-3587.
  12. Lee J, Cho K. Flaxseed sprouts induce apoptosis and inhibit growth in MCF-7 and MDA-MB-231 human breast cancer cells. In vitro cellular & developmental biology Animal. Apr 2012;48(4):244-250.
  13. Sturgeon SR, Heersink JL, Volpe SL, et al. Effect of dietary flaxseed on serum levels of estrogens and androgens in postmenopausal women. Nutrition and cancer. 2008;60(5):612-618.
  14. Tantamango-Bartley Y, Jaceldo-Siegl K, Fan J, et al. Vegetarian diets and the incidence of cancer in a low-risk population. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. Feb 2013;22(2):286-294.
  15. Craig WJ, Mangels AR, American Dietetic A. Position of the American Dietetic Association: vegetarian diets. Journal of the American Dietetic Association. Jul 2009;109(7):1266-1282.
  16. Mason JK, Chen J, Thompson LU. Flaxseed oil-trastuzumab interaction in breast cancer. Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association. Aug-Sep 2010;48(8-9):2223-2226.
  17. Dr. Johanna Budwig: The Practical Implementation of My Oil-Protein Diet. 2004-2013; http://www.healingcancernaturally.com/budwig_protocol.html. Accessed 11/13/2014.
  18. Austria JA, Richard MN, Chahine MN, et al. Journal of the American College of Nutrition. April 1, 2008 2008;27(2):214-221.
  19. Prasad K. Flaxseed and cardiovascular health. Journal of cardiovascular pharmacology. Nov 2009;54(5):369-377.
  20. Zhang W, Wang X, Liu Y, et al. Dietary flaxseed lignan extract lowers plasma cholesterol and glucose concentrations in hypercholesterolaemic subjects. Br J Nutr. Jun 2008;99(6):1301-1309.
  21. Laitinen LA, Tammela PS, Galkin A, et al. Effects of extracts of commonly consumed food supplements and food fractions on the permeability of drugs across Caco-2 cell monolayers. Pharmaceutical research. Oct 2004;21(10):1904-1916.
  22. Pan A, Yu D, Demark-Wahnefried W, et al. Meta-analysis of the effects of flaxseed interventions on blood lipids. The American journal of clinical nutrition. Aug 2009;90(2):288-297.
  23. Khan G, Penttinen P, Cabanes A, et al. Maternal flaxseed diet during pregnancy or lactation increases female rat offspring's susceptibility to carcinogen-induced mammary tumorigenesis. Reproductive toxicology. Apr-May 2007;23(3):397-406.

Consumer Information

How It Works

Bottom Line: Budwig Diet has not been proven to treat or prevent cancer.
The Budwig Diet is an unproven anticancer treatment. Budwig Diet was developed by the German biochemist Dr. Johanna Budwig in the 1950s. The diet consists of multiple daily servings of flaxseed oil and cottage cheese, as well as vegetables, fruits and juices. Processed foods, meats, most dairy products and sugar are prohibited. Budwig believed that the combination of flaxseed oil, a food high in polyunsaturated fatty acids, and cottage cheese, would improve cellular function. No large scale clinical studies have been conducted using the Budwig diet.
While a diet consisting of high amounts of vegetables and fruits can be beneficial, diets restricted in meat and dairy products may reduce the intake of essential nutrients leading to nutritional deficiencies. Some variations of the diet encourage daily sunbathing to energize the fatty acids, and a coffee or oil enema. Coffee enemas can result in electrolyte imbalance, infections, proctocolitis (inflammation of the rectum and colon) and burns. High levels of sun exposure can result in increased risk of sunburn and skin cancer.

Purported Uses
  • Cancer Treatment and Prevention:
    There is no large scale study to support this claim.
Do Not Take If
  • You have bleeding disorders (may increase risk of bleeding).
  • You are pregnancy (may increase risk of breast cancer in the offspring).
Side Effects
  • Nutrient deficiencies
  • Sunbathing: Increases risk of sunburn and skin cancer
  • Flaxseed supplementation: Gastrointestinal discomfort such as gas, bloating, constipation, stomach ache and frequent bowel movements
Special Point

Eating a well-balanced diet, rich in vegetables and fruit, can be beneficial for health. A restricted diet can lead to nutritional deficiencies. There is no scientific evidence that supports the Budwig Diet in disease prevention. Delaying or avoiding standard medical treatment can have serious consequences.

E-mail your questions and comments to aboutherbs@mskcc.org.