A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer

Cohen, Caroline W.; Fontaine, Kevin R.; Arend, Rebecca C.; Alvarez, Ronald D.; Leath, Charles A.; Huh, Warner K.; Bevis, Kerri S.; Kim, Kenneth Hyunchung; Straughn, J. Michael; Gower, Barbara A.

doi:10.1093/jn/nxy119

Cited by 116 publications

(128 citation statements)

References 54 publications

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“…Accordingly, the muscle/fat mass ratio improved, with the SD group showing the weakest effect and the KD group the most prominent effect. This nding is in accordance with the previously published superiority of KD to SD in reducing central obesity in female cancer patients [27]. LCD patients, who started from the worst ratio, managed to improve nearly as well as patients on a KD.…”

Section: Energy Uptake/body Compositionsupporting

confidence: 92%

“…Based on the known metabolic situation in cancer patients, we expect both the KD and the LCD to better account for the metabolic alterations compared to the SD regimen recommended thus far. In addition, the KD was reported to be safe for cancer patients in several clinical settings [27,35,41] and to improve overall survival in a group of breast cancer patients compared to a SD [42]. Thus, our work provides further evidence supporting the safety and bene ts of this dietary approach for BC patients.…”

Section: Quality Of Lifesupporting

confidence: 61%

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Low Carb (LCD) and Ketogenic (KD) Diets Increase Quality of Life, Physical Performance, Body Composition and Metabolic Health of Women with Breast Cancer Better Than a Standard Diet (SD)

Kämmerer¹,

Klement²,

Sütterlin³

et al. 2020

Preprint

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Background: Breast Cancer (BC) patients often ask for a healthy diet. Here, we compared three different diets which could support BC patients during the rehabilitation process: a healthy standard diet (SD), a low carb diet (LCD) and a ketogenic diet (KD).Patients and Methods:KOLIBRI was a one-site nutritional intervention trial, combining inpatient and outhouse phases for 20 weeks. Female BC patients (n=152; mean age 51.7 years) could select their diet. Data collected were: quality of life (QoL), spiroergometry, body composition, blood biochemistry. 30, 92 and 30 patients started the KD, LCD and SD, respectively. Of those, 20, 72 and 25 completed the final examination.Results:Patients rated all diets as feasible in daily life. No adverse effects occurred in any diet group. KD offered the highest amount of energy and protein. All groups improved in QoL, body composition and physical performance. KD was superior in improving fatigue, insomnia and physical functioning. KD participants finished with the best physical performance and the highest muscle/fat ratio. Despite their increased cholesterol, KD patients had the best triglyceride/HDL ratio and HOMA-IR. Most metabolic parameters significantly improved in the LCD group. SD participants ended with remarkably low cholesterol levels, but did not improve triglyceride/HDL or HOMA-IR.Conclusions:A well-defined KD and LCD are safe and beneficial for BC. Both diets could thus be recommended for patients wanting to self-support their rehabilitation process.Trial registration IDNCT02092753 Protocol Registration date:02/26/2014Ketogenic Or LOGI Diet In a Breast Cancer Rehabilitation Intervention (KOLIBRI)URL: https://clinicaltrials.gov/ct2/show/NCT02092753?cond=KOLIBRI&draw=2&rank=1

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Section: Energy Uptake/body Compositionsupporting

confidence: 92%

Section: Quality Of Lifesupporting

confidence: 61%

Low Carb (LCD) and Ketogenic (KD) Diets Increase Quality of Life, Physical Performance, Body Composition and Metabolic Health of Women with Breast Cancer Better Than a Standard Diet (SD)

Kämmerer¹,

Klement²,

Sütterlin³

et al. 2020

Preprint

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“…We now have some evidence for beneficial effects of a KD on body composition in gynecological cancers [19,21], pancreatic cancer [23] and head and neck cancer patients [21]. We also have some evidence for synergistic effects between KDs and other therapies, in accordance with predictions from animal studies [2].…”

Section: Current State Of the Researchsupporting

confidence: 62%

“…However, more recently higher-quality clinical studies have been published. Table 1 gives an overview of the controlled clinical trials published to date and their endpoints [17][18][19][20][21][22].…”

Section: Current State Of the Researchmentioning

confidence: 99%

“…Finally, a randomized controlled trial in breast cancer patients receiving neoadjuvant chemotherapy found that a KD resulted in significantly longer overall survival compared to a control diet over a follow-up period of 30 months [22]. As a drawback, only some of these controlled studies have also been randomized, patient numbers were [18] 2018 HGG 17 15 Intranasal perillyl alcohol Yes Yes No Cohen [19] 2018 Ovarian, endometrial cancer 25 20 Chemotherapy (24% of the patients) No No Yes Furukawa [20] 2018 Rectal cancer 7 13 Chemotherapy No Yes No Klement [21] 2019 Breast, rectal, HNC 20 61 Radiotherapy ± chemotherapy No No Yes Khodabakhshi [22] 2019 Breast cancer 30 30 Chemotherapy Yes No Yes small, diets were not well described and ketosis not reached by all patients [6]. Some studies have also provided disappointing results.…”

Section: Current State Of the Researchmentioning

confidence: 99%

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Addressing the controversial role of ketogenic diets in cancer treatment

Klement

2020

Expert Review of Anticancer Therapy

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Plant-Based and Ketogenic Diets As Diverging Paths to Address Cancer

Shah

Iyengar

2022

JAMA Oncol

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ImportanceAs the incidence of cancer and metabolic disorders, such as obesity, concurrently rise, there has been increasing awareness of the pervasive effect of nutrition. The whole foods plant-based diet (WFPBD) and ketogenic diet (KD) have gained popularity in oncology, and this topic is increasingly permeating clinical dialogue.ObservationsDietary intake is associated with multiple pathways involved in carcinogenesis and tumor progression. Consumption of a plant-enriched diet is associated with reduced cancer incidence and is recommended by dietary guidelines for cancer prevention. Despite a starkly different nutrient composition, a WFPBD and KD can be associated with weight loss, decreased inflammation, and decreased insulin levels. In addition, a WFPBD is associated with increased fiber, phytochemicals, and butyrate levels and decreased insulin-like growth factor 1 levels, whereas a KD exerts potential anticancer effects by increasing β hydroxybutyrate levels. A KD may be of interest in select, less common settings, such as tumors treated with phosphatidylinositol 3-kinase inhibitors, which induce hyperinsulinemia and hyperglycemia. Completed interventional trials have focused on increasing fruit and vegetable intake or reducing fat intake but have not specifically tested WFPBD or KD for cancer prevention or treatment. Currently available data support plant-based diets as opposed to KD as part of a lifestyle associated with reduced cancer risk. In the postdiagnosis setting, there are currently no rigorously tested approaches that support the recommendation of any diet to treat cancer.Conclusions and RelevanceThe results of this review suggest that the collective evidence supports plant-enriched diets vs KD for the reduction of cancer risk and the improvement of metabolic disorders in survivors. Additional prospective randomized clinical trials are needed to encourage use of dietary modification across the cancer continuum. Rigorous trial designs that adapt classical oncologic end points may identify populations that are likely to benefit from starkly contrasting diets. Current data support prioritization of plant-based diets, and future data could further personalize dietary recommendations in cancer populations.

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A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer

Cited by 116 publications

References 54 publications

Low Carb (LCD) and Ketogenic (KD) Diets Increase Quality of Life, Physical Performance, Body Composition and Metabolic Health of Women with Breast Cancer Better Than a Standard Diet (SD)

Low Carb (LCD) and Ketogenic (KD) Diets Increase Quality of Life, Physical Performance, Body Composition and Metabolic Health of Women with Breast Cancer Better Than a Standard Diet (SD)

Addressing the controversial role of ketogenic diets in cancer treatment

Plant-Based and Ketogenic Diets As Diverging Paths to Address Cancer

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