A Nutritional Perspective of Ketogenic Diet in Cancer: A Narrative Review

Oliveira, Camila L. P.; Mattingly, Stephanie J.; Schirrmacher, Ralf; Sawyer, Michael B.; Fine, Eugene J.; Prado, Carla M.

doi:10.1016/j.jand.2017.02.003

Cited by 55 publications

(34 citation statements)

References 75 publications

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“…First, the ketogenic ratio in this study was 1.05-1.75:1, which was different from the 4:1-3:1 ratio commonly reported in the literature. Furthermore, a previous study argued that a KD should be provided for at least three weeks in order to induce ketosis (11), but this study found an increase in urine ketone bodies within an average of two weeks or less. Moreover, ketone body analysis was qualitative, not quantitative in this study.…”

Section: Discussioncontrasting

confidence: 56%

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The Potential Use of a Ketogenic Diet in Pancreatobiliary Cancer Patients After Pancreatectomy

Lee

Chung

et al. 2018

Anticancer Res

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Background/Aim: High-carbohydrate diets are generally provided to post-pancreatectomy cancer patients. Low energy density of this diet may obstruct proper energy intake and recovery. This study aimed to assess the effects of high-fat, high-energy ketogenic diet (KD) in these patients. Patients and Methods: After pancreatectomy, 9 patients were provided with general diet (GD) while 10 were served KD. Meal compliance, energy intake rate, meal satisfaction and presence of complications were monitored throughout hospital stay. Data on nutritional status, serum lipids and body composition were collected and compared between groups. Results: Meal compliance, energy intake rate and meal satisfaction score were higher in KD. There were no differences in complications, nutritional status and serum lipids. The decrease in body cell mass (BCM) was greater in GD. Conclusion: Postpancreatectomy cancer patients who consumed KD had a higher energy intake and BCM. These results suggest the potential use of KD as an adjuvant anti-cancer therapy. Pancreatic cancer accounts for 2.4% of the cancer incidence worldwide and has a particularly poor prognosis, resulting in 4.0% mortality. Gallbladder cancer accounts for 1.3% of all cancers with a mortality of 1.7% (1). Pancreatic cancer in South Korea was the eighth most common at 3% and gallbladder and other biliary cancers were the ninth most common at 2.9% in 2015 which, with regard to mortality, were ranked fifth with a rate of 7.2% and sixth with a rate of 5.6%, respectively. The five-year relative survival rate of pancreatic cancer was the lowest of all cancers at 10.8% (2). Radical resection is the only method that can completely cure pancreatobiliary cancer, as complete tumor removal can considerably reduce the risk of cancer recurrence and increase patient survival rates (3, 4). However, patients who undergo pancreatectomy are more susceptible to malnourishment and weight loss due to complications such as pancreatic fistula, delayed gastric emptying, dumping syndrome, impaired digestive enzyme secretion, dysfunctional nutrient absorption, diarrhea, and steatorrhea (5). Furthermore, delayed or reduced food intake after surgery due to difficulty in consuming food can also induce weight loss. This weight loss may subsequently impact cancer cachexia caused by malignant tumors, malnutrition, and reduced quality of life (6, 7). Multiple studies have reported that cancer patients experience at least 10% of their total weight loss within six months after surgery due to cancer cachexia and that death caused by serious weight loss accounts for 80% of deaths caused by pancreatic cancer (8). According to a 2015 Korean study, 60% of patients who undergo pancreatoduodenectomy experience at least two factors that hinder food intake and subsequent weight loss, suggesting the need to improve the standard meals provided after pancreatectomy (9). Recently, ketogenic diets (KD) have gained traction as a potential adjuvant anticancer therapy for targeting specific metabolic reactions of cancer tissu...

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Section: Discussioncontrasting

confidence: 56%

“…that the restricted use of glucose during KD increases oxidative stress in cancer cells (11). Several clinical trials investigating the effects of KD in various cancer patients are currently being conducted.…”

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confidence: 99%

The Potential Use of a Ketogenic Diet in Pancreatobiliary Cancer Patients After Pancreatectomy

Lee

Chung

et al. 2018

Anticancer Res

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“…Most energy in a KD comes from fat with moderate protein intake and minimal carbs intake -one of the strictest ratios being 90 : 2 : 8 (Oliveira et al, 2017). Most common rule implies 20 to 50 grams of carbs daily (Noakes et al, 2017).…”

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confidence: 99%

“…Most common rule implies 20 to 50 grams of carbs daily (Noakes et al, 2017). This induces ketosis: the liver starts producing ketone bodies (KB) as a metabolite of fats, glucose levels settle down and its concentration normalizes; insulin levels decrease, plasma pH decreases slightly as well (Oliveira et al, 2017). KB become the predominant source of energy for central nervous system (Paoli et al, 2014), musculoskeletal system and the heart (Barbanti et al, 2017).…”

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confidence: 99%

“…KD surpasses the benefits of high carbohydrate diets (Chang et al, 2017), for example in cancer, diabetes, cardiovascular diseases (Bazzano et al, 2015), AD and multiple sclerosis (Erickson et al, 2017). It's efficient for weight loss (Yancy et al, 2010, Bueno et al, 2013, appetite regulation, glycaemic control (Volek et al, 2009), stabilisation of hyperinsulinemia, improving insulin sensitivity and normalizing blood lipid profiles (Chang et al, 2017, Noakes et al, 2017, Oliveira et al, 2017. KD has been studied as adjuvant therapy in brain neoplasms.…”

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confidence: 99%

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Ketogenic diet and its impact on mental processes of working population

Grom¹

2017

Zdravje Delovno Aktivne Populacije / Health of the Working-Age Population

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Introduction: Ketogenic diet has been evaluated for wide variety of conditions, although it was initially used for treatment of epilepsy. As alternative dietary pattern it can represent means of better quality of life, improved ability to work and can prevent against cognitive decline, different dementias and more serious forms of neurodegenerative diseases. Methods: This is a systematic review of available literature. Results: As energy substrates and as signaling agents, ketones are potentially usable in mitochondriopathies that come with aging and neurodegenerative diseases, or are a consequence of stroke, trauma. It has antioxidative, antiinflammatory and antiseizure properties, improves bioenergetics of the brain, neuronal plasticity and has epigenetic function. Discussion: Expansion of current nutritional knowledge might be a paradigmatic shift in understanding what is "healthy diet" in general or in terms of segments of population.

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