Does a ketogenic diet have beneficial effects on quality of life, physical activity or biomarkers in patients with breast cancer: a randomized controlled clinical trial

Abstract

Introduction: Despite recent interest in the use of ketogenic diets (KDs) for cancer, evidence of beneficial effects is lacking. This study examined the impact of a randomly assigned KD on quality of life, physical activity and biomarkers in patients with breast cancer. Method: A total of 80 patients with locally advanced or metastatic breast cancer and without a history of renal disease or diabetes were randomly assigned to either a KD or a control group for this 12-week trial. Concurrent with the first, third, and fifth chemotherapy sessions, quality of life, physical activity, and biomarkers (thyroid function tests, electrolytes, albumin, ammonia, ALP, lactate and serum ketones) were assessed. Dietary intake was also recorded on admission and the end of the treatment. Results: No significant differences were seen in quality of life or physical activity scores between the two groups after 12 weeks; however, the KD group showed higher global quality of life and physical activity scores compared to the control group at 6 weeks (P = 0.02 P = 0.01). Also, serum lactate and ALP levels decreased significantly in the KD group compared to the control group at the end of the intervention (10.7 ± 3 vs 13.3 ± 4, 149 ± 71 vs 240 ± 164, P = 0.02 and P = 0.007, respectively). A significant inverse association was observed between total carbohydrate intake and serum beta-hydroxybutyrate at 12 weeks (r = − 0.77 P < 0.001). No significant differences between groups were observed in thyroid hormones, electrolytes, albumin, LDH or ammonia. Compliance among KD subjects ranged from 66.7 to 79.2% as assessed by dietary intake and serum ketones levels of > 0.5.

Low Carb and Ketogenic Diets Increase Quality of Life, Physical Performance, Body Composition, and Metabolic Health of Women with Breast Cancer

“…Recently, the KETOCOMP study also showed various improvements in QoL parameters in women with early-stage breast cancer consuming a KD during radiotherapy [52]. However, a recent Iranian study showed that KD did not significantly improve QoL in more advanced breast cancer patients over a 12-week interval during chemotherapy [53]. Contrary to the patients in the KOLIBRI trial, which significantly reduced their fatigue score, the Iranian patients clearly increased in fatigue, presumably due to the chemotherapy, which might have counteracted the beneficial effects of a KD on QoL observed here.…”

“…Strengths of the study include the well-controlled dietary intervention, the uniform multimodal treatment of patients within the closed setting of the rehabilitation center, and a tight supervision in the outpatient phase by the study team (physician, dietitian, study nurse). Furthermore, the 20-week intervention ensured a profound adjustment of fuel utilization according to diet type and was longer than in typical comparable trials comprising at least 12 weeks of observational time only [53]. This resulted in measurements at T20 that were free of problems with metabolic adaption.…”

Implementation of a Low-Carbohydrate Diet Improves the Quality of Life of Cancer Patients – An Online Survey

“…Some worsened, reflecting their very advanced disease (10). In a recent study of 80 patients with locally advanced or metastatic breast cancer and randomly assigned either to a KD or a control group for 12 weeks, the KD group showed higher global QoL and physical activity scores compared to the control group (37). This is in agreement with our study cohort, where the majority of participants stated that they felt stronger through the diet: 28 participants had the impression that the diet had an influence on chemotherapy side effects, and 23 declared that the chemotherapy side effects improved because of the diet.…”

Is There any Possible Association Between Trimethylamine N-Oxide (TMAO) and Cancer? A Review Study

“…In previous articles, we discussed about glucose and glutamine restrictions along with the increase in non-fermentable ketones for cancer treatment [50][51][52][53]. It is suggested that TMAO Should be considered in dietary interventions for cancer prevention and treatment purposes.…”