Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study

Khodabakhshi, Adeleh; Akbari, Mohammad Esmaeil; Mirzaei, Hamid Reza; Mehrad‐Majd, Hassan; Kalamian, Miriam; Davoodi, Sayed Hossein

doi:10.1080/01635581.2019.1650942

Cited by 94 publications

(98 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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: 60%

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

View full text Add to dashboard Cite

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

show abstract

Section: Quality Of Lifesupporting

confidence: 60%

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

View full text Add to dashboard Cite

show abstract

“…Rapamycin was selected for the current animal study because it a) has the potential to be a successful anti-cancer drug when administered at doses known to be normo-glycemic in mice b) it may yet have utility in humans and c) has been an FDA approved drug since 1999 [11]. The principle of combining a ketogenic diet with other forms of anti-cancer chemotherapies for widely metastatic disease has been reported to have additive effects in mice [12] [13] [14], as well as in limited human studies [4] [15] [16] [17]. As above, rapamycin is not expected to induce hyperglycemia in our mouse model and we wished to determine if a KD would exert its cytotoxic effects even in the absence of hyperglycemia.…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Ketogenic Diet and Synergy with Rapamycin in a Mouse Model of Breast Cancer

Zou

Fineberg

Pearlman

et al. 2020

Preprint

View full text Add to dashboard Cite

14 Background: The effects of diet in cancer, in general, and breast cancer in particular, 15 are not well understood. Insulin inhibition in ketogenic, high fat diets, modulate 16 downstream signaling molecules and are postulated to have therapeutic benefits.17 Obesity and diabetes have been associated with higher incidence of breast cancer.18 Addition of anti-cancer drugs together with diet is also not well studied.19 Methods: Two diets, one ketogenic, the other standard mouse chow, were tested in a 20 spontaneous breast cancer model in mice. The diets were implemented either with or 21 without added rapamycin, an mTOR inhibitor and potential anti-cancer drug.22 Results: Blood glucose and insulin concentrations in mice ingesting the ketogenic diet 23 (KD) were significantly lower, whereas beta hydroxybutyrate (BHB) levels were 24 significantly higher, respectively, than in mice on the standard diet (SD). Growth of 25 primary breast tumors and lung metastases were inhibited, and lifespans were longer in 26 the KD mice compared to mice on the SD (p<0.005). Rapamycin improved survival in 27 both mouse diet groups, but when combined with the KD was more effective than when 28 combined with the SD.29 Conclusions: The study provides proof of principle that a ketogenic diet a) results in 30 serum insulin reduction and ketosis in a spontaneous breast cancer mouse model; b) 31 can serve as a therapeutic anti-cancer agent; and c) can enhance the effects of 32 rapamycin, an anti-cancer drug, permitting dose reduction for comparable effect.33 Further, the ketogenic diet in this model produces superior cancer control than standard 34 mouse chow whether with or without added rapamycin. 36 Introduction 37Insulin inhibition by a ketogenic diet has been shown to slow cancer growth and 38 prolong survival in animal models and has shown safety and feasibility in small pilot 39 studies in humans [1], [2] [3] [4] . We previously demonstrated in a pilot study of ten 40 people with diverse, metastatic PET positive cancers that higher levels of ketosis 41 correlated with stability vs. disease progression [5]. The full potential of ketosis in 42 cancer therapy, however, may reside in its potential to synergize with anti-cancer drugs 43 and other modalities of treatment. Increased overall efficacy may permit lower drug 44 doses, thereby reducing their toxicities and side effects. Accordingly, it may be possible 45 that the overall improvement in therapy will result in extended survival with a better 46 quality of life. 47 An understanding of ketogenic diets (KD) in cancer is limited at this point but it 48 seems unlikely that KDs by themselves can control all the features of the oncogenic 49 state. There is much interest, therefore, in the possibility of synergy with other drugs or 50 other therapies. Hsieh, et al., for example, demonstrated that a squamous cell 51 carcinoma that over expressed GLUT1 receptors showed attenuated growth when 52 animals were on a KD [6]. There was, however, little regression of tumors. The addition 53 of th...

show abstract

“…Ketogenic metabolic therapy (KMT) is emerging as an effective complementary or alternative therapeutic strategy for managing a broad range of malignant cancers including breast cancer (151)(152)(153)(154)(155)(156)(157)(158)(159)(160). Calorie restriction and low-carbohydrate high-fat ketogenic diets (KD) reduce the glucose needed to propell the Warburg effect while also elevating ketone bodies (34).…”

Section: Ketogenic Metabolic Therapymentioning

confidence: 99%

Consideration of Ketogenic Metabolic Therapy as a Complementary or Alternative Approach for Managing Breast Cancer

et al. 2020

Self Cite

View full text Add to dashboard Cite

Breast cancer remains as a significant cause of morbidity and mortality in women. Ultrastructural and biochemical evidence from breast biopsy tissue and cancer cells shows mitochondrial abnormalities that are incompatible with energy production through oxidative phosphorylation (OxPhos). Consequently, breast cancer, like most cancers, will become more reliant on substrate level phosphorylation (fermentation) than on oxidative phosphorylation (OxPhos) for growth consistent with the mitochondrial metabolic theory of cancer. Glucose and glutamine are the prime fermentable fuels that underlie therapy resistance and drive breast cancer growth through substrate level phosphorylation (SLP) in both the cytoplasm (Warburg effect) and the mitochondria (Q-effect), respectively. Emerging evidence indicates that ketogenic metabolic therapy (KMT) can reduce glucose availability to tumor cells while simultaneously elevating ketone bodies, a non-fermentable metabolic fuel. It is suggested that KMT would be most effective when used together with glutamine targeting. Information is reviewed for suggesting how KMT could reduce systemic inflammation and target tumor cells without causing damage to normal cells. Implementation of KMT in the clinic could improve progression free and overall survival for patients with breast cancer.

show abstract

Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study

Cited by 94 publications

References 25 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)

The Effect of a Ketogenic Diet and Synergy with Rapamycin in a Mouse Model of Breast Cancer

Consideration of Ketogenic Metabolic Therapy as a Complementary or Alternative Approach for Managing Breast Cancer

Contact Info

Product

Resources

About