Keto diet

A Ketogenic diet, also known as a Keto Diet (KD) or a Low-Carb Diet, has been the topic of research for many years. It recommends a balanced combination of high fat, adequate protein and less/no carbohydrates to change the way energy is consumed in our body. A Keto Diet forces your body to use fat, instead of glucose, for its energy requirements. Hence, ketones are produced in higher quantity. Also, ketones preferred by the brain and have the ability to change the body’s metabolism – from glucose-burning to fat-burning.

The goal is to alter the metabolism of cancer cells and their associated stromal cells by decreasing glucose and increasing ketones as available energy sources. KD can be implemented either with calorie restriction or as an isocaloric diet, with no change in total calories from the patient’s previous diet.

While isocaloric KD may be somewhat beneficial, caloric restriction is considered an important component of an anticancer KD. Caloric restriction supports the body’s retention of ketones and also lowers caloric drivers of cancer growth pathways.

Ketogenic diets are medically regimented, high in fat, moderate in protein and low in carbohydrates. The goal of using KD in cancer is to reduce the energy production of cancer cells as well as tumor-associated stromal cells, thereby decreasing cancer growth and spread.

KD has been studied primarily in malignant glioblastoma. To date, few clinical trials using an isocaloric ketogenic diet as a therapy for cancer patients have been conducted. No clinical trials have been published to date on calorie-restricted KD.

Keto Diet and Cancer

Many Oncology clinicians are recommending Ketogenic diets to patients as a potential anti-cancer therapy. This diet has the potential to decrease glucose and increase ketones as available energy sources leading to an altered metabolism of cancer cells and the associated stromal cells. Here are some studies of Ketogenic Diet in Cancer:

• In animal studies, it was found that a Ketogenic diet reduced the growth of tumor and improved survival rates in the following types of cancer:
  • Malignant Glioma
  • Prostate Cancer
  • Colon Cancer
  • Gastrointestinal Cancer
• Human or Clinical Studies:
  • A Ketogenic diet was given to two female patients with advanced stage malignant Astrocytoma tumors. The results showed a promising potential.
  • A Ketogenic dietary trial was conducted across ten patients with advanced cancer for a period of 26-28 days. The extent of ketosis correlated with stable disease or partial remission.
  • 16 patients with advanced metastatic cancers and no conventional therapy options were advised to follow a Ketogenic diet. Many positive effects were observed in those who completed the diet.
  • In 2017, a systematic review was conducted evaluating the clinical evidence of Ketogenic diet on Cancer. The review highlighted some essential limitation of all clinical trials till date.
    • Most couldn’t evaluate the anti-tumor effects 
    • Small sample sizes and non-rigorous study designs make comparisons and conclusions very difficult.
    • No two studies followed the same dietary protocol.
    • In many studies, the patient’s diet was not supervised.
    • Intravenous infusions of the Ketogenic diet showed no significant difference in tumor growth among three groups

Key Points

• This therapeutic diet was designed to induce ketosis and deprive cancer and cancer-associated stromal cells of glucose for energy production.
• LHC’s interest in this therapy derives from preclinical animal studies and published case studies showing that a ketogenic diet may reduce tumor growth and improve survival.
• Limited human studies are available, most of which were not designed to measure effectiveness.
• Risk of nutrient deficiencies, unwanted weight loss and other potential side effects suggest using KD only under qualified medical supervision.
• Dietitian or qualified clinical nutritionist monitoring and support are suggested to improve adherence and outcomes.

Current Studies

As of October 2017, clinical trials are in progress using KD with the following cancers:

• Pancreatic cancer
• Head and neck cancer
• Non small-cell lung cancer
• Glioblastoma
• Breast cancer
• Prostate cancers
• General cancers
• Advanced cancers

For more details on these studies, see table 2 of Rationale, feasibility and acceptability of ketogenic diet for cancer treatment.

For the most current updates on clinical trials for KD and cancer, search ClinicalTrials.gov.

References & More Information

1. Credit: Beyond Conventional Care Therapies
2. ZenOnco.io Integrative Oncology Cancer Care
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19. BCCT: Beyond Conventional Cancer Therapies