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
- 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.
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
- 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
- Credit: Beyond Conventional Care Therapies
- ZenOnco.io Integrative Oncology Cancer Care
- Wikipedia. Ketogenic Diet. Viewed on October 1, 2018.
- Maurer GD, Brucker DP et al. Differential utilization of ketone bodies by neurons and glioma cell lines: a rationale for ketogenic diet as experimental glioma therapy. BMC Cancer. 2011 Jul 26;11:315.
- Seyfried TN, Sanderson TM, El-Abbadi MM, McGowan R, Mukherjee P. Role of glucose and ketone bodies in the metabolic control of experimental brain cancer. British Journal of Cancer 2003;89:1375–82.
- Stafford P, Abdelwahab MG, Kim DY, Preul MC, Rho JM, Scheck AC. The ketogenic diet reverses gene expression patterns and reduces reactive oxygen species levels when used as an adjuvant therapy for glioma. Nutrition & Metabolism (Lond). 2010 Sep 10;7:74.
- Freedland SJ, Mavropoulos J et al. Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis. Prostate. 2008 Jan 1;68:11–9.
- Masko EM, Thomas JA et al. Low-carbohydrate diets and prostate cancer: how low is “low enough”? Cancer Prevention Research (Philadelphia, Pennsylvania). 2010 Sep;3(9):1124-31.
- Beck SA, Tisdale MJ. Nitrogen excretion in cancer cachexia and its modification by a high fat diet in mice. Cancer Research. 1989 Jul 15;49:3800–4.
- Otto C, Kaemmerer U et al. Growth of human gastric cancer cells in nude mice is delayed by a ketogenic diet supplemented with omega-3 fatty acids and medium-chain triglycerides. BMC Cancer 2008;8:122.
- Nebeling LC, Miraldi F, Shurin SB, Lerner E. Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports. Journal of the American College of Nutrition. 1995 Apr;14(2):202-8.
- Fine EJ, Segal-Isaacson CJ et al. Targeting insulin inhibition as a metabolic therapy in advanced cancer: a pilot safety and feasibility dietary trial in 10 patients. Nutrition. 2012 Oct;28(10):1028–35.
- Schmidt M, Pfetzer N, Schwab M, Strauss I, Kammerer U. Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: a pilot trial. Nutrition & Metabolism. 2011 July 27;8(1):54.
- Erickson N, Boscheri A, Linke B, Huebner J. Systematic review: isocaloric ketogenic dietary regimes for cancer patients. Medical Oncology. 2017 May;34(5):72.
- Chung HY, Park YK. Rationale, feasibility and acceptability of ketogenic diet for cancer treatment. Journal of Cancer Prevention. 2017 Sep;22(3):127-134.
- Five to Thrive Live: Keto for Cancer
- Kalamian M. Keto for Cancer. Vermont: Chelsea Green Publishing. 2017.
- Winters N, Kelley JH. The Metabolic Approach to Cancer: Integrating Deep Nutrition, the Ketogenic Diet, and Nontoxic Bio-Individualized Therapies. Vermont: Chelsea Green Publishing. 2017.
- BCCT: Beyond Conventional Cancer Therapies