From the Guidelines
For cancer treatment on a keto diet, maintaining stable ketosis is generally more important than temporary blood sugar fluctuations. The morning blood sugar rise you're experiencing is likely due to the dawn phenomenon, where your body naturally releases hormones like cortisol and growth hormone in the early morning, causing glucose release from the liver. To address this while maintaining therapeutic ketosis, consider eating your first meal later in the day after this natural rise subsides, or try a small protein-fat snack before bed to minimize the morning glucose spike.
Key Considerations
- Monitoring your ketone levels (aiming for 3-5 mmol/L for cancer therapy) is more crucial than occasional glucose variations, as supported by the ESPEN guidelines on nutrition in cancer patients 1.
- Some cancer patients find intermittent fasting helpful alongside keto, although the ESPEN guidelines recommend against all forms of diets that are not based on clinical evidence, have no proven efficacy, and that potentially could be harmful 1.
- Therapeutic ketosis for cancer is more stringent than dietary ketosis for other purposes, typically requiring keeping carbs under 20g daily, moderate protein (0.8-1.0g per kg of body weight), and high healthy fats (70-80% of calories), as suggested by the effects of fasting or fasting mimicking diets on wanted and unwanted effects of anticancer agents 1.
Important Recommendations
- Always work with your oncologist and a dietitian experienced in ketogenic therapy for cancer, as individual needs vary based on cancer type, treatment protocols, and personal metabolism.
- Be aware that due to their low palatability, ketogenic diets may lead to insufficient energy intake and weight loss, and patients with or at risk of malnutrition should be cautious when adopting such diets 1.
- The ESPEN guidelines recommend against dietary provisions that restrict energy intake in patients with or at risk of malnutrition, highlighting the importance of balancing nutritional needs with therapeutic goals 1.
From the Research
Importance of Strict Keto Limits and Blood Sugar Stability
When following a keto diet for cancer treatment, it's essential to consider both strict keto limits and blood sugar stability. The studies suggest that:
- Ketogenic diets have gained attention as a potential therapeutic approach to target the metabolic differences between normal and cancer cells 2, 3.
- The diet's effectiveness in cancer management may be influenced by various mechanisms, including the inhibition of glucose/insulin signaling, oxidative stress, mitochondrial metabolism, and inflammation 3.
- However, the clinical evidence for the effectiveness of ketogenic diets in cancer patients is still lacking due to the heterogeneity of studies and methodological limitations 4, 5.
Blood Sugar Stability and Ketosis
Regarding blood sugar stability and ketosis:
- Cancer cells predominantly use aerobic glycolysis for their metabolism, which can be targeted by dietary manipulation, such as a ketogenic diet 3.
- The ketogenic diet may impede cancer development and progression by restricting carbohydrate content and altering tumor metabolism and gene expression 6.
- However, the morning increase in blood sugar levels, even with low-carb intake, may temporarily kick the body out of ketosis, highlighting the importance of monitoring and managing blood sugar levels 2, 3.
Key Considerations
Key considerations for individuals following a keto diet for cancer treatment include:
- Receiving dietary counseling to avoid common mistakes and optimize compliance 2.
- Working with a qualified nutritionist to personalize the diet and reduce potential complications 3.
- Monitoring blood sugar levels and adjusting the diet as needed to maintain stability and ketosis.
- Being aware of the potential for weight loss and mild to moderate side effects, as well as the importance of adherence to the diet 4, 5.