From the Guidelines
The ketogenic diet is not recommended as a treatment for cancer due to the lack of clinical evidence and potential risks of malnutrition and micronutrient deficiency. The ESPEN guidelines on nutrition in cancer patients 1 emphasize the importance of avoiding dietary restrictions that may exacerbate malnutrition, and the ketogenic diet may lead to insufficient energy intake and weight loss due to its low palatability 1. While some laboratory and animal studies suggest that the ketogenic diet may have anti-tumor effects by depriving cancer cells of glucose 1, there are no clinical trials demonstrating a benefit of the ketogenic diet in cancer patients 1.
Some key points to consider when evaluating the use of the ketogenic diet in cancer treatment include:
- The diet's potential to restrict energy intake and lead to malnutrition, particularly in patients who are already malnourished 1
- The lack of clinical evidence supporting the use of the ketogenic diet as a treatment for cancer 1
- The potential for the diet to cause side effects such as fatigue, constipation, and nutrient deficiencies 1
- The importance of careful monitoring and close collaboration with an oncologist and dietitian experienced in ketogenic diets 1
It is essential to prioritize the patient's nutritional needs and overall health when considering any dietary interventions, and to avoid recommending diets that are not based on clinical evidence and may potentially be harmful 1. Instead, patients should focus on maintaining a balanced diet that meets their nutritional needs and supports their overall health and well-being.
From the Research
Research Overview
- The use of ketogenic diets in cancer patients has been studied in various research papers, with a focus on their potential anti-tumor effects, impact on quality of life, and adherence to the diet 2, 3, 4, 5, 6.
- Most studies have found that the evidence for the effectiveness of ketogenic diets in cancer patients is still lacking due to methodological limitations, heterogeneity, and low adherence to the diet 2, 3, 6.
Anti-Tumor Effects
- There is no conclusive evidence for anti-tumor effects or improved overall survival (OS) in cancer patients using ketogenic diets 2.
- Some studies suggest that ketogenic diets may have a therapeutic potential in cancer treatment, particularly when combined with pro-oxidative or targeted therapies initiated in early stages of the disease 4, 5.
- The ketogenic diet may sensitize cancer cells to standard therapy by utilizing the reprogrammed metabolism of cancer cells, making it a promising candidate for adjuvant cancer treatment 5.
Quality of Life and Adherence
- The majority of patients had significant weight loss and mild to moderate side effects when using ketogenic diets 2.
- Adherence to the diet was rather low in most studies, ranging from 23.5% to 100% 2, 6.
- Beneficial effects on body composition and quality of life have also been found in some studies 4.
Future Research Directions
- Thorough, well-designed randomized control trials are needed to elucidate the potential advantages of ketogenic diets in cancer care and survivorship 3.
- Future research should focus more on important clinical endpoints, such as progression-free and overall survival, and explore the potential of ketogenic diets as adjuvant treatments combined with standard therapies 4, 5.