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Literature Review: Ketogenic Diets and Cancer: Emerging Evidence

Updated: Feb 24

The research paper titled "Ketogenic Diets and Cancer: Emerging Evidence" explores the potential role of ketogenic diets (KDs) as an adjunct to traditional cancer therapies. Authored by Dr. Jocelyn Tan-Shalaby, the paper delves into the historical context, mechanisms of action, and current research findings related to the use of KDs in oncology.






Historical Context:

  • Early Observations: Fasting has been utilised since 500 BC to treat various medical conditions. In 1921, researchers observed that both fasting and high-fat, low-carbohydrate diets led to the production of ketone bodies (acetone and β-hydroxybutyrate) by the liver, providing alternative energy sources in the absence of glucose.

  • Development of the Ketogenic Diet: The term "ketogenic diet" was introduced by Wilder and Peterman, who established a dietary regimen consisting of 1 gram of protein per kilogram of body weight in children, 10 to 15 grams of carbohydrates daily, with the remaining caloric intake derived from fats. This diet was initially used to manage epilepsy and showed improvements in patients' cognitive functions.


Mechanisms of Action in Cancer Therapy:

  • Glucose and Insulin Dynamics: High carbohydrate intake stimulates pancreatic β cells to release insulin, facilitating glucose entry into cells for energy. Elevated insulin levels can promote cell growth and proliferation, processes that may be detrimental in cancer patients.

  • Ketogenic Diet's Impact: By significantly reducing carbohydrate intake, a KD lowers blood glucose levels and insulin secretion. This metabolic shift leads to the production of ketone bodies, which healthy cells can utilize for energy. In contrast, many cancer cells, due to mitochondrial dysfunction, are less efficient at using ketone bodies, potentially inhibiting their growth.


Current Research and Findings:

  • Preclinical Studies: Various in vitro and animal studies have demonstrated that KDs can reduce tumour growth and enhance the efficacy of standard cancer treatments.

  • Clinical Observations: While human data are still emerging, some case reports and small clinical trials suggest that combining a KD with conventional therapies may improve tumour responses and patient outcomes.


Considerations and Future Directions:

  • Individual Variability: The effectiveness of a KD may vary among individuals, depending on tumour type, genetic factors, and overall health status.

  • Need for Further Research: Comprehensive clinical trials are necessary to establish standardised guidelines, determine which patient populations may benefit most, and understand the long-term effects of KDs in cancer therapy.


In summary, the paper highlights the potential of ketogenic diets as a complementary approach in cancer treatment. By altering metabolic pathways, KDs may create an unfavourable environment for cancer cells while supporting the energy needs of healthy cells. However, more extensive research is required to fully elucidate their role and efficacy in oncology.



 

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