Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial

Melanie Schmidt, Pfetzer Nadja, Schwab Micheal, Strauss Ingrid, Kämmerer, Kämmerer Ulrike

Description

Tumor patients exhibit an increased peripheral demand of fatty acids and protein. Contrarily, tumors utilize glucose as their main source of energy supply. Thus, a diet supplying the cancer patient with sufficient fat and protein for his demands while restricting the carbohydrates (CHO) tumors thrive on, could be a helpful strategy in improving the patients' situation. A ketogenic diet (KD) fulfills these requirements. Therefore, we performed a pilot study to investigate the feasibility of a KD and its influence on the quality of life of patients with advanced metastatic tumors. Methods Sixteen patients with advanced metastatic tumors and no conventional therapeutic options participated in the study. The patients were instructed to follow a KD (less than 70 g CHO per day) with normal groceries and were provided with a supply of food additives to mix a protein/fat shake to simplify the 3-month intervention period. Quality of life [assessed by EORTC QLQ-C30 (version 2)], serum and general health parameters were determined at baseline, after every two weeks of follow-up, or after drop out. The effect of dietary change on metabolism was monitored daily by measuring urinary ketone bodies. Results One patient did not tolerate the diet and dropped out within 3 days. Among those who tolerated the diet, two patients died early, one stopped after 2 weeks due to personal reasons, one felt unable to stick to the diet after 4 weeks, one stopped after 6 and two stopped after 7 and 8 weeks due to progress of the disease, one had to discontinue after 6 weeks to resume chemotherapy and five completed the 3 month intervention period. These five and the one who resumed chemotherapy after 6 weeks report an improved emotional functioning and less insomnia, while several other parameters of quality of life remained stable or worsened, reflecting their very advanced disease. Except for temporary constipation and fatigue, we found no severe adverse side effects, especially no changes in cholesterol or blood lipids. Conclusions These pilot data suggest that a KD is suitable for even advanced cancer patients. It has no severe side effects and might improve aspects of quality of life and blood parameters in some patients with advanced metastatic tumors.

Sujets

• Ketogenic diet
• Pilot experiment
• Quality of life

Informations

• Publié par: biomed
• Publié le: 01 janvier 2011
• Nombre de lectures: 9
• Langue: English

Extrait

Schmidtet al.Nutrition & Metabolism2011,8:54 http://www.nutritionandmetabolism.com/content/8/1/54

R E S E A R C HOpen Access Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial * Melanie Schmidt, Nadja Pfetzer, Micheal Schwab, Ingrid Strauss and Ulrike Kämmerer

Abstract Background:Tumor patients exhibit an increased peripheral demand of fatty acids and protein. Contrarily, tumors utilize glucose as their main source of energy supply. Thus, a diet supplying the cancer patient with sufficient fat and protein for his demands while restricting the carbohydrates (CHO) tumors thrive on, could be a helpful strategy in improving the patients’situation. A ketogenic diet (KD) fulfills these requirements. Therefore, we performed a pilot study to investigate the feasibility of a KD and its influence on the quality of life of patients with advanced metastatic tumors. Methods:Sixteen patients with advanced metastatic tumors and no conventional therapeutic options participated in the study. The patients were instructed to follow a KD (less than 70 g CHO per day) with normal groceries and were provided with a supply of food additives to mix a protein/fat shake to simplify the 3month intervention period. Quality of life [assessed by EORTC QLQC30 (version 2)], serum and general health parameters were determined at baseline, after every two weeks of followup, or after drop out. The effect of dietary change on metabolism was monitored daily by measuring urinary ketone bodies. Results:One patient did not tolerate the diet and dropped out within 3 days. Among those who tolerated the diet, two patients died early, one stopped after 2 weeks due to personal reasons, one felt unable to stick to the diet after 4 weeks, one stopped after 6 and two stopped after 7 and 8 weeks due to progress of the disease, one had to discontinue after 6 weeks to resume chemotherapy and five completed the 3 month intervention period. These five and the one who resumed chemotherapy after 6 weeks report an improved emotional functioning and less insomnia, while several other parameters of quality of life remained stable or worsened, reflecting their very advanced disease. Except for temporary constipation and fatigue, we found no severe adverse side effects, especially no changes in cholesterol or blood lipids. Conclusions:These pilot data suggest that a KD is suitable for even advanced cancer patients. It has no severe side effects and might improve aspects of quality of life and blood parameters in some patients with advanced metastatic tumors. Keywords:Ketogenic diet, cancer patients, pilot study, quality of life

Introduction In the recent past, a remarkable growing interest could be observed in scientific literature concerning the striking carbohydrate metabolism of tumor tissue. In contrast to normal tissues, which can metabolize glucose, fatty acids and ketone bodies, according to Warburg’s observations, many tumors depend heavily on glucose for their meta bolic demands and ferment it to lactate  even under

* Correspondence: [e-mail]wuerzburg.de Dept. Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef SchneiderStr. 4, D97080 Wuerzburg, Germany

sufficient oxygen supply [1,2]. For this purpose, tumor cells have a remarkable up regulation of glucose trans porter molecules on their surface. In addition, there is a frequent over expression of several key enzymes of glyco lysis and attached pathways [3,4]. This prominent change in metabolism and associated enzymes/receptors could provide attractive targets for tumorspecific therapies. Several substances such as specific drugs interfering with the Warburg effect are under investigation [57]. How ever, to date, no safe and established therapy is available that targets tumor metabolism to fight cancer.

© 2011 Schmidt et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.