KETOGENIC DIET & CANCER SURVIVAL

  

Simply avoid sugars and carbohydrates - healthy, clean eating.

Elevated circulating Ketones (referred to as Ketosis) is a significant catalyst towards immune modulation.

Prof Dominic D'Agostino - 'Advantages of a Ketogenic Diet for treating autoimmune illness'

Therapeutic ketosis can be used to treat a wide variety of neuropathologies linked pathophysiologically to metabolic dysregulation.

 * Cancer is characterized by metabolic dysregulation and is responsive to metabolic therapies that lower blood glucose and elevate blood ketonesCancer cells require glucose to survive and lack the ability to derive energy from ketones due to mitochondrial defects.

 ** Other areas of Ketogenic interest involve exploiting the anti-inflammatory and anticatabolic effects of metabolic therapies to prevent muscle wasting associated with aging, cancer and motor neuron diseases. Elevated circulating Ketones reduce neuronal hyper-excitability, oxidative stress and enhances brain metabolism.

For more information

Advantages of a Ketogenic Diet for treating autoimmune illness

Therapeutic ketosis can be used to treat a wide variety of neuropathologies linked pathophysiologically to metabolic dysregulation. Cancer is characterized by metabolic dysregulation and is responsive to metabolic therapies that lower blood glucose and elevate blood ketones.

  • Cancer cells require glucose to survive and lack the ability to derive energy from ketones due to mitochondrial defects.

  • Other areas of Ketogenic interest involve exploiting the anti-inflammatory and anticatabolic effects of metabolic therapies to prevent muscle wasting associated with aging, cancer and motorneuron diseases. Elevated circulating Ketones reduce neuronal hyper-excitability, oxidative stress and enhances brain metabolism.

Effects of Exogenous Ketone Supplementation On Blood Ketone, Glucose, Triglyceride and Lipoprotein Levels

Emerging evidence supports the therapeutic potential of the ketogenic diet (KD) for a variety of disease states, leading investigators to research methods of harnessing the benefits of nutritional ketosis without the dietary restrictions.

  • The KD has been used as an effective non-pharmacological therapy for pediatric intractable seizures since the 1920s [13].

  • In addition to epilepsy, the ketogenic diet has elicited significant therapeutic effects for weight loss and type-2 diabetes (T2D) [4].

  • Several studies have shown significant weight loss on a high fat, low carbohydrate diet without significant elevations of serum cholesterol [512].

  • Another study demonstrated the safety and benefits of long-term application of the KD in T2D patients. Patients exhibited significant weight loss, reduction of blood glucose, and improvement of lipid markers after eating a well-formulated KD for 56 weeks [13].

  • Recently, researchers have begun to investigate the use of the KD as a treatment for acne, polycystic ovary syndrome (PCOS), cancer, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI) and Alzheimer’s disease (AD) with promising preliminary results [1426]

  • Conclusions: Several studies have investigated the safety and efficacy of ketone supplements for disease states such as AD and Parkinson’s disease, and well as for parenteral nutrition [40, 48–50, 100–103]. Our research demonstrates that several forms of dietary ketone supplementation can effectively elevate blood ketone levels and achieve deleted: therapeutic nutritional ketosis without the need for dietary carbohydrate restriction. We also demonstrated that ketosis achieved with exogenous ketone supplementation can reduce blood glucose, and this is inversely associated with the blood ketone levels

Dominic D'Agostino PhD

Assistant Professor University of South Florida

https://dominicdagostino.wordpress.com/

  • "Our laboratory develops and tests metabolic therapies, including calorie restriction, ketogenic diets and ketogenic agents for CNS oxygen toxicity (seizures), epilepsy, metabolic disorders, Alzheimer's disease, ALS, muscle wasting and cancer. To investigate the mechanism of these pathologies we use a variety of in vivo and in vitro techniques, including radio-telemetry (EEG, EMG), electrophysiology, fluorescence microscopy, confocal microscopy, atomic force microscopy (AFM), biochemical assays, in vivo bioluminescence imaging, behavioral testing and exercise performance.

  • We have adapted many of these techniques for use inside hyperbaric chambers, which allows us to manipulate oxygen concentrations (from hypoxia to hyperbaric oxygen). Our current project is to identify physiological and cellular mechanisms of seizures and impaired brain metabolism. Our efforts have focused specifically on measuring brain EEG, neuronal excitability, reactive oxygen species (ROS) production and biomarkers of oxidative stress.

  • Recently we have been interested in understanding the anticonvulsant and neuroprotective mechanism of the ketogenic diet, ketone esters and other ketogenic agents.

  • Ketones reduce neuronal hyper-excitability, oxidative stress and enhances brain metabolism. Therapeutic ketosis can be used to treat a wide variety of neuropathologies linked pathophysiologically to metabolic dysregulation. Cancer is characterized by metabolic dysregulation and is responsive to metabolic therapies that lower blood glucose and elevate blood ketones.

  • Cancer cells require glucose to survive and lack the ability to derive energy from ketones due to mitochondrial defects. Other areas of interest involve exploiting the anti-inflammatory and anti-catabolic effects of metabolic therapies to prevent muscle wasting associated with aging, cancer and motor neuron diseases."

Ketones & MCT Oil Concept Is NOT New

J Am Coll Nutr. 1995 Apr;14(2):202-8.

Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports

Nebeling LC1, Miraldi F, Shurin SB, Lerner E.

Author information

  • 1Nutrition Department, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.

Abstract

OBJECTIVE:

Establish dietary-induced ketosis in pediatric oncology patients to determine if a ketogenic state would decrease glucose availability to certain tumors, thereby potentially impairing tumor metabolism without adversely affecting the patient's overall nutritional status.

DESIGN:

Case report.

SETTING:

University Hospitals of Cleveland.

SUBJECTS:

Two female pediatric patients with advanced stage malignant Astrocytoma tumors.

INTERVENTIONS:

Patients were followed as outpatients for 8 weeks. Ketosis was maintained by consuming a 60% medium chain triglyceride oil-based diet.

MAIN OUTCOME MEASURES:

Tumor glucose metabolism was assessed by Positron Emission Tomography (PET), comparing [Fluorine-18] 2-deoxy-2-fluoro-D-glucose (FDG) uptake at the tumor site before and following the trial period.

RESULTS:

Within 7 days of initiating the ketogenic diet, blood glucose levels declined to low-normal levels and blood ketones were elevated twenty to thirty fold.

  • Results of PET scans indicated a 21.8% average decrease in glucose uptake at the tumor site in both subjects. One patient exhibited significant clinical improvements in mood and new skill development during the study. She continued the ketogenic diet for an additional twelve months, remaining free of disease progression.

 

CONCLUSION:

While this diet does not replace conventional antineoplastic treatments, these preliminary results suggest a potential for clinical application which merits further research.

Clinical Trials

Ketogenic Diet as Adjunctive Treatment in Refractory/End-stage Glioblastoma Multiforme: a Pilot Study

  • Glioblastoma Multiforme. Intervention: Other: ketogenic diet

  • Malignant gliomas are the most common type of brain tumor in adults. They are the second leading cause of cancer mortality in people under the age of 35 and the fourth leading cause in those under the age of 54. Standard therapy for glioblastoma multiforme (GBM) includes surgery followed by radiation and chemotherapy. Despite optimal treatment the prognosis remains poor. Patients with GBM have a median survival of approximately 10-15 months. Essentially all patients suffer recurrent disease, usually within 8 months of diagnosis. For patients with malignant glioma whose tumors recur, the median time to tumor progression is 9-13 weeks with the current standard of treatment for recurrent glioblastoma, bevacizumab (AVASTIN®). There is an urgent need for more effective therapies.

  • GBM cancer cells depend on glucose for energy supply and survival. When glucose levels are reduced, normal brain cells metabolize ketone bodies for energy. Brain tumor cells cannot do so. This makes the tumor cells vulnerable to death using therapies that target glucose metabolism.

  • In brain cancer patients, high blood glucose levels are associated with reduced survival.

  • In mice, reduction in circulating glucose levels through ketogenic diet (KD) reduces tumor growth.

  • Ketogenic diet (KD) reduces blood glucose levels while elevating levels of ketone bodies, and may thus be beneficial in the treatment of GBM as a non-toxic metabolic therapy. KD is a high fat, low carbohydrate diet used for treatment of refractory seizures. There have been two case reports of KD use in patients with GBM showing slowing of tumor progression.

  • Ketogenic diet (KD) is a high fat, low protein, low carbohydrate diet that is an effective treatment of refractory epilepsy in children. The diet consists of long chain saturated triglycerides with a 3:1 or 4:1 [fat] : [protein + carbohydrate] ratio by weight, with 87-90% of calories derived from fat. The investigators have recently evaluated KD with caloric restriction of 1600 kcal /day in adults with refractory epilepsy. The diet was well tolerated. Side effects included mild nausea (n=2), mild diarrhea (n= 2), and mild constipation (n=2). No subjects stopped treatment because of side effects. Mild transient hunger was experienced by 3 subjects but there was no clinically significant hunger.

  • The goal of the present study is to evaluate efficacy, safety and tolerability of 4:1 KD in a small number of patients with GBM progressing or recurring after standard treatment of surgery, radiation and chemotherapy with temozolamide and, after further rescue threrapy with bevacizumab (AVASTIN®), as the first step in evaluation of therapeutic potential of KD in the treatment of GBM.

  • This will be a small, open label pilot study. 6 patients with GBM recurring or progressing after surgery, radiation and chemotherapy (temazolamide) and after further rescue treatment with bevacizumab will be treated with 4:1 [fat]:[protein+carbohydrate] ratio, 1600 kcal/day diet. Survival, time to steroid rescue treatment and progression free survival will be compared to historical controls with life expectancy of ≤ 3 months.

  • The diet (KD) will consist of pre-made meals, including breakfast, lunch, dinner and two snacks, one each between breakfast and lunch and lunch and dinner, with a 2 week-long meal plan consisting of different recipes for each day of the month, with repeating 2-week-long cycles. The diet will be supplemented with vitamins, calcium and phosphorus supplements to meet the requirements of US Dietary Reference Intakes (DRI) standard. Treatment will last 6 months.

  • Primary aims of the study will be to (1) obtain pilot data on efficacy of ketogenic diet as adjunctive treatment of treatment-refractory glioblastoma multiforme, (2) evaluate the safety of ketogenic diet as adjunctive treatment of treatment-refractory glioblastoma multiforme, and (3) evaluate tolerability of ketogenic diet as adjunctive treatment of treatment-refractory glioblastoma multiforme.

  • Participants will be evaluated in face-to face visit during weeks 1, 2 and 4 of the study, then monthly. Primary outcome measures will include (a) survival time and (b) time to dexamethasone rescue therapy for cerebral edema, determined by treating physician, and (c) adverse events. Secondary outcome measures will include MRI progression, treatment compliance, hunger scale scores, fasting serum glucose and BOH levels.

Ketogenic Diet vs.Antiepileptic Drug Treatment in Drug Resistant Epilepsy

Conditions: Epilepsy;   Mental Retardation

Interventions: Dietary Supplement: Ketogenic diet;   Drug: Antiepileptic drug (AED)

Ketogenic Diet Treatment of Obesity With Co-morbid Type 2 Diabetes Mellitus and/or Obstructive Sleep Apnea

Conditions: Obesity;   Diabetes;   Obstructive Sleep Apnea

Interventions: Other: Ketogenic diet;   Drug: Orlistat;   Other: Standardized diet

Ketogenic Diet in Infants With Epilepsy (KIWE)

Condition: Epilepsy

Interventions: Other: Ketogenic diet;   Drug: Antiepileptic drug therapy

Ketogenic Diet With Radiation and Chemotherapy for Newly Diagnosed Glioblastoma

Condition: Glioblastoma (GBM)

Interventions: Dietary Supplement: Ketogenic Diet;   Radiation: Radiation therapy;   Drug: Temozolomide

Ketogenic Diet for Refractory Status Epilepticus

Conditions: Status Epilepticus;   Seizure;   Epilepsy;   Refractory Status Epilepticus;   Medically Resistant Status Epilepticus

Intervention: Dietary Supplement: Ketogenic diet

Calorie-restricted, Ketogenic Diet and Transient Fasting During Reirradiation for Patients With Recurrent Glioblastoma

Condition: Recurrent Glioblastoma

Interventions: Dietary Supplement: calorie-restricted ketogenic diet and transient fasting;   Dietary Supplement: standard nutrition

Efficacy and Safety of Ketogenic Diet as Adjunctive Treatment in Adults With Refractory Epilepsy

Condition: Epilepsy

Intervention: Other: ketogenic diet

The Ketogenic Diet for Pediatric Acute Brain Injury

Condition: Acute Brain Injuries

Intervention: Dietary Supplement: Ketogenic diet

Efficacy of Modified Atkins Diet Versus Ketogenic Diet in Children With Refractory Epilepsy Aged 1 Year to 18 Years: A Randomized Controlled Trial

Condition: Ketogenic Diet, Modified Atkin's Diet, Refractory Epilepsy

Interventions: Other: Ketogenic diet (2.5 to 4:1);   Other: Modified Atkin's diet

Ketogenic Diet for Recurrent Glioblastoma

Condition: Recurrent Glioblastoma

Intervention: Dietary Supplement: TAVARLIN

Ketogenic Diet Phase 1 for Head & Neck Cancer

Condition: Head and Neck Neoplasms

Intervention: Dietary Supplement: Ketogenic diet

Ketogenic Diet With Chemoradiation for Lung Cancer (KETOLUNG)

Condition: Carcinoma, Non-Small-Cell Lung

Intervention: Dietary Supplement: Ketogenic diet

Ketogenic Diet With Concurrent Chemoradiation for Pancreatic Cancer

Condition: Pancreatic Neoplasms

Intervention: Dietary Supplement: Ketogenic diet

Effects of a Ketogenic Diet on Acute Stroke

Condition: Acute Stroke

Interventions: Dietary Supplement: Ketocal 4:1 (Nutricia);   Dietary Supplement: Control diet: Regular diet offered at the hospitals;   Dietary Supplement: Ketogenic meals

Evaluating Dietary Intervention Before surgicaL Treatment for Epilepsy

Condition: Cortical Dysplasia

Intervention: Dietary Supplement: Classical ketogenic diet

A Low-Carbohydrate, Ketogenic Diet Versus Orlistat for Weight Loss

Conditions: Diabetes Mellitus;   Obesity

Interventions: Behavioral: Low carbohydrate ketogenic diet;   Drug: Orlistat;   Behavioral: Low-fat diet

The Effect of Ketogenic Diet on Malignant Tumors- Recurrence and Progress

Condition: Malignant Tumors

Interventions: Other: Nutritional support with Standard diet;   Other: Nutritional intervention with the Ketogenic diet

RCT of the Efficacy of the Ketogenic Diet in the Treatment of Epilepsy

Condition: Epilepsy

Intervention: Dietary Supplement: Ketogenic  diet

Safety and Tolerability of the Ketogenic Diet in Amyotrophic Lateral Sclerosis (ALS)

Condition: Amyotrophic Lateral Sclerosis

Intervention: Dietary Supplement: KetoCal

Ketogenic Diet for Child Epilepsy and Seizure Control

Conditions: Epilepsy;   Seizures;   Lennox-Gastaut Syndrome

Intervention: Behavioral: Ketogenic diet

Pilot Study of a Metabolic Nutritional Therapy for the Management of Primary Brain Tumors

Condition: Glioblastoma

Intervention: Dietary Supplement: Energy restricted Ketogenic Diet (ERKD) (Metabolic Nutritional Therapy)

Ketogenic Or LOGI Diet In a Breast Cancer Rehabilitation Intervention (KOLIBRI)

Condition: Quality of Life

Interventions: Other: Standard diet (SD);   Other: Experimental 1: Ketogenic diet (KD).;   Other: Experimental 2: "Low glycämic and insulinemic" diet (LOGI)

Effects of Dietary Manipulation on Metabolism in Healthy Adults

Conditions: Metabolic Regulation;   Fasting;   Ketogenic Diet

Interventions: Behavioral: Dietary manipulation ketogenic diet;   Behavioral: Dietary Manipulation - 12 day ketogenic diet;   Behavioral: 16 Hour Fast

Synergistic Enteral Regimen for Treatment of the Gangliosidoses

Conditions: GM1 Gangliosidoses;   GM2 Gangliosidoses;   Tay-Sachs Disease;   Sandhoff Disease

Interventions: Drug: miglustat;   Behavioral: Ketogenic Diet

A Taste and Acceptance Study of FruitiVits in Children Aged 4-8 Years Following a Ketogenic Diet.

Condition: Seizure Disorders

Intervention: Dietary Supplement: FruitiVits

Short-term Ketogenic Diet as Compared With Conventional Long-term Trial in Refractory Infantile Spasms: A Randomized, Controlled Study

Condition: Infantile Spasms

Intervention:  

Ketogenic Diet in Lafora Disease

Condition: Lafora Disease

Intervention:  

Diet, Imaging and Energy Balance Trial (DIET)

Condition: Obesity

Interventions: Behavioral: Low Carbohydrate Ketogenic Diet (LCKD);   Behavioral: Low Fat Diet (LFD)

Prospective Study of Comparison Between the Modified Atkins Diet and Classic Ketogenic Diet for Intractable Childhood Epilepsy

Condition: Epilepsy

Intervention:  

Ketogenic Diets for Symptoms of Parkinson's Disease

Condition: Parkinson's Disease

Interventions: Dietary Supplement: Ketone ester drink;   Dietary Supplement: Placebo (carbohydrate containing) drink

Study of the Effect of a Very-Low-Carbohydrate Diet on Energy Expenditure

Conditions: Obesity;   Appetite

Intervention:  

Effects of a Ketogenic Diet on Body Weight and Cardiovascular Risk Factors

Condition: Obesity

Intervention: Behavioral: Clinical diet trial

Efficacy of Modified Ketogenic Diet (Atkins) in Management of Epilepsy

Condition: Epilepsy

Interventions: Behavioral: atkins diet;   Behavioral: ability to follow low carbohydrate diet

A Pilot Study to Determine the Efficacy of a Low Carbohydrate Diet in Treatment of Adolescents With Metabolic Syndrome

Conditions: Elevated Triglycerides;   Systolic Hypertension;   Insulin Resistance;   Abdominal Obesity

Interventions: Dietary Supplement: standard ADA diet;   Dietary Supplement: energy restricted very-low carbohydrate diet;   Dietary Supplement: low glycemic diet

Ketogenic Diet in Advanced Cancer

Condition: Cancer

Intervention:  

Lifestyle Modification for Obesity-Related Type 2 Diabetes

Conditions: Type 2 Diabetes Mellitus;   Overweight;   Obesity

Interventions: Behavioral: Low carbohydrate, ketogenic diet;   Behavioral: Low glycemic index, reduced calorie diet

Wahls Paleo Diet and Progressive Multiple Sclerosis

Condition: Multiple Sclerosis

Interventions: Other: Wahls Paleo Plus;   Other: Wahls Diet

Modified Atkins Diet in Children and Adolescents With Drug-resistant Epilepsy

Condition: Epilepsy

Intervention: Other: The Modified Atkins Diet

Ketogenic Therapy Effects on Electrical and Metabolic Abnormalities in Epilepsy

Condition: Seizures

Intervention: Dietary Supplement: Ketogenic Therapy

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