A ketogenic diet is a high fat, moderate to low protein, very low carbohydrate diet — approximately 90%, 8%, 2% of total daily calories, respectively. Ketone bodies are derived from fatty acids in the liver and are produced to compensate for glucose depletion during periods of food restriction (Meidenbaurer et al., 2015).
Fasting, which induces a state of ketosis has shown to enhance the effectiveness of chemotherapy. Therefore, ketogenic diets have been used for brain cancer management. Tumor cells depend on glucose, which derives from carbohydrates. When the body is deprived of carbohydrates, the body is forced to burn fat, instead of glucose for energy production (Allen et al., 2014). However, tumor cells, unlike normal brain cells, have mitochondrial defects which prevent the body from successfully using ketone bodies for energy when glucose is limited (Meidenbaurer et al., 2015).
According to the research of Allen et al. (2014), there are over 60 trials assessing low carbohydrate diets as a potential therapy for a variety of diseases and conditions. Preliminary reports of cancer patients on a ketogenic diet have shown improved physical conditions, tumor shrinkage and/or slowed tumor growth, over a 3-month time period.
Poff et al. (2016) demonstrated the combination of a ketogenic diet with hyperbaric oxygen therapy (HBO2T), which involves breathing high pressure oxygen, to slow the progression of tumor growth. Tumors create hypoxic, or oxygen deprived, pockets, which promote cancer cell growth. HBO2T reverses this by saturating tumors with oxygen.
Xu & Cao (2016) found growth repression and apoptosis of cancer cells in the presence of musk ketone. “Musk is used to treat bacterial, anti-inflammatory, immunity-enhancing, and gas heavy diseases,” (Xu & Cao, 2016). Their findings also suggest that musk ketone can upregulate Interleukin-24 (IL-24) and DNA Damage Inducible Transcript 3 (DDIT3) in lung cancer cells. IL-24 has shown to be toxic to cancer cells and DDIT3 has shown to increase apoptosis and block the progression of cancer cells.
Ketogenic diets have also been used to treat epilepsy and childhood seizures. Evidence has shown benefits of ketogenic diets for patients with Alzheimer’s Disease or Parkinson’s Disease. Additionally, there are studies showing improvement in patients with autism, depression, polycystic ovary syndrome, and type 2 diabetes (Allen et al., 2014).
The most well known ketogenic diet is known as the Atkins diet. This diet calls for 3-4 servings of 6-ounce protein per day and 3 servings of healthy fats per day. Depending on which diet plan you select, you can either limit your carbohydrates to 20 grams (Atkins20) or 40 grams (Atkins40), minus your fiber intake. The Atkins20 limits carbohydrate intake and suggests starchy vegetables as the primary source of carbohydrates. The Atkins40 is less restrictive and allows dieters to consume all food groups. Successful dieters have decreased fat stores, reduced appetite and hunger, and a steady sugar level. The science behind this diet parallels the mechanism behind a ketogenic state. When glucose is limited, the body is forced to use fat as energy, decreasing the total amount of fat stores in the body.
However, with every method of treatment, comes certain risks. Ketogenic diets have acute and chronic risks. Acute risks include GI discomfort, nausea and vomiting, lethargy, elevated blood ketones, hypoglycemia, and deficiency in trace minerals. Chronic risks include increased LDL cholesterol, bone mineral loss, kidney stones, decreased IFG-1, and renal damage (Allen et al., 2014). With that being said, it is important to consider these risks when determining whether or not a ketogenic diet is a good fit for you, and your dietary goals.
For more information, follow the links below:
Poff, A. M., Ward, N., Seyfried, T. N., Arnold, P., & D’Agostino, D. P. (2015). Non-toxic metabolic management of metastatic cancer in VM mice: Novel combination of ketogenic diet, ketone supplementation, and hyperbaric oxygen therapy: E0127407. PLoS One, 10(6) doi:10.1371/journal.pone.
Xu, L., & Cao, Y. (2016). Native musk and synthetic musk ketone strongly induced the growth repression and the apoptosis of cancer cells. BMC Complementary and Alternative Medicine, 16(1) doi:10.1186/s12906-016-1493-2
Meidenbauer, J. J., Mukherjee, P., & Seyfried, T. N. (2015). The glucose ketone index calculator: A simple tool to monitor therapeutic efficacy for metabolic management of brain cancer. Nutrition & Metabolism, 12(1), 12-12. doi:10.1186/s12986-015-0009-2
Researchers develop novel ketone supplements to enhance non-toxic cancer therapy. (2015). Health & Medicine Week, 859.
Allen, B. G., Bhatia, S. K., Anderson, C. M., Eichenberger-Gilmore, J. M., Sibenaller, Z. A., Mapuskar, K. A., … Fath, M. A. (2014). Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism. Redox Biology, 2, 963–970.http://doi.org/10.1016/j.
Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University