Low Carb and Ketogenic Diets Increase Quality of Life, Physical Performance, Body Composition, and Metabolic Health of Women with Breast Cancer

Abstract

Breast cancer (BC) patients often ask for a healthy diet. Here, we investigated a healthy standard diet (SD), a low carb diet (LCD), and a ketogenic diet (KD) for BC patients during the rehabilitation phase. KOLIBRI was an open-label non-randomized one-site nutritional intervention trial, combining inpatient and outpatient phases for 20 weeks. Female BC patients (n = 152; mean age 51.7 years) could select their diet. Data collected were: Quality of life (QoL), spiroergometry, body composition, and blood parameters. In total 30, 92, and 30 patients started the KD, LCD, and SD, respectively. Of those, 20, 76, and 25 completed the final examination. Patients rated all diets as feasible in daily life. All groups enhanced QoL, body composition, and physical performance. LCD participants showed the most impressive improvement in QoL aspects. KD participants finished with a very good physical performance and muscle/fat ratio. Despite increased cholesterol levels, KD patients had the best triglyceride/high-density lipoprotein (HDL) ratio and homeostatic model assessment of insulin resistance index (HOMA-IR). Most metabolic parameters significantly improved in the LCD group. SD participants ended with remarkably low cholesterol levels but did not improve triglyceride/HDL or HOMA-IR. In conclusion, both well-defined KDs and LCDs are safe and beneficial for BC patients and can be recommended during the rehabilitation phase.

Associations between Dietary Patterns and Malnutrition, Low Muscle Mass and Sarcopenia in Adults with Cancer: A Scoping Review

“…The seven included studies were published between 2018 and 2021. Study designs included two randomised controlled trials [33,34], three non-randomised controlled trials [35][36][37] and two observational cross-sectional studies [38,39]. The number of participants ranged from 23 to 285, including adults aged between 52 to 74 years.…”

“…People with prostate, ovarian, endometrial, bladder, breast, and upper and lower gastrointestinal cancers were included. One study included treatment naive participants [38], two studies included people undergoing radiotherapy [35,37], one study included people during rehabilitation [36] and three studies included people who were diagnosed or treated between 2 to over 5 years prior to assessment [33,34,39].…”

“…Bioelectrical impedance analysis (BIA) was used for estimation of changes in fat-free mass (kg) [35,37] and dual energy X-ray absorptiometry (DXA) was used for estimation of changes in total body lean mass (kg) [33,34]. Changes in skeletal muscle mass (kg) were also estimated using measures derived from both BIA and DXA [35][36][37]. Computed tomography (CT) was used to derive a skeletal muscle index (SMI; skeletal muscle area [cm 2 ] divided by height squared [m 2 ]) at the third lumbar vertebrae (L3) [38,39].…”

“…Dietary intake was assessed via food frequency questionnaire (FFQ; Portuguesespecific semi-quantitative questionnaire and Diet History Questionnaire II) [38,39], food diaries [34][35][36][37] or one-month diet history (Wollongong Dietary Inventory) [33].…”

The Impact of a High-Carbohydrate/Low Fat vs. Low-Carbohydrate Diet on Performance and Body Composition in Physically Active Adults: A Cross-Over Controlled Trial

“…Furthermore, we did not perform gender-specific analyses as most participants within the intervention group and only one person of the control group was female. Finally, it must be considered that any kind of diet might be impacting psychological factors such as quality of life [ 36 ]; unfortunately, this outcome was not assessed in our study.…”