A Nutrition Perspective on the Ketogenic Diet as Therapy for Malignant Brain Cancer

Abstract

Glioblastoma multiforme is the most deadly primary brain tumor. Current therapies have not demonstrated improved outcomes for patients; generally the median life expectancy is 8-15 months. Due to brain tumor cells dependence on glucose as a sole energy source, there is potential to target treatments towards glucose metabolism. The ketogenic diet (KD) is a high fat, low carbohydrate diet that has proven successful in the animal model. However, human studies are limited and there currently is not enough research to conclude the KD is an effective therapy. A few aspects need to be addressed for inclusion in protocols of future studies: (1) when to initiate the KD during treatment; (2) how much carbohydrate per day to provide to patients; (3) how to ensure patient compliance to diet; (4) the optimum duration of the diet; (5) how to mitigating patient weight loss. In addition, the registered dietitian nutritionist (RD or RDN) is a vital, and underutilized, member of the health care team. The inclusion of a RD to future KD protocol, as well as oncology practices, can enhance patient outcomes and help future patients overcome barriers when adhering to the KD.