Favorable Effects of a Ketogenic Diet on Physical Function, Perceived Energy, and Food Cravings in Women with Ovarian or Endometrial Cancer: A Randomized, Controlled Trial

Abstract

Ketogenic diets (KDs) are gaining attention as a potential adjuvant therapy for cancer, but data are limited for KDs’ effects on quality of life. We hypothesized that the KD would (1) improve mental and physical function, including energy levels, (2) reduce hunger, and (3) diminish sweet and starchy food cravings in women with ovarian or endometrial cancer. Participants were randomized to a KD (70:25:5 energy from fat, protein, and carbohydrate) or the American Cancer Society diet (ACS: high-fiber, lower-fat). Questionnaires were administered at baseline and after 12 weeks on the assigned diet to assess changes in mental and physical health, perceived energy, appetite, and food cravings. We assessed both between-group differences and within-group changes using ANCOVA and paired t-tests, respectively. After 12 weeks, there was a significant between-group difference in adjusted physical function scores (p < 0.05), and KD participants not receiving chemotherapy reported a significant within-group reduction in fatigue (p < 0.05). There were no significant between-group differences in mental function, hunger, or appetite. There was a significant between-group difference in adjusted cravings for starchy foods and fast food fats at 12 weeks (p < 0.05 for both), with the KD group demonstrating less frequent cravings than the ACS. In conclusion, in women with ovarian or endometrial cancer, a KD does not negatively affect quality of life and in fact may improve physical function, increase energy, and diminish specific food cravings. This trial was registered at as NCT03171506.

Low Carb (LCD) and Ketogenic (KD) Diets Increase Quality of Life, Physical Performance, Body Composition and Metabolic Health of Women with Breast Cancer Better Than a Standard Diet (SD)

“…Based on the known metabolic situation in cancer patients, we expect both the KD and the LCD to better account for the metabolic alterations compared to the SD regimen recommended thus far. In addition, the KD was reported to be safe for cancer patients in several clinical settings [27,35,41] and to improve overall survival in a group of breast cancer patients compared to a SD [42]. Thus, our work provides further evidence supporting the safety and bene ts of this dietary approach for BC patients.…”

“…While fatigue and insomnia scores remained stable in the LCD and SD groups, they further improved in the KD group to T20, almost reaching the reference values of healthy age-matched adults. This remarkable reduction in fatigue was also seen in other cancer patients eating a KD [35] Blood/serum Although evidence exists that fat-rich diets do improve rather than worsen cardiovascular risk factors and especially increase HDL and decrease triglycerides [17,36,37] some oncologists fear that such diets have a detrimental effect on blood lipid pro les and liver-and kidney function. Here, a remarkable positive effect of the LCD on nearly all parameters could be observed -a signi cant improvement in lipid pro le and optimization of the liver pro le and kidney function parameters.…”

“…However, in parallel to the increase in physical performance, the KD group had the best physical functioning value, reaching the mean value of healthy persons published as the "reference scale" [34]. This positive effect of KD on physical functioning was also seen in women with endometrial and ovarian cancer [35] highlighting this important aspect as general.…”

The position of low carb diet in the cancer adjuvant therapy: Clinical nutrition with low carb diet in cancer patients

“…However, in cancer patients more benefits than harms have been detected, eg. no negative influence on the quality of life has been observed in a 12 week randomized, controlled trial with 45 ovarian and endometrial cancer patients on KD [10]. One other example of the use of LCD is the study of Fine and coworkers [11].…”

Significance of calorie-restricted ketogenic diet for lung cancer with brain metastases and hepatoma with pulmonary metastases: report of two cases

“…Most of the clinical data are from case reports [13][14][15][16][17] or pilot studies mainly focusing on the safety of the KD [18,19]. Only one randomized controlled trial is available to date [20]. The results of these clinical trials were encouraging, speci cally for brain tumour [5,13,14].…”