Ketogenic and low-sugar diets for patients with cancer: perceptions and practices of medical oncologists in Canada

Klassen, Pamela; Goldenberg, Benjamin; Lambert, Pascal; Vagianos, Kathy; Kim, Christina

doi:10.1007/s00520-020-05361-9

Cited by 8 publications

(4 citation statements)

References 22 publications

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“…Não obstante, a DC se apresenta como uma importante opção terapêutica muito segura, barata e eficaz que pode ser utilizada no manejo de pacientes com epilepsia refratária, principalmente, em crianças e adolescentes, uma vez que esses apresentam uma resposta terapêutica mais efetiva nesses pacientes quando comparados aos adultos (DOS SANTOS DK et al, 2019). Em alguns casos citados na literatura, relata-se os efeitos colaterais que ocorrem no início da terapia, como a letargia (provavelmente pelo efeito sedativo dos corpos cetônicos) e a hipoglicemia (KLASSEN PN, et al, 2020). Em situações onde há grave retardo, as crianças podem apresentar desidratação intensa e acidose metabólica, justificando hospitalização.…”

Section: Discussionunclassified

Hiperglicinemia não cetótica em uso de dieta cetogênica: relato de caso

Freitas,

Guimarães,

Lima

et al. 2024

Acervo Saúde

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Objetivo: Relatar um estudo de caso sobre hiperglicinemia não cetótica e o tratamento nutricional prescrito com dieta cetogênica. Detalhamento do caso: Paciente do sexo feminino, com 3 anos de idade, natural de Cajazeiras-PB. Foi admitida num Hospital Universitário (EBSERH) da cidade com quadro de sonolência excessiva, associado a piora do quadro de crises convulsivas. Nos primeiros dias de internamento, a paciente utilizou uma dieta 4:1 semelhante a que estava ingerindo em casa. No quarto dia de reposição de potássio os níveis sanguíneos desse mineral reduziram significativamente mesmo a terapia de reposição não ter sido cessada o que gerou a suspeita de que a dieta cetogênica em 4:1 pudesse estar influenciando o quadro. Assim foi realizada involução da dieta passando para 3:1 e logo em seguida 2:1 e nessa concentração a paciente conseguiu manter os níveis de potássio normais e recebeu alta. Considerações finais: Considera-se que a dieta cetogênica apresentou-se como importante estratégia nutricional no controle das convulsões na hiperglicinemia não cetótica, porém a utilização dessa dieta de modo prolongado, sobretudo nas concentrações de 4g de gordura para 1 g de carboidrato foi relacionada ao desenvolvimento de hipocalemia.

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Section: Discussionunclassified

Hiperglicinemia não cetótica em uso de dieta cetogênica: relato de caso

Freitas,

Guimarães,

Lima

et al. 2024

Acervo Saúde

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“…The limited availability of Clinical Nutrition services in most countries has likely contributed to the increased number of patients following unsupervised nutritional programs, as well as the reluctance of Oncologists to discuss nutritional issues with their patients. 14 The actual prevalence of cancer patients on restrictive diets is unknown, but is probably high. The NutriNet-Santé study on more than 2700 cancer survivors found that 6% of patients had fasted in the attempt to improve cancer prognosis.…”

Section: Patients' Reasons For Undergoing Anticancer Restrictive Diet...mentioning

confidence: 99%

“…In fact, the preliminary evidence on the potential benefits of FMDs and KDs and the consequent associated “marketing rumors” have induced many patients to follow low calorie and/or low carbohydrate diets without medical supervision. The limited availability of Clinical Nutrition services in most countries has likely contributed to the increased number of patients following unsupervised nutritional programs, as well as the reluctance of Oncologists to discuss nutritional issues with their patients 14 …”

Section: Introductionmentioning

confidence: 99%

Anticancer restrictive diets and the risk of psychological distress: Review and perspectives

Da Prat,

Pravettoni,

Casirati

et al. 2024

Cancer Medicine

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IntroductionThe most studied anticancer restrictive diets include fasting, fasting‐mimicking diets (FMDs) and ketogenic diets (KDs). Besides the current lack of established clinical benefit and the significant risk of malnutrition and micronutrient deficiencies, dietary restrictions in cancer patients might have relevant psychological effects.Materials and MethodsWe reviewed the randomized and non‐randomized controlled clinical trials (CCTs) reporting data on the psychological impact of fasting, FMDs and KDs in cancer patients. We excluded trials on restrictive diets performed for weight reduction in obese or overweight patients, studies on dietary restrictions lasting less than 24 h, and studies on fasting related to cultural or religious beliefs.ResultsThree CCTs on fasting or FMDs and eight CCTs on KDs in cancer patients were included. In terms of diet‐related distress, emotional, social, and family well‐being, none of these studies showed a detrimental impact of fasting, FMDs and KDs. However, clinical trials specifically assessing the psychological aspects in the long term are lacking.Conclusions and PerspectivesIn the absence of a conclusive evidence on the clinical benefits of restrictive diets, which carry significant risks especially if unsupervised, further studies are needed to clarify their psychological impact in cancer patients. Multidisciplinary approaches including psychological evaluations should be used to ameliorate patient selection for clinical trials, identify early distress symptoms, and increase patient compliance to dietary recommendations.

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“…It provides at least 75% of daily calories from fat, is adequate in protein (1.0-1.4 g/kg body weight/day), and is very low in carbohydrates (20-50 g per day). This diet is still a matter of concern and leads to a debate among oncologists and nutritionists, who expect cardiovascular side effects and loss of quality of life due to the high amount of fat [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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

Kämmerer

Klement

Joos³

et al. 2021

Nutrients

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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.

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Ketogenic and low-sugar diets for patients with cancer: perceptions and practices of medical oncologists in Canada

Cited by 8 publications

References 22 publications

Hiperglicinemia não cetótica em uso de dieta cetogênica: relato de caso

Hiperglicinemia não cetótica em uso de dieta cetogênica: relato de caso

Anticancer restrictive diets and the risk of psychological distress: Review and perspectives

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

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