The ketogenic diet is a hot topic these days, with news stories and multiple health claims spurring interest in this extremely high-fat and low-carb diet plan. One major area of activity centers around how the ketogenic diet may help individuals diagnosed with cancer. The theories behind this potential health benefit are not new; they go back nearly 100 years. But emerging research in cellular metabolism and a handful of recent studies – including an AICR-supported study published in August – are adding insights into the possible effects of the ketogenic diet during cancer treatment. Combining a ketogenic diet with standard chemotherapeutic and radiotherapeutic options may help improve tumor response, although more research is needed.
Can Ketogenic diet prevent Cancer?
In recent years, scientists have been testing a new class of cancer drugs. They target a specific molecular pathway that has been shown to be faulty in many types of cancer. Specifically, these drugs target a cell signaling pathway called phosphatidylinositol-3 kinase (PI3K), which is activated by insulin. Previous studies have shown that mutations in this kinase, or enzyme, are present in most tumors.
So, in an attempt to inhibit this pathway, over 50 drugs have been developed, with several clinical trials testing their efficacy. Thus far, however, the results of these trials have been disappointing; for the most part, the drugs’ efficacy is hit-or-miss, or their toxicity is too high. Taking these drugs often leads to hyperglycemia, or abnormally high levels of blood sugar. This occurs because inhibiting the pathway causes the insulin to drop, which increases blood sugar levels. When the pancreas is unable to make up for the loss by producing more insulin, patients have to stop taking the drugs. Now, however, researchers led by Benjamin D. Hopkins, a postdoctoral associate at Weill Cornell Medicine in New York City, NY, may have found a way around this problem. The “trendy” ketogenic diet — a diet high in fats but very low in carbs — may be the best way to boost the efficacy of these new-generation therapies and avoid their side effects. The researchers published their findings in the journal Nature. Of all the treatments tested, the keto diet performed best at both keeping blood sugar and insulin in check and simultaneously inhibiting tumor growth signals.
“The ketogenic diet turned out to be the perfect approach,” says Hopkins. “It reduced glycogen stores, so the mice couldn’t release glucose in response to PI3K inhibition.”
“This suggests,” he continues, “that if you can block spikes in glucose and the subsequent insulin feedback, you can make the drugs much more effective at controlling cancer growth.”
Co-senior author Dr. Siddhartha Mukherjee — an associate professor of medicine at the Columbia University Vagelos College of Physicians and Surgeons in New York City, NY — also weighs in on the findings.
According to Dr. Siddhartha Mukherjee “This study represents a truly innovative approach to cancer. For decades, we’ve been trying to alter human metabolism to make cancer cells more sensitive to chemotherapy or targeted drugs.”
“The fact that this drug itself was enabling a kind of resistance — at least in animal models — comes as a total surprise,” he adds. “We are excited to try this approach in humans.”
Currently, no major cancer health organizations, including AICR, recommend the ketogenic diet for cancer patients – or for cancer prevention.