April 4, 2018

Science: my note on keto diet and cancer

There is an internal grant. Since the deadline would be 4/6, we were exchanging emails busily between offices to finalize the application for past a few days. Then, the sponsor changed the deadline to 4/23.

Duh.

Since there is no other change in the announcement, we will send it out anyway, 2.5 weeks ahead of new deadline.


Since I was busy for the grant writing, I had shorter time to prepare for journal club I am supposed to be presenting tomorrow 4/5/18.

So I picked a theme from previous small research project, "ketogenic diet and cancer". See, it turns out to be useful.


If you search indexed publications in Pubmed with "ketogenic diet" and "cancer" keywords, you get 193 publications as of 4/4/2018.

Some are reviews, some are original research.

Original research papers (excluding in virto and in silico studies) are categorized to; 

  Preclinical animal-based studies (usually with rodents/mice or rats)
  Human case reports
  Human clinical trials (small scale)
  Human randomized clinical trials (larger scale)
  meta analysis papers that analyze existing multiple papers to draw conclusion from a higher viewpoint

For human studies, there are still very limited number of publications for randomized controlled trials. Results in Case reports are hard to interpret due to the small size, so how much trust you put on them is tough call.

For animal-based studies, most are cohort studies. Within the limit of using animal model, the results are more sound, scientifically.


In short, keto diet seems to be beneficial in discouraging cancer growth, or enhancing chemotherapy. At least for relatively short term.

[There are theories behind it, which I skip in this blog.]

Many human studies were conducted with brain tumors. Since brain cells show established glucose dependency, it may have been easier for researchers to rationalize the use of ketogenic diet that limit energy source to fat/fatty acids instead of carb/glucose.

But there are some cautionary data. For renal cancer with longer term, keto diet may worsen cancer. Or, for breast cancer in animal models, ketosis may also worsen cancer.


So far, they say keto diet is promising in discouraging cancer. But jury is still out.


For otherwise healthy people to lose weight, up to 4 weeks of keto diet should be fine. Yet, with carb/glucose addition, poorly practiced keto diet can easily turn to western style high fat diet, which is known to facilitate cancer. Standardization and implementation of keto diet in experimental setting is another issue in practice. Know that even a glass of orange juice can break this diet. Be careful.




PS

Also important is the type of fat. Saturated fat are bad for your cardiac health and cancer development.

For all skeptics to consider: Medical research publications are subjected to "survivor's bias". Positive results tend to be published, while negative results may be left on researcher's desk without getting published.