Ketogenic and low-carbohydrate diets in people with cancer

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A statement by the Working Group on Prevention and Integrative Oncology (PRIO) in the German Cancer Society (GCS) and the German Society for Nutritional Medicine (DGEM)

Introduction

The importance of a low-carbohydrate diet or – if carbohydrates are largely avoided – a ketogenic diet has been discussed in oncology for years. These diets are thought to reduce tumor growth, improve the efficacy of tumor therapies, and/or reduce the side effects of tumor therapy by protecting healthy cells. A ketogenic diet is a significant dietary restriction. Therefore, the question of the benefits and risks of this type of diet in tumor patients is highly relevant.

Definition of ketogenic and low carbohydrate diets

Ketogenic or low-carbohydrate diets in different variants currently exist under different names. Their common feature is that they are all characterized by a high fat content combined with a low carbohydrate content of mostly < 70 g daily compared to the national recommendations for nutrient intake of the German Nutrition Society (DGE) [1–5]. ...

Abstract

For several years, people with cancer have been offered so-called "cancer diets" that are low-carbohydrate or ketogenic to varying degrees. The rationale for these diets is that the metabolism of tumor cells is dependent on carbohydrates. Depending on the interpretation of the study data, these diets promise a direct influence on tumor growth (and metastasis) as well as an improvement in the efficacy and tolerability of chemotherapy and/or radiotherapy (especially chemotherapy). However, there is a lack of methodologically high-quality studies and thus of reliable evidence for the ketogenic diet. For this reason, the authors of the statement conclude that at the present time, the use of a low-carbohydrate or ketogenic diet for this indication must be discouraged.

Keywords: nutritional medicine, ketogenic diet, carbohydrate reduction, cancer, malnutrition, side effects, tumor therapy.

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