Department of Nutrition Services, CancerCare Manitoba, Winnipeg, MB, Canada.
Division of Human Nutrition, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-126A Li Ka Shing Centre for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada.
Support Care Cancer. 2020 Nov;28(11):5243-5249. doi: 10.1007/s00520-020-05361-9. Epub 2020 Feb 23.
Many patients with cancer are interested in complementary therapies, including strategies such as reduced carbohydrate diets. Guidelines regarding the use of these diets during cancer treatment are lacking; therefore, we aimed to explore the perceptions and practices of medical oncologists in Canada regarding low-sugar and ketogenic diets.
A cross-sectional, online multiple-choice survey was distributed to 206 Canadian medical oncologists. Questions explored frequency of patient interactions, oncologist perceptions of efficacy, advice given to patients, and concerns about side effects related to reduced carbohydrate diets.
Responses were received from 57 medical oncologists in seven of thirteen provinces and territories, with an overall response rate of 28%. Forty-nine percent of respondents were asked at least weekly about a low-sugar diet, and 9% about the ketogenic diet. Eighty-five percent supported the use of a low-added sugar diet in patients with diabetes or hyperglycemia, while conversely 87% did not support the use of a ketogenic diet for any of their patients undergoing active cancer treatment. Respondents felt either that a ketogenic diet was not effective (31%) or that the effect on cancer outcomes was unknown (69%). Ninety-six percent of respondents had concerns about a ketogenic diet for patients receiving active cancer treatment.
The role of reduced carbohydrate diets during cancer treatment is topical. Canadian oncologists are particularly reluctant to support a ketogenic diet for patients on active cancer treatment, with concerns about side effects and unknown efficacy. There may be a role for continuing medical education and institutional guidelines to inform these discussions with patients.
许多癌症患者对补充疗法感兴趣，包括减少碳水化合物饮食等策略。由于缺乏关于在癌症治疗期间使用这些饮食的指南，因此，我们旨在探讨加拿大肿瘤内科医生对低糖和生酮饮食的看法和实践。
采用横断面、在线多项选择的调查方式，向 206 名加拿大肿瘤内科医生发放问卷。问题涉及患者互动的频率、肿瘤内科医生对疗效的看法、向患者提供的建议以及与减少碳水化合物饮食相关的副作用的担忧。
在十三个省份和地区中的七个地区收到了五十七名肿瘤内科医生的回复，总体回复率为 28%。49%的受访者每周至少被问到一次低糖饮食，9%的受访者被问到生酮饮食。85%的人支持在患有糖尿病或高血糖的患者中使用低糖饮食，而相反地，87%的人不支持在接受积极癌症治疗的任何患者中使用生酮饮食。受访者认为生酮饮食要么没有效果（31%），要么对癌症结果的影响未知（69%）。96%的受访者对接受积极癌症治疗的患者使用生酮饮食表示担忧。
癌症治疗期间减少碳水化合物饮食的作用是热门话题。加拿大肿瘤内科医生特别不愿意支持对接受积极癌症治疗的患者使用生酮饮食，担心会产生副作用和疗效未知。继续教育和机构指南可能有助于为这些与患者的讨论提供信息。
