Yang Ya-Feng, Mattamel Preety Babychen, Joseph Tanya, Huang Jian, Chen Qian, Akinwunmi Babatunde O, Zhang Casper J P, Ming Wai-Kit
School of Medicine, Jinan University, Guangzhou 510632, China.
International School, Jinan University, Guangzhou 510632, China.
Nutrients. 2021 Apr 21;13(5):1388. doi: 10.3390/nu13051388.
The role of low-carbohydrate ketogenic diet (LCKD) as an adjuvant therapy in antitumor treatment is not well established. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate the efficacy of LCKD as an adjuvant therapy in antitumor treatment compared to non-ketogenic diet in terms of lipid profile, body weight, fasting glucose level, insulin, and adverse effects; Methods: In this study, databases such as PubMed, Web of Science, Scopus, CINAHL, and Cochrane trials were searched. Only RCTs that involved cancer participants that were assigned to dietary interventions including a LCKD group and a control group (any non-ketogenic dietary intervention) were selected. Three reviewers independently extracted the data, and the meta-analysis was performed using a fixed effects model or random effects model depending on the I value or -value; Results: A total of six articles met the inclusion/exclusion criteria. In the overall analysis, the post-intervention results = standard mean difference, SMD (95% CI) showed total cholesterol (TC) level = 0.25 (-0.17, 0.67), HDL-cholesterol = -0.07 (-0.50, 0.35), LDL-cholesterol = 0.21 (-0.21, 0.63), triglyceride (TG) = 0.09 (-0.33, 0.51), body weight (BW) = -0.34 (-1.33, 0.65), fasting blood glucose (FBG) = -0.40 (-1.23, 0.42) and insulin = 0.11 (-1.33, 1.55). There were three outcomes showing significant results in those in LCKD group: the tumor marker PSA, = 0.03, the achievement of ketosis = 0.010, and the level of satisfaction, = 0.005; Conclusions: There was inadequate evidence to support the beneficial effects of LCKDs on antitumor therapy. More trials comparing LCKD and non-KD with a larger sample size are necessary to give a more conclusive result.
低碳水化合物生酮饮食（LCKD）作为辅助治疗手段在抗肿瘤治疗中的作用尚未明确。本系统评价和随机对照试验（RCT）的荟萃分析旨在研究与非生酮饮食相比，LCKD作为辅助治疗手段在抗肿瘤治疗中对血脂、体重、空腹血糖水平、胰岛素及不良反应方面的疗效。方法：本研究检索了PubMed、Web of Science、Scopus、CINAHL和Cochrane试验等数据库。仅纳入涉及癌症参与者且被分配至饮食干预组（包括LCKD组和对照组，任何非生酮饮食干预）的RCT。三位评价者独立提取数据，并根据I值或P值使用固定效应模型或随机效应模型进行荟萃分析。结果：共有6篇文章符合纳入/排除标准。在总体分析中，干预后结果=标准均差（SMD，95%可信区间）显示总胆固醇（TC）水平=0.25（-0.17，0.67），高密度脂蛋白胆固醇=-0.07（-0.50，0.35），低密度脂蛋白胆固醇=0.21（-0.21，0.63），甘油三酯（TG）=0.09（-0.33，0.51），体重（BW）=-0.34（-1.33，0.65），空腹血糖（FBG）=-0.40（-1.23，0.42），胰岛素=0.1（-1.33，1.55）。LCKD组有3个结果显示出显著差异：肿瘤标志物PSA，P=0.03；达到酮症，P=0.010；满意度水平，P=0.005。结论：尚无充分证据支持LCKD在抗肿瘤治疗中的有益作用。需要更多样本量更大的比较LCKD和非生酮饮食的试验才能得出更具结论性的结果。
