Mundi Manpreet S, Mohamed Elfadil Osman, Patel Ishani, Patel Jalpan, Hurt Ryan T
Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
JPEN J Parenter Enteral Nutr. 2021 Nov;45(S2):26-32. doi: 10.1002/jpen.2226.
As the prevalence of smoking continues to decline, dietary factors are rapidly becoming the leading preventable cause of disease. Diet and obesity are also leading to a shift in cancer prevalence with increases noted in breast, liver, pancreas, and uterine cancers. Once cancer is detected, obesity is also associated with poorer outcomes with therapy as well as higher morbidity and mortality. Key factors are associated with the link between obesity and cancer including chronic inflammation, change in sex hormones, alteration in insulin-IGF-1 axis, alteration in adipokines, as well as cancer stem cells that are derived from adipose tissue. Because of these associations, a great deal of effort is being placed in implementing lifestyle changes that mitigate obesity-associated factors that contribute to development of cancer, reduce side effects of treatment, and improve survival. Ketogenic diet is emerging as an attractive option in countering obesity-related tumor-promoting factors, as it is associated with weight loss as well as a reduction in insulin resistance and inflammation. Ketogenic diet can also deprive cancer cells of glucose, a fuel source that is predominantly used by many cancer lines through aerobic glycolysis in the setting of dysregulated mitochondria. Current manuscript reviews the theoretical benefits for use of ketogenic diet in cancer as well as the data available from clinical trials.
随着吸烟率持续下降，饮食因素正迅速成为主要的可预防疾病病因。饮食和肥胖还导致癌症患病率发生变化，乳腺癌、肝癌、胰腺癌和子宫癌的患病率有所上升。一旦检测出癌症，肥胖还与治疗效果较差以及更高的发病率和死亡率相关。肥胖与癌症之间的联系涉及多个关键因素，包括慢性炎症、性激素变化、胰岛素 - 胰岛素样生长因子 -1 轴改变、脂肪因子改变以及源自脂肪组织的癌症干细胞。鉴于这些关联，人们正在付出巨大努力来改变生活方式，以减轻与肥胖相关的、促使癌症发生的因素，减少治疗副作用并提高生存率。生酮饮食正成为对抗与肥胖相关的肿瘤促进因素的一个有吸引力的选择，因为它与体重减轻以及胰岛素抵抗和炎症的减轻有关。生酮饮食还可以剥夺癌细胞的葡萄糖，在线粒体功能失调的情况下，许多癌细胞系主要通过有氧糖酵解利用葡萄糖作为燃料来源。本手稿综述了生酮饮食在癌症治疗中的理论益处以及临床试验所得数据。
