AlMutairi Hanan, Mccullough Fiona, Siddiqui Khawar, Ghemlas Ibrahim, AlHarbi Manal, Grundy Richard, Dandapani Madhumita
Clinical Nutrition Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Department of Bioscience, University of Nottingham, Nottingham NG7 2RD, UK.
J Nutr Metab. 2025 Mar 18;2025:7935879. doi: 10.1155/jnme/7935879. eCollection 2025.
Evidence suggests the positive effects of ketogenic diet (KD) on cancers by limiting glucose availability to cancer cells. This systematic review aimed to explore the safety, feasibility, and effectiveness of KD in children with brain tumors including diet side effects, patient tolerance and compliance, tumor response, quality of life, and nutritional status. Six databases were searched for relevant publications between 1995 and 2022; non-English language publications were excluded to avoid misinterpretation. The Joanna Briggs Institute assessment scale for observational studies was used to measure study methodology quality and evaluate the extent to which the bias possibility in study design, conduct, and analysis has been stated. The study was registered in PROSPERO under registration number (CRD42021281620). Ultimately, eight eligible publications involving a total of 11 children with brain tumors following KD were included. Nine patients followed classic KD with medium-chain triglyceride oil, whereas others followed a modified Atkin or low-carbohydrate diet. KD was well-tolerated, having nonsevere side effects. Six patients showed positive tumor response, five improved neurological skills, and four reported growth improvement. Six patients reported a median overall survival of 17.6 months. Lastly, statistical analyses could not be performed; hence, a meta-analysis was not possible. KD may be a safe and feasible dietary intervention for children with brain tumors. However, the effects on tumors remain unclear and require further study. The study limitation included the lack of high-quality and appropriately controlled trials with large samples. Moreover, heterogeneity was observed, and quality-of-life assessments were self-reported, which might have resulted in bias or inaccuracy.
有证据表明生酮饮食（KD）通过限制癌细胞的葡萄糖供应对癌症产生积极影响。本系统评价旨在探讨KD在脑肿瘤患儿中的安全性、可行性和有效性，包括饮食副作用、患者耐受性和依从性、肿瘤反应、生活质量和营养状况。检索了六个数据库中1995年至2022年间的相关出版物；排除非英文出版物以避免误解。采用乔安娜·布里格斯研究所观察性研究评估量表来衡量研究方法的质量，并评估研究设计、实施和分析中偏差可能性的说明程度。该研究已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为（CRD42021281620）。最终，纳入了八项符合条件的出版物，共涉及11例接受KD治疗的脑肿瘤患儿。9例患者采用含中链甘油三酯油的经典KD，而其他患者采用改良阿特金斯或低碳水化合物饮食。KD耐受性良好，副作用不严重。6例患者肿瘤反应呈阳性，5例患者神经技能有所改善，4例患者报告生长情况改善。6例患者报告中位总生存期为17.6个月。最后，由于无法进行统计分析，因此无法进行荟萃分析。KD可能是脑肿瘤患儿一种安全可行的饮食干预措施。然而，其对肿瘤的影响仍不明确，需要进一步研究。研究局限性包括缺乏高质量且样本量足够的对照试验。此外，观察到存在异质性，生活质量评估为自我报告，这可能导致偏差或不准确。
