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生酮饮食对癌症患者预后的影响:一项系统评价和荟萃分析。

Impact of ketogenic diets on cancer patient outcomes: a systematic review and meta-analysis.

作者信息

Zhang Meiying, Zhang Qing, Huang Sheng, Lu Yifu, Peng Mengyun

机构信息

Department of Diagnostic Imaging, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Front Nutr. 2025 Jul 18;12:1535921. doi: 10.3389/fnut.2025.1535921. eCollection 2025.

DOI:10.3389/fnut.2025.1535921
PMID:40756563
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12313497/
Abstract

BACKGROUND

The ketogenic diet, characterized by high fat, moderate protein, and extremely low carbohydrate intake, has been widely used as a medical treatment for various conditions and has gained increasing attention in recent years due to its health benefits.

OBJECTIVES

This study aims to investigate the effectiveness of a ketogenic diet on outcomes in cancer patients compared to conventional non-ketogenic diets.

MATERIALS AND METHODS

Studies that assigned cancer patients to either a ketogenic diet or a standard diet control group were included. Two reviewers independently extracted and analyzed the data.

RESULTS

This meta-analysis revealed that the ketogenic diet significantly reduced fat mass, visceral fat, insulin levels, blood glucose, fatigue, and insomnia compared to a non-ketogenic diet while improving low-density lipoprotein (LDL) cholesterol, total cholesterol, thyroid-stimulating hormone (TSH) levels, protein uptake, ketosis events, emotional function, and social function. Furthermore, the ketogenic diet induced ketosis by increasing β-hydroxybutyrate levels.

CONCLUSION

The ketogenic diet was found to improve cancer patients' outcomes more effectively than non-ketogenic diets. Notably, C-reactive protein levels showed greater improvement when the intervention lasted more than 12 weeks, with a diet composition of 2-4% carbohydrates, 16-18% protein, and 80-85% fat.

SYSTEMATIC REVIEW REGISTRATION

(https://www.crd.york.ac.uk/PROSPERO/view/CRD42024553878) PROSPERO CRD4202455387.

摘要

背景

生酮饮食的特点是高脂肪、适量蛋白质和极低的碳水化合物摄入量,已被广泛用作各种病症的医学治疗方法,并且近年来因其对健康的益处而受到越来越多的关注。

目的

本研究旨在调查与传统非生酮饮食相比,生酮饮食对癌症患者预后的有效性。

材料和方法

纳入将癌症患者分配到生酮饮食组或标准饮食对照组的研究。两名评价者独立提取和分析数据。

结果

这项荟萃分析表明,与非生酮饮食相比,生酮饮食显著降低了脂肪量、内脏脂肪、胰岛素水平、血糖、疲劳和失眠,同时改善了低密度脂蛋白(LDL)胆固醇、总胆固醇、促甲状腺激素(TSH)水平、蛋白质摄取、酮症发生、情绪功能和社会功能。此外,生酮饮食通过提高β-羟基丁酸水平诱导酮症。

结论

发现生酮饮食比非生酮饮食更有效地改善癌症患者的预后。值得注意的是,当干预持续超过12周,碳水化合物含量为2-4%、蛋白质含量为16-18%、脂肪含量为80-85%的饮食组成时,C反应蛋白水平有更大改善。

系统评价注册

(https://www.crd.york.ac.uk/PROSPERO/view/CRD42024553878)PROSPERO CRD4202455387。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/9a0b0fb744d8/fnut-12-1535921-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/2b0f0db48cf4/fnut-12-1535921-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/37990213ee20/fnut-12-1535921-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/1ed76116eccf/fnut-12-1535921-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/8517b0889809/fnut-12-1535921-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/9a0b0fb744d8/fnut-12-1535921-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/2b0f0db48cf4/fnut-12-1535921-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/37990213ee20/fnut-12-1535921-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/1ed76116eccf/fnut-12-1535921-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/8517b0889809/fnut-12-1535921-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3891/12313497/9a0b0fb744d8/fnut-12-1535921-g005.jpg

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本文引用的文献

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Nutrients. 2022 Oct 8;14(19):4192. doi: 10.3390/nu14194192.
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Effect of Ketogenic Diets on Cardio-Metabolic Outcomes in Cancer Patients: A Systematic Review and Meta-Analysis of Controlled Clinical Trials.生酮饮食对癌症患者心血管代谢结局的影响:对照临床试验的系统评价和荟萃分析
Nutr Cancer. 2023;75(1):95-111. doi: 10.1080/01635581.2022.2117388. Epub 2022 Sep 15.
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Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails.
生酮饮食对 2 型糖尿病肥胖患者体重减轻、血糖控制和血脂谱的影响:一项随机对照试验的荟萃分析。
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Answer to the critical remarks to the article by Khodabakhshi and colleagues reporting results from a randomized study on ketogenic diet.对霍达巴赫希及其同事发表的关于生酮饮食随机研究结果的文章的批判性评论的回应。
Clin Nutr. 2022 Sep;41(9):2063-2066. doi: 10.1016/j.clnu.2022.06.025. Epub 2022 Jul 5.
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The Effect of Ketogenic Diet on Weight Loss in Adult Patients with Cancer: A Systematic Review and Meta-Analysis of Controlled Clinical Trials.生酮饮食对成年癌症患者体重减轻的影响:对照临床试验的系统评价和荟萃分析
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