Efficacy of Low-Carbohydrate Ketogenic Diet as an Adjuvant Cancer Therapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background: 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...
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| Published in | Nutrients Vol. 13; no. 5; p. 1388 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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21.04.2021
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| Abstract | Background: 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 I2 value or p-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, p = 0.03, the achievement of ketosis p = 0.010, and the level of satisfaction, p = 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. |
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| AbstractList | Background: 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[sup.2] value or p-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, p = 0.03, the achievement of ketosis p = 0.010, and the level of satisfaction, p = 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. 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. Background: 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 I² value or p-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, p = 0.03, the achievement of ketosis p = 0.010, and the level of satisfaction, p = 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. Background: 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 I2 value or p-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, p = 0.03, the achievement of ketosis p = 0.010, and the level of satisfaction, p = 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. 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 I2 value or p-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, p = 0.03, the achievement of ketosis p = 0.010, and the level of satisfaction, p = 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.BACKGROUNDThe 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 I2 value or p-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, p = 0.03, the achievement of ketosis p = 0.010, and the level of satisfaction, p = 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. Background: 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 2 value or p -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, p = 0.03, the achievement of ketosis p = 0.010, and the level of satisfaction, p = 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. |
| Audience | Academic |
| Author | Akinwunmi, Babatunde O. Huang, Jian Zhang, Casper J. P. Joseph, Tanya Yang, Ya-Feng Mattamel, Preety Babychen Ming, Wai-Kit Chen, Qian |
| AuthorAffiliation | 5 Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; bakinwunmi@bwh.harvard.edu 4 Department of Epidemiology and Biostatistics, School of Public Health, St Mary’s Campus, Imperial College London, London W2 1PG, UK; jian.huang@imperial.ac.uk 6 School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China; casperz1@connect.hku.hk 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia 2 International School, Jinan University, Guangzhou 510632, China 1 School of Medicine, Jinan University, Guangzhou 510632, China; mapleyang@um.edu.my (Y.-F.Y.); pret22@stu2014.jnu.edu.cn (P.B.M.); tanyajoseph1996@yahoo.com (T.J.); chenqian@stu2020.jnu.edu.cn (Q.C.) |
| AuthorAffiliation_xml | – name: 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia – name: 1 School of Medicine, Jinan University, Guangzhou 510632, China; mapleyang@um.edu.my (Y.-F.Y.); pret22@stu2014.jnu.edu.cn (P.B.M.); tanyajoseph1996@yahoo.com (T.J.); chenqian@stu2020.jnu.edu.cn (Q.C.) – name: 2 International School, Jinan University, Guangzhou 510632, China – name: 4 Department of Epidemiology and Biostatistics, School of Public Health, St Mary’s Campus, Imperial College London, London W2 1PG, UK; jian.huang@imperial.ac.uk – name: 6 School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China; casperz1@connect.hku.hk – name: 5 Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; bakinwunmi@bwh.harvard.edu |
| Author_xml | – sequence: 1 givenname: Ya-Feng orcidid: 0000-0001-5688-7585 surname: Yang fullname: Yang, Ya-Feng – sequence: 2 givenname: Preety Babychen surname: Mattamel fullname: Mattamel, Preety Babychen – sequence: 3 givenname: Tanya surname: Joseph fullname: Joseph, Tanya – sequence: 4 givenname: Jian orcidid: 0000-0002-3931-5013 surname: Huang fullname: Huang, Jian – sequence: 5 givenname: Qian surname: Chen fullname: Chen, Qian – sequence: 6 givenname: Babatunde O. surname: Akinwunmi fullname: Akinwunmi, Babatunde O. – sequence: 7 givenname: Casper J. P. orcidid: 0000-0003-1047-0287 surname: Zhang fullname: Zhang, Casper J. P. – sequence: 8 givenname: Wai-Kit surname: Ming fullname: Ming, Wai-Kit |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33918992$$D View this record in MEDLINE/PubMed |
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| Keywords | low-carbohydrate diet adjuvant cancer therapy cancer randomized controlled trials ketogenic diet |
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| Snippet | Background: The role of low-carbohydrate ketogenic diet (LCKD) as an adjuvant therapy in antitumor treatment is not well established. This systematic review... The role of low-carbohydrate ketogenic diet (LCKD) as an adjuvant therapy in antitumor treatment is not well established. This systematic review and... |
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| SubjectTerms | Adjuvant treatment Adjuvants Analysis Antimitotic agents Antineoplastic agents Bias Biomarkers Biomarkers, Tumor - metabolism Blood cholesterol blood glucose Blood Glucose - metabolism Blood sugar Body Weight Brain cancer Cancer Cancer therapies cancer therapy Carbohydrates Case-Control Studies Chemotherapy Cholesterol Clinical trials Diabetes Diet Diet, Carbohydrate-Restricted - adverse effects Diet, Ketogenic - adverse effects Fasting Fasting - blood Glucose Health aspects high density lipoprotein cholesterol Humans Immunotherapy Insulin Insulin - blood ketogenic diet Ketosis lipid composition Lipids Lipids - blood low density lipoprotein cholesterol Low density lipoproteins Meta-analysis neoplasms Neoplasms - blood Neoplasms - diet therapy nutritional intervention Odds Ratio Patient Satisfaction Performance evaluation Proteins Radiation therapy Randomized Controlled Trials as Topic sample size Standard deviation Statistical analysis Systematic review Treatment Outcome triacylglycerols |
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| Title | Efficacy of Low-Carbohydrate Ketogenic Diet as an Adjuvant Cancer Therapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
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