Is there a role for carbohydrate restriction in the treatment and prevention of cancer
TL;DR: The possible beneficial effects of low CHO diets on cancer prevention and treatment are addressed, with emphasis on the role of insulin and IGF1 signaling in tumorigenesis as well as altered dietary needs of cancer patients.
Abstract: Over the last years, evidence has accumulated suggesting that by systematically reducing the amount of dietary carbohydrates (CHOs) one could suppress, or at least delay, the emergence of cancer, and that proliferation of already existing tumor cells could be slowed down. This hypothesis is supported by the association between modern chronic diseases like the metabolic syndrome and the risk of developing or dying from cancer. CHOs or glucose, to which more complex carbohydrates are ultimately digested, can have direct and indirect effects on tumor cell proliferation: first, contrary to normal cells, most malignant cells depend on steady glucose availability in the blood for their energy and biomass generating demands and are not able to metabolize significant amounts of fatty acids or ketone bodies due to mitochondrial dysfunction. Second, high insulin and insulin-like growth factor (IGF)-1 levels resulting from chronic ingestion of CHO-rich Western diet meals, can directly promote tumor cell proliferation via the insulin/IGF1 signaling pathway. Third, ketone bodies that are elevated when insulin and blood glucose levels are low, have been found to negatively affect proliferation of different malignant cells in vitro or not to be usable by tumor cells for metabolic demands, and a multitude of mouse models have shown antitumorigenic properties of very low CHO ketogenic diets. In addition, many cancer patients exhibit an altered glucose metabolism characterized by insulin resistance and may profit from an increased protein and fat intake. In this review, we address the possible beneficial effects of low CHO diets on cancer prevention and treatment. Emphasis will be placed on the role of insulin and IGF1 signaling in tumorigenesis as well as altered dietary needs of cancer patients.
Citations
More filters
Journal Article•
TL;DR: In this article, a modified Block food-frequency questionnaire was used to obtain dietary information from 3377 participants in the Age-Related Eye Disease Study (AREDS) to test whether recent dietary carbohydrate intakes or glycemic index (GI; a measure of carbohydrate intake quality) was associated with the presence of cortical or nuclear opacities.
Abstract: BACKGROUND
Little is known about the association between dietary carbohydrates and cataract in nondiabetic persons.
OBJECTIVE
The aim was to test whether recent dietary carbohydrate intakes or glycemic index (GI; a measure of carbohydrate intake quality) was associated with the presence of cortical or nuclear opacities.
DESIGN
A modified Block food-frequency questionnaire was used to obtain dietary information from 3377 participants (aged 60-80 y; 56% were women) in the Age-Related Eye Disease Study (AREDS). Lens status was evaluated by using the AREDS System for Classifying Cataracts. Associations were examined for eyes with only a single, or pure, type of lens opacity by using the generalized estimating approach to logistic regression to account for the lack of independence between the eyes of a person.
RESULTS
For participants in the highest quartile, dietary GI was associated with a higher prevalence of all pure nuclear opacities [grade >2; odds ratio (OR): 1.29; 95% CI: 1.04, 1.59; P for trend = 0.02] and moderate nuclear opacities (grade > or =4; OR: 1.43; 95% CI: 0.96, 2.14; P for trend = 0.052). The OR in a comparison of the highest with the lowest quartile of intake was 1.27 (95% CI: 0.99, 1.63; P for trend = 0.09) for cortical opacities of any severity (>0% of area opaque), and the OR increased somewhat for moderate cortical opacities (>5% of area opaque; OR: 1.71; 95% CI: 1.00, 2.95; P for trend = 0.056).
CONCLUSIONS
Results from the cross-sectional analysis of AREDS baseline data suggest that dietary glycemic quality and dietary carbohydrate quantity may be associated with prevalent nuclear and cortical opacities, respectively.
3 citations
TL;DR: It can be speculated that higher carbohydrate and lower protein and fat intakes may be associate with the increased odds of NMOSD, however, further studies are needed to confirm these results.
Abstract: Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a demyelinating inflammatory disease of The Central nervous system. We aimed to investigate the association between low carbohydrate diet (LCD) and NMOSD odds. Method: Seventy NMOSD patients with definite diagnosis and 164 hospital-based controls were enrolled in this case-control study. Dietary data was obtained using a validated 168-item food frequency questionnaire. To determine the LCD score, participants were stratified into 11 groups according to carbohydrate, protein, fat, animal fat, animal protein, vegetable fat and vegetable protein intakes. Higher intake of protein and fat, and lower intake of carbohydrate received a higher score between 0-10. Macronutrients scores were summed together and LCD scores calculated. The association between LCD scores and likelihood of being assigned to NMOSD group was investigated using multiple regression models. Results: Total LCD scores increased from the median of 21.00 in the first decile to 53.00 in the tenth decile of LCD score. After adjustment for confounding factors including age, gender, BMI, energy intake, cigarette smoking and alcohol consumption, an inverse association was detected between LCD scores and odds of NMOSD. The odds of suffering from NMOSD declined significantly about 78% (OR: 0.22; 95% CI: 0.05-0.87) and 76% (OR: 0.24; 95% CI: 0.06-0.93) in the fifth and sixth deciles of LCD score compared to the first decile. Conclusion: From the obtained results it can be speculated that higher carbohydrate and lower protein and fat intakes may be associate with the increased odds of NMOSD. However, further studies are needed to confirm these results.
3 citations
Journal Article•
TL;DR: The results revealed that, among case group the majority of women ages above 50 and more, and most of them lived in Khartoum state compared with control group, the most of women is ages are between 30–40 and 40-50years old and most the cases group, which means all breast cancer patients receiving chemotherapy should have nutritional assessment from the beginning of the treatment.
Abstract: This study is a case control hospital base study conducted from July 2012 to April 2013 to assess the effect of chemotherapy doses on nutritional status of 276 female who diagnosed with breast cancer attending Radiation and Isotopes Center Khartoum (RICK) has been selected randomly to participate in this study. The main objective of the study was to assess the effect of chemotherapy on nutritional status of breast cancer patients. Data collected by using questionnaire and 24-hour food recall were filed through interviews with respondents. The collected data were analyzed using computerized methods of analysis (SPSS and Nutri-sarvey). The results revealed that, among case group the majority of women ages above 50 and more, and most of them lived in Khartoum state compared with control group, the majority of women is ages are between 30–40 and 40-50years old and most of them live in Khartoum state as the cases group,.BMI among control group compared with BMI of women received chemotherapy (case group), as follows: about 43.5% Vs 54.3%of women had normal body weight (BMI = 18.5–24.9 kg/m2). 27.9%vs 23.2% were overweight (BMI= 25–29.9 kg/m2) and 14.9% vs 6.9% were obese class I (30–34.9kg/m2), 3.3% vs 15.6% were under weight (BMI=<18.5 kg/m2), only 7.3% of control group were obese class II (35–39.9 kg/m2). 24 hours recall demonstrated that energy intake among respondents cases compared with respondents control were lower than the recommended daily allowances (RDA). The intake of fat and cholesterol were lower than the recommended daily allowances (RDA) among both (case and control group) while fiber intake among control group was more than recommended daily allowances compared with lower intake of respondent cases. The intake of Carbohydrates and protein among cases and control group in the present study were more than the RDA and at the same time the intake of fiber among cases was lower than the RDA compared with control group which was more than RDA. The intake of vitamins (A, E, C) zinc and folic acid among women both of case and control group in the present study was less than RDA.The intake of mineral (Sodium, calcium and magnesium) among both cases and control group was less than RDA. Also the intake of potassium was less than RDAamong cases compared with control group which their intake was more than RDA, while the phosphorus intake and iron intake was more than RDA among both case and control group. The intake of B vitamins (B1, B2 and B6) among the respondents cases and control in the present study was less than the RDA. Hemoglobin level among 83% of respondents cases within the normal range (10.4–15.6g/dl)and 13.4% were anemic (<10. 4g/dl). Significant association was found between energy intake(P=0.001), carbohydrate intake (P=0.041) zinc intake (P=0.027) and magnesium intake (P=0.002) with chemotherapy dose among cases group, On the other hand, no significant correlation were detected between intake of fat (P=0.911), cholesterol (P= 0.781), proteins intake (p= 0.336), sodium, intake (P= 0.789), potassium intake (P= 0.468), calcium intake (P=0.684), iron intake (P=0.632), and BMI (P=0.609), Hemoglobin level (P= 0.437) with chemotherapy doses among the respondents cases. The study recommended that, all breast cancer patients receiving chemotherapy should have nutritional assessment from the beginning of the treatment. Nutrition education is needed among Sudanese populations regarding the breast cancer patients who are receiving chemotherapy.
2 citations
Cites result from "Is there a role for carbohydrate re..."
...Previous study was not in line with the present study which revealed that, decreased in carbohydrate intake with increased chemotherapy doses (Klement and Kammerer, 2011)....
[...]
TL;DR: Investigation of the association between GI or GL and nutritional status and antioxidant/oxidant status in lung cancer patients shows that in Lung cancer oxidative stress is related to GI, while TAS isrelated to nutritional status.
Abstract: Background A low glycemic index (GI) and glycemic load (GL) of diets as well as proper nutritional status may partially slow down depletion in antioxidant capacity, and may therefore have an impact on antioxidant/ oxidant status in lung cancer patients. However, no studies concerning these associations had previously been conducted. Objectives The aim of this study was to investigate the association between GI or GL and nutritional status and antioxidant/oxidant status in lung cancer patients. Material and methods The study was conducted among 180 lung cancer patients (82 women and 98 men) and 171 control subjects (78 women and 93 men). Exclusion criteria for the control subjects included cancers, pro-inflammatory conditions, brain diseases, and psychiatric disorders. All participants were evaluated in terms of their systemic antioxidant/oxidant status, nutritional status (anthropometric parameters), dietary GI and GL and parameters related to circulating glucose: fasting glucose, insulin level and homeostasis model assessment for insulin resistance (HOMA-IR). Results In women who were lung cancer-positive, associations were observed between total antioxidant status (TAS) and parameters of nutritional status, and between oxidative stress index (OSI) and fasting glucose. In men with lung cancer, we found a positive correlation between total oxidant status (TOS) and GI. In the control group of women, TAS positively correlated with anthropometric parameters, but negatively with dietary fiber and total carbohydrate content. Additionally, TOS and OSI negatively correlated with parameters related to body weight and positively with insulin. In control men, we observed significant negative correlations between parameters related to fasting glucose and TAS and positive ones with TOS and OSI. Conclusions The results show that in lung cancer oxidative stress is related to GI, while TAS is related to nutritional status. Further investigations performed on a larger cohort are required to better clarify the observed relationships as well as to explain the potential mechanisms involved.
2 citations
TL;DR: A standardized definition of KD for patients with glioma and a consensus on methodological implementation are needed as well as to what extent KD treatment can be optimized to secure optimal nutrient status and patient satisfaction.
Abstract: Abstract Ketogenic diets (KD) have received increasing interest in neuro-oncology based on their ability to inhibit glioma growth In Vitro and their established role in medically refractory seizures. This review analyses the methodological aspects of KD treatment alongside standard care for patients with gliomas from a nutritional point of view. A literature search was performed in March 2022 searching PubMed and Scopus. We identified 13 articles including 187 patients with a histological—new or recurrent—diagnosis of glioma and treated by KD during the course of the disease. Dietary treatments were categorized as the classical ketogenic diet (CKD), the Modified Atkins diet (MAD), and the medium-chain triglyceride (MCT) diet. We identified a large variation in dietary characteristics regarding restriction of carbohydrates, ketogenic ratio, and additional dietary support. This striking heterogenicity in the methodological approaches of KD treatments made it problematic to compare effects between the included studies. Therefore, a standardized definition of KD for patients with glioma and a consensus on methodological implementation is needed. It would also be desirable to further investigate to what extent KD treatment can be optimized to secure optimal nutrient status and patient satisfaction.
2 citations
References
More filters
TL;DR: Recognition of the widespread applicability of these concepts will increasingly affect the development of new means to treat human cancer.
51,099 citations
"Is there a role for carbohydrate re..." refers background in this paper
..., a pathological capability common to most, if not all, cancer cells [39]....
[...]
TL;DR: The molecular pathways of this cancer-related inflammation are now being unravelled, resulting in the identification of new target molecules that could lead to improved diagnosis and treatment.
Abstract: The mediators and cellular effectors of inflammation are important constituents of the local environment of tumours. In some types of cancer, inflammatory conditions are present before a malignant change occurs. Conversely, in other types of cancer, an oncogenic change induces an inflammatory microenvironment that promotes the development of tumours. Regardless of its origin, 'smouldering' inflammation in the tumour microenvironment has many tumour-promoting effects. It aids in the proliferation and survival of malignant cells, promotes angiogenesis and metastasis, subverts adaptive immune responses, and alters responses to hormones and chemotherapeutic agents. The molecular pathways of this cancer-related inflammation are now being unravelled, resulting in the identification of new target molecules that could lead to improved diagnosis and treatment.
9,282 citations
"Is there a role for carbohydrate re..." refers background in this paper
...Inflammation is a wellestablished driver of early tumorigenesis and accompanies most, if not all cancers [148]....
[...]
TL;DR: In this article, the authors propose that persistent metabolism of glucose to lactate even in aerobic conditions is an adaptation to intermittent hypoxia in pre-malignant lesions, which leads to microenvironmental acidosis requiring evolution to phenotypes resistant to acid-induced cell toxicity.
Abstract: If carcinogenesis occurs by somatic evolution, then common components of the cancer phenotype result from active selection and must, therefore, confer a significant growth advantage. A near-universal property of primary and metastatic cancers is upregulation of glycolysis, resulting in increased glucose consumption, which can be observed with clinical tumour imaging. We propose that persistent metabolism of glucose to lactate even in aerobic conditions is an adaptation to intermittent hypoxia in pre-malignant lesions. However, upregulation of glycolysis leads to microenvironmental acidosis requiring evolution to phenotypes resistant to acid-induced cell toxicity. Subsequent cell populations with upregulated glycolysis and acid resistance have a powerful growth advantage, which promotes unconstrained proliferation and invasion.
4,361 citations
2,524 citations
TL;DR: Dietary restriction and reduced activity of nutrient-sensing pathways may slow aging by similar mechanisms, which have been conserved during evolution, and their potential application to prevention of age-related disease and promotion of healthy aging in humans, and the challenge of possible negative side effects.
Abstract: When the food intake of organisms such as yeast and rodents is reduced (dietary restriction), they live longer than organisms fed a normal diet. A similar effect is seen when the activity of nutrient-sensing pathways is reduced by mutations or chemical inhibitors. In rodents, both dietary restriction and decreased nutrient-sensing pathway activity can lower the incidence of age-related loss of function and disease, including tumors and neurodegeneration. Dietary restriction also increases life span and protects against diabetes, cancer, and cardiovascular disease in rhesus monkeys, and in humans it causes changes that protect against these age-related pathologies. Tumors and diabetes are also uncommon in humans with mutations in the growth hormone receptor, and natural genetic variants in nutrient-sensing pathways are associated with increased human life span. Dietary restriction and reduced activity of nutrient-sensing pathways may thus slow aging by similar mechanisms, which have been conserved during evolution. We discuss these findings and their potential application to prevention of age-related disease and promotion of healthy aging in humans, and the challenge of possible negative side effects.
2,522 citations
"Is there a role for carbohydrate re..." refers background in this paper
...As indicated in Figure 2, restriction of dietary CHOs would counteract this signalling cascade by normalizing glucose and insulin levels in subjects with metabolic syndrome, in this way acting similar to calorie restriction/fasting [61,62]....
[...]