Does Ketogenic diet have any health benefits particularly in Cancer?

Tina asked me whether Ketogenic diet is good for cancer. I promised her that I would do some research and get back. Next day one of my patients, Nandita, said she is actually on ketogenic diet to lose weight, no carb, only fat and protein. She and her husband confirmed that they have lost weight. Well I said okay, this is interesting. Then my friend Rajesh said that he in fact used ketogenic diet for treating one of his relatives with epilepsy and it worked. I thought there has to be some benefit and I decided to go little deeper into this ‘ketogenic diet’.

Ketogenic diet, typically, is low to no carb diet with only fats and proteins. First of all I must say that it is difficult to handle because most of your foodstuffs do have some carbs. Particularly for a vegetarian ‘no carb and only protein’ diet can be almost impossible to handle.

Glucose is our absolutely basic substrate for producing energy.  That is how the entire human physiology works, using energy from Glucose and oxygen by the Krebs’ cycle. In the absence of glucose, however, there is an alternative source, a pathway developed for fat and protein metabolism. It may lead to catabolic phase  and then lipolysis of fat producing ketonic acid.

Brain is one organ, which finds it hard to metabolize anything other than glucose. Brain is dependent on glucose metabolism. So its not only tough, but difficult for the body to adjust to this new diet.

So let us look at the medical aspect of diet and see if any  benefit. Most of the studies have been done in epilepsy and it is certainly found to be beneficial in epilepsy. But in the randomized trial conducted, though there is decrease in the seizure rate in those on ketogenic diet, at least a third of them dropped off the diet because they could not handle the diet. For something like an epilepsy, it is a lifelong change in diet  can be difficult to adjust.

How about cancer? Though there is theoretical premise that cancer cells will be starved of glucose, it is hardly true. The cancer cells produce substances that produce a catabolic state and that is why there is a loss of weight in cancer and loss of appetite too. The muscles get completely wasted. So there is inherently a ketotic state. So far I have tried looking for any kind of scientific information or confirmed studies on ketogenic diet and cancer. I must say that except for a couple of case reports in brain tumours, no major study exists on the benefits of ketogenic diet in cancer. So if you believe that cancer in some way is going to be affected with ketogenic diet, right now, I can say that there is not enough proof for this.

If you are fighting cancer, it is good if you eat well, good proteins, good exercise, so that your body is in top shape and that really helps.

For weight loss; I believe it is important not go on crash diet. It is much easier to space your meals and good bit of exercise would control the weight. The effort you invest on ketogenic diet if you might want to try it out, I would be cautions in having it for a longer period of time.

I am sure there will be some responses and anecdotes on this but we need to go by scientific evidence rather than some individual anecdotes when we recommend it to a larger population. Hope this helps.


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