The Dual Nature of the Keto Diet: Potential Cancer Therapy and Unintended Consequences

by François Dupont
keto diet

Image Caption: Keto diets show promise in slowing tumor growth through ferroptosis, but pose risks of cachexia. (Image Credit: Janowitz lab/Cold Spring Harbor Laboratory)

According to nutrition experts, a ketogenic diet holds the potential to facilitate weight loss of up to 10% of your body weight. These meal plans, characterized by their high fat and low carbohydrate content, prompt the body to burn its own fat reserves. Furthermore, they may have additional benefits in combating various forms of cancer by depriving tumors of the glucose they require for growth. At first glance, this seems like an optimal approach. However, research suggests that these diets may have a detrimental side effect for individuals battling cancer.

Studies conducted on mice with pancreatic and colorectal cancer have demonstrated that a ketogenic diet could potentially accelerate the onset of a fatal wasting disease called cachexia. Cachexia, characterized by diminished appetite, significant weight loss, fatigue, and weakened immunity, affects both human patients and mice. Regrettably, there is currently no effective treatment for this condition, which is responsible for approximately 2 million deaths annually.

“Cachexia is a consequence of a non-healing wound,” explains Tobias Janowitz, Assistant Professor at Cold Spring Harbor Laboratory (CSHL). “It is prevalent among patients with progressive cancer, causing them to become so weak that they are unable to tolerate anti-cancer treatments. Simple daily tasks become monumental challenges.”

Cachexia is a complex metabolic syndrome associated with an underlying disease. It involves the loss of muscle mass, and possibly fat mass, often accompanied by anorexia or loss of appetite. Other significant characteristics of cachexia include inflammation, insulin resistance, and increased protein breakdown.

To address this issue, Janowitz and Miriam Ferrer, a Postdoc at CSHL, are striving to separate the cancer-fighting benefits of the keto diet from its adverse side effect. They discovered that combining keto with corticosteroids, a common class of drugs, prevented cachexia in mice with cancer. Notably, the tumors in these mice shrank, and their lifespan increased.

“While healthy mice also experience weight loss on the keto diet, their metabolism adapts, leading to a plateau,” clarifies Janowitz. “However, mice with cancer are unable to adapt because they are unable to produce enough of the hormone called corticosterone, which helps regulate the effects of keto. As a result, they continue to lose weight.”

The ketogenic diet causes toxic lipid byproducts to accumulate in cancer cells, leading to their destruction through a process known as ferroptosis. While this process slows tumor growth, it also triggers the early onset of cachexia. However, when researchers replenished the depleted hormone with a corticosteroid, the keto diet still caused tumor shrinkage but did not induce cachexia.

“Cancer is a systemic disease that reprograms normal biological processes to support its own growth,” explains Ferrer. “Due to this reprogramming, mice are unable to utilize the nutrients from the keto diet and waste away. However, with the administration of corticosteroids, their condition improved significantly. They lived longer compared to any other treatment we tried.”

Janowitz and Ferrer are part of an international effort, called Cancer Grand Challenges, dedicated to addressing cancer cachexia. They recently published an authoritative overview of this condition and are currently working to refine the timing and dosage of corticosteroids to expand the window of effective cancer therapies in combination with the ketogenic diet.

“Our aim is to fight cancer even more aggressively, slowing its growth further,” Janowitz affirms. “By broadening the positive effects and improving the efficiency of treatment, we can ultimately benefit patients and advance cancer therapeutics.”

Reference: “Ketogenic diet promotes tumor ferroptosis but induces relative corticosterone deficiency that accelerates cachexia” by Miriam Ferrer, Nicholas Mourikis, Emma E. Davidson, Sam O. Kleeman, Marta Zaccaria, Jill Habel, Rachel Rubino, Qing Gao, Thomas R. Flint, Lisa Young, Claire M. Connell, Michael J. Lukey, Marcus D. Goncalves, Eileen P. White, Ashok R. Venkitaraman and Tobias Janowitz, 12 June 2023, Cell Metabolism.
DOI: 10.1016/j.cmet.2023.05.008

The study received funding from the “la Caixa” Foundation, the MRC Cancer Unit, Cancer Grand Challenges, Cancer Research UK, the Mark Foundation For Cancer Research, Cold Spring Harbor Laboratory, Cold Spring Harbor Laboratory Cancer Center, the National Institutes of Health, CK Hutchison Holdings Limited, the University of Cambridge, Atlantic Philanthropies, and the Medical Research Council.

Frequently Asked Questions (FAQs) about keto diet, cachexia, cancer therapy

What is a ketogenic diet?

A ketogenic diet is a meal plan characterized by high fat and low carbohydrate content. It stimulates the body to burn its own fat reserves and has been claimed to facilitate weight loss.

How does a ketogenic diet potentially combat cancer?

A ketogenic diet may combat cancer by depriving tumors of the glucose they require for growth. By restricting carbohydrates and promoting the burning of fat, it aims to limit the fuel supply to cancer cells.

What is cachexia?

Cachexia is a wasting disease associated with underlying illnesses like cancer. It involves the loss of muscle and possibly fat mass, leading to symptoms such as diminished appetite, significant weight loss, fatigue, and weakened immunity.

How does cachexia relate to the ketogenic diet?

Research has shown that a ketogenic diet can potentially accelerate the onset of cachexia, particularly in mice with cancer. It appears that the metabolic effects of the diet, such as the accumulation of toxic lipid byproducts, contribute to the development of cachexia.

Can cachexia be prevented in the context of a ketogenic diet?

Studies on mice have found that combining a ketogenic diet with corticosteroids can prevent cachexia. Corticosteroids help regulate the effects of the diet and improve the condition of mice with cancer, leading to tumor shrinkage and increased lifespan.

What are the implications of this research for cancer therapy?

The research highlights the dual nature of the ketogenic diet as both a potential cancer therapy and a risk factor for cachexia. By understanding the mechanisms involved, scientists aim to fine-tune treatments that harness the benefits of the diet while mitigating the risks of cachexia.

More about keto diet, cachexia, cancer therapy

  • “Ketogenic diet promotes tumor ferroptosis but induces relative corticosterone deficiency that accelerates cachexia” (Cell Metabolism): Link
  • Cold Spring Harbor Laboratory: Link
  • Cancer Grand Challenges: Link
  • Cancer Research UK: Link
  • National Institutes of Health: Link

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FitnessJunkie June 14, 2023 - 7:25 pm

Keto diets for weight loss are popular, but this study raises concerns for cancer patients. Cachexia is a tough condition, and it’s great they’re lookin’ into ways to make keto safer for them. Gotta prioritize health!

JohnDoe23 June 14, 2023 - 8:09 pm

Keto diets r interesting, can’t believe they slow tumor growth by causin’ toxic buildup! But it’s sad that it also leads to cachexia, no treatment for that yet. They shud keep workin’ on findin’ a solution!

Alice90 June 15, 2023 - 1:09 am

wow, this keto diet is somethin’. it can help u lose weight, but it also got sum nasty side effect for cancer patients. cachexia sounds terrifyin’! hope they figure out how to fix it.

ScienceGeek99 June 15, 2023 - 2:32 am

Fascinatin’ research on ketogenic diet and cachexia! It’s amazin’ how diet can affect tumor growth. Finding the right balance with corticosteroids could make a big difference in cancer treatments. Excitin’ times in cancer research!

HealthNut22 June 15, 2023 - 8:56 am

This study shows the risks of keto diet in cancer patients. Cachexia is a serious problem, but it’s good they found that corticosteroids can prevent it. Research like this helps improve cancer therapies!


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