Efficacy of Low-Carbohydrate Ketogenic Diet as an Adjuvant Cancer Therapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Open accessAbstract
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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One association showed no significant increase in adverse events (e.g., constipation, abdominal pain, and nausea) with KD.
“In terms of safety, one association showed no significant increase in adverse events (e.g., constipation, abdominal pain, and nausea) with KD [44].”
From Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials (2023) · cites this paper as [44]
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Ramadhani, R. A., Arvin, N., Moussa, S., Janda, M., Playdon, M. C., & Obermair, A. (2026) · PLoS ONE · doi:10.1371/journal.pone.0360238
- Authors
- Yang, Y.-F., Mattamel, P. B., Joseph, T., Huang, J., Chen, Q., Akinwunmi, B. O., Zhang, C. J. P., & Ming, W.-K.
- Affiliations
- Jinan University (CN)
- Imperial College London (GB)
- Brigham and Women's Hospital (US)
- University of Hong Kong (HK)
- Corresponding author
- Ming, Wai-Kit
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2021-04-21
- Volume
- 13
- Issue
- 5
- Pages
- 1388
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC8142992
- OpenAlex
- W3156108334
- Cited by
- 57
- References
- 34
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 10 · 2023: 14 · 2022: 12 · 2021: 4
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- adjuvant cancer therapy, lipid profile, body weight, fasting blood glucose, insulin, ketosis, prostate-specific antigen, patient satisfaction, adverse effects
- MeSH terms
- Blood Glucose, Body Weight, Fasting, Humans, Insulin, Lipids, Neoplasms, Biomarkers, Tumor, Odds Ratio, Case-Control Studies, Randomized Controlled Trials as Topic, Treatment Outcome, Patient Satisfaction, Diet, Carbohydrate-Restricted, Diet, Ketogenic
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