A Ketogenic Diet Is Acceptable in Women with Ovarian and Endometrial Cancer and Has No Adverse Effects on Blood Lipids: A Randomized, Controlled Trial

Abstract

Ketogenic diets (KDs) are emerging as effective therapies for several chronic diseases, including cancer. However, concerns regarding safety and adherence may prevent clinicians from prescribing KDs. We hypothesized that a KD does not negatively affect blood lipid profile compared to a lower-fat diet in ovarian and endometrial cancer patients, and that KD subjects would demonstrate acceptable adherence. Subjects were randomized to either a KD (70% fat, 25% protein, 5% carbohydrate), or the American Cancer Society diet (ACS; high-fiber and lower-fat). Blood lipids and ketones were measured at baseline and after 12 weeks of the assigned intervention. Adherence measures included urinary ketones in the KD and 4 days’ diet records. Diet records were also examined to identify general patterns of consumption. Differences between the diets on blood lipids and dietary intake were assessed with Analysis of covariance and independent t-tests. Correlation analyses were used to estimate associations between dietary intake and serum analytes. At 12 weeks, there were no significant differences between diet groups in blood lipids, after adjusting for baseline values and weight loss. Adherence among KD subjects ranged from 57% to 80%. These findings suggest that KDs may be a safe and achievable component of treatment for some cancer patients.

ClinicalTrials.gov registration:

• NCT03171506

Acknowledgments

The authors gratefully thank UAB Gynecologic Oncology for assistance with subject recruitment.

Disclosure Statement

None of the authors have conflicts of interest to report.

Author contributions

BAG and KRF designed the research project; CWC and RCA conducted the research; CWC analyzed the data; CWC wrote the first draft with contributions from BAG and KRF; all authors reviewed subsequent drafts of the manuscript.

Additional information

Funding

This study was supported by the American Institute of Cancer Research, University of Alabama at Birmingham Comprehensive Cancer Center, University of Alabama at Birmingham Nutrition Obesity Research Center P30DK56336, University of Alabama at Birmingham Diabetes Research Center P60DK079626.