بررسی نظام‌مند اثرات رژیم کتوژنیک بر پیامدهای درمانی و کیفیت زندگی بیماران مبتلا به سرطان پستان

نوع مقاله : مروری

نویسندگان

1 دانشجوی کارشناسی علوم تغذیه، کمیته تحقیقات دانشجویی، دانشکده علوم تغذیه و صنایع غذایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استادیار گروه تغذیه سلولی مولکولی، دانشکده علوم تغذیه و صنایع غذایی، انستیتو تحقیقات تغذیه‌ای و صنایع غذایی کشور، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 دانشجوی کارشناسی ارشد تغذیه ورزشی، دانشکده علوم تغذیه و رژیم درمانی، دانشگاه علوم پزشکی تهران، تهران، ایران.

4 دانشجوی کارشناسی ارشد علوم تغذیه، کمیته تحقیقات دانشجویی، دانشکده علوم تغذیه و صنایع غذایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

5 دانشجوی پزشکی عمومی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید پزشکی، تهران، ایران.

چکیده

مقدمه: انجام مداخلاتی که ترکیب بدن و وضعیت متابولیک زنان مبتلا به سرطان پستان را بهبود بخشد، ضروری است، زیرا می ­تواند منجر به بهبود پیش‌آگهی این بیماران شود. رژیم­ غذایی کتوژنیک به‌عنوان درمان­ های تغذیه­ ای مکمل برای بیماران سرطانی پیشنهاد شده ­اند، این مطالعه مرور نظام‌مند با هدف تعیین اثر رژیم کتوژنیک بر پیامدهای متابولیک، درمانی و کیفیت زندگی در بیماران مبتلا به سرطان پستان انجام شد.
روش‌کار: در این مطالعه مرور نظام ­مند جهت یافتن مقالات مرتبط، پایگاه­ های اطلاعاتی Medline، PubMed، Embase، Science Direct، Magiran، ISD، ISC و Cochrane با کلید واژه­ های رژیم کم‌کربوهیدرات، محدودیت کربوهیدرات، رژیم کتوژنیک، سرطان پستان، تومور پستان و نئوپلازم پستان به زبان­ های فارسی و انگلیسی تا نوامبر 2022 مورد جستجو قرار گرفتند.
یافته­ ها: پنج مطالعه مورد بررسی قرار گرفت. نتایج نشان داد که بیماران مبتلا به سرطان پستان با پیروی از رژیم کتوژنیک، پیشرفت­ های قابل توجهی در عملکردهای عاطفی و اجتماعی، کاهش علائم بیماری و بهبود بیومارکرهای سلامت متابولیک (کراتینین، تری‌گلیسیرید، انسولین و فاکتورهای رشد شبه انسولین-I) داشتند.
نتیجه­ گیری: پیروی طولانی‌مدت از رژیم کتوژنیک می­ تواند منجر به کاهش وزن، کاهش اندازه تومور، بهبود کیفیت زندگی، بهبود فاکتورهای التهابی، ترکیب بدن، مقاومت به انسولین و اختلالات چربی خون در بیماران مبتلا به سرطان پستان شود. انجام کارآزمایی­ های بالینی بیشتر برای تعیین اثرات رژیم کتوژنیک بر این عوامل متابولیک، درمانی و کیفیت زندگی در زنان مبتلا به سرطان پستان پیشنهاد می­ شود. 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

A systematic review of the effects of ketogenic diet on treatment outcomes and quality of life in breast cancer patients

نویسندگان [English]

  • Pardis Noura 1
  • Ghazaleh Eslamian 2
  • Haniyeh Lorzadeh Amin 3
  • Mohammadjavad Pasand 1
  • Sepideh Fazeli Taherian 4
  • Amirreza Noura 5
1 B.Sc. Student of Nutrition Sciences, Student Research Committee, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Cellular and Molecular Nutrition, School of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 M.Sc. Student of Sports Nutrition, School of Nutrition and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
4 M.Sc. Student of Nutrition Sciences, Student Research Committee, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 MD Student, Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Interventions which improve the body composition and metabolic health of women with breast cancer are essential because they can improve the prognosis of this disease. Ketogenic diets have been suggested as complementary nutritional treatments for cancer patients. This systematic review was conducted with aim to determine the effect of ketogenic diets on the therapeutic and metabolic outcomes of breast cancer.
Methods: In this systematic review, in order to find the related articles, Medline, Embase, Google Scholar, ScienceDirect, Magiran, SID, ISC, and Cochrane databases were searched with the keywords of low carbohydrate, carbohydrate restriction, Ketogenic diet, breast cancer, breast tumor, and breast neoplasms in English and Persian languages until November 2022.
Results: Five studies were reviewed. The results showed that breast cancer patients following a ketogenic diet had significant improvements in emotional and social functions, reduced disease symptoms, and improved metabolic health biomarkers (creatinine, triglycerides, insulin and free insulin-like growth factor I).
Conclusion: Long-term adherence to a ketogenic diet can lead to weight loss, tumor size reduction, improved quality of life, improved inflammatory factors, body composition, insulin resistance, and serum lipid profile disorders in breast cancer patients. Clinical trials are suggested to evaluate the effects of ketogenic diets on these metabolic factors, treatment, and quality of life in women with breast cancer.

کلیدواژه‌ها [English]

  • Breast cancer
  • Carbohydrate restriction
  • Ketogenic diet
  • Low carbohydrate diet

مراجع

  1. Feng Y, Spezia M, Huang S, Yuan C, Zeng Z, Zhang L, et al. Breast cancer development and progression: Risk factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis. Genes & diseases 2018; 5(2):77-106.
  2. Smolarz B, Nowak AZ, Romanowicz H. Breast cancer—epidemiology, classification, pathogenesis and treatment (review of literature). Cancers 2022; 14(10):2569.
  3. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians 2021; 71(3):209-49.
  4. SeyyedHosseini S, Asemi A, Shabani A, CheshmehSohrabi M. An infodemiology study on breast cancer in Iran: Health information supply versus health information demand in PubMed and Google Trends. The Electronic Library 2018; 36(2):258-69.
  5. Kashyap D, Pal D, Sharma R, Garg VK, Goel N, Koundal D, et al. Global increase in breast cancer incidence: risk factors and preventive measures. BioMed research international 2022; 2022.
  6. Moo TA, Sanford R, Dang C, Morrow M. Overview of breast cancer therapy. PET clinics 2018; 13(3):339-54.
  7. Souvizi B, Shahid Sales S, Noferesti GH, Makhdoumi Y, Rezaei Kalat A, Jafarzadeh Esfehani R, et al. Assessment of effective factors on prognosis of breast cancer patients. Iran J Obstet Gynecol Infertil 2017; 19(39):18-24.
  8. Cava E, Marzullo P, Farinelli D, Gennari A, Saggia C, Riso S, et al. Breast cancer diet “BCD”: A review of healthy dietary patterns to prevent breast cancer recurrence and reduce mortality. Nutrients 2022; 14(3):476.
  9. Weber DD, Aminzadeh-Gohari S, Tulipan J, Catalano L, Feichtinger RG, Kofler B. Ketogenic diet in the treatment of cancer–where do we stand?. Molecular metabolism 2020; 33:102-21.
  10. Klement RJ, Champ CE, Kämmerer U, Koebrunner PS, Krage K, Schäfer G, et al. Impact of a ketogenic diet intervention during radiotherapy on body composition: III—final results of the KETOCOMP study for breast cancer patients. Breast Cancer Research 2020; 22:1-4.
  11. Crosby L, Davis B, Joshi S, Jardine M, Paul J, Neola M, et al. Ketogenic diets and chronic disease: weighing the benefits against the risks. Frontiers in nutrition 2021; 8:702802.
  12. Williams MS, Turos E. The chemistry of the ketogenic diet: Updates and opportunities in organic synthesis. International journal of molecular sciences 2021; 22(10):5230.
  13. Tan-Shalaby J. Ketogenic diets and cancer: emerging evidence. Federal Practitioner 2017; 34(Suppl 1):37S-42S.
  14. Zou Y, Fineberg S, Pearlman A, Feinman RD, Fine EJ. The effect of a ketogenic diet and synergy with rapamycin in a mouse model of breast cancer. PLoS One 2020; 15(12):e0233662.
  15. Khodabakhshi A, Akbari ME, Mirzaei HR, Seyfried TN, Kalamian M, Davoodi SH. Effects of Ketogenic metabolic therapy on patients with breast cancer: A randomized controlled clinical trial. Clinical Nutrition 2021; 40(3):751-8.
  16. Khodabakhshi A, Seyfried TN, Kalamian M, Beheshti M, Davoodi SH. Does a ketogenic diet have beneficial effects on quality of life, physical activity or biomarkers in patients with breast cancer: a randomized controlled clinical trial. Nutrition journal 2020; 19(1):1-10.
  17. Kämmerer U, Klement RJ, Joos FT, Sütterlin M, Reuss-Borst M. Low carb and ketogenic diets increase quality of life, physical performance, body composition, and metabolic health of women with breast cancer. Nutrients 2021; 13(3):1029.
  18. Klement RJ, Weigel MM, Sweeney RA. A ketogenic diet consumed during radiotherapy improves several aspects of quality of life and metabolic health in women with breast cancer. Clinical Nutrition 2021; 40(6):4267-74.
  19. Lorzadeh Amin H, Noormohammadi M, Eslamian G. The effects of ketogenic diet on the outcomes of polycystic ovary syndrome: A systematic review on clinical trials. Iran J Obstet Gynecol Infertil 2022; 25(7):128-38.
  20. Li Y, Gao P, Yang J, Yu H, Zhu Y, Si W. Relationship between IL-10 expression and prognosis in patients with primary breast cancer. Tumor Biology 2014; 35:11533-40.
  21. Seyfried TN, Mukherjee P, Iyikesici MS, Slocum A, Kalamian M, Spinosa JP, et al. Consideration of ketogenic metabolic therapy as a complementary or alternative approach for managing breast cancer. Frontiers in Nutrition 2020: 21.
  22. Gatenby RA, Gillies RJ. Glycolysis in cancer: a potential target for therapy. The international journal of biochemistry & cell biology 2007; 39(7-8):1358-66.
  23. Martínez-Reza I, Díaz L, García-Becerra R. Preclinical and clinical aspects of TNF-α and its receptors TNFR1 and TNFR2 in breast cancer. Journal of Biomedical Science 2017; 24(1):1-8.
  24. Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, Koo J, Madarnas Y, et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. Journal of clinical oncology 2002; 20(1):42-51.
  25. Vadgama JV, Wu Y, Datta G, Khan H, Chillar R. Plasma insulin-like growth factor-I and serum IGF-binding protein 3 can be associated with the progression of breast cancer, and predict the risk of recurrence and the probability of survival in African-American and Hispanic women. Oncology 1999; 57(4):330-40.
  26. Renehan AG, Egger M, Minder C, O'Dwyer ST, Shalet SM, Zwahlen M. IGF‐I, IGF binding protein‐3 and breast cancer risk: comparison of 3 meta‐analyses. International journal of cancer 2005; 115(6):1006-7.
  27. Khodabakhshi A, Akbari ME, Mirzaei HR, Mehrad-Majd H, Kalamian M, Davoodi SH. Feasibility, safety, and beneficial effects of MCT-based ketogenic diet for breast cancer treatment: a randomized controlled trial study. Nutrition and cancer 2020; 72(4):627-34.
  28. Gershuni VM, Yan SL, Medici V. Nutritional ketosis for weight management and reversal of metabolic syndrome. Current nutrition reports 2018; 7:97-106.
  29. Dowling RJ, Goodwin PJ, Stambolic V. Understanding the benefit of metformin use in cancer treatment. BMC medicine 2011; 9:1-6.
  30. Simone BA, Champ CE, Rosenberg AL, Berger AC, Monti DA, Dicker AP, et al. Selectively starving cancer cells through dietary manipulation: methods and clinical implications. Future oncology 2013; 9(7):959-76.
  31. Siddle K. Molecular basis of signaling specificity of insulin and IGF receptors: neglected corners and recent advances. Frontiers in endocrinology 2012; 3:34.
  32. D’Esposito V, Passaretti F, Hammarstedt A, Liguoro D, Terracciano D, Molea G, et al. Adipocyte-released insulin-like growth factor-1 is regulated by glucose and fatty acids and controls breast cancer cell growth in vitro. Diabetologia 2012; 55:2811-22.
  33. Zuccoli G, Marcello N, Pisanello A, Servadei F, Vaccaro S, Mukherjee P, et al. Metabolic management of glioblastoma multiforme using standard therapy together with a restricted ketogenic diet: Case Report. Nutrition & metabolism 2010; 7(1):1-7.
  34. Fine EJ, Miller A, Quadros EV, Sequeira JM, Feinman RD. Acetoacetate reduces growth and ATP concentration in cancer cell lines which over-express uncoupling protein 2. Cancer cell international 2009; 9(1):1-1.
  35. Grabacka M, Pierzchalska M, Dean M, Reiss K. Regulation of ketone body metabolism and the role of PPARα. International journal of molecular sciences 2016; 17(12):2093.
  36. d’Avignon DA, Puchalska P, Ercal B, Chang Y, Martin SE, Graham MJ, et al. Hepatic ketogenic insufficiency reprograms hepatic glycogen metabolism and the lipidome. JCI insight 2018; 3(12).
  37. Schwingshackl L, Hoffmann G. Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis. Journal of the Academy of Nutrition and Dietetics 2013; 113(12):1640-61.
  38. Rusek M, Pluta R, Ułamek-Kozioł M, Czuczwar SJ. Ketogenic diet in Alzheimer’s disease. International journal of molecular sciences 2019; 20(16):3892.
  39. Champ CE, Volek JS, Siglin J, Jin L, Simone NL. Weight gain, metabolic syndrome, and breast cancer recurrence: are dietary recommendations supported by the data?. International journal of breast cancer 2012; 2012.
  40. Inglis JE, Kleckner AS, Lin PJ, Gilmore NJ, Culakova E, VanderWoude AC, et al. Excess body weight and cancer-related fatigue, systemic inflammation, and serum lipids in breast cancer survivors. Nutrition and cancer 2021; 73(9):1676-86.
  41. Mullur R, Liu YY, Brent GA. Thyroid hormone regulation of metabolism. Physiological reviews 2014; 94(2):355-82.
  42. Seyfried TN, Yu G, Maroon JC, D’Agostino DP. Press-pulse: a novel therapeutic strategy for the metabolic management of cancer. Nutrition & metabolism 2017; 14:1-7.
  43. Chinopoulos C, Seyfried TN. Mitochondrial substrate-level phosphorylation as energy source for glioblastoma: review and hypothesis. ASN neuro 2018; 10:1759091418818261.
  44. Wu GY, Thompson JR. The effect of ketone bodies on alanine and glutamine metabolism in isolated skeletal muscle from the fasted chick. Biochemical journal 1988; 255(1):139-44.
  45. Ji CC, Hu YY, Cheng G, Liang L, Gao B, Ren YP, et al. A ketogenic diet attenuates proliferation and stemness of glioma stem‑like cells by altering metabolism resulting in increased ROS production. International Journal of Oncology 2020; 56(2):606-17.
  46. Magee BA, Potezny N, Rofe AM, Conyers RA. The inhibition of malignant cell growth by ketone bodies. Australian Journal of Experimental Biology and Medical Science 1979; 57(5):529-39.
  47. Bartmann C, Janaki Raman SR, Flöter J, Schulze A, Bahlke K, Willingstorfer J, et al. Beta-hydroxybutyrate (3-OHB) can influence the energetic phenotype of breast cancer cells, but does not impact their proliferation and the response to chemotherapy or radiation. Cancer & metabolism 2018; 6:1-9.
  48. Pitroda SP, Wakim BT, Sood RF, Beveridge MG, Beckett MA, MacDermed DM, et al. STAT1-dependent expression of energy metabolic pathways links tumour growth and radioresistance to the Warburg effect. BMC medicine 2009; 7:1-0.
  49. Mukherjee P, Augur ZM, Li M, Hill C, Greenwood B, Domin MA, et al. Therapeutic benefit of combining calorie-restricted ketogenic diet and glutamine targeting in late-stage experimental glioblastoma. Communications Biology 2019; 2(1):200.
مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 9
آذر 1402
صفحه 88-104

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