Abstract

Background: In light of the mitochondrial metabolic theory, cancer could be considered a metabolic disease. It has been suggested that cancer metabolic therapies, including ketogenic diets (KD) may be useful to exploit differences in metabolism from non-neoplastic cells. In this systematic review and meta-analysis of randomized controlled trials (RCTs) we aimed to investigate the efficacy of KD as an adjuvant therapy in the treatment of cancer compared to a traditional non-ketogenic diet. Methods: In this study, databases such as MEDLINE/PubMed, Web of Science, SCOPUS, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Only RCTs that involved cancer participants that were assigned to dietary interventions including a KD group and a control group (any non-ketogenic dietary intervention) were selected Two 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 This meta-analysis showed a significant reduction in weight (WMD = -3.58 kg; 95% CI: -6.24, -0.92; P = 0.008, BMI (WMD = -1.96 kg/m2; 95% CI: -2.83, -1.09; P Ë? 0.001) and fat mass (WMD = -1.90; 95% CI: -3.57, -0.24; P = 0.025) with ketogenic diet. KD significantly decreased glucose (WMD = -9.52 mg/dl; 95% CI: -13.81, -5.23; P Ë? 0.001) and IGF-1 (WMD = -16.27 ng/ml; 95% CI: -22.44, -10.09; P Ë? 0.001). Furthermore, ketogenic diet induced ketosis by increasing β-hydroxybutyrate.