KETOGENIC DIET AND CANCER: STATE OF THE EVIDENCE AND FUTURE DIRECTIONS

Dr. Mehnaz Khan, Dr. Sharique Ahmad*, Dr. Tanaz Khan

ABSTRACT

The ketogenic diet (KD) has been proposed as an adjunctive approach in cancer management, primarily through its impact on tumor energy metabolism. This review dissects the mechanistic basis of KD’s potential effects, focusing on four interrelated domains: (1) glucose metabolism — restriction of carbohydrate intake lowers circulating glucose and insulin, potentially limiting glycolysis-dependent tumor growth; (2) mitochondrial function — ketone bodies may alter oxidative phosphorylation and reactive oxygen species dynamics, influencing cancer cell viability; (3) inflammation — KD’s anti-inflammatory effects may modulate the tumor microenvironment; and (4) cell growth pathways — downregulation of mTOR and insulin-like growth factor signaling may impede proliferation. Evidence synthesis was conducted using databases including PubMed and Google Scholar, identifying both preclinical and clinical studies on glioblastoma, breast, and colon cancers. Preclinical animal models consistently show slowed tumor progression, yet human trials reveal variable and often modest benefits, with heterogeneity in study design, dietary adherence, and patient selection limiting interpretation. Furthermore, the possibility of tumor adaptation to ketone utilization remains an unresolved concern. Current evidence supports KD as biologically plausible but insufficiently validated for routine clinical use. Well-controlled, long-term trials are essential to clarify efficacy, optimal patient selection, and integration with standard oncologic therapies.

Keywords: Ketogenic diet, Cancer metabolism, Glucose restriction, Tumor growth inhibition, Ketone bodies, Dietary interventions, Cancer therapy.