Feasibility and Biological Activity of a Ketogenic/Intermittent-Fasting Diet in Patients With Glioma
Schreck KC, Hsu FC, Berrington A, Henry-Barron B, Vizthum D, Blair L, Kossoff EH, Easter L, Whitlow CT, Barker PB, Cervenka MC, Blakeley JO, Strowd RE
Neurology · 57 citas
Cómo se estudió
- Diseño
- Ensayo clínico controlado (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Cancer Institute
- Gobierno
- National Center for Advancing Translational Sciences
- Gobierno
- NCI NIH HHS
- Gobierno
- NCATS NIH HHS
- Subvenciones
- National Center for Advancing Translational Sciences (UL1-TR003098); National Cancer Institute (P30CA012197); National Center for Advancing Translational Sciences (KL2TR001421); National Center for Advancing Translational Sciences (UL1TR001420)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2021-07-07 · Neurology · vol. 97 · número 9 · págs. e953–e963
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 70 citas · más que el 95% de estudios similares · 4.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 45 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · CC-BY
- Áreas de investigación
- Diet and metabolism studies · Dietary Effects on Health · Metabolism and Genetic Disorders
- Palabras clave
- Ketonuria, Medicine, Ketogenic diet, Glioma, Internal medicine, Ketone bodies, Hypoglycemia, Ketosis, Gastroenterology, Endocrinology, Insulin, Diabetes mellitus, Epilepsy
- MeSH
- brain, humans, glioma, brain neoplasms, ketosis, fasting, feasibility studies, adult, aged, middle aged, female, male, diet, high-protein low-carbohydrate, diet, ketogenic
13 autores
- Karisa C. Schreck🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Fang‐Chi Hsu🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Adam Berrington🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Bobbie J. Henry-Barron🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Diane Vizthum🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Lindsay Blair🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Eric H. Kossoff🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Linda H. Easter🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Christopher T. Whitlow🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Peter B. Barker🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Mackenzie C. Cervenka🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Jaishri O'Neill Blakeley🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
- Roy Ervin Strowd III🇬🇧🇺🇸🇧🇾University of Nottingham; Johns Hopkins University; Research Institute of Radiology
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To examine the feasibility, safety, systemic biological activity, and cerebral activity of a ketogenic dietary intervention in patients with glioma.
Methods
Twenty-five patients with biopsy-confirmed World Health Organization grade 2 to 4 astrocytoma with stable disease after adjuvant chemotherapy were enrolled in an 8-week Glioma Atkins-Based Diet (GLAD). GLAD consisted of 2 fasting days (calories <20% calculated estimated needs) interleaved between 5 modified Atkins diet days (net carbohydrates ≤20 g/d) each week. The primary outcome was dietary adherence by food records. Markers of systemic and cerebral activity included weekly urine ketones, serum insulin, glucose, hemoglobin A1c, insulin-like growth factor-1, and magnetic resonance spectroscopy at baseline and week 8.
Results
Twenty-one patients (84%) completed the study. Eighty percent of patients reached ≥40 mg/dL urine acetoacetate during the study. Forty-eight percent of patients were adherent by food record. The diet was well tolerated, with two grade 3 adverse events (neutropenia, seizure). Measures of systemic activity, including hemoglobin A1c, insulin, and fat body mass, decreased significantly, while lean body mass increased. Magnetic resonance spectroscopy demonstrated increased ketone concentrations (β-hydroxybutyrate [bHB] and acetone) in both lesional and contralateral brain compared to baseline. Average ketonuria correlated with cerebral ketones in lesional (tumor) and contralateral brain (bHB R s = 0.52, p = 0.05). Subgroup analysis of isocitrate dehydrogenase-mutant glioma showed no differences in cerebral metabolites after controlling for ketonuria.
Conclusion
The GLAD dietary intervention, while demanding, produced meaningful ketonuria and significant systemic and cerebral metabolic changes in participants. Ketonuria in participants correlated with cerebral ketone concentration and appears to be a better indicator of systemic activity than patient-reported food records.
Trial registration information
ClinicalTrials.gov Identifier: NCT02286167.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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