Could ketogenic diet “starve” cancer? Emerging evidence

on behalf of the Obesity Programs of nutrition, Education, Research and Assessment (OPERA) group

Research output: Contribution to journalReview articlepeer-review


Cancer cells (CCs) predominantly use aerobic glycolysis (Warburg effect) for their metabolism. This important characteristic of CCs represents a potential metabolic pathway to be targeted in the context of tumor treatment. Being this mechanism related to nutrient oxidation, dietary manipulation has been hypothesized as an important strategy during tumor treatment. Ketogenic diet (KD) is a dietary pattern characterized by high fat intake, moderate-to-low protein consumption, and very-low-carbohydrate intake (<50 g), which in cancer setting may target CCs metabolism, potentially influencing both tumor treatment and prognosis. Several mechanisms, far beyond the originally proposed inhibition of glucose/insulin signaling, can underpin the effectiveness of KD in cancer management, ranging from oxidative stress, mitochondrial metabolism, and inflammation. The role of a qualified Nutritionist is essential to reduce and manage the short and long-term complications of this dietary therapy, which must be personalized to the individual patient for the planning of tailored KD protocol in cancer patients. In the present review, we summarize the proposed antitumor mechanisms of KD, the application of KD in cancer patients with obesity and cachexia, and the preclinical and clinical evidence on KD therapy in cancer.

Original languageEnglish
Number of pages22
JournalCritical Reviews in Food Science and Nutrition
Early online date2021
Publication statusE-pub ahead of print - 2021


  • Cachexia
  • cancer
  • diet
  • ketogenic diet
  • nutrition
  • nutritionist
  • obesity

ASJC Scopus subject areas

  • Food Science
  • Industrial and Manufacturing Engineering


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