The use of the ketogenic diet (KD) as an adjuvant therapy in high-grade gliomas (HGG) is supported by preclinical studies, but clinical data on its effects on metabolism are currently lacking. In this study, we describe the effects of a KD on glucose profile, ketonemia, energy metabolism, and nutritional status, in adults affected by HGG. This was a single-arm prospective study. An isocaloric 3:1 KD was administered for 1 mo. Glucose profile was assessed by using fasting glycemia, insulin, and glycated hemoglobin. To evaluate ketonemia changes, a hand-held ketone meter was used from home. Energy metabolism was assessed by indirect calorimetry. Nutritional status was evaluated through changes in body composition and in lipid and hepatic profile. No changes in fasting glycemia were observed; however, insulinemia dropped to half of baseline levels. The KD shifted the metabolism, rising ketonemia and decreasing glucose oxidation rate to a quarter of the initial values. Moreover, the KD was generally safe. One-month intervention with the KD was able to act upon key metabolic substrates potentially involved in HGG metabolism. The lack of a significant reduction in fasting glycemia should be investigated in future studies.

Isocaloric Ketogenic Diet in Adults with High-Grade Gliomas: A Prospective Metabolic Study / A. Foppiani, R. De Amicis, C. Lessa, A. Leone, S. Ravella, E. Ciusani, A. Silvani, G. Zuccoli, A. Battezzati, E. Lamperti, S. Bertoli. - In: NUTRITION AND CANCER. - ISSN 0163-5581. - 73:6(2021 Jul 03), pp. 1004-1014. [10.1080/01635581.2020.1779759]

Isocaloric Ketogenic Diet in Adults with High-Grade Gliomas: A Prospective Metabolic Study

A. Foppiani
Primo
Writing – Original Draft Preparation
;
R. De Amicis
Secondo
Investigation
;
C. Lessa
Investigation
;
A. Leone
Writing – Review & Editing
;
S. Ravella
Writing – Review & Editing
;
A. Silvani
Writing – Review & Editing
;
A. Battezzati
Supervision
;
S. Bertoli
Ultimo
Conceptualization
2021

Abstract

The use of the ketogenic diet (KD) as an adjuvant therapy in high-grade gliomas (HGG) is supported by preclinical studies, but clinical data on its effects on metabolism are currently lacking. In this study, we describe the effects of a KD on glucose profile, ketonemia, energy metabolism, and nutritional status, in adults affected by HGG. This was a single-arm prospective study. An isocaloric 3:1 KD was administered for 1 mo. Glucose profile was assessed by using fasting glycemia, insulin, and glycated hemoglobin. To evaluate ketonemia changes, a hand-held ketone meter was used from home. Energy metabolism was assessed by indirect calorimetry. Nutritional status was evaluated through changes in body composition and in lipid and hepatic profile. No changes in fasting glycemia were observed; however, insulinemia dropped to half of baseline levels. The KD shifted the metabolism, rising ketonemia and decreasing glucose oxidation rate to a quarter of the initial values. Moreover, the KD was generally safe. One-month intervention with the KD was able to act upon key metabolic substrates potentially involved in HGG metabolism. The lack of a significant reduction in fasting glycemia should be investigated in future studies.
Keywords: ketogenic diet; glioma; glioblastoma; glucose; metabolism; nutritional status
Settore MED/49 - Scienze Tecniche Dietetiche Applicate
Settore BIO/09 - Fisiologia
17-giu-2020
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/742278
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