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Aktuelle Ernährungsmedizin 2016; 41(02): 95-102
DOI: 10.1055/s-0042-102150
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Kann eine kohlenhydratarme/ketogene Ernährung das Tumorwachstum verzögern?

Can a Low Carbohydrate/ketogenic Diet Retard Tumor Growth?
R. J. Klement
1   Klinik für Strahlentherapie und Radioonkologie, Leopoldina Krankenhaus Schweinfurt
,
U. Kämmerer
2   Frauenklinik des Universitätsklinikums Würzburg
› Author Affiliations
Further Information

Publication History

Publication Date:
11 April 2016 (online)

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Zusammenfassung

Hintergrund: Der Stoffwechsel maligner Tumoren unterscheidet sich von dem gesunder Gewebe oftmals durch eine gesteigerte Rate an Glukoseumsatz. In den letzten Jahren stieg das Interesse an einem diätischen Therapieansatz, der das Ziel verfolgt, mithilfe einer Kohlenhydrateinschränkung diese metabolische Besonderheit von Tumorzellen auszunutzen. Präklinische Studien, bei denen tumortragende Tiere eine kohlenhydratbeschränkte Diät – entweder in Form von Fasten/Kalorienrestriktion oder einer kohlenhydratarmen, fettreichen ketogenen Diät – verabreicht bekamen, konnten wachstumshemmende Effekte gegenüber Tumoren nachweisen. Dabei wirken diese Diäten über mehrere verschiedene und sich teilweise überlappende Signalwege, die hauptsächlich über 4 Stoffwechselveränderungen induziert werden. Dies sind eine Absenkung des Blutzucker- und damit Insulinspiegels und eine Erhöhung des Ketonkörper- sowie freien Fettsäurespiegels. Die Übertragbarkeit dieser zumeist an Mäusen gewonnenen Ergebnisse auf den Menschen erscheint zunächst fraglich. Deshalb werden in dieser Arbeit die bisher publizierten klinischen Daten in Bezug auf eine mögliche Wachstumshemmung durch ketogene Diäten untersucht.

Material und Methodik: Es wurden alle bisher erschienenen relevanten klinischen Studien ausgewertet, die tumorwachstumshemmende Effekte untersuchten.

Ergebnisse: Bisher existieren nur Studien mit kleinen Fallzahlen. Deshalb lassen sich derzeit nur ein paar vorsichtige Schlüsse ziehen. Zum einen scheint es so, dass eine ketogene Ernährung als Monotherapie keine tumorhemmenden Effekte auf das Wachstum fortgeschrittener Tumoren hat. Zum anderen scheint es aber einen messbaren Einfluss auf den Tumorzellstoffwechsel zu geben, wie in FDG-PET-Studien und anhand von intratumoralen Laktatmessungen bei HNO-Tumoren gezeigt werden konnte. Wahrscheinlich eignet sich eine ketogene Ernährung am besten als Unterstützung von Standardtherapien.

Schlussfolgerung: Eine ketogene Diät scheint den Tumorstoffwechsel beeinflussen zu können und käme damit als Unterstützung zytotoxischer Standardtherapien infrage.

Abstract

Background: The metabolism of malignant tumors often differs from that of benign tissue by an increased rate of glucose utilization. Dietary modulation in the form of carbohydrate restriction has recently gained large attention as a therapeutic approach to target this metabolic anomaly. Preclinical studies in tumor-bearing animals have shown that a carbohydrate-restricted diet – either in the form of calorie restriction/fasting or a low carbohydrate, high fat ketogenic diet – leads to an attenuation of tumor growth. These diets act through a variety of partly overlapping signaling pathways that are mainly triggered by four physiological shifts, namely a decrease in blood glucose and therefore insulin levels and an increase in ketone body and free fatty acid concentrations. As the translation of these findings to humans is questionable, the aim of this work was to investigate putative growth-inhibiting effects of ketogenic diets based on the clinical data published so far.

Materials and Methods: All relevant clinical studies published to date assessing tumor growth-inhibitory effects of ketogenic diets were evaluated.

Results: Due to the small patient numbers published so far only some preliminary conclusions can be drawn. While a ketogenic diet seems unable to limit the growth of advanced tumors when used as a monotherapy, it may act synergistically with cytotoxic standard therapies. A measurable effect on tumor cell metabolism has been shown in FDG-PET studies and through intra-tumoral lactate measurements.

Conclusions: A ketogenic diet seems able to influence tumor metabolism and may be an option to increase the efficacy of cytotoxic therapies.

Schlüsselwörter

Krebsstoffwechsel - Ketogene Diät - Kohlenhydrate - Krebs - Kalorienrestriktion

Keywords

cancer metabolism - ketogenic diet - carbohydrates - cancer - calorie restriction
 

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