Abstract
Breast cancer (BC) patients often ask for a healthy diet. Here, we investigated a healthy standard diet (SD), a low carb diet (LCD), and a ketogenic diet (KD) for BC patients during the rehabilitation phase. KOLIBRI was an open-label non-randomized one-site nutritional intervention trial, combining inpatient and outpatient phases for 20 weeks. Female BC patients (n = 152; mean age 51.7 years) could select their diet. Data collected were: Quality of life (QoL), spiroergometry, body composition, and blood parameters. In total 30, 92, and 30 patients started the KD, LCD, and SD, respectively. Of those, 20, 76, and 25 completed the final examination. Patients rated all diets as feasible in daily life. All groups enhanced QoL, body composition, and physical performance. LCD participants showed the most impressive improvement in QoL aspects. KD participants finished with a very good physical performance and muscle/fat ratio. Despite increased cholesterol levels, KD patients had the best triglyceride/high-density lipoprotein (HDL) ratio and homeostatic model assessment of insulin resistance index (HOMA-IR). Most metabolic parameters significantly improved in the LCD group. SD participants ended with remarkably low cholesterol levels but did not improve triglyceride/HDL or HOMA-IR. In conclusion, both well-defined KDs and LCDs are safe and beneficial for BC patients and can be recommended during the rehabilitation phase.
Highlights
Breast cancer (BC) is one of the most common cancer types worldwide, with over 2 million new cases every year (www.wcrf.org) [1]
All diets were well tolerated and safe and supported the quality of life and physical performance of BC patients in the rehabilitation process, most significant improvements were observed within the low carb diet (LCD) group
The avoidance of refined carbohydrates was a commonality among all three diet types and could have played a key role in inducing weight loss, on the one hand by reducing secretion of the “fattening” hormone insulin [38], which was lower at T20 than at T0 in all diet groups, and on the other hand by promoting a healthy microbiome [39]
Summary
Breast cancer (BC) is one of the most common cancer types worldwide, with over 2 million new cases every year (www.wcrf.org (accessed on 19 March 2021)) [1]. Despite a generally good prognosis, the disease itself as well as its standard treatments via surgery, radiation, and chemotherapy can have a negative influence on the health and physical fitness of affected patients. Typical problems such as weakness and loss of muscle mass (sarcopenia) are on the one hand significantly related to treatment adherence and overall survival [2] and, on the other hand, to the particular cancer patient’s whole-body metabolism. An increased inflammatory environment may characterize the latter [3,4]. Fat oxidation rate increases [7,8]
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