Abstract
Introduction: Purple perilla, P. frutescens var. acuta, has been reported to have anti-inflammatory and antitumor properties. Low-carbohydrate, high-fat (LCHF) ketogenic diet might limit glucose consumption to selectively enhance metabolic stress in cancer cells. This prospective case-control study was performed to evaluate feasibility and efficacy of the newly developed low-carbohydrate-high-fat(LCHF)-plus formula which was enriched with purple perilla extract after pancreaticobiliary cancer surgery. Method: Twenty-eight adult pancreatic cancer patients undergoing pancreaticoduodenectomy or distal pancreatectomy were enrolled. The case group received 3 packs of LCHF-plus formula per day besides meals until the 1st visit to outpatient clinic (OPD) after surgery. The LCHF-plus formula consisted of ketogenic and non-ketogenic macronutrient at a ratio of 1.73:1, and contained energy at a ratio of 80:16:4 from fat, protein, and carbohydrate. The purple perilla extract was added to the formula at a rate of 0.6%. Changes of the patients’ nutrient intake, nutritional status and satisfaction for the formula were evaluated. Changes in plasma lipid profile, visceral protein and NK cell activity were assessed. Result: Since postoperative day 7, the case group(n=17) took significantly more calories(p=0.0004) and protein(p=0.0123) than the control group(n=11) in the linear mixed model. The case group consumed 66.1±18.0% of provided formula, which was approximate to 2 packs a day. Overall satisfaction score was 7.9±2.0. Plasma lipid profile was not significantly different between the two groups during the study period. Compared to preoperative value, NK-cell activity at the 1st visit to OPD increased significantly in the case group (14.4±8.2 vs. 21.4±11.5, p=0.001) while there was no significant changes in the control group(21.1±12.1 vs. 24.6±9.1, p=0.342). No gastrointestinal complaint was reported while the case group consumed the formula. Conclusion: LCHF-plus formula enriched with purple perilla, P. frutescens var. acuta, might contribute to pancreatic cancer patients to improve nutritional intake and immune function after surgery.
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