Ketogenic and low-sugar diets for patients with cancer: perceptions and practices of medical oncologists in Canada
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ORIGINAL ARTICLE
Ketogenic and low-sugar diets for patients with cancer: perceptions and practices of medical oncologists in Canada Pamela N. Klassen 1,2
&
Benjamin A. Goldenberg 3 & Pascal Lambert 4 & Kathy Vagianos 5,6 & Christina A. Kim 3
Received: 20 November 2019 / Accepted: 13 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Many patients with cancer are interested in complementary therapies, including strategies such as reduced carbohydrate diets. Guidelines regarding the use of these diets during cancer treatment are lacking; therefore, we aimed to explore the perceptions and practices of medical oncologists in Canada regarding low-sugar and ketogenic diets. Method A cross-sectional, online multiple-choice survey was distributed to 206 Canadian medical oncologists. Questions explored frequency of patient interactions, oncologist perceptions of efficacy, advice given to patients, and concerns about side effects related to reduced carbohydrate diets. Results Responses were received from 57 medical oncologists in seven of thirteen provinces and territories, with an overall response rate of 28%. Forty-nine percent of respondents were asked at least weekly about a low-sugar diet, and 9% about the ketogenic diet. Eighty-five percent supported the use of a low–added sugar diet in patients with diabetes or hyperglycemia, while conversely 87% did not support the use of a ketogenic diet for any of their patients undergoing active cancer treatment. Respondents felt either that a ketogenic diet was not effective (31%) or that the effect on cancer outcomes was unknown (69%). Ninety-six percent of respondents had concerns about a ketogenic diet for patients receiving active cancer treatment. Conclusion The role of reduced carbohydrate diets during cancer treatment is topical. Canadian oncologists are particularly reluctant to support a ketogenic diet for patients on active cancer treatment, with concerns about side effects and unknown efficacy. There may be a role for continuing medical education and institutional guidelines to inform these discussions with patients. Keywords Diet . Ketogenic . Oncologists . Surveys . Cancer . Perceptions
Introduction Cancer is the leading cause of death in Canada, with nearly 1 in 2 Canadians expected to receive a cancer diagnosis during their lifetime [1]. While the hallmarks of cancer
are common across disease sites [2], etiology and treatment approaches differ significantly. In both the presence and absence of curative treatments, many patients explore complementary and alternative therapies. In a recent Canadian study, nearly 75% of cancer survivors had used some form
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05361-9) contains supplementary material, which is available to authorized users. * Pamela N. Klassen [email protected] 1
2
Department of Nutrition Services, CancerCare Manitoba, Winnipeg, MB, Canada Division of Human Nutrition, Department of Agricultural, Food
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