Les résultats pour la diète cétogène (régime “keto” ou “ketogenic diet”) et le cancer sont préliminaires, mais intéressants:
– Une méta-analyse publiée en 2014 conclut que: “ketogenic diet are effective against cancer in animal experiments”).
– Une revue systématique publiée en 2018 conclut que: “KCRDs [ketogenic or caloric restricted diets] have positive effects on malignant gliomas in published preclinical studies” chez l’humain. Elle note cependant que “However, because of the paucity of clinical data, the efficacy of KCRDs for improving survival and quality of life of glioma patients remains to be proven in prospective studies”. À noter: le gliome est un cancer du cerveau. On est pas certain que les conclusions s’appliquent au cancer du sein.
– Une “realist review” publiée en 2017 semble bien résumer la question: “In total, 29 animal and 24 human studies were included in the analysis. The majority of animal studies (72%) yielded evidence for an anti-tumor effect of KDs [ketogenic diets]. Evidential support for such effects in humans was weak and limited to individual cases, but a probabilistic argument shows that the available data strengthen the belief in the anti-tumor effect hypothesis at least for some individuals. Evidence for pro-tumor effects was lacking completely. Feasibility of KDs for cancer patients has been shown in various contexts. The probability of achieving an anti-tumor effect seems greater than that of causing serious side effects when offering KDs to cancer patients”.
– Par contre, d’autres chercheurs sont plus conservateurs et affirment dans une revue systématique publiée en 2017 que “more robust and consistent clinical evidence is necessary before the KD can be recommended for any single cancer diagnosis or as an adjunct therapy”.
Tout bien pesé, après cette lecture rapide de la littérature et sans être un expert de la question, je serais d’accord avec le probabilistic argument de la “realist review” de 2017. On peut concevoir qu’il y ait des bienfaits et les risques semblent minimes.
Une revue de la littérature en dit plus long sur les mécanismes sous-jacents:
“The preclinical data and mechanistic insights reviewed here support the notion that ketogenic therapy could improve the outcome after RT, both in terms of higher tumor control and lower normal-tissue complication probability. The first effect relates to the metabolic shift from glycolysis towards mitochondrial metabolism, which selectively increases ROS production and impairs ATP production in tumor cells. The second effect is based on the differential stress resistance phenomenon that is achieved when glucose and growth factors are reduced and ketone bodies are elevated, which causes normal cells to switch to a cellular maintenance and stress resistance program. Underlying both effects are the metabolic differences between normal and tumor cells that have been reviewed here and elsewhere [42,43,118,140]. First clinical studies indicate that a differential stress resistance can be induced by STF in humans; however, it has not been studied yet whether such as resistance could be mimicked by KDs and in this way be utilized for a longer course of RT. The large variety of RT and chemotherapy schedules employed in modern cancer treatment opens up a large number of possible ketogenic interventions, ranging from STF over KDs to the administration of exogenous ketone bodies. Ultimately, patient preferences and patient-related factors such as body composition will determine which form of ketogenic intervention can be considered.”
Voir aussi: Jeûner pour prévenir et survivre au cancer.
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