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Impact of a ketogenic diet intervention during radiotherapy on body composition: V. Final results of the KETOCOMP study for head and neck cancer patients.
Klement, RJ, Sweeney, RA
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 2022;198(11):981-993
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Plain language summary
Head and neck cancer (HNC) describes cancers originating from the lip, oral and nasal cavity, paranasal sinuses, pharynx, larynx, and trachea. Patients with HNC frequently present with feeding difficulties and malnutrition, which are often further aggravated by tobacco and alcohol abuse and a general unhealthy lifestyle. This study aimed to investigate the impact of a ketogenic diet (KD) versus an unspecified standard diet (SD) on body composition and survival in HNC patients undergoing radio(chemo)therapy. This study is a controlled clinical trial. Results show that an individualized KD supplemented with essential amino acids consumed during curative radio(chemo)therapy of HNC patients was able to slow down the negative consequences of therapy on body composition to some extent. Authors conclude that further research of KDs in frail cancer patient populations is required which may help to motivate their implementation as complementary therapies for select patients.
Abstract
PURPOSE Patients with head and neck cancer (HNC) are at risk of malnutrition, especially during radiochemotherapy. We aimed to study the impact of a ketogenic diet (KD) versus an unspecified standard diet (SD) on body composition and survival in HNC patients undergoing radio(chemo)therapy. METHODS As part of a controlled clinical trial, non-metastasized HNC patients were enrolled into either a KD (N = 11) or an SD (N = 21) group between May 2015 and May 2021. Body composition was measured weekly by bioimpedance analysis and analyzed using linear mixed effects models. Overall and progression-free survival was assessed during regular follow-up. RESULTS A total of 7 KD and 21 SD patients completed the study and were eligible for comparative analysis. Chemotherapy was significantly associated with declines in all body composition parameters, while the KD had opposing, yet nonsignificant effects. In patients receiving chemotherapy, average weekly reductions of body mass (BM) and skeletal muscle mass (SMM) were 0.9 kg and 0.31 kg in the KD group versus 1.2 kg and 0.57 kg in the SD group, respectively. Patients in the KD group receiving no chemotherapy achieved an average increase of 0.04 kg BM and 0.12 kg SMM per week. After a median follow-up of 42 months (range 6.7-78 months) there were no significant differences in progression-free or overall survival between the groups. CONCLUSION The KD may partially counteract the detrimental effects of radiochemotherapy on body composition in HNC patients. This should encourage further research into KDs in frail cancer patient populations and motivate their implementation as complementary therapy for selected patients.
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Effect of shiitake (Lentinus edodes) extract on antioxidant and inflammatory response to prolonged eccentric exercise.
Zembron-Lacny, A, Gajewski, M, Naczk, M, Siatkowski, I
Journal of physiology and pharmacology : an official journal of the Polish Physiological Society. 2013;64(2):249-54
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Shiitake (Lentinus edodes) is a popular culinary and medicinal mushroom. It contains numerous active compounds including ergothioneine which has anti-inflammatory and antioxidant properties. This study evaluated the antioxidant and anti-inflammatory effect of shiitake extract in healthy men exposed to exercise-induced muscle damage. Fourteen healthy males participated in this placebo-controlled crossover study. Subjects ingested shiitake extract or placebo for 10 days prior to exercise, with a 30 day period between the two phases of the crossover. Bloods were drawn at 20 minutes, 24 hours and 48 hours after exercise. There was no statistically significant difference between the shiitake and the placebo group in the inflammation related parameters measured. But there was a significant change in certain compounds suggesting an increased antioxidant activity in the shiitake group. The authors conclude that shiitake does not affect the inflammatory response following exercise but has antioxidant action, and that further studies are needed to make recommendations for use of shiitake by athletes.
Abstract
The shiitake (Lentinus edodes) extract is purported to have potent antioxidant, anti-inflammatory and regenerative properties due to presence of many bioactive compounds such as ergothioneine. This study was designed to assess the antioxidant and anti-inflammatory activity of shiitake extract in healthy men exposed to exercise-induced skeletal muscles damage. Subjects ingested shiitake mushroom extract (700 mg, two times per day) or placebo for 10 days prior to two separate exercise trials (crossover study). The exercise session involved 90 min run at 65% VO2max (0% gradient) and 15-min eccentric phase at 65% VO2max (-10% gradient). Subjects experienced creatine kinase (peak 461±206 IU/L) and leukocytes (peak 9.82 x 103/μL) elevations indicating muscle damage and inflammation. Exercise altered plasma IL-6 (peak 5.29±0.78 pg/mL), IL-10 (peak 24.75±6.22 pg/mL) and IL-1β (peak 0.54±0.09 pg/mL) levels but did not affect tumour necrosis factor α (TNF-α) level relative to baseline. Shiitake extract did not demonstrate any effect on immune cells number and inflammatory mediators level, with the exception of IL-10. Thiol redox status (GSHtotal-2GSSG/GSSG) and niric oxide (NO) concentration increased after shiitake extract whereas H2O2 and 8-isoprostanes did not change. In conclusion, shiitake mushroom extract had no effect on markers of inflammation following prolonged eccentric exercise but demonstrated an antioxidant activity through the regulation of nitric oxide concentration and thiol redox status.