撰写：Michelle 日期：2023年5月26日
有人担心生酮的安全，日本医生团队却证明长期生酮饮食可提高癌症生存率
许多人对生酮饮食的安全性一直抱有警惕，不过日本大阪大学医学院于2023年5月16日发表在国际《营养》（Nutrients）期刊上的临床研究显示，它可提高癌症生存率。结果让医学团队获得进一步研究的灵感和动力。
生酮饮食是一种高脂肪、低碳水化合物的饮食方法。此前，对卵巢癌和子宫内膜癌患者进行的人体随机对照试验显示，生酮饮食可以改善患者的生活质量，减少脂肪量和血液胰岛素水平。由于研究设计的差异或普适性不足，生酮饮食与癌症患者总体生存率的关联还一直存在争议。上周发表的近10年的研究揭示了这种饮食对癌症患者的潜在长期影响。
大阪大学医院进行的研究于2013年2月至2018年12月期间进行，纳入了诊断为第四期癌症的患者。研究开始时，参与者在第一周内严格限制每天摄入的碳水化合物量不超过10克。从第二周开始，他们每天的碳水化合物摄入量被限制在20克，持续三个月。那些想要继续生酮饮食的患者在三个月后将碳水化合物摄入量限制在30克以下。他们的进展在生酮饮食期间和之后得到了持续监测，随访持续至2023年3月。
论文中提到，2014年诊断为晚期肺腺癌的患者在日本的五年生存率为8.0%，而结肠癌的五年生存率为19.8%。然而，该研究发现，长期坚持生酮饮食可以改善晚期癌症患者的预后。在坚持饮食三个月以上的37名患者中，中位总生存期为25.1个月，五年生存率为23.9%。该研究还评估了55名患者对生酮饮食持续时间与预后的关联，并发现持续饮食12个月以上的患者与未持续饮食的患者相比，总生存率显著更高。因此，生酮饮食似乎可以改善晚期癌症患者的生存率。 这项研究规模还比较小且为回顾性研究，未来仍需要进行前瞻性和对照性试验，并扩大病人群体规模，以进一步证实这一观点。
Some people have concerns about the safety of the ketogenic diet, but a team of doctors from Osaka University in Japan has proven that long-term adherence to the ketogenic diet can improve cancer survival rates. This clinical study, published in the international journal “Nutrients” on May 16, 2023, has inspired and motivated the medical team for further research.
The ketogenic diet is a high-fat, low-carbohydrate dietary approach. Previous randomized controlled trials on ovarian cancer and endometrial cancer patients have shown that the ketogenic diet can improve patients’ quality of life, reduce fat mass, and decrease blood insulin levels. However, due to differences in study design or limited generalizability, the association between the ketogenic diet and overall cancer survival rates has been controversial. The recently published decade-long study sheds light on the potential long-term effects of this diet on cancer patients.
The study conducted at Osaka University Hospital took place from February 2013 to December 2018 and included patients diagnosed with stage IV cancer. At the beginning of the study, participants strictly limited their daily carbohydrate intake to no more than 10 grams during the first week. From the second week onwards, their daily carbohydrate intake was limited to 20 grams for three months. Patients who wished to continue the ketogenic diet restricted their carbohydrate intake to below 30 grams after three months. Their progress was continuously monitored during and after the ketogenic diet, with follow-ups until March 2023.
The paper mentions that the five-year survival rate for patients diagnosed with advanced lung adenocarcinoma in Japan in 2014 was 8.0%, while the five-year survival rate for colon cancer was 19.8%. However, the study found that long-term adherence to the ketogenic diet can improve the prognosis of advanced cancer patients. Among the 37 patients who adhered to the diet for three months or more, the median overall survival period was 25.1 months, with a five-year survival rate of 23.9%.
The study also evaluated the association between the duration of ketogenic diet adherence and prognosis in 55 patients and found that patients who continued the diet for more than 12 months had significantly higher overall survival rates compared to those who did not. Therefore, the ketogenic diet appears to improve the survival rate of patients with advanced cancer.
Although this study has a relatively small sample size and is retrospective in nature, future prospective and controlled trials with larger patient populations are needed to further confirm these findings.
