Thread by @UrviShahMD

1/8 Our review on the evidence behind Plant-Based and Ketogenic Diets in Cancer Patients @Neil_Iyengar @JAMAOnc @JAMANetwork @MSKCancerCenter @aicrtweets @ASCOPost @ASHClinicalNews @AmericanCancer @NCIMedia
ja.ma/3NPks2G #cancer #nutrition #diet #wfpb #plantbased #keto

2/8 Plant based (WFPBD) and keto diets (KD) have gained popularity in oncology and this topic is often permeating clinical dialogue. It is of interest to patients, caregivers, physicians and oncologists. #plantbased #keto

3/8 WFPBD and KD have starkly different nutrition composition. WFPBD maximizes nutrient-dense plant foods and minimizes processed foods, oils, and animal foods. KD focuses on ketone body production and is typically very low carbohydrate and with high animal-based foods.

4/8 Mechanistic evidence for both diets - weight loss, decreased inflammation, decreased insulin levels. For WFPBD alone - increased fiber, phytochemicals, and butyrate levels and decreased IGF-1 levels. For KD alone - increased β hydroxybutyrate levels.

5/8 Large RCTs have tested low-fat and weight loss interventions in cancer populations, although trials with WFPBD or KD interventions with cancer-specific outcomes are not available.

6/8 Epidemiologic studies show that plant enriched diets are associated with reduced cancer incidence and recommended in dietary guidelines by @aicrtweets and @AmericanCancer

7/8 Despite this evidence, clinicaltrials.gov currently has 46 KD trials (20 active, 10 completed, and 6 terminated [poor accrual/compliance]; 5 with unknown status) and only 8 WFPBD trials (6 active, 2 completed, and 0 terminated). @theNCI

8/8 It is important to prioritize studies that evaluate a WFPBD in cancer given the limited number of plant enriched diet trials & to design clinical trials with mechanistic translational correlatives - epigenetic, immune, and microbiome @theNCI