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Member Research & Reports

Member Research & Reports

UAB: A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer

A growing body of research suggests that cancer is a metabolic disease. The glycolytic nature of cancer cells presents a potential treatment target that may be addressed by a ketogenic diet (KD).


A team of researchers at UAB, including Dr. Kevin Fontaine, chair of the Department of Health Behavior at the School of Public Health along with others from the Departments of Nutritional Sciences and Obstetrics and Gynecology hypothesized that a KD would improve body composition and lower serum insulin and insulin-like growth factor-I (IGF-I) in women with ovarian or endometrial cancer.


This study was conducted at UAB. Participants were women with ovarian or endometrial cancer, recruited between October 2015 and April 2017, from the UAB Gynecologic Oncology clinic and from other treatment centers via physician referral, flyers, local television advertisements, and news articles. Eligibility criteria were BMI (kg/m2) ≥18.5, age ≥19 y, no pre-existing medical conditions affecting body weight (other than cancer and associated treatment), not actively attempting weight loss/gain or diet modification, and no medical history contraindicating enrollment. Women with T2D were eligible to participate (4 with T2D completed the study; 3 managed blood glucose for the duration of the study using only metformin, and 1 used only insulin glargine at baseline but discontinued use after initiating the KD). UAB’s Institutional Review Board approved the study, and all participants provided written informed consent prior to enrollment.


After 12 weeks, the KD (compared with ACS) group had lower adjusted total (35.3 compared with 38.0 kg, P < 0.05) and android (3.0 compared with 3.3 kg, P < 0.05) fat mass. Percentage of change in visceral fat was greater in the KD group (compared with the ACS group; –21.2% compared with –4.6%, P < 0.05). Adjusted total lean mass did not differ between the groups. The KD (compared with ACS) group had lower adjusted fasting serum insulin (7.6 compared with 11.2 µU/mL, P < 0.01). There was a significant inverse association between the changes in serum β-hydroxybutyrate and IGF-I concentrations (r = –0.57; P < 0.0001).


The researchers concluded that in women with ovarian or endometrial cancer, a KD results in selective loss of fat mass and retention of lean mass. Visceral fat mass and fasting serum insulin also are reduced by the KD, perhaps owing to enhanced insulin sensitivity. Elevated serum β-hydroxybutyrate may reflect a metabolic environment inhospitable to cancer proliferation.


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