Ketogenic diet for ovarian disorders - promising nutritional approach in polycystic ovarian syndrome and ovarian cancer
DOI:
https://doi.org/10.12775/JEHS.2024.65.007Keywords
ketogenic diet, PCOS, ovarian cancer, obesity, hormonesAbstract
Introduction and purpose:
Polycystic ovary syndrome (PCOS) is the most common endocrine disease in the female reproductive age. As treatment guidelines include lifestyle changes, various diet types are being evaluated in terms of efficacy among them ketogenic diet (KD) which was also assessed in terms of its influence on another ovarian related disease - ovarian cancer. The aim of this paper is an analysis of the available scientific data in respect of the role of the KD as a part of the therapy of ovarian related disorders. The search was conducted using PubMed and Google Scholarship databases.
Brief description of the state of knowledge:
Ketogenic diet demonstrates favorable effects in the hormonal profile of PCOS-affected women. It was also noticed that its administration results in the reduction of BMI and the improvement in glycemic parameters. Most of the research was conducted by linking the ketogenic diet with the caloric restriction. In the matter of ovarian cancer the results are unclear; some of the research states the improvement of the quality of life of the participants, but there is some alarming data of the possible role of KD in enhancing the tumor growth.
Conclusions:
Ketogenic diet merits further research as a possible factor in the treatment of PCOS as foregoing results are pointing to its efficacy. Nevertheless, still more data is needed to determine its role as studies were conducted within a short period of time with relatively small research groups. There are also other limitations such as the lack of comparison with other dietary patterns with the caloric deficit which makes it difficult to deduce the main profitable factor. When it comes to ovarian cancer the results of the current data are also unclear and unambiguous with the possible negative effects.
References
Dyńka D, Kowalcze K, Paziewska A. The Role of Ketogenic Diet in the Treatment of Neurological Diseases. Nutrients. 2022 Nov 24;14(23):5003. doi: 10.3390/nu14235003. PMID: 36501033; PMCID: PMC9739023.
Dyńka D, Kowalcze K, Charuta A, Paziewska A. The Ketogenic Diet and Cardiovascular Diseases. Nutrients. 2023 Jul 28;15(15):3368. doi: 10.3390/nu15153368. PMID: 37571305; PMCID: PMC10421332.
Alesi S, Ee C, Moran LJ, Rao V, Mousa A. Nutritional Supplements and Complementary Therapies in Polycystic Ovary Syndrome. Adv Nutr. 2022 Aug 1;13(4):1243-1266. doi: 10.1093/advances/nmab141. PMID: 34970669; PMCID: PMC9340985.
Barrea L, Verde L, Camajani E, Cernea S, Frias-Toral E, Lamabadusuriya D, Ceriani F, Savastano S, Colao A, Muscogiuri G. Ketogenic Diet as Medical Prescription in Women with Polycystic Ovary Syndrome (PCOS). Curr Nutr Rep. 2023 Mar;12(1):56-64. doi: 10.1007/s13668-023-00456-1. Epub 2023 Jan 25. Erratum in: Curr Nutr Rep. 2023 Feb 16;: PMID: 36695999; PMCID: PMC9974679.
Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004 Jan;19(1):41-7. doi: 10.1093/humrep/deh098. PMID: 14688154.
Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016 Jul;106(1):6-15. doi: 10.1016/j.fertnstert.2016.05.003. Epub 2016 May 24. PMID: 27233760.
Frias-Toral E, Garcia-Velasquez E, de Los Angeles Carignano M, Rodriguez-Veintimilla D, Alvarado-Aguilera I, Bautista-Litardo N. Polycystic ovary syndrome and obesity: clinical aspects and nutritional management. Minerva Endocrinol (Torino). 2022 Jun;47(2):215-241. doi: 10.23736/S2724-6507.21.03349-6. Epub 2021 Apr 1. PMID: 33792235.
Xu Y, Qiao J. Association of Insulin Resistance and Elevated Androgen Levels with Polycystic Ovarian Syndrome (PCOS): A Review of Literature. J Healthc Eng. 2022 Mar 21;2022:9240569. doi: 10.1155/2022/9240569. PMID: 35356614; PMCID: PMC8959968.
Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2014 Sep-Oct;20(5):748-58. doi: 10.1093/humupd/dmu012. Epub 2014 Mar 30. PMID: 24688118; PMCID: PMC4326303.
Rodriguez-Paris D, Remlinger-Molenda A, Kurzawa R, Głowińska A, Spaczyński R, Rybakowski F, Pawełczyk L, Banaszewska B. Psychiatric disorders in women with polycystic ovary syndrome. Psychiatr Pol. 2019 Aug 31;53(4):955-966. English, Polish. doi: 10.12740/PP/OnlineFirst/93105. Epub 2019 Aug 31. PMID: 31760419.
Cowan S, Lim S, Alycia C, Pirotta S, Thomson R, Gibson-Helm M, Blackmore R, Naderpoor N, Bennett C, Ee C, Rao V, Mousa A, Alesi S, Moran L. Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity. BMC Endocr Disord. 2023 Jan 16;23(1):14. doi: 10.1186/s12902-022-01208-y. PMID: 36647089; PMCID: PMC9841505.
Khalid K, Apparow S, Mushaddik IL, Anuar A, Rizvi SAA, Habib A. Effects of Ketogenic Diet on Reproductive Hormones in Women With Polycystic Ovary Syndrome. J Endocr Soc. 2023 Sep 7;7(10):bvad112. doi: 10.1210/jendso/bvad112. PMID: 37693687; PMCID: PMC10484165.
Calcaterra V, Cena H, Sottotetti F, Hruby C, Madini N, Zelaschi N, Zuccotti G. Low-Calorie Ketogenic Diet: Potential Application in the Treatment of Polycystic Ovary Syndrome in Adolescents. Nutrients. 2023 Aug 15;15(16):3582. doi: 10.3390/nu15163582. PMID: 37630772; PMCID: PMC10459579.
Magagnini MC, Condorelli RA, Cimino L, Cannarella R, Aversa A, Calogero AE, La Vignera S. Does the Ketogenic Diet Improve the Quality of Ovarian Function in Obese Women? Nutrients. 2022 Oct 6;14(19):4147. doi: 10.3390/nu14194147. PMID: 36235799; PMCID: PMC9571725.
Mavropoulos JC, Yancy WS, Hepburn J, Westman EC. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab (Lond). 2005 Dec 16;2:35. doi: 10.1186/1743-7075-2-35. PMID: 16359551; PMCID: PMC1334192.
Marzouk TM, Sayed Ahmed WA. Effect of Dietary Weight Loss on Menstrual Regularity in Obese Young Adult Women with Polycystic Ovary Syndrome. J Pediatr Adolesc Gynecol. 2015 Dec;28(6):457-61. doi: 10.1016/j.jpag.2015.01.002. Epub 2015 Jan 7. PMID: 26298524.
Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med. 2020 Feb 27;18(1):104. doi: 10.1186/s12967-020-02277-0. PMID: 32103756; PMCID: PMC7045520.
Cincione RI, Losavio F, Ciolli F, Valenzano A, Cibelli G, Messina G, Polito R. Effects of Mixed of a Ketogenic Diet in Overweight and Obese Women with Polycystic Ovary Syndrome. Int J Environ Res Public Health. 2021 Nov 27;18(23):12490. doi: 10.3390/ijerph182312490. PMID: 34886216; PMCID: PMC8656706.
Meneghini C, Bianco C, Galanti F, Tamburelli V, Dal Lago A, Licata E, Gallo M, Fabiani C, Corno R, Miriello D, Rago R. The Impact of Nutritional Therapy in the Management of Overweight/Obese PCOS Patient Candidates for IVF. Nutrients. 2023 Oct 20;15(20):4444. doi: 10.3390/nu15204444. PMID: 37892519; PMCID: PMC10609803.
Cincione IR, Graziadio C, Marino F, Vetrani C, Losavio F, Savastano S, Colao A, Laudisio D. Short-time effects of ketogenic diet or modestly hypocaloric Mediterranean diet on overweight and obese women with polycystic ovary syndrome. J Endocrinol Invest. 2023 Apr;46(4):769-777. doi: 10.1007/s40618-022-01943-y. Epub 2022 Nov 19. PMID: 36401759.
Li, J., Bai, W.-P., Jiang, B., Bai, L.-R., Gu, B., Yan, S.-X., Li, F.-Y. and Huang, B. (2021), Ketogenic diet in women with polycystic ovary syndrome and liver dysfunction who are obese: A randomized, open-label, parallel-group, controlled pilot trial. J. Obstet. Gynaecol. Res., 47: 1145-1152. https://doi.org/10.1111/jog.14650
Mehrzad Samarin, Mahnoush, Mandana Gholami, and Freshteh Shahmohamadi. "The effect of eight weeks of ketogenic diet and resistance training on insulin resistance index and lipid profile in women with polycystic ovary syndrome." Journal of Applied Health Studies in Sport Physiology (2023).
LI Jian, BAI Wenpei, JIANG Bo, LIU Feiran, CHEN Yanrong. Effects of ketogenic diet on vitamin D and glycolipid metabolism in overweight or obese patients with polycystic ovary syndrome[J]. Journal of Clinical Medicine in Practice, 2022, 26(4): 14-17. DOI: 10.7619/jcmp.20220496
Roett MA, Evans P. Ovarian cancer: an overview. Am Fam Physician. 2009 Sep 15;80(6):609-16. PMID: 19817326.
Sambasivan S. Epithelial ovarian cancer: Review article. Cancer Treat Res Commun. 2022;33:100629. doi: 10.1016/j.ctarc.2022.100629. Epub 2022 Sep 8. PMID: 36127285.
Kossaï M, Leary A, Scoazec JY, Genestie C. Ovarian Cancer: A Heterogeneous Disease. Pathobiology. 2018;85(1-2):41-49. doi: 10.1159/000479006. Epub 2017 Oct 12. PMID: 29020678.
Klement RJ, Kämmerer U. Is there a role for carbohydrate restriction in the treatment and prevention of cancer? Nutr Metab (Lond). 2011 Oct 26;8:75. doi: 10.1186/1743-7075-8-75. PMID: 22029671; PMCID: PMC3267662.
Simone BA, Champ CE, Rosenberg AL, Berger AC, Monti DA, Dicker AP, Simone NL. Selectively starving cancer cells through dietary manipulation: methods and clinical implications. Future Oncol. 2013 Jul;9(7):959-76. doi: 10.2217/fon.13.31. PMID: 23837760.
Siddle K. Molecular basis of signaling specificity of insulin and IGF receptors: neglected corners and recent advances. Front Endocrinol (Lausanne). 2012 Feb 28;3:34. doi: 10.3389/fendo.2012.00034. PMID: 22649417; PMCID: PMC3355962.
Cohen CW, Fontaine KR, Arend RC, Alvarez RD, Leath CA III, Huh WK, Bevis KS, Kim KH, Straughn JM Jr, Gower BA. A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer. J Nutr. 2018 Aug 1;148(8):1253-1260. doi: 10.1093/jn/nxy119. PMID: 30137481; PMCID: PMC8496516.
Cohen CW, Fontaine KR, Arend RC, Soleymani T, Gower BA. Favorable Effects of a Ketogenic Diet on Physical Function, Perceived Energy, and Food Cravings in Women with Ovarian or Endometrial Cancer: A Randomized, Controlled Trial. Nutrients. 2018 Aug 30;10(9):1187. doi: 10.3390/nu10091187. PMID: 30200193; PMCID: PMC6163837.
AlHilli MM, Rhoades EE, Chau D, Tewari S, Reich A, Myers A, Lindner DJ, Lathia JD, Zhang R, Willard B, Cresci G, Berger NA, Reizes O. Unrestricted Ketogenic Diet Feeding Enhances Epithelial Ovarian Cancer Growth In Vivo. Nutrients. 2023 Jun 13;15(12):2730. doi: 10.3390/nu15122730. PMID: 37375634; PMCID: PMC10301007.
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