title: Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports.
abstract: OBJECTIVE
  Establish dietary-induced ketosis in pediatric oncology patients to determine if a ketogenic state would decrease glucose availability to certain tumors, thereby potentially impairing tumor metabolism without adversely affecting the patient's overall nutritional status.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University Hospitals of Cleveland.
  
  
  METHODS
  Two female pediatric patients with advanced stage malignant Astrocytoma tumors.
  
  
  METHODS
  Patients were followed as outpatients for 8 weeks. Ketosis was maintained by consuming a 60% medium chain triglyceride oil-based diet.
  
  
  METHODS
  Tumor glucose metabolism was assessed by Positron Emission Tomography (PET), comparing [Fluorine-18] 2-deoxy-2-fluoro-D-glucose (FDG) uptake at the tumor site before and following the trial period.
  
  
  RESULTS
  Within 7 days of initiating the ketogenic diet, blood glucose levels declined to low-normal levels and blood ketones were elevated twenty to thirty fold. Results of PET scans indicated a 21.8% average decrease in glucose uptake at the tumor site in both subjects. One patient exhibited significant clinical improvements in mood and new skill development during the study. She continued the ketogenic diet for an additional twelve months, remaining free of disease progression.
  
  
  CONCLUSIONS
  While this diet does not replace conventional antineoplastic treatments, these preliminary results suggest a potential for clinical application which merits further research.
authors.affiliation: Nutrition Department, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
authors.forename: L C
authors.initials: LC
authors.lastname: Nebeling
authors.forename: F
authors.initials: F
authors.lastname: Miraldi
authors.forename: S B
authors.initials: SB
authors.lastname: Shurin
authors.forename: E
authors.initials: E
authors.lastname: Lerner
mesh_terms: D001254:Astrocytoma / Q000178:diet therapy* / Q000378:metabolism; D002528:Cerebellar Neoplasms / Q000178:diet therapy* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007662:Ketosis / Q000209:etiology / Q000378:metabolism*; D009752:Nutritional Status; D013120:Spinal Cord Neoplasms / Q000178:diet therapy* / Q000378:metabolism; D014280:Triglycerides / Q000008:administration & dosage
chemical_list: D004042:Dietary Fats, Unsaturated; D014280:Triglycerides