title: Obesity and tumor growth: inflammation, immunity, and the role of a ketogenic diet.
abstract: This article reviews the impact the obese state has on malignancy through inflammation and immune dysregulation using recent excerpts from the medical literature.
  
  
  
  The obese state creates a proinflammatory endocrinologic milieu altering cellular signaling between adipocytes, immunologic cells, and epithelial cells, leading to the over-activation of adipose tissue macrophages and the upregulation of compounds associated with carcinogenesis. Obesity correlates with a deficiency in numerous immunologic cells, including dendritic cells, natural killer cells, and T cells. In part, this can be attributed to a recent finding of leptin receptor expression on these immune cells and the upregulation of leptin signaling in the obese state. A number of clinical trials have demonstrated the feasibility of a high-fat, low-carbohydrate diet as an adjuvant treatment for cancer, and current trials are investigating the impact of this intervention on disease outcomes. In preclinical trials, a ketogenic diet has been shown to impede tumor growth in a variety of cancers through anti-angiogenic, anti-inflammatory, and proapoptotic mechanisms.
  
  
  
  Obesity is becoming more prevalent and its link to cancer is clearly established providing a rationale for the implementation of dietary interventions as an adjuvant therapeutic strategy for malignancy.
authors.affiliation: aSidney Kimmel Medical College at Thomas Jefferson University bDepartment of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Wright
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Simone
mesh_terms: D056704:Adaptive Immunity; D050154:Adiposity; D000818:Animals; D063646:Carcinogenesis; D003131:Combined Modality Therapy; D055423:Diet, Ketogenic; D004038:Diet, Reducing; D004700:Endocrine System Diseases / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D015444:Exercise; D006801:Humans; D007154:Immune System Diseases / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D007113:Immunity, Innate; D018836:Inflammation Mediators / Q000378:metabolism; D050152:Intra-Abdominal Fat / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D009369:Neoplasms / Q000209:etiology / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D009765:Obesity / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D047368:Tumor Burden
chemical_list: D018836:Inflammation Mediators