Fasting, or low-cal diets, may improve efficacy of cancer chemotherapy

The results of one of the first randomized control trials to investigate fasting as an adjunct to chemotherapy have been published in the journal Nature Communications. The findings offer the prospect a simple dietary intervention can improve the outcome of cancer chemotherapy and potentially reduce cellular damage associated with the therapy.

The idea that fasting can potentially improve the efficacy of chemotherapy is not extraordinarily novel. Observational research and extensive preclinical animal studies have all suggested fasting, or very low-calorie diets, can both help protect healthy cells from stressors such as chemotherapy while making cancer cells more vulnerable. However, until now, this method has not been rigorously tested in the context of a randomized control trial.

Beginning back in 2014, the DIRECT trial set out to test this oft-raised intervention. The trial recruited 131 subjects receiving chemotherapy for non-metastatic breast cancer. Half the cohort were randomly allocated a fasting-mimicking diet (FMD) consisting of plant-based meal plan of around 200 calories a day. The FMD group followed the diet for three days prior to, and one day following, each chemotherapy cycle, while the control continued with their normal dietary patterns.

The promising findings suggest those subjects on the FMD diet did display more positive chemotherapy outcomes compared to the control, with greater overall rates of tumor reduction. General toxicity responses to the chemotherapy were similar between the two groups but pathology tests did reveal the FMD subjects displayed significantly less DNA damage in their white blood cells, implying the dietary strategy did somewhat protect against cellular damage caused by the treatment.

Judith Kroep, an oncologist from Leiden University who worked on the project, is cautious to base any broad therapeutic recommendation on this one single study. Instead, she says that although this kind of dietary strategy seems at the very least safe for chemotherapy patients to undertake, more work is needed to understand exactly how useful this method may be.

“Although the study is a steppingstone in cancer dietary management, and shows potential efficacy on cancer cell loss, additional research should further demonstrate the impact of the FMD on cancer treatment outcome,” says Kroep. “However, the study is an important step on the road towards the use of the FMD as an adjunct to cancer therapy, as a safe and effective alternative to current diets, rich in proteins (especially of animal source) and refined sugars.”

A similar controlled trial, run by the University of Southern California, is currently underway, with results hopefully appearing over the next year.

The new study was published in the journal Nature Communications.

Source: Leiden University via MedicalXpress

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