Healthy keto breakfast, directly above view
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A ketogenic diet very low in carbohydrates can counteract the reduced blood platelet counts that often result from chemotherapy, a study in mice and men suggests.

The findings, which appear in Science Translational Medicine, add to the potential therapeutic benefits of this diet, which is already being used for epilepsy and obesity.

The diet is additionally being explored for its impact on diabetes, polycystic ovary syndrome, innate immune responses, lymphodema, and for its antitumor effects in cancer.

Researchers in the current study admit that their clinical data are preliminary for examining the diet’s impact on low platelet counts, otherwise known as thrombocytopenia.

“However, these findings reconcile with findings from preclinical models and provide preliminary data that ketogenic diets have potential for treating CIT [chemotherapy-induced thrombocytopenia] in cancer,” they maintain.

Low platelet counts occur in one in 10 patients undergoing chemotherapy for cancer, placing them at increased risk of complications during surgery, with an increased chance of bleeding.

Noting that ketogenic diets boost the production of liver ketone bodies and have metabolic effects, Sisi Xie, from Fudan University in Shanghai, China, and colleagues examined whether this dietary regime could potentially prevent thrombocytopenia.

The team found that the ketone body β-hydroxybutyrate, which is boosted by the diet, activated platelet-forming genes by encouraging histone acetylation in bone marrow cells called megakaryocytes.

Mice with pancreatic or liver cancer fed ketogenic diets were also more resistant to thrombocytopenia induced by chemotherapy using gemcitabine than animals receiving control diets.

The team then tested the platelet effects of a ketogenic diet in humans using five healthy male volunteers.

Following a strict ketogenic diet for seven days modestly increased functional platelet count by approximate 1.1 fold compared with a regular diet, without affecting platelet distribution width, mean platelet volume, or either red or white blood cell counts.

Platelet counts increased in all volunteers but remained below potentially pathogenic amounts.

Finally, the researchers retrospectively studied 28 patients with cancer, who were receiving conventional chemotherapy either alone or in combination with hormones or monoclonal antibodies.

A ketogenic dietary lifestyle involving low carbohydrate, moderate protein, and high fat was reported by 11 patients, and a conventional dietary lifestyle by the remaining 17.

Despite the groups being comparable in terms of age and gender, those individuals on the ketogenic diet had significantly higher platelet counts than others.

Chemotherapy-induced thrombocytopenia, in which platelet counts were less than 100 x 109/liter, occurred in none of the individuals on a ketogenic diet versus 11.8% of those on a conventional diet. Differences in other blood cell types were not seen.

The researchers conclude: “Together, these results demonstrate ketogenic diet’s preventive and therapeutic potential for CIT.”

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