Low carb diet and cancer. What do current prospective cohort trials and

randomized risk marker studies show?

11/04/20231 http://twitter.com/pronutritionist

Reijo Laatikainen, Authorized Nutritionist, MBA http://twitter.com/pronutritionist

http://www.facebook.com/pronutritionist

Low carb diet likely to increase the risk of colorectal cancer if it’s animal based

Low Carb cohorts

• Risk of colorectal cancer • Data restricted to men and animal based Low Carb

Diet

Low Carb

RCTs

(surrogate

)

• Risk markers of colorectal cancer • (low production of short chain fatty acids, decreased

colonisation of healthy bacteria)

Other

data

• High intake of red and processed meat is linked to colorectal in many prospective cohorts

• Low intake of fiber increases the risk of colon cancer

11/04/20232 http://twitter.com/pronutritionist

Evidence on colorectal cancer

Low Carb cohorts

• Fung et al. 2010

Low Carb

RCTs

(surrogate)

• Brinkworth et al. 2010• Russel et al. 2011

Indirect

data

• Larsson & Volk 2006 (red meat increases risk, meta-analysis), Gonzales et al. 2010 (red meat increases risk, EPIC study)

• Park et el. 2005 (fiber protects, meta-analysis)

11/04/20233 http://twitter.com/pronutritionist

Data on other cancer types (effect and evidence)

Low Carb cohorts High fat intake High intake of protein/red meat

Lung cancer Increases (Fung et al.2010*)

No effect (Gonzales et al. 2009, Epic study

No effect (Gonzales et al. 2009, Epic study

Breast cancer No effect (Fung et al.2010*)

No effect*(Martin et al. 2011, Prentice 2006#)

No effect (Alexander et al.2010, meta-analysis)

Prostate cancer No effect (Fung et al. 2010?)

Increases?(Ma&Chapman 2009, meta-analysis)

No effect (Gonzales et al. 2009, Epic study)

*) Only Low Carb cohort to look cancer sub-types#) Two North American large RCTs breast cancer incidence as end point. Previous meta-analyses of cohort studies yielded conflicting results

11.04.20234 http://twitter.com/pronutritionist

Summary

• Low carb diet is likely to increase the risk of colorectal cancer at least among men if it is based on animal products, especially red and processed meat

• Low carb diet is NOT likely to increase breast cancer even if it’s high in fat

• There is limited evidence to suggest that high fat content of low carb diet might induce prostate cancer

• In two large cohorts low carb diet is also linked to overall cancer mortality (Trichopoulou et al. 2007, Fung et al 2010)

• Risk marker studies results are in line with cohort outcomes. Production of short chain fatty acids is reduced and amount of healthy bacteria in gut are reduced during a low carb diet

11.04.20235 http://twitter.com/pronutritionist

Palaeolithic diet improves satiety and can improve many metabolic

parameters. However, the changes in the composition of diets used in clinical studies are smaller than

commonly proposed in ancestral diets.

11/04/20236http://twitter.com/pronutritionist

Reijo Laatikainen, Authorized Nutritionist, MBA http://twitter.com/pronutritionist

http://www.facebook.com/pronutritionist