ArticlePloS one2024
Feasibility and metabolic outcomes of a well-formulated ketogenic diet as an adjuvant therapeutic intervention for women with stage IV metastatic breast cancer: The Keto-CARE trial.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03535701 (Ketogenic Diet and Chemotherapy to Affect Recurrence of Breast Cancer), which is not on this map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Ketogenic Diet and Chemotherapy to Affect Recurrence of Breast Cancer (The KETO-CARE Study)
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Ketogenic diets and cardiovascular health balancing metabolic benefits against lipid-related risk.BMC cardiovascular disorders · 2026Pooled it
- Effect of a whole food plant-based dietary intervention on cancer progression and inflammatory markers.The oncologist · 2025Trial
- Trial
- Ketogenic Diet as an Adjuvant in Epithelial Cancers: Mechanisms, Model Systems, and Translational Opportunities.Cancers · 2026Review
- Lactate, Carbohydrate Restriction, and Cancer Metabolism.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026Review
- Multi-omic analysis of the liver-breast axis reveals key hepatic mediators of breast cancer progression.Science China. Life sciences · 2026Review
- β-Hydroxybutyrate elicits divergent metabolic responses between MCF-7 and T47D ER+ breast cancer cells under glucose restriction.bioRxiv : the preprint server for biology · 2026Article
- Nutritional approaches in combating therapeutic resistance and enhancing treatment efficacy in cancer: the impact of ketogenic diets.Nutrition & metabolism · 2025Review
- β-Hydroxybutyrate promotes chemoresistance and proliferation in breast cancer cells.Biochemistry and biophysics reports · 2025Article
- The nutritional equation: decoding diet's influence on breast cancer risk and progression - a perspective.Annals of medicine and surgery (2012) · 2025Article
- Review
- Comprehensive Overview of Ketone Bodies in Cancer Metabolism: Mechanisms and Application.Biomedicines · 2025Review
- The role of β-hydroxybutyrate testing in ketogenic metabolic therapies.Frontiers in nutrition · 2025Review
- Ketone body, as an emerging modulator of metabolic reprogramming and epigenetics in breast cancer.Iranian journal of basic medical sciences · 2025Review
- Effect of dietary patterns and nutritional supplementation in the management of endometriosis: a review.Frontiers in nutrition · 2025Review
- Nutritional strategies in supporting immune checkpoint inhibitor, PI3K inhibitor, and tyrosine kinase inhibitor cancer therapies.Frontiers in nutrition · 2025Review
- Ketosis suppression and ageing (KetoSAge): the effect of suppressing ketosis on SHBG and sex hormone profiles in healthy premenopausal women, and its implications for cancer risk and therapy.Frontiers in nutrition · 2025Article
- Clinical research framework proposal for ketogenic metabolic therapy in glioblastoma.BMC medicine · 2024Review
- Nutrition Intervention and Microbiome Modulation in the Management of Breast Cancer.Nutrients · 2024Review
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 5 institutions in 2 countries.
Funding
Abstract
purposeKetogenic diets may positively influence cancer through pleiotropic mechanisms, but only a few small and short-term studies have addressed feasibility and efficacy in cancer patients. The primary goals of this study were to evaluate the feasibility and the sustained metabolic effects of a personalized well-formulated ketogenic diet (WFKD) designed to achieve consistent blood beta-hydroxybutyrate (βHB) >0.5 mM in women diagnosed with stage IV metastatic breast cancer (MBC) undergoing chemotherapy.
methodsWomen (n = 20) were enrolled in a six month, two-phase, single-arm WFKD intervention (NCT03535701). Phase I was a highly-supervised, ad libitum, personalized WFKD, where women were provided with ketogenic-appropriate food daily for three months. Phase II transitioned women to a self-administered WFKD with ongoing coaching for an additional three months. Fasting capillary βHB and glucose were collected daily; weight, body composition, plasma insulin, and insulin resistance were collected at baseline, three and six months.
resultsCapillary βHB indicated women achieved nutritional ketosis (Phase I mean: 0.8 mM (n = 15); Phase II mean: 0.7 mM (n = 9)). Body weight decreased 10% after three months, primarily from body fat. Fasting plasma glucose, plasma insulin, and insulin resistance also decreased significantly after three months (p < 0.01), an effect that persisted at six months.
conclusionsWomen diagnosed with MBC undergoing chemotherapy can safely achieve and maintain nutritional ketosis, while improving body composition and insulin resistance, out to six months.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.