Rapid Review Quiz: Diet and Nutrition Recent Studies

Romesh Khardori, MD, PhD


February 10, 2022

Italian researchers report that the FMD regimen is well-tolerated by patients with cancer, is safe, and leads to positive changes in the immune system and metabolism that may be critical in anticancer therapies.

Studies of tumor-bearing mice reveal that FMDs boost antineoplastic treatment activity by enhancing antitumor immunity and modulating systemic metabolism. To assess similar dietary regimens in humans, investigators studied 101 patients undergoing treatment for various types of cancer. The patients with cancer followed an FMD regimen in which they consumed 1800 kcal in 5 days (600 on the first day and up to 300 in the subsequent 4 days). In between cycles, patients followed healthy diet and lifestyle guidelines. The cycles repeated every 3-4 weeks.

Patients on the FMD regimen reduced their serum levels of insulin and insulin-like growth factor 1 and their median plasma glucose concentrations by 50.7%, 30.3%, and 18.6%, respectively. Over several cycles, the modifications remained stable. In contrast to previous studies, almost all patients were able to follow the dietary regimen; the compliance rate was 91.8% over all FMD cycles. Data on body weight loss, a potentially problematic area for these patients, was also positive: During the healthy-eating intervals between FMD cycles, weight loss was reversible.

The FMD regimen had a broad immunomodulation effect. Specifically, severe calorie restriction enhanced standard antineoplastic antitumor activity of treatments by creating a sort of metabolic shock and activating several populations of immune cells.

The researchers caution that it is not yet feasible to start moving toward the clinical use of this strategy, however, because the study did not permit the investigators to draw conclusions about the antitumor effects of calorie restriction. The patients had different types of tumors and anticancer therapies, and it was not possible to properly assess the therapeutic effects of calorie restriction. The researchers recently initiated the BREAKFAST trial and other new clinical trials that will be the next step in understanding the clinical relevance of the immunologic and metabolic effects of calorie restriction.

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