The anti-tumour role of ketogenic diet based on energy metabolism

Clin Nutr. 2025 Jun 13:51:174-186. doi: 10.1016/j.clnu.2025.06.006. Online ahead of print.

Abstract

Background: Unlike the energy metabolism of normal cells, tumour cells favor aerobic glycolysis to meet their unique energy demands, while disrupting normal mitochondrial metabolism. This specialized energy metabolic pathway promotes tumour growth, proliferation, and metastasis. The ketogenic diet (KD) is a high-fat diet inducing ketone bodies (KBs) for energy metabolism by restricting carbohydrate intake and promoting fatty acid breakdown. Due to the unique energy metabolism of tumours, KD has the potential to counteract tumour energy metabolism.

Methods: The current literature was reviewed for potential anti-tumour mechanisms of KD based on energy metabolism and the clinical evidence suggested for KD roles in tumours.

Results: KD exerts anti-tumour effects by inhibiting tumour aerobic glycolysis, inducing KBs, activating AMP-activated protein kinase (AMPK), and regulating reactive oxygen species (ROS) levels.

Conclusion: This review groundbreakingly concludes that KD manifests the potential of anti-tumour effects based on energy metabolism. Furthermore, this study establishes a theoretical foundation for exploring the anti-cancer properties of KD and its potential as a adjunctive therapy for cancer.

Keywords: Energy metabolism; Glycolysis; Ketogenic diet; Tumour.

Publication types

  • Review