Quality of Life Clinical Trial
Official title:
Ketogenic Or LOGI Diet In a Breast Cancer Rehabilitation Intervention (KOLIBRI)
The aim of the study is to analyze if a ketogenic diet (KD) compared to either a "low
glycämic and insulinemic" (LOGI) diet or to a standard diet (SD) is feasible, safe and
tolerable and will improve quality of life and physical performance in patients with Breast
Cancer during the rehabilitation phase.
It will be an open-label trial of nutritional intervention for 20 weeks spanning three
phases: 3 weeks of stationary intervention, 16 weeks of outhouse phase and one final week of
stationary intervention.
Cancer patient's whole body metabolism is characterized by an increased fat oxidation rate
and a decrease ability to metabolize glucose for energy demands (insulin resistance). In
preliminary studies it was shown, that a fat rich diet allows to spare muscle mass from
being reduced due to catabolic mechanisms. The resulting better body composition relates to
less fatigue and higher quality of life, the latter was shown in advanced cancer patients
for a ketogenic diet.
The aim of the KOLIBRI-study is to analyze if a very fat rich ketogenic diet (KD) or a
moderate fat rich "low glycämic and insulinemic" (LOGI) diet compared to a standard low fat
diet (SD) are feasible, safe and tolerable and will improve quality of life and physical
performance in patients with Breast Cancer during the rehabilitation phase.
The most stringent nutritional regime high in fat and low in carbohydrates is the ketogenic
diet (KD) comprised of at least 75% of daily calories via fat (derived from several plant
oils, nuts, avocado, butter, cream, cheese, eggs, fatty fish and fat rich meat), balanced in
protein (1.4 g/kg body weight/day) and very low in carbohydrates (approx. 20-30 grams per
day, derived from salad, vegetable, some berries or fruits, and milk products like yoghurt).
A less strict but even lower in carbohydrates and richer in fat and protein than a standard
diet is the LOGI regimen. It allows up to 120 grams of carbohydrates (inclusion of more
vegetable and fruit and rare grains and potatoes compared to KD), is high in protein (1.7
g/kg body weight/day) and rich in fat (remaining calories) The control nutritional regime
follows the standard recommendations of the German society for nutrition (DGE) and is
comprised of at least 50% of the daily energy derived from carbohydrates, 0.8 grams/kg of
body weight protein and 30% of daily energy expenditure from fat.
It will be an open-label trial of nutritional intervention for 20 weeks spanning three
phases:
The first phase spans 3 weeks of stationary intervention in a hospital (location: Bad
Kissingen, Bavaria, Germany) with the initial examination (medical, body composition, food
preferences, quality of life, blood samples, physical performance) followed by
implementation of the allocated diet and respective training of the patients in diet
calculation, cooking and realization of the diet regimen in routine daily life.
The second phase encompasses16 weeks of an outhouse phase with continuing the selected
nutritional regime under close contact and supervision of the study team accompanied by
urine measurements (KD group), food diaries, questionnaires covering the quality of life and
one blood sample) The third phase of the study represents one week of stationary
intervention at the hospital with the final examination and further teaching in eiterh
sticking to the selected diet or in changing the diet to the individually preferred one.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label
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