Kardiovaskuläres Risiko und Lebensqualität von Brustkrebsüberlebenden unter kohlenhydratreduzierter Ernährung – Auswertung der „KOLIBRI-Studie“
Cardiovascular risk and quality of life among breast cancer survivors on carbohydrate restriction - analysis of the "KOLIBRI-study"
von Theresa Schäfer
Datum der mündl. Prüfung:2022-07-28
Betreuer:Prof. Dr. Monika, Reuss-Borst
Gutachter:Prof. Dr. Monika, Reuss-Borst
Gutachter:PD Dr. Thomas, Ellrott
Name:Dissertation vollständig 26.07.2022.pdf
EnglischIn the present “KOLIBRI” (carbohydrate limited breast cancer intervention) study, we analyzed the effects of a ketogenic diet, a moderate low-carbohydrate diet (LOGI) and a diet based on the recommendations of the “DGE” (German nutrition society) on different domains of health and life of 152 breast cancer patients. During the first three weeks of the study, the patients participated in a multimodal rehabilitation where they were educated concerning their chosen diet. The analysis was conducted using laboratory values, questionnaires and nutrition diaries. Overall, the interest for a dietary change and carbohydrate restriction was very high and guidelines were reliably followed. Most participants chose the LOGI-method with a moderate carbohydrate restriction. Self-efficacy was not relevant in this context. In the Keto group, we found the highest calory intake along with a high intake of fat and protein. Therefore, this dietary pattern could be beneficial for cancer patients with unwanted weight loss and imminent cancer cachexia. In the LOGI group, we found a significant improvement of the lipid profile and a significant reduction of blood glucose. Furthermore, the increased body-mass-index in this group was significantly reduced, which additionally reduces the metabolic risk. The LOGI method could therefore contribute to the improvement of the cardiovascular risk, especially in overweight patients. Evaluations after three weeks showed that Glutamic pyruvic transaminase (GTP) was significantly higher in the LOGI group and uric acid was significantly higher in the Keto group as compared to the initial evaluation. After 20 weeks of following the dietary program, these values decreased and were not different from baseline values. Further, we did not find any evidence for a long-term health risk in any of the groups. We suggest laboratory tests in the beginning of the dietary change to detect potential alterations at an early stage. Before participation to the current study, the quality of life of many participants had been considerably reduced and was improved during our study on a range of sub-scores. The psycho-oncological rehabilitation played a major role in this improvement and should thus be rendered possible for all breast cancer patients and cancer-survivors. One limitation of the KOLIBRI study is the lack of randomization. As one of the first and longest intervention studies concerning low-carbohydrate nutrition and breast cancer, the present results contribute to helping many advice-seeking patients.
Keywords: cardiovascular risk; quality of life; breast cancer; KOLIBRI; LOGI; ketogenic diet; carbohydrate restriction; low carb