Please select the eligibility criteria that correspond to the clinical trial below.
Title: Targeted Disruption to Cancer Metabolism Through Dietary Macronutrient Modification
Brief Summary: The objective of this investigation is to examine the effects of 12 weeks of usual care plus a ketogenic diet (KD) or usual care plus dietary recommendations endorsed by the Academy of Nutrition and Dietetics (AND) in women with ovarian and endometrial cancer. Participants undergo testing at baseline and at 12 weeks; the testing consists of blood draws, questionnaires, and measures of body composition. The baseline visit also includes a meeting with a registered dietitian to discuss the guidelines of the assigned diet.

It is hypothesized that the KD group will have improved cancer outcome measures, beneficial body composition changes, reduced fasting concentrations of glucose and insulin, and higher ratings of patient satisfaction with the diet relative to the AND group.


Options:
A: Inclusion Criteria:

* Diagnosis of breast cancer (stages I (≥1 cm), stage II, or stage IIIA, B, C excluding distant metastasis) diagnosed between 6 months and 5 years earlier; after initial therapies are completed, diagnosed between six months and five years earlier
* BMI between 25 to 45 kg/m2
* Able to comply with all required study procedures and schedule

Exclusion Criteria:

* Serious medical condition or psychiatric illness
* Inability to be moderately physically active
* Obesity of known endocrine origin (e.g., untreated hypothyroidism, PCOS)
* Currently enrolled in a weight loss program
* Current use of weight loss medication or supplements
* Previous surgical procedures for weight reduction
* Planning weight loss surgery in the next 2 years.
* 6+ months use of meds likely to cause weight gain or prevent weight loss
* Planned surgical procedure that can impact the conduct of the study
* Currently pregnant/breastfeeding
* Planning to become pregnant within the next 2 years
* Have plans to relocate from area within 2 years
* Family relative or close friend is a trial staff member or a study participant
* Any condition which in the opinion of the investigator makes the subject unsuitable for inclusion in this study
B: DISEASE CHARACTERISTICS:

* Diagnosed colorectal, prostate, or female breast cancer

  * At least 5 years beyond date of diagnosis with no clinical evidence of progressive disease or second primaries
* Body mass index ≥ 25 kg/m\^2 and \< 40 kg/m\^2
* Currently exercising \< 150 minutes/week
* Hormone receptor status not specified

PATIENT CHARACTERISTICS:

* Menopausal status not specified
* No serious intercurrent medical condition or disability that could preclude study treatment, including any of the following:

  * Severe orthopedic condition or scheduled hip or knee replacement within the next 6 months
  * Paralysis
  * End-stage renal disease
  * Dementia
  * Unstable angina
  * Heart attack, congestive heart failure, or pulmonary condition that required oxygen or hospitalization within the past 6 months
* Ability to read, write, and speak English

PRIOR CONCURRENT THERAPY:

* No concurrent warfarin
C: Inclusion Criteria:

* measurable disease or elevated CA-125
* classified as normal weight, overweight, or obese (BMI \> 18.5)
* English speaking \& reading
* can sign consent and are willing to be randomized and to adhere to the assigned protocol

Exclusion Criteria:

* pre-existing medical conditions that preclude enrollment: uncontrolled hypertension, myocardial infarction or cerebrovascular accident in the past six months, unstable angina within the last six months, congestive heart failure, serious infectious diseases, chronic hepatitis, cirrhosis, chronic malabsorption syndrome, chronic pancreatitis, chronic lung disease, major depressive or psychiatric disorder.
* current or medical condition that affects body weight such as uncontrolled hypo- or hyperthyroidism
* taking any of the following medications: anti-psychotic agents, monoamine oxidase inhibitors, antibiotics for HIV or tuberculosis, weight loss medications, or have taken weight loss medications in the last six months
* currently dieting
D: Inclusion Criteria:

* Female women 18 years of age or older and with biopsy-proven endometrial cancer.
* BMI greater than or equal to 30 kg/m\^2.
* Must be able to read and speak English.
* All patients must be informed of the investigational nature of this study and must sign and give written informed consent for Aim 1 study activities in accordance with institutional and federal guidelines.
* Has completed prior surgical management and adjuvant endometrial cancer treatment, if adjuvant treatment is indicated, prior to starting Aim 1.
* Is not receiving concurrent cytotoxic chemotherapy and/or radiation therapy at time of enrollment AND, if randomized, is not anticipated that the participant will need to receive concurrent cytotoxic chemotherapy and/or radiation therapy at any time during the Aim 1 intervention
* Patients with BMI greater than or equal to 30 kg/m\^2 who are undergoing hormonal treatment of endometrial cancer.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2
* Life expectancy of at least one year
* Must have a phone capable of receiving text messages.

Exclusion Criteria:

* Females under the age of 18 years
* BMI less than 30 kg/m\^2
* Must not be participating in another formal weight loss program.
* Must not have any other clinically significant medical disease or condition that, in the Investigator's opinion, may interfere with protocol adherence or a participant's ability to give informed consent.
* For participants who are randomized in Aim 1:

  * No uncontrolled serious medical or psychiatric condition(s) that would affect the patient's ability to participate in the interventional study, e.g., uncontrolled hypertension, symptomatic cardiac disease, or severe/uncontrolled depression as indicated by a previously completed Patient Health Questionnaire (PHQ-9) score \>9 (Kroenke)
  * No diagnoses of any other invasive malignancy other than endometrial cancer or non-melanoma skin cancer which required active treatment currently or within the last 2 years.

Answer: C