# Consequences of Glucose Enriched Diet on Oncologic Patients
### Role of Sugar in Cancer Metabolism
#### 1.2.3 Significance of Low-Carbohydrate Diets and Fasting  
The research [63] assessed the association between applied fasting and the body's immunity to cancer. The authors of the research discovered that, in mice, the introduction of a two-week period of fasting resulted in the prevention of tumor growth without generating a change in body weight. It was found that the introduction of fasting can promote autophagy in colon cancer cells, which ultimately decreases tumor growth by increasing immunity against cancer [63; 64].  
Metabolic alterations related with caloric limits significantly influenced health, including reduced angiogenesis, enhanced insulin sensitivity, and lower inflammation. Moreover, the introduction of processes influenced by caloric restriction are directly associated to the pathogenic mechanism of cancer, including the protection of toxic substances, accelerated autophagy, DNA repair processes, and the removal of cells damaged as a result of apoptosis [64].  
In recent years, some publications have explored the association between ketogenic diet and tumors related to the nervous system. In 1995, the ketogenic diet model with 60% of calories coming from medium chain fatty acids was developed based on a study of two cases of adolescent patients with brain cancer (astrocytoma) in an advanced stage of the disease. The remaining macronutrients were distributed as follows: 20% of the energy share comes from proteins, 10% from the remaining fats, and 10% from carbohydrates. In the location where the tumor was positioned, glucose uptake was evaluated using positron emission tomography. Both patients followed the diet for 7 days, during which time there was a 28.7% decrease in glucose uptake in the tumor area. In one of the patients, a notable clinical improvement was noticed in terms of acquisition of new abilities and mood. During the continuance of the diet for 12 months, no advancement of the disease was identified [64].  
The other version of the case referred to a 65-year-old patient who was diagnosed with glioblastoma multiforme (GBM). The ketogenic diet was also included into normal care in this example following surgical resection of GBM, employing a 4:1 ratio (4 g of fat to 1 g of proteins and carbohydrates in total). The daily calorie intake was fixed at the 600 Kcal level. The patient's body mass reduced by roughly 20% after two months of administration of the diet and the presence of brain cancer cells was not observed. For six months, the stringent diet was continued. Relapse of the disease was identified by magnetic resonance imaging two months following the course of the same [64,65].  
In the ERGO research, 20 patients with recurrent gliomas were reviewed 3 months after the finish of radiation therapy to see whether a ketogenic diet (60 g of carbohydrates daily) might be employed [64]. The diet comprised, among other things, vegetable oils and fermented milk drinks (500 mL). Patients were given rules regarding which items they could eat as part of the dietary model, which did not require caloric restriction. The treatment was boosted by the diet that was put into place. The median progression-free survival time was 5 weeks and the median survival was 32 weeks. The study points out that due to the absence of randomization, the restricted number of patients, and the fact that there was no control group in the experiment, the effectiveness of the ketogenic diet could not be confirmed with certainty [64,66] (Table 1).