Anti-Tumor Effects of Ketogenic Diets in Mice: A Meta-Analysis
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{"title"=>"Anti-tumor effects of ketogenic diets in mice: A meta-analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Rainer J.", "last_name"=>"Klement", "scopus_author_id"=>"57194602380"}, {"first_name"=>"Colin E.", "last_name"=>"Champ", "scopus_author_id"=>"36192717900"}, {"first_name"=>"Christoph", "last_name"=>"Otto", "scopus_author_id"=>"7202697100"}, {"first_name"=>"Ulrike", "last_name"=>"K�mmerer", "scopus_author_id"=>"57201174624"}], "year"=>2016, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84968877340", "pui"=>"610342689", "doi"=>"10.1371/journal.pone.0155050", "sgr"=>"84968877340", "pmid"=>"27159218"}, "id"=>"0db03d6c-5273-3fc7-9f14-6bae4d12cdeb", "abstract"=>"BACKGROUND Currently ketogenic diets (KDs) are hyped as an anti-tumor intervention aimed at exploiting the metabolic abnormalities of cancer cells. However, while data in humans is sparse, translation of murine tumor models to the clinic is further hampered by small sample sizes, heterogeneous settings and mixed results concerning tumor growth retardation. The aim was therefore to synthesize the evidence for a growth inhibiting effect of KDs when used as a monotherapy in mice. METHODS We conducted a Bayesian random effects meta-analysis on all studies assessing the survival (defined as the time to reach a pre-defined endpoint such as tumor volume) of mice on an unrestricted KD compared to a high carbohydrate standard diet (SD). For 12 studies meeting the inclusion criteria either a mean survival time ratio (MR) or hazard ratio (HR) between the KD and SD groups could be obtained. The posterior estimates for the MR and HR averaged over four priors on the between-study heterogeneity τ2 were MR = 0.85 (95% highest posterior density interval (HPDI) = [0.73, 0.97]) and HR = 0.55 (95% HPDI = [0.26, 0.87]), indicating a significant overall benefit of the KD in terms of prolonged mean survival times and reduced hazard rate. All studies that used a brain tumor model also chose a late starting point for the KD (at least one day after tumor initiation) which accounted for 26% of the heterogeneity. In this subgroup the KD was less effective (MR = 0.89, 95% HPDI = [0.76, 1.04]). CONCLUSIONS There was an overall tumor growth delaying effect of unrestricted KDs in mice. Future experiments should aim at differentiating the effects of KD timing versus tumor location, since external evidence is currently consistent with an influence of both of these factors.", "link"=>"http://www.mendeley.com/research/antitumor-effects-ketogenic-diets-mice-metaanalysis", "reader_count"=>59, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>4, "Researcher"=>8, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>3, "Student > Master"=>18, "Other"=>4, "Student > Bachelor"=>8, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>4, "Researcher"=>8, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>3, "Student > Master"=>18, "Other"=>4, "Student > Bachelor"=>8, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Nursing and Health Professions"=>6, "Biochemistry, Genetics and Molecular Biology"=>8, "Medicine and Dentistry"=>28, "Agricultural and Biological Sciences"=>10, "Neuroscience"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>28}, "Neuroscience"=>{"Neuroscience"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>10}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>6}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>8}, "Unspecified"=>{"Unspecified"=>4}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "group_count"=>3}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/5210455"], "description"=>"<p>Studies fulfilling all inclusion criteria for this meta-analysis: General data.</p>", "links"=>[], "tags"=>["KD timing", "brain tumor model", "sample sizes", "future experiments", "survival times", "density interval", "murine tumor models", "ketogenic diets", "tumor volume", "cancer cells", "SD groups", "HR", "HPDI", "tumor location", "tumor growth", "MR", "hazard rate", "survival time ratio", "12 studies meeting", "Ketogenic Diets", "inclusion criteria", "hazard ratio", "tumor initiation", "tumor growth retardation"], "article_id"=>3368338, "categories"=>["Medicine", "Cell Biology", "Biotechnology", "Mathematical Sciences not elsewhere classified", "Cancer"], "users"=>["Rainer J. Klement", "Colin E. Champ", "Christoph Otto", "Ulrike Kämmerer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0155050.t001", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Studies_fulfilling_all_inclusion_criteria_for_this_meta-analysis_General_data_/3368338", "title"=>"Studies fulfilling all inclusion criteria for this meta-analysis: General data.", "pos_in_sequence"=>4, "defined_type"=>3, "published_date"=>"2016-05-09 06:00:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/5210464"], "description"=>"<p>Studies fulfilling all inclusion criteria for this meta-analysis: Outcome data.</p>", "links"=>[], "tags"=>["KD timing", "brain tumor model", "sample sizes", "future experiments", "survival times", "density interval", "murine tumor models", "ketogenic diets", "tumor volume", "cancer cells", "SD groups", "HR", "HPDI", "tumor location", "tumor growth", "MR", "hazard rate", "survival time ratio", "12 studies meeting", "Ketogenic Diets", "inclusion criteria", "hazard ratio", "tumor initiation", "tumor growth retardation"], "article_id"=>3368347, "categories"=>["Medicine", "Cell Biology", "Biotechnology", "Mathematical Sciences not elsewhere classified", "Cancer"], "users"=>["Rainer J. Klement", "Colin E. Champ", "Christoph Otto", "Ulrike Kämmerer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0155050.t002", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Studies_fulfilling_all_inclusion_criteria_for_this_meta-analysis_Outcome_data_/3368347", "title"=>"Studies fulfilling all inclusion criteria for this meta-analysis: Outcome data.", "pos_in_sequence"=>5, "defined_type"=>3, "published_date"=>"2016-05-09 06:00:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/5210473"], "description"=>"<p>Results of the Bayesian meta-analyses for the mean survival time ratio (MR) investigating four different priors for the between-study variance.</p>", "links"=>[], "tags"=>["KD timing", "brain tumor model", "sample sizes", "future experiments", "survival times", "density interval", "murine tumor models", "ketogenic diets", "tumor volume", "cancer cells", "SD groups", "HR", "HPDI", "tumor location", "tumor growth", "MR", "hazard rate", "survival time ratio", "12 studies meeting", "Ketogenic Diets", "inclusion criteria", "hazard ratio", "tumor initiation", "tumor growth retardation"], "article_id"=>3368356, "categories"=>["Medicine", "Cell Biology", "Biotechnology", "Mathematical Sciences not elsewhere classified", "Cancer"], "users"=>["Rainer J. Klement", "Colin E. Champ", "Christoph Otto", "Ulrike Kämmerer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0155050.t003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Results_of_the_Bayesian_meta-analyses_for_the_mean_survival_time_ratio_MR_investigating_four_different_priors_for_the_between-study_variance_/3368356", "title"=>"Results of the Bayesian meta-analyses for the mean survival time ratio (MR) investigating four different priors for the between-study variance.", "pos_in_sequence"=>6, "defined_type"=>3, "published_date"=>"2016-05-09 06:00:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/5210443"], "description"=>"<p>Values less than 1 indicated a beneficial effect of the KD.</p>", "links"=>[], "tags"=>["KD timing", "brain tumor model", "sample sizes", "future experiments", "survival times", "density interval", "murine tumor models", "ketogenic diets", "tumor volume", "cancer cells", "SD groups", "HR", "HPDI", "tumor location", "tumor growth", "MR", "hazard rate", "survival time ratio", "12 studies meeting", "Ketogenic Diets", "inclusion criteria", "hazard ratio", "tumor initiation", "tumor growth retardation"], "article_id"=>3368326, "categories"=>["Medicine", "Cell Biology", "Biotechnology", "Mathematical Sciences not elsewhere classified", "Cancer"], "users"=>["Rainer J. Klement", "Colin E. Champ", "Christoph Otto", "Ulrike Kämmerer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0155050.g003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Forest_plot_of_the_meta-analysis_for_the_hazard_ratio_/3368326", "title"=>"Forest plot of the meta-analysis for the hazard ratio.", "pos_in_sequence"=>3, "defined_type"=>1, "published_date"=>"2016-05-09 06:00:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/5210431"], "description"=>"<p>Values less than 1 indicated a beneficial effect of the KD. The observed effects <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0155050#pone.0155050.e002\" target=\"_blank\">Eq (1)</a> are the effects extracted from the individual studies, while the Bayesian effect estimates <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0155050#pone.0155050.e003\" target=\"_blank\">Eq (2)</a> represent the true study effects and are influenced by all the other studies.</p>", "links"=>[], "tags"=>["KD timing", "brain tumor model", "sample sizes", "future experiments", "survival times", "density interval", "murine tumor models", "ketogenic diets", "tumor volume", "cancer cells", "SD groups", "HR", "HPDI", "tumor location", "tumor growth", "MR", "hazard rate", "survival time ratio", "12 studies meeting", "Ketogenic Diets", "inclusion criteria", "hazard ratio", "tumor initiation", "tumor growth retardation"], "article_id"=>3368314, "categories"=>["Medicine", "Cell Biology", "Biotechnology", "Mathematical Sciences not elsewhere classified", "Cancer"], "users"=>["Rainer J. Klement", "Colin E. Champ", "Christoph Otto", "Ulrike Kämmerer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0155050.g002", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Forest_plot_of_the_meta-analysis_for_the_mean_survival_time_ratio_/3368314", "title"=>"Forest plot of the meta-analysis for the mean survival time ratio.", "pos_in_sequence"=>2, "defined_type"=>1, "published_date"=>"2016-05-09 06:00:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/5210413"], "description"=>"<p>Flow chart of the study selection procedure.</p>", "links"=>[], "tags"=>["KD timing", "brain tumor model", "sample sizes", "future experiments", "survival times", "density interval", "murine tumor models", "ketogenic diets", "tumor volume", "cancer cells", "SD groups", "HR", "HPDI", "tumor location", "tumor growth", "MR", "hazard rate", "survival time ratio", "12 studies meeting", "Ketogenic Diets", "inclusion criteria", "hazard ratio", "tumor initiation", "tumor growth retardation"], "article_id"=>3368299, "categories"=>["Medicine", "Cell Biology", "Biotechnology", "Mathematical Sciences not elsewhere classified", "Cancer"], "users"=>["Rainer J. Klement", "Colin E. Champ", "Christoph Otto", "Ulrike Kämmerer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0155050.g001", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Flow_chart_of_the_study_selection_procedure_/3368299", "title"=>"Flow chart of the study selection procedure.", "pos_in_sequence"=>1, "defined_type"=>1, "published_date"=>"2016-05-09 06:00:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/5210482"], "description"=>"<p>Similar to <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0155050#pone.0155050.t003\" target=\"_blank\">Table 3</a>, but for the hazard ratio (HR) as the effect measure.</p>", "links"=>[], "tags"=>["KD timing", "brain tumor model", "sample sizes", "future experiments", "survival times", "density interval", "murine tumor models", "ketogenic diets", "tumor volume", "cancer cells", "SD groups", "HR", "HPDI", "tumor location", "tumor growth", "MR", "hazard rate", "survival time ratio", "12 studies meeting", "Ketogenic Diets", "inclusion criteria", "hazard ratio", "tumor initiation", "tumor growth retardation"], "article_id"=>3368365, "categories"=>["Medicine", "Cell Biology", "Biotechnology", "Mathematical Sciences not elsewhere classified", "Cancer"], "users"=>["Rainer J. Klement", "Colin E. Champ", "Christoph Otto", "Ulrike Kämmerer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0155050.t004", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Similar_to_Table_3_but_for_the_hazard_ratio_HR_as_the_effect_measure_/3368365", "title"=>"Similar to Table 3, but for the hazard ratio (HR) as the effect measure.", "pos_in_sequence"=>7, "defined_type"=>3, "published_date"=>"2016-05-09 06:00:28"}

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Relative Metric

{"start_date"=>"2016-01-01T00:00:00Z", "end_date"=>"2016-12-31T00:00:00Z", "subject_areas"=>[]}
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