Obesity and tumor growth: inflammation, immunity, and the role of a ketogenic diet

Curr Opin Clin Nutr Metab Care. 2016 Jul;19(4):294-9. doi: 10.1097/MCO.0000000000000286.


Purpose of review: This article reviews the impact the obese state has on malignancy through inflammation and immune dysregulation using recent excerpts from the medical literature.

Recent findings: The obese state creates a proinflammatory endocrinologic milieu altering cellular signaling between adipocytes, immunologic cells, and epithelial cells, leading to the over-activation of adipose tissue macrophages and the upregulation of compounds associated with carcinogenesis. Obesity correlates with a deficiency in numerous immunologic cells, including dendritic cells, natural killer cells, and T cells. In part, this can be attributed to a recent finding of leptin receptor expression on these immune cells and the upregulation of leptin signaling in the obese state. A number of clinical trials have demonstrated the feasibility of a high-fat, low-carbohydrate diet as an adjuvant treatment for cancer, and current trials are investigating the impact of this intervention on disease outcomes. In preclinical trials, a ketogenic diet has been shown to impede tumor growth in a variety of cancers through anti-angiogenic, anti-inflammatory, and proapoptotic mechanisms.

Summary: Obesity is becoming more prevalent and its link to cancer is clearly established providing a rationale for the implementation of dietary interventions as an adjuvant therapeutic strategy for malignancy.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity
  • Adiposity
  • Animals
  • Carcinogenesis*
  • Combined Modality Therapy
  • Diet, Ketogenic*
  • Diet, Reducing
  • Endocrine System Diseases / immunology
  • Endocrine System Diseases / pathology
  • Endocrine System Diseases / physiopathology
  • Endocrine System Diseases / therapy*
  • Exercise*
  • Humans
  • Immune System Diseases / immunology
  • Immune System Diseases / pathology
  • Immune System Diseases / physiopathology
  • Immune System Diseases / therapy*
  • Immunity, Innate
  • Inflammation Mediators / metabolism
  • Intra-Abdominal Fat / immunology
  • Intra-Abdominal Fat / metabolism
  • Intra-Abdominal Fat / pathology
  • Neoplasms / etiology
  • Neoplasms / immunology
  • Neoplasms / pathology
  • Neoplasms / therapy*
  • Obesity / immunology
  • Obesity / pathology
  • Obesity / physiopathology
  • Obesity / therapy*
  • Tumor Burden


  • Inflammation Mediators