Keto Cancer Recipes

August 20, 2023

By Angie N Choi, EdD, Author of Whole New Me: Healing From Cancer in Body, Mind, and Spirit

Ketogenic diet recipes for cancer can be complex depending upon a patient’s cancer, stage, treatment, support, and motivation. Before implementing a keto diet for cancer, patients should consult with a registered dietitian who understands ketogenic diets and the metabolic approach to cancer. Not all dietitians or nutritionists have experience with ketogenic diets for cancer treatment, so it is important to ask. Ketogenic diets have been popularized for weight loss, but when implementing the diet as treatment, it is called a therapeutic ketogenic diet which is typically stricter than one for weight loss. In this article, I’ll share ketogenic cancer recipes and explain important concepts to understand in implementing ketogenic diets for cancer. I wrote another article on the metabolic approach to cancer and metabolic therapies if you need some context on how and why a therapeutic ketogenic diet works to manage cancer.

Ketogenic Diet for Cancer Recipes

A weekly sample menu is presented below. These are generalized menus that are not specific to individuals or cancer types or stages. Some individuals may require a higher caloric intake than others, so grams are not included in the sample menus. For more specific information on macronutrient (carbs, proteins, fats) ratios with sample calories see my article on ketogenic diet cancer menus. Depending on portion sizes (or food weight in grams), calorie counts may be higher. For those with cancer, weighing portions on a food scale and tracking nutrients and calories in a nutrition-tracking application like Cronometer would be important for specific measurements. Also, macronutrient ratios may require adjustments in the menus below.

Day 1

• Breakfast: Scrambled eggs with spinach and feta cheese cooked in butter
• Lunch: Grilled chicken salad and feta cheese cooked in butter
• Snack: Celery sticks with cream cheese
• Dinner: Baked salmon with steamed broccoli drizzled with melted butter

Day 2

• Breakfast: Chia seed pudding made with coconut milk and topped with sliced almonds
• Lunch: Turkey and cheese lettuce wraps with mustard
• Snack: Handful of macadamia nuts
• Dinner: Stir-fried ground beef with bell peppers, onions, and cauliflower rice

Day 3

• Breakfast: Greek yogurt with raspberries and a sprinkle of chia seeds
• Lunch: Tuna salad with mayo and chopped cucumber, wrapped in lettuce leaves
• Snack: Cheese cubes
• Dinner: Grilled steak with a side of sautéed spinach in olive oil

Day 4

• Breakfast: Omelette with cheese, tomatoes, and onions cooked in coconut oil
• Lunch: Zucchini noodles with pesto sauce and grated Parmesan cheese
• Snack: Pork rinds
• Dinner: Baked chicken thighs with roasted Brussels sprouts

Day 5

• Breakfast: Smoothie made with unsweetened almond milk, spinach, and avocado
• Lunch: Steak with sliced bell peppers cooked in coconut aminos
• Snack: Handful of almonds
• Dinner: Grilled shrimp with a side of asparagus roasted in olive oil

Day 6

• Breakfast: Avocado and bacon mini salad
• Lunch: Egg salad with mayonnaise and chopped celery
• Snack: Olives
• Dinner: Baked cod with a side of sautéed kale in butter

Day 7

• Breakfast: Cottage cheese with sliced strawberries and a sprinkle of walnuts
• Lunch: Chicken Caesar salad with romaine lettuce, grilled chicken, and Caesar dressing
• Snack: Sunflower seeds
• Dinner: Pork chops with cauliflower mash and a side salad

Glucose Ketone Index

An important measure to understand in ketogenic diets for cancer is the Glucose Ketone Index (GKI). According to research, a ketogenic diet for cancer management that yields a GKI of 1 is recommended for even the most aggressive cancers like brain cancer.¹ A GKI within the range of 2-3 may also be helpful to manage many types of cancer (as in my case). The GKI is a ratio that measures an individual’s blood glucose and ketone levels. Individuals may measure blood glucose with a glucometer and ketone levels with a ketone meter. Some monitors can provide both measurements like the Keto Mojo Glucose & Ketone Testing Kit or the Precision Xtra Blood Glucose & Ketone Monitoring System. To calculate the GKI, blood glucose (mg/dL) is divided by 18, and then the total is divided again by ketone levels (mmol/L). To have a lower GKI, individuals with cancer would want lower glucose but higher ketone levels.

GKI = (blood glucose ÷ 18) ÷ blood ketones.

For example, if blood glucose is 90 and blood ketones are 3, the GKI would be 1.7.

 Ex. GKI = (90 ÷ 18) ÷ 3 = 1.7.

In order to lower glucose and increase ketone levels, a ketogenic diet is an effective means. Fasting is another way to lower glucose and raise ketone levels, but long-term fasting is not possible for most cancer patients. Nutrients are needed to supply the body with energy for healing and body functions, but these nutrients should strictly reduce carbohydrates. The ketogenic diet allows cancer patients to take in nutrients to support body functions long-term while severely restricting fuel (glucose) for cancer cells. After carbohydrates are restricted in the diet, the body will consume its glucose stores in the liver (glycogen) and metabolically switch over to using ketones instead of glucose. The body’s cells adapt well to use ketones for energy when glucose is no longer available, but cancer cells do not have this flexibility and effectively starve which leads to cellular death.

Although a therapeutic ketogenic diet is a good strategy against cancer proliferation, it may not be effective just by itself to stop cancer proliferation. An interesting study by Dr. Thomas Seyfried and his collaborators indicated that unrestricted diets, where mice could eat as many calories as they liked whether a standard or ketogenic diet, did not limit tumor growth.^1,2 However, mice who had restricted diets (low calorie standard or keto), had about an 80% reduction in tumor growth. Their research supported the conclusion that calorie reduction was more significant than type of diet. Combining metabolic therapies such as a calorie-restricted diet in combination with a ketogenic diet was more effective than either alone. Their research indicated that implementing a ketogenic diet can be good for cancer, but it should not be a high-calorie ketogenic diet. Each cancer patient’s energy needs differ, so this is another reason why working with a dietitian or nutritionist is important. I wrote another article about choosing a cancer nutritionist or oncology dietitian if you’re interested.

Ketogenic Food Pyramid for Cancer Patients

Other important concepts to understand are the ketogenic food pyramid and ratios of macronutrients. Two keto food pyramids are presented below. The first one illustrates a 7:2:1 or 7.5:2:.5 ratio of fats, proteins, and carbohydrates, and the second illustrates a more restrictive ratio of 9:1:0 which may be more appropriate for the most aggressive cancers. These ratios indicate the percentage of total nutrients (calories) consumed per meal. For example, a 7:2:1 ratio would mean that 70% of total calories for the meal would be fat, 20% protein, and 10% carbohydrates. A 9:1:0 ratio would mean that per meal, total calories would be comprised of 90% fat, 10% protein, and 0% carbohydrates (no carbs). So, if a meal was 600 total calories, 540 of those would be from fat, 60 from protein, and 0 carbs on a 9:1:0 ratio.

Fats

The base of any meal should be high quality, organic (as much as possible), unsaturated fats. Unsaturated fats are characterized by their chemical structure (monounsaturated and polyunsaturated), are typically soft or liquid at room temperature, and are considered healthier than saturated fats which mainly come from animal sources.

The molecular structure of monounsaturated fats is one double bond. Monounsaturated fats tend to be liquid at room temperature but become solid when refrigerated. These fats include olive oil, avocado oil, nuts (almonds, cashews, and pistachios), seeds (pumpkin and sesame) and avocados which are fruit.

Polyunsaturated fats have multiple double bonds in their chemical structure. They remain liquid even at low temperatures. Polyunsaturated fats can be categorized into two types: omega-3 fatty acids and omega-6 fatty acids. Omega-3s include fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, and walnuts. Omega-6s are found in vegetable oils (corn, sunflower, safflower, soybean, peanut), nuts (pine, Brazil, pecan, peanuts, pistachios) and seeds (sunflower, pumpkin, sesame, safflower). Omega-6s should be eaten in moderation.

One important note is that omega 6s and 3s should be kept in balance to control inflammation in the body. Our ancestors had a diet that had a 1:1 ratio of omega-6s to3s, but Western diets today exhibit a far more unbalanced ratio of approximately 15 – 16.71:1.³ A high omega-6 to omega-3 ratio is associated with cancer, heart disease, autoimmune disease, and inflammation whereas increased levels of omega-3s (or low omega-6 to omega-3 ratios) are related to reductions in these diseases.

Protein

Good sources of protein include most meats due to their low carbohydrate count. Meats with higher fat content or high fat cuts of meat are more keto-friendly than lean cuts of meat. Good choices include fatty fish (salmon, mackerel, sardines, or herring) and fatty meats or nutrient-dense organ meats (lamb, steak/short ribs, pork belly, organ meats). Chicken and turkey are also good protein sources but have less fat. Leaner meats may be cooked in grass-fed organic butter, lard, duck fat, beef tallow, coconut oil, or heavy cream to increase fat content. Full fat dairy products like cheese also provide protein but avoid milk which has carbohydrates (lactose).

When choosing meats, it is important to source them from organic, grass-fed animals. Many factory-farmed animals are fed grains which are carbohydrates, and they are fed growth hormones and antibiotics unless otherwise labelled. Their living conditions are neither sanitary nor humane in many cases and limiting inflammation-provoking, hormone-disrupting, and bacteria-riddled food is important for cancer patients, not to mention animal welfare. Although organic is more expensive than conventional food, try to steer toward whole food that grows naturally in nature as much as the budget allows. If eating a lower-calorie ketogenic diet, cost may be lowered as not as much food is consumed.

Carbohydrates

For those who may eat carbohydrates on a therapeutic ketogenic diet for cancer, cruciferous vegetables are good choices. These include broccoli, kale, collard and mustard greens, bok choy, cabbage, Brussels sprouts, and cauliflower). Avoid starchy and root vegetables that are higher in carbohydrates (potatoes, carrots, beets, squash, pumpkin, peas, legumes). Some cancer patients may be able to transition to eat more carbohydrates as their health improves.

Ketogenic diets are typically rich, savory diets and many cancer patients will not find them lacking. The feeling of deprivation is not so noticeable on a ketogenic diet because fat is satiating and doesn’t metabolize as quickly as sugars. Some patients may experience challenges on the ketogenic diet such as constipation, so water and fiber intake are important. Having the support of your family and friends especially during meals will ease the transition to a therapeutic ketogenic diet. Those on a strict 9:1:0 ratio may experience more challenges in the beginning of adapting to the diet and need to work with a registered dietitian or nutritionist, but as health improves, motivation will increase. Slight tweaks in the diet may also be required as challenges arise. Some may also find it less stressful to be on a strict macronutrient ratio (low GKI) because meal planning and food choices become more defined. Most patients will be able to adjust well to the diet because nutrient intake will help maintain energy levels in the body while healing occurs.

References

¹Seyfried TN. Cancer as a Metabolic Disease: On the Origin, Management and Prevention of Cancer. John Wiley & Sons; 2012.

²Seyfried, TN, Sanderson, T., El-Abbadi, MM, McGowan, R, & Mukherjee, P. (2003). Role of glucose and ketone bodies in the metabolic control of experimental brain cancer. British journal of cancer, 89(7), 1375-1382.

³ Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002;56(8):365-79.