\u6b27\u5dde\u80a5\u6e80\u5b66\u4f1a\uff08EASO\uff09\u306f\u3053\u306e\u5ea6\u3001\u904e\u4f53\u91cd\u307e\u305f\u306f\u80a5\u6e80\u304a\u3088\u3073\u304c\u3093\u60a3\u8005\u306e\u7ba1\u7406\u306e\u305f\u3081\u306e\u533b\u7642\u6804\u990a\u7642\u6cd5\u306b\u95a2\u3059\u308b\u610f\u898b\u8868\u660e\u3092\u51fa\u3057\u307e\u3057\u305f\u3002\u305d\u306e\u4e2d\u8eab\u3092\u898b\u3066\u307f\u307e\u3057\u3087\u3046\u3002<\/p>\n
\u300cObesity, a chronic and multifactorial disease, has reached epidemic proportions globally, significantly impacting public health. \u300d<\/span><\/p>\n \u300c\u6162\u6027\u7684\u304b\u3064\u591a\u56e0\u5b50\u6027\u306e\u75be\u60a3\u3067\u3042\u308b\u80a5\u6e80\u306f\u3001\u4e16\u754c\u7684\u306a\u6d41\u884c\u306b\u9054\u3057\u3001\u516c\u8846\u885b\u751f\u306b\u5927\u304d\u306a\u5f71\u97ff\u3092\u4e0e\u3048\u3066\u3044\u308b\u3002\u300d<\/span><\/p>\n \u3068\u307e\u305a\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002\u80a5\u6e80\u306f\u78ba\u304b\u306b\u591a\u56e0\u5b50\u6027\u3067\u306f\u3042\u308a\u307e\u3059\u304c\u3001\u305d\u306e\u5927\u90e8\u5206\u306f\u98df\u4e8b\u306b\u3088\u308b\u3082\u306e\u3001\u7279\u306b\u7cd6\u8cea\u904e\u5270\u6442\u53d6\u306b\u3088\u308b\u3082\u306e\u3067\u3059\u3002<\/p>\n \u300cThe Mediterranean Diet (MedDiet), in particular, characterized by a high intake of fruits, vegetables, legumes, whole grains, and moderate consumption of extra virgin olive oil, fish, and nuts, has been correlated with a decreased risk of several cancers. This dietary model not only promotes a healthy body weight but also provides nutrients and bioactive compounds that may have synergistic protective effects against cancer development.\u300d<\/span><\/p>\n \u300c\u7279\u306b\u3001\u679c\u7269\u3001\u91ce\u83dc\u3001\u8c46\u985e\u3001\u5168\u7c92\u7a40\u7269\u3092\u591a\u304f\u6442\u53d6\u3057\u3001\u30a8\u30ad\u30b9\u30c8\u30e9\u30d0\u30fc\u30b8\u30f3\u30aa\u30ea\u30fc\u30d6\u30aa\u30a4\u30eb\u3001\u9b5a\u3001\u30ca\u30c3\u30c4\u985e\u3092\u9069\u5ea6\u306b\u6442\u53d6\u3059\u308b\u5730\u4e2d\u6d77\u98df\uff08MedDiet\uff09\u306f\u3001\u3044\u304f\u3064\u304b\u306e\u304c\u3093\u306e\u767a\u75c7\u30ea\u30b9\u30af\u306e\u4f4e\u4e0b\u3068\u76f8\u95a2\u3057\u3066\u3044\u308b\u3002\u3053\u306e\u98df\u4e8b\u30e2\u30c7\u30eb\u306f\u5065\u5eb7\u7684\u306a\u4f53\u91cd\u3092\u4fc3\u9032\u3059\u308b\u3060\u3051\u3067\u306a\u304f\u3001\u304c\u3093\u306e\u767a\u75c7\u306b\u5bfe\u3059\u308b\u76f8\u4e57\u7684\u306a\u4fdd\u8b77\u52b9\u679c\u3092\u6301\u3064\u53ef\u80fd\u6027\u306e\u3042\u308b\u6804\u990a\u7d20\u3068\u751f\u7406\u6d3b\u6027\u5316\u5408\u7269\u3082\u63d0\u4f9b\u3059\u308b\u3002\u300d<\/span><\/p>\n \u76f8\u5909\u308f\u3089\u305a\u6b27\u7c73\u3067\u306f\u5730\u4e2d\u6d77\u98df\u304c\u5927\u597d\u304d\u3067\u3059\u306d\u3002\u305d\u3057\u3066\u3001\u6b21\u306e\u6587\u7ae0\u306f\u5927\u304d\u306a\u9032\u6b69\u3067\u3059\u3002<\/p>\n \u300cAmong other dietary interventions, the ketogenic diet (KD) has recently garnered significant attention. Initially developed to manage drug-resistant epilepsy in children, KD has shown potential benefits in promoting weight loss and improving metabolic profiles in individuals with obesity. By drastically reducing carbohydrate intake, KD induces a state of ketosis, where ketone bodies become the primary energy source, potentially exerting anticancer effects by altering tumor metabolism and reducing insulin levels.\u300d<\/span><\/p>\n \u300c\u4ed6\u306e\u98df\u4e8b\u7642\u6cd5\u306e\u4e2d\u3067\u3082\u3001\u30b1\u30c8\u30f3\u98df\uff08KD\uff09\u304c\u6700\u8fd1\u5927\u304d\u306a\u6ce8\u76ee\u3092\u96c6\u3081\u3066\u3044\u308b\u3002\u3082\u3068\u3082\u3068\u5c0f\u5150\u306e\u85ac\u5264\u8010\u6027\u3066\u3093\u304b\u3093\u3092\u7ba1\u7406\u3059\u308b\u305f\u3081\u306b\u958b\u767a\u3055\u308c\u305fKD\u306f\u3001\u80a5\u6e80\u8005\u306e\u6e1b\u91cf\u3092\u4fc3\u9032\u3057\u3001\u4ee3\u8b1d\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u3092\u6539\u5584\u3059\u308b\u6f5c\u5728\u7684\u306a\u5229\u70b9\u3092\u793a\u3057\u3066\u3044\u308b\u3002KD\u306f\u70ad\u6c34\u5316\u7269\u306e\u6442\u53d6\u3092\u5927\u5e45\u306b\u6e1b\u3089\u3059\u3053\u3068\u3067\u30b1\u30c8\u30fc\u30b7\u30b9\u72b6\u614b\u3092\u8a98\u767a\u3057\u3001\u30b1\u30c8\u30f3\u4f53\u304c\u4e3b\u8981\u306a\u30a8\u30cd\u30eb\u30ae\u30fc\u6e90\u3068\u306a\u308a\u3001\u816b\u760d\u306e\u4ee3\u8b1d\u3092\u5909\u3048\u3066\u30a4\u30f3\u30b9\u30ea\u30f3\u30ec\u30d9\u30eb\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u3053\u3068\u3067\u6297\u304c\u3093\u52b9\u679c\u3092\u767a\u63ee\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u300d<\/span><\/p>\n \u306a\u3093\u3068\u3001\u30b1\u30c8\u30f3\u98df\u306e\u8a18\u8ff0\u304c\u51fa\u3066\u304d\u307e\u3057\u305f\u3002\u3055\u3089\u306b\u3001<\/p>\n \u300cIntermittent fasting (IF) is another dietary approach that has gained popularity for obesity management. IF involves periodic cycles of fasting and eating, which can improve insulin sensitivity, reduce inflammation, and promote weight loss. Variants of IF have shown promise in improving metabolic health and a potential role in the prevention and treatment of cancer.\u300d<\/span><\/p>\n \u300c\u30a4\u30f3\u30bf\u30fc\u30df\u30c3\u30c6\u30f3\u30c8\u30d5\u30a1\u30b9\u30c6\u30a3\u30f3\u30b0 \u65ad\u7d9a\u7684\u65ad\u98df\uff08IF\uff09\u306f\u3001\u80a5\u6e80\u7ba1\u7406\u306e\u305f\u3081\u306b\u4eba\u6c17\u3092\u96c6\u3081\u3066\u3044\u308b\u3082\u3046\u4e00\u3064\u306e\u98df\u4e8b\u7642\u6cd5\u3067\u3042\u308b\u3002IF\u306f\u65ad\u98df\u3068\u98df\u4e8b\u306e\u5468\u671f\u7684\u306a\u30b5\u30a4\u30af\u30eb\u3092\u4f34\u3044\u3001\u30a4\u30f3\u30b9\u30ea\u30f3\u611f\u53d7\u6027\u3092\u6539\u5584\u3057\u3001\u708e\u75c7\u3092\u8efd\u6e1b\u3057\u3001\u4f53\u91cd\u6e1b\u5c11\u3092\u4fc3\u9032\u3059\u308b\u3002IF\u306e\u5909\u7a2e\u306f\u3001\u4ee3\u8b1d\u306e\u5065\u5eb7\u3092\u6539\u5584\u3059\u308b\u52b9\u679c\u304c\u671f\u5f85\u3055\u308c\u3066\u304a\u308a\u3001\u304c\u3093\u306e\u4e88\u9632\u3068\u6cbb\u7642\u306b\u304a\u3051\u308b\u6f5c\u5728\u7684\u306a\u5f79\u5272\u304c\u793a\u3055\u308c\u3066\u3044\u308b\u3002\u300d<\/span><\/p>\n \u30a4\u30f3\u30bf\u30fc\u30df\u30c3\u30c6\u30f3\u30c8\u30d5\u30a1\u30b9\u30c6\u30a3\u30f3\u30b0\u306e\u8a00\u8449\u3082\u51fa\u3066\u304d\u307e\u3057\u305f\u3002\u51c4\u3044\u3067\u3059\u306d\u3002\u3053\u308c\u3089\u306e\u52b9\u679c\u3092\u3082\u3046\u7121\u8996\u3067\u304d\u306a\u3044\u306e\u3067\u3057\u3087\u3046\u3002<\/p>\n \u300cSeveral epidemiological studies have shown an association between obesity and cancer in terms of increased incidence, risk of progression, and relapse.\u300d<\/span><\/p>\n \u300c\u3044\u304f\u3064\u304b\u306e\u75ab\u5b66\u7814\u7a76\u3067\u3001\u767a\u751f\u7387\u3001\u9032\u884c\u30ea\u30b9\u30af\u3001\u518d\u767a\u306e\u5897\u52a0\u3068\u3044\u3046\u70b9\u3067\u3001\u80a5\u6e80\u3068\u304c\u3093\u3068\u306e\u95a2\u9023\u304c\u793a\u3055\u308c\u3066\u3044\u308b\u3002\u300d<\/span><\/p>\n \u3082\u3046\u3053\u306e\u3053\u3068\u306f\u307f\u306a\u3055\u3093\u3054\u5b58\u3058\u3067\u3057\u3087\u3046\u3002\u305d\u306e\u5f8c\u306f\u3001\u80a5\u6e80\u3068\u304c\u3093\u30ea\u30b9\u30af\u306b\u3064\u3044\u3066\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n \u30fb\u4e73\u304c\u3093\u306f\u4e16\u754c\u4e2d\u3067\u5973\u6027\u306b\u6700\u3082\u591a\u304f\u307f\u3089\u308c\u308b\u304c\u3093\u3067\u3001\u7279\u306bBMI >35.0\u306e\u80a5\u6e80\u3092\u4f34\u3046\u9589\u7d4c\u5f8c\u5973\u6027\u3067\u306f\u4e73\u304c\u3093\u306e\u767a\u75c7\u30ea\u30b9\u30af\u304c\u9ad8\u304f\u306a\u308b\u3002\u76f8\u5bfe\u30ea\u30b9\u30af\u306f\u3001BMI\u304c10\u5897\u52a0\u3059\u308b\u30681.40\u500d\u3001BMI\u304c5\u5897\u52a0\u3059\u308b\u30681.12\u500d\u3002<\/p>\n \u30fb\u5b50\u5bae\u5185\u819c\u304c\u3093\u306f\u4ed6\u306e\u3069\u306e\u304c\u3093\u7a2e\u3088\u308a\u3082\u80a5\u6e80\u3068\u5f37\u304f\u95a2\u9023\u3057\u3066\u3044\u308b\u3002\u76f8\u5bfe\u30ea\u30b9\u30af\u306f\u3001BMI\u304c10\u5897\u52a0\u3059\u308b\u30682.89\u500d\u3001 BMI\u304c5\u5897\u52a0\u3059\u308b\u30681.59\u500d\u3002\u6b63\u5e38\u4f53\u91cd\u306e\u5973\u6027\u3068\u6bd4\u8f03\u3059\u308b\u3068\u3001\u4e2d\u7b49\u5ea6\u306e\u80a5\u6e80\uff08BMI 35\uff5e39.99\uff09\u306e\u5973\u6027\u306e\u6b7b\u4ea1\u7387\u306e\u76f8\u5bfe\u30ea\u30b9\u30af\u306f2.53\u500d\u3001\u91cd\u5ea6\u306e\u80a5\u6e80\uff08BMI\u226540\uff09\u306e\u5973\u6027\u306e\u6b7b\u4ea1\u7387\u306e\u76f8\u5bfe\u30ea\u30b9\u30af\u306f6.25\u500d\u3002\u3055\u3089\u306b\u3001\u80a5\u6e80\u306f\u8ee2\u5e30\u306e\u60aa\u5316\u3068\u3082\u95a2\u9023\u3057\u3066\u3044\u308b\u3002<\/p>\n \u30fb\u80a5\u6e80\u306f\u5375\u5de3\u304c\u3093\u306e\u767a\u75c7\u30ea\u30b9\u30af\u3068\u3082\u95a2\u9023\u3057\u3066\u3044\u308b\u3002\u76f8\u5bfe\u30ea\u30b9\u30af\u306f\u3001BMI\u304c\u5897\u52a0\u3059\u308b\u30681.14\u500d\u3001 BMI\u304c5\u5897\u52a0\u3059\u308b\u30681.03\u500d\u3002\u5185\u81d3\u8102\u80aa\u306f\u3001BMI\u81ea\u4f53\u3088\u308a\u3082\u5375\u5de3\u304c\u3093\u306e\u767a\u75c7\u3068\u95a2\u9023\u3057\u3066\u3044\u308b\u3068\u601d\u308f\u308c\u308b\u3002<\/p>\n \u30fb\u98df\u9053\u817a\u304c\u3093\uff08EAC\uff09\u304a\u3088\u3073\u80c3\u98df\u9053\u63a5\u5408\u90e8\u304c\u3093\u306b\u306f\u3044\u304f\u3064\u304b\u306e\u5371\u967a\u56e0\u5b50\u304c\u3042\u308b\u3002EAC\u767a\u751f\u306e\u76f8\u5bfe\u30ea\u30b9\u30af\u306f\u3001\u7537\u6027\u3067\u306fBMI\u304c5\u5897\u52a0\u3059\u308b\u3054\u3068\u306b1.52\u500d\u3001\u5973\u6027\u3067\u306f1.51\u500d\u3002<\/p>\n \u306a\u3069\u3044\u308d\u3044\u308d\u3068\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002\u80a5\u6e80\u306f\u3055\u307e\u3056\u307e\u306a\u304c\u3093\u306e\u30ea\u30b9\u30af\u3092\u5927\u5e45\u306b\u9ad8\u3081\u3001\u7279\u306b\u9589\u7d4c\u5f8c\u5973\u6027\u306b\u9855\u8457\u3067\u3001\u80a5\u6e80\u306f\u4e73\u304c\u3093\u3001\u5b50\u5bae\u5185\u819c\u304c\u3093\u3001\u5927\u8178\u304c\u3093\u3001\u814e\u81d3\u304c\u3093\u306a\u3069\u3068\u5f37\u304f\u95a2\u9023\u3057\u3066\u3044\u308b\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u307e\u305f\u5185\u81d3\u8102\u80aa\u306e\u5b58\u5728\u306f\u3001\u7279\u306b\u5375\u5de3\u304c\u3093\u3084\u98df\u9053\u304c\u3093\u306b\u304a\u3044\u3066\u3001\u304c\u3093\u306e\u767a\u75c7\u306b\u91cd\u8981\u306a\u5f79\u5272\u3092\u679c\u305f\u3057\u3001\u3055\u3089\u306b\u3001\u80a5\u6e80\u306f\u304c\u3093\u306e\u4e88\u5f8c\u306b\u5f71\u97ff\u3092\u53ca\u307c\u3057\u3001\u591a\u304f\u306e\u5834\u5408\u3001\u4e88\u5f8c\u3092\u60aa\u5316\u3055\u305b\u3001\u6cbb\u7642\u52b9\u679c\u3092\u8907\u96d1\u306b\u3059\u308b\u3068\u3082\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n \u305d\u306e\u5f8c\u3082\u30e1\u30ab\u30cb\u30ba\u30e0\u306a\u3069\u304c\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u304c\u3001\u300c\u80a5\u6e80\u3068\u304c\u3093\u3092\u60a3\u3046\u4eba\u3005\u306b\u5bfe\u3059\u308b\u6804\u990a\u5b66\u7684\u30a2\u30d7\u30ed\u30fc\u30c1\u300d\u306e\u3068\u3053\u308d\u3092\u898b\u3066\u307f\u307e\u3057\u3087\u3046\u3002<\/p>\n \u5730\u4e2d\u6d77\u98df\u306e\u5f8c\u306b\u3001\u304b\u306a\u308a\u306e\u6587\u66f8\u91cf\u3067\u30b1\u30c8\u30f3\u98df\u306b\u3064\u3044\u3066\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002\u305d\u306e\u90e8\u5206\u306e\u5168\u6587\u3092\u8f09\u305b\u3066\u3044\u307e\u3059\u304c\u3001\u96e3\u3057\u3044\u90e8\u5206\u306f\u98db\u3070\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n \u300cKetogenic Diet\uff08KD\uff09<\/span> With a diet that limits intake of carbohydrate, glucose availability for glycolysis is limited, preventing the formation of pyruvate and subsequent conversion to lactate to generate ATP . Lipid and ketone bodies become the predominant source of energy and require the cell to use mitochondria, which may be dysfunctional in cancer cells as noted above. This, combined with the limited availability of glucose for the pentose phosphate pathway and the generation of NADPH, leads to oxidative stress in cancer cells compared with normal cells. Evidence of this oxidative stress was demonstrated in mouse models of neuroblastoma through measurement of activation of energy sensor adenosine monophosphate (AMP)-activated protein kinase (AMPK). In response to KD, they found higher activation of AMPK in tumor tissue but not in normal tissue. It is important to note that a few mitochondrial enzymes are key in the metabolism of ketone bodies for energy, and tumor cells tend to express these enzymes in varying amounts. Zhang et al. demonstrated that expression of genes encoding the two ketolytic enzymes 3-hydroxybutyrate dehydrogenase 1 (BDH1) and succinyl-CoA:3-oxoacid CoA transferase 1 in tumor cells correlated with response to KD.<\/span><\/p>\n In addition to these metabolic benefits, KD, perhaps through the action of ketone bodies, can exert several other benefits, including modulation of signaling molecules and gene expression, as well as reduction in inflammation. \u03b2-hydroxybutyrate and acetone have been noted to modulate the signaling of N-methyl-D-aspartate, which is physiologically relevant as N-methyl-D-aspartate receptor expression has been observed in various types of cancers. Similarly, hydroxy-carboxylic acid receptor 2 is activated by \u03b2-hydroxybutyrate. Hydroxy-carboxylic acid receptor 2 is described as a tumor suppressor and activates specific macrophages that have neuroprotective effects. KD and ketone bodies have also been associated with anti-inflammatory effects through reduction in cytokines such as TNF-\u03b1, IL-1, and IL-6. A recent study in a mouse model of colon cancer noted that a KD was associated with lower tumor weight, as well as plasma IL-6 levels. Additionally, blood ketone body concentrations were also negatively correlated with tumor weight. KD also reduces inflammation through suppression of NLRP3 inflammasome, which is a multiprotein complex that controls the activation of caspase-1 and subsequent release of proinflammatory cytokines. \u03b2-hydroxybutyrate was shown to inhibit assembly of NLRP3 inflammasome.<\/span><\/p>\n Despite these theoretical benefits, clinical trials with KD are quite limited. A recent review of clinical trials regarding use of KD in cancer noted that of the approximately 30 trials, the vast majority were case reports or pilot\/feasibility studies, with most focusing on the tolerability of KD in this population as well as its impact on body weight, glucose, and other metabolic parameters. As an example, a clinical trial retrospectively evaluated 53 patients undergoing treatment for high-grade glioma who had adequate glucose values recorded. Six of the 53 patients were on KD during treatment with a micronutrient composition of 77% fat, 8% carbohydrate, and 15% protein. They noted that the mean blood glucose for patients on a standard diet was 122 mg\/dL, whereas that of patients on a KD was 84 mg\/dL and decreased from 142.5 mg\/dL prior to initiation of KD. Another clinical trial randomized 73 women with ovarian or endometrial cancer to either a KD (energy from fat, protein, and carbohydrate of 70:25:5) or a diet recommended by the American Cancer Society. After 12 weeks, KD resulted in lower overall and central fat mass. There was also a 21.2% reduction in visceral fat mass with KD compared with 4.6% with the American Cancer Society diet, along with a more significant reduction in insulin, C-peptide levels, glucose, and IGF-1 levels . KD also showed more significant improvement in physical function scores, reports of fatigue, as well as cravings for starchy foods and fast-food fat.<\/span><\/p>\n Another randomized clinical trial was designed to enroll three cohorts, including patients with breast, rectal, and head and neck cancer, and included two interventions: ketogenic breakfast with a ketogenic drink and whole food KD. However, ketogenic breakfast drink was not tolerated by many, thus limiting the data to individuals with nonmetastatic breast cancer comparing either whole-food KD (n = 29) or standard diet (n = 30). The authors noted that the KD was well tolerated and resulted in body weight loss of 0.4 kg per week, as well as fat mass. Although fat-free mass and skeletal muscle mass declined initially, they were subsequently preserved. Insulin and IGF-1 levels also decreased more in the KD group .<\/span><\/p>\n The potential contraindications of KD in patients with cancer come from in vitro studies and some early-stage in vivo evidence. In a preclinical model of tuberous sclerosis complex, a rare genetic disorder, the growth of renal lesions in Eker rats (Tsc2+\/\u2212) was evaluated subjected to ad libitum prolonged feeding of KD for 4, 6, and 8 months. The authors demonstrated that, especially in its long-term usage, KD leads to excessive growth of renal tumors by recruiting ERK1\/2 and mTOR, which are related to oleic acid accumulation and the overproduction of growth hormone. The authors also reported the exhaustion of the initial adaptive upregulation of some protective proteins such as Nrf2, p53, and 8-oxoguanine glycosylase, suggesting that KD may be contraindicated in patients with tuberous sclerosis complex. KD may also be contraindicated in cancer patients with the BRAF V600E mutation. In a xenograft mouse model, the ketone body acetoacetate selectively enhanced BRAF V600E mutant-dependent MEK1 activation in human tumors, promoting the growth of human melanoma cells expressing this mutation.<\/span><\/p>\n Additionally, KD can be deficient in selenium, vitamin D, zinc, and other vitamins and minerals. These potential adverse side effects can be prevented or corrected if KD is prescribed and monitored by a qualified nutritionist who selects appropriate patients and ensures that KD is well formulated and adjusted in food choices and supplements with necessary vitamins and minerals. In conclusion, data on the safety and efficacy of KD in cancer patients remain relatively sparse and well designed, and rigorous clinical trials are urgently needed to evaluate the efficacy and safety of KD in the cancer setting.<\/span><\/p>\n Recommendations<\/span> \u300c\u30b1\u30c8\u30f3\u98df\uff08KD\uff09<\/span> 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KD\u3067\u306f\u3001\u8eab\u4f53\u6a5f\u80fd\u30b9\u30b3\u30a2\u3001\u75b2\u52b4\u611f\u3001\u3067\u3093\u3077\u3093\u8cea\u306e\u98df\u54c1\u3084\u30d5\u30a1\u30fc\u30b9\u30c8\u30d5\u30fc\u30c9\u306e\u8102\u80aa\u3078\u306e\u6e07\u671b\u306b\u304a\u3044\u3066\u3082\u3001\u3088\u308a\u9855\u8457\u306a\u6539\u5584\u304c\u898b\u3089\u308c\u305f\u3002<\/span><\/p>\n \u5225\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u81e8\u5e8a\u8a66\u9a13\u306f\u3001\u4e73\u304c\u3093\u3001\u76f4\u8178\u304c\u3093\u3001\u982d\u9838\u90e8\u304c\u3093\u306e\u60a3\u8005\u3092\u542b\u30803\u3064\u306e\u30b3\u30db\u30fc\u30c8\u3092\u767b\u9332\u3059\u308b\u3088\u3046\u306b\u8a2d\u8a08\u3055\u308c\u30012\u3064\u306e\u4ecb\u5165\u3001\u30b1\u30c8\u30b8\u30a7\u30cb\u30c3\u30af\u671d\u98df\u3068\u30b1\u30c8\u30b8\u30a7\u30cb\u30c3\u30af\u30c9\u30ea\u30f3\u30af\u3001\u30db\u30fc\u30eb\u30d5\u30fc\u30c9KD\u304c\u542b\u307e\u308c\u3066\u3044\u305f\u3002\u3057\u304b\u3057\u3001\u30b1\u30c8\u30b8\u30a7\u30cb\u30c3\u30af\u671d\u98df\u30c9\u30ea\u30f3\u30af\u306f\u591a\u304f\u306e\u4eba\u306b\u8010\u5bb9\u3055\u308c\u306a\u304b\u3063\u305f\u305f\u3081\u3001\u30db\u30fc\u30eb\u30d5\u30fc\u30c9KD\uff08n = 29\uff09\u307e\u305f\u306f\u6a19\u6e96\u98df\u4e8b\uff08n = 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V600E\u5909\u7570\u3092\u6709\u3059\u308b\u764c\u60a3\u8005\u306b\u3082\u7981\u5fcc\u3067\u3042\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u7570\u7a2e\u79fb\u690d\u30de\u30a6\u30b9\u30e2\u30c7\u30eb\u3067\u306f\u3001\u30b1\u30c8\u30f3\u4f53\u30a2\u30bb\u30c8\u9162\u9178\u306f\u3001\u30d2\u30c8\u816b\u760d\u306b\u304a\u3051\u308bBRAF V600E\u5909\u7570\u4f9d\u5b58\u6027MEK1\u6d3b\u6027\u5316\u3092\u9078\u629e\u7684\u306b\u5897\u5f37\u3057\u3001\u3053\u306e\u5909\u7570\u3092\u767a\u73fe\u3059\u308b\u30d2\u30c8\u30e1\u30e9\u30ce\u30fc\u30de\u7d30\u80de\u306e\u5897\u6b96\u3092\u4fc3\u9032\u3057\u305f\u3002<\/span><\/p>\n \u3055\u3089\u306b\u3001KD\u3067\u306f\u30bb\u30ec\u30f3\u3001\u30d3\u30bf\u30df\u30f3D\u3001\u4e9c\u925b\u3001\u305d\u306e\u4ed6\u306e\u30d3\u30bf\u30df\u30f3\u3084\u30df\u30cd\u30e9\u30eb\u304c\u6b20\u4e4f\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u3053\u308c\u3089\u306e\u6f5c\u5728\u7684\u306a\u6709\u5bb3\u306a\u526f\u4f5c\u7528\u306f\u3001\u9069\u5207\u306a\u60a3\u8005\u3092\u9078\u629e\u3057\u3001KD\u304c\u9069\u5207\u306b\u51e6\u65b9\u3055\u308c\u3001\u98df\u54c1\u306e\u9078\u629e\u3068\u5fc5\u8981\u306a\u30d3\u30bf\u30df\u30f3\u3084\u30df\u30cd\u30e9\u30eb\u306e\u30b5\u30d7\u30ea\u30e1\u30f3\u30c8\u3067\u8abf\u6574\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u3092\u78ba\u8a8d\u3059\u308b\u8cc7\u683c\u306e\u3042\u308b\u6804\u990a\u58eb\u306b\u3088\u3063\u3066KD\u304c\u51e6\u65b9\u3055\u308c\u3001\u76e3\u8996\u3055\u308c\u308c\u3070\u3001\u4e88\u9632\u307e\u305f\u306f\u4fee\u6b63\u3067\u304d\u308b\u3002\u7d50\u8ad6\u3068\u3057\u3066\u3001\u304c\u3093\u60a3\u8005\u306b\u5bfe\u3059\u308bKD\u306e\u5b89\u5168\u6027\u3068\u6709\u52b9\u6027\u306b\u95a2\u3059\u308b\u30c7\u30fc\u30bf\u306f\u6bd4\u8f03\u7684\u5c11\u306a\u304f\u3001\u9069\u5207\u306b\u8a2d\u8a08\u3055\u308c\u3066\u304a\u308a\u3001\u304c\u3093\u8a2d\u5b9a\u3067\u306eKD\u306e\u6709\u52b9\u6027\u3068\u5b89\u5168\u6027\u3092\u8a55\u4fa1\u3059\u308b\u305f\u3081\u306e\u53b3\u683c\u306a\u81e8\u5e8a\u8a66\u9a13\u304c\u7dca\u6025\u306b\u5fc5\u8981\u3068\u3055\u308c\u3066\u3044\u308b\u3002<\/span><\/p>\n \u63a8\u5968\u4e8b\u9805<\/span> \u306a\u304b\u306a\u304b\u826f\u3044\u3067\u3059\u306d\u3002\u305f\u3060\u3001\u30d3\u30bf\u30df\u30f3\u3084\u30df\u30cd\u30e9\u30eb\u304c\u6b20\u4e4f\u3059\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3068\u3044\u3046\u306e\u306f\u8aa4\u89e3\u3067\u3057\u3087\u3046\u3002\u901a\u5e38\u306e\u98df\u4e8b\u3067\u306f\u6b20\u4e4f\u305b\u305a\u306b\u3001\u30b1\u30c8\u30f3\u98df\u3067\u3053\u308c\u3089\u304c\u6b20\u4e4f\u3059\u308b\u3068\u3044\u3046\u306e\u306f\u30a6\u30bd\u3067\u3059\u3002\u30bb\u30ec\u30f3\u3084\u30d3\u30bf\u30df\u30f3D\u306f\u9b5a\u4ecb\u985e\u3084\u5375\u306b\u591a\u304f\u542b\u307e\u308c\u307e\u3059\u3057\u3001\u30d3\u30bf\u30df\u30f3D\u306f\u592a\u967d\u3092\u6d74\u3073\u308c\u3070\u826f\u3044\u3067\u3059\u3002\u4e9c\u925b\u3082\u8089\u985e\u3067\u6442\u308c\u308b\u306e\u3067\u3001\u306a\u305c\u3053\u306e\u3088\u3046\u306a\u8a18\u8ff0\u306b\u306a\u308b\u306e\u304b\u306f\u3088\u304f\u308f\u304b\u308a\u307e\u305b\u3093\u3002\u307e\u3042\u3001\u6839\u5e95\u306b\u306f\u8089\u5acc\u3044\u304c\u3042\u308b\u306e\u3067\u3057\u3087\u3046\u3002<\/p>\n \u30a4\u30f3\u30bf\u30fc\u30df\u30c3\u30c6\u30f3\u30c8\u30d5\u30a1\u30b9\u30c6\u30a3\u30f3\u30b0\u306b\u3064\u3044\u3066\u3082\u540c\u3058\u3088\u3046\u306a\u30dc\u30ea\u30e5\u30fc\u30e0\u306e\u6587\u7ae0\u3067\u3059\u3002<\/p>\n \u300cIntermittent Fasting\uff08IF\uff09<\/span> Emerging evidence suggests that fasting could play a key role in cancer treatment by fostering conditions that limit cancer cells\u2019 adaptability, survival, and growth. Fasting could increase the efficacy of cancer treatments and limit adverse events. Yet, we lack an integrated mechanistic model for how these two complicated systems interact, limiting our ability to understand, prevent, and treat cancer using fasting.<\/span><\/p>\n Clinical studies have been carried out to measure the relevance of various modalities of IF on metabolic and hormonal endpoints correlated to cancer development and prognosis, given their practicality and the beneficial weight reduction effect in individuals with obesity. IF has been demonstrated to improve cancer risk variables in several short-term randomized clinical studies, including lowered levels of glucose, insulin, leptin, and higher adiponectin, which are linked to cancer etiology. TRF has been reported to cause substantial alterations in biochemical indicators linked to weight, including insulin sensitivity and oxidative stress, in small and underpowered investigations. Nonetheless, in one study (n = 116) in individuals with obesity on TRF, no significant change in weight, fasting insulin, or fasting glucose level was reported. Furthermore, evidence shows that, unlike rats, people require weight loss to optimize metabolic health. Whether weight reduction has a causal function in lowering cancer risk and improving prognosis without considerable food composition changes remains a critical but unresolved issue.<\/span><\/p>\n A few studies have used IF in cancer patients as one of the regimens. In one clinical trial of glioma with 25 patients, a significant decrease in HbA1c, insulin, and fat was observed, while lean body weight and ketone bodies (in the brain) were increased with a well-tolerated ketogenic IF diet . Another study on 23 overweight premenopausal women with a high risk of breast cancer reported that 1 month of IF resulted in a 4.8% weight loss, 8% fat loss, and an improvement in insulin resistance. Furthermore, a study that enrolled 13 stage II breast cancer women receiving (neo) adjuvant chemotherapy suggested that IF was well tolerated, with a lower rate of withdrawals from adverse events. In addition, fasting for a brief time was observed to minimize hematologic damage in women receiving chemotherapy, with the fasting group having considerably increased erythrocyte and thrombocyte levels following treatment. Following chemotherapeutic treatments, women in the control group exhibited higher DNA damage indicators and lowered circulating IGF-1 levels than those who had fasted and had lower IGF-1 levels. In another clinical study of diverse tumor types, fasting for 24, 48, or 72 h before treatment was determined to be possible and safe, with only minor adverse effects, such as weariness, headache, and dizziness. Patients fasting for 48\u201372 h before the chemotherapeutic treatment had a nonsignificant tendency towards a lower incidence of neutropenia and neuropathy than those who fasted for 24 h before treatment. In peripheral blood mononuclear cells, markers of DNA damage increased in all groups, although to a lesser extent in the extended fasting group.<\/span><\/p>\n Despite initial concerns about weight loss in patients with cancer receiving chemotherapy, no trials have revealed substantial loss of lean body mass or malnutrition due to IF. IF was found safe and tolerable in an observational study of 28 children with type 1 diabetes with diverse cancers undergoing treatment during Ramadan. In a case series, IF before and after chemotherapy was reported to be secure and well received in 10 patients with a variety of cancers. Finally, in another clinical trial, 25 patients with head or neck cancer undergoing chemotherapy were assigned to either a short-term fasting diet followed by a standard caloric diet or a standard caloric diet followed by a short-term fasting diet. Those patients fasted for 36 h before treatment and 24 h thereafter, having a total of 350 calories per day. Within 8 days of chemotherapy, no substantial weight loss was recorded, although there was an improvement in quality of life and weariness. Such benefits, in contrast, were not seen while having a regular diet.<\/span><\/p>\n Despite the limited clinical evidence currently available, several ongoing clinical trials are exploring the potential benefits of IF in various advanced cancer scenarios. However, data on the specific nutritional interventions applied in these clinical trials remain incomplete and inconsistent. This includes details on nutritional guidelines, meal quality, and specific foods included in the diets. Comprehensive and standardized information on these aspects is critical to assessing the efficacy and feasibility of IF as a therapeutic strategy in cancer treatment. Further rigorous and well-designed clinical trials, especially in subjects with obesity, are needed to provide conclusive evidence on the role of IF in cancer treatment and survival.<\/span><\/p>\n Recommendations<\/span> \u300c\u65ad\u7d9a\u7684\u65ad\u98df\uff08IF\uff09<\/span> 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= 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\u63a8\u5968\u4e8b\u9805<\/span> \u3044\u304b\u304c\u3067\u3057\u3087\u3046\u3002\u30a4\u30f3\u30bf\u30fc\u30df\u30c3\u30c6\u30f3\u30c8\u30d5\u30a1\u30b9\u30c6\u30a3\u30f3\u30b0\u306e\u8a18\u8ff0\u3082\u306a\u304b\u306a\u304b\u306e\u3082\u306e\u3067\u3059\u3002<\/p>\n 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\nKD is a dietary pattern characterized by high fat intake, moderate-to-low protein consumption, and very low-carbohydrate intake (<50 g). Initially, the KD was employed to treat drug-resistant epilepsy in children, but it has now gained widespread acceptance for obesity management. Due to the connection between obesity, diet, and cancer, there is a growing interest in using the KD as an adjuvant therapy in cancer treatment. Preclinical and some clinical trials have shown that the KD can be cost-effective and relatively well tolerated, with the potential to improve metabolic abnormalities, reduce inflammation, limit tumor growth, and protect healthy cells from the damage caused by chemotherapy and radiation.<\/span><\/p>\n
\nThe KD is suitable for patients with obesity and cancer who seek to manage weight and metabolic abnormalities while undergoing treatment (Fig. 2). It may be beneficial for those needing to improve glucose regulation and reduce inflammation. However, KD may not be appropriate for patients with certain genetic mutations or conditions, such as tuberous sclerosis complex or BRAF V600E mutation, due to potential adverse effects. It may also result in deficiencies of essential nutrients, which can be managed with careful planning and supplementation by a qualified nutritionist. KD should consist of about 70\u201380% of daily calories from fat, 15\u201325% from protein, and 5\u201310% from carbohydrates. However, there are different ketogenic approaches, and the correct macronutrient composition may vary on a case-by-case basis. Regular monitoring and adjustment are necessary to ensure nutritional adequacy and safety.\u300d<\/span><\/p>\n
\nKD\u306f\u3001\u9ad8\u8102\u80aa\u6442\u53d6\u3001\u4e2d\u7a0b\u5ea6\u304b\u3089\u4f4e\u30bf\u30f3\u30d1\u30af\u8cea\u6442\u53d6\u3001\u304a\u3088\u3073\u975e\u5e38\u306b\u4f4e\u3044\u70ad\u6c34\u5316\u7269\u6442\u53d6\uff08<50 g\uff09\u3092\u7279\u5fb4\u3068\u3059\u308b\u98df\u4e8b\u30d1\u30bf\u30fc\u30f3\u3067\u3042\u308b\u3002\u5f53\u521d\u3001KD\u306f\u5c0f\u5150\u306e\u85ac\u5264\u62b5\u6297\u6027\u3066\u3093\u304b\u3093\u306e\u6cbb\u7642\u306b\u63a1\u7528\u3055\u308c\u3066\u3044\u305f\u304c\u3001\u73fe\u5728\u3067\u306f\u80a5\u6e80\u7ba1\u7406\u306b\u3082\u5e83\u304f\u53d7\u3051\u5165\u308c\u3089\u308c\u3066\u3044\u308b\u3002\u80a5\u6e80\u3001\u98df\u4e8b\u3001\u304c\u3093\u306e\u95a2\u4fc2\u306b\u3088\u308a\u3001\u304c\u3093\u6cbb\u7642\u306e\u88dc\u52a9\u7642\u6cd5\u3068\u3057\u3066KD\u3092\u4f7f\u7528\u3059\u308b\u3053\u3068\u306b\u95a2\u5fc3\u304c\u9ad8\u307e\u3063\u3066\u3044\u308b\u3002\u524d\u81e8\u5e8a\u304a\u3088\u3073\u3044\u304f\u3064\u304b\u306e\u81e8\u5e8a\u8a66\u9a13\u3067\u306f\u3001KD\u306f\u8cbb\u7528\u5bfe\u52b9\u679c\u304c\u9ad8\u304f\u3001\u6bd4\u8f03\u7684\u5fcd\u5bb9\u6027\u304c\u9ad8\u304f\u3001\u4ee3\u8b1d\u7570\u5e38\u306e\u6539\u5584\u3001\u708e\u75c7\u306e\u8efd\u6e1b\u3001\u816b\u760d\u306e\u5897\u6b96\u306e\u5236\u9650\u3001\u5316\u5b66\u7642\u6cd5\u3084\u653e\u5c04\u7dda\u306b\u3088\u308b\u640d\u50b7\u304b\u3089\u5065\u5eb7\u306a\u7d30\u80de\u3092\u4fdd\u8b77\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u3044\u308b\u3002<\/span><\/p>\n
\nKD \u306f\u3001\u6cbb\u7642\u3092\u53d7\u3051\u306a\u304c\u3089\u4f53\u91cd\u3084\u4ee3\u8b1d\u7570\u5e38\u3092\u7ba1\u7406\u3057\u305f\u3044\u80a5\u6e80\u3084\u304c\u3093\u306e\u60a3\u8005\u306b\u9069\u3057\u3066\u3044\u308b\u3002\u8840\u7cd6\u8abf\u7bc0\u3092\u6539\u5584\u3057\u3001\u708e\u75c7\u3092\u8efd\u6e1b\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u60a3\u8005\u306b\u306f\u6709\u76ca\u3067\u3042\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u305f\u3060\u3057\u3001\u7d50\u7bc0\u6027\u786c\u5316\u75c7\u8907\u5408\u4f53\u3084 BRAF V600E \u5909\u7570\u306a\u3069\u3001\u7279\u5b9a\u306e\u907a\u4f1d\u5b50\u5909\u7570\u3084\u75be\u60a3\u3092\u6301\u3064\u60a3\u8005\u306b\u306f\u3001\u6f5c\u5728\u7684\u306a\u526f\u4f5c\u7528\u306e\u305f\u3081\u3001KD \u306f\u9069\u5207\u3067\u306f\u306a\u3044\u5834\u5408\u304c\u3042\u308b\u3002\u307e\u305f\u3001\u5fc5\u9808\u6804\u990a\u7d20\u306e\u6b20\u4e4f\u306b\u3064\u306a\u304c\u308b\u53ef\u80fd\u6027\u3082\u3042\u308b\u304c\u3001\u8cc7\u683c\u306e\u3042\u308b\u6804\u990a\u58eb\u306b\u3088\u308b\u614e\u91cd\u306a\u8a08\u753b\u3068\u88dc\u5145\u306b\u3088\u3063\u3066\u7ba1\u7406\u3067\u304d\u308b\u3002KD \u306f\u30011 \u65e5\u306e\u30ab\u30ed\u30ea\u30fc\u306e\u7d04 70\uff5e80% \u3092\u8102\u80aa\u300115\uff5e25% \u3092\u30bf\u30f3\u30d1\u30af\u8cea\u30015\uff5e10% \u3092\u70ad\u6c34\u5316\u7269\u3067\u69cb\u6210\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3002\u305f\u3060\u3057\u3001\u3055\u307e\u3056\u307e\u306a\u30b1\u30c8\u30f3\u98df\u30a2\u30d7\u30ed\u30fc\u30c1\u304c\u3042\u308a\u3001\u9069\u5207\u306a\u4e3b\u8981\u6804\u990a\u7d20\u306e\u69cb\u6210\u306f\u30b1\u30fc\u30b9\u30d0\u30a4\u30b1\u30fc\u30b9\u3067\u7570\u306a\u308b\u5834\u5408\u304c\u3042\u308b\u3002\u6804\u990a\u306e\u9069\u5207\u6027\u3068\u5b89\u5168\u6027\u3092\u78ba\u4fdd\u3059\u308b\u306b\u306f\u3001\u5b9a\u671f\u7684\u306a\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u3068\u8abf\u6574\u304c\u5fc5\u8981\u3067\u3042\u308b\u3002\u300d<\/span><\/p>\n
\nIn recent decades, there has been a growing interest in IF as a strategy for managing obesity. IF involves periodic episodes of minimal to no calorie consumption. The variations of IF include complete 24-h fasting every other day or fasting on one or two nonconsecutive days per week, commonly known as the 6:1 and 5:2 diets, respectively. Many IF programs recommend a minimal caloric intake (e.g., 500 kcal daily) during fasting periods, allowing unlimited consumption of calorie-free beverages. Another approach, time-restricted feeding (TRF), limits calorie intake to a specific window of time each day, typically between 4 and 12 h. TRF may also involve calorie restriction during the non-fasting period, potentially offering additional benefits, such as improvements in circadian rhythm.<\/span><\/p>\n
\nIF may benefit cancer patients, such as those with glioma or early-stage breast cancer, by showing improvements in biomarkers like HbA1c and insulin resistance and potentially reducing side effects during chemotherapy. Possible minor side effects include fatigue, headache, and dizziness. While IF generally does not cause significant weight loss or malnutrition, ongoing monitoring is essential. IF typically involves minimal caloric intake (e.g., 500 kcal\/day) during fasting periods with unlimited calorie-free beverages. TRF limits calorie intake to specific hours, but detailed macronutrient composition varies and should be adjusted to individual needs.\u300d<\/span><\/p>\n
\n\u8fd1\u5e74\u3001\u80a5\u6e80\u7ba1\u7406\u6226\u7565\u3068\u3057\u3066\u65ad\u98df\u3078\u306e\u95a2\u5fc3\u304c\u9ad8\u307e\u3063\u3066\u3044\u308b\u3002\u65ad\u98df\u3067\u306f\u3001\u30ab\u30ed\u30ea\u30fc\u6442\u53d6\u3092\u6700\u5c0f\u9650\u307e\u305f\u306f\u5168\u304f\u6442\u53d6\u3057\u306a\u3044\u5b9a\u671f\u7684\u306a\u30a8\u30d4\u30bd\u30fc\u30c9\u304c\u884c\u308f\u308c\u307e\u3059\u3002\u65ad\u98df\u306e\u30d0\u30ea\u30a8\u30fc\u30b7\u30e7\u30f3\u306b\u306f\u30011\u65e5\u304a\u304d\u306b\u5b8c\u5168\u306a24\u6642\u9593\u65ad\u98df\u3092\u884c\u3046\u3082\u306e\u3084\u3001\u9031\u306b1\u65e5\u307e\u305f\u306f2\u65e5\u9023\u7d9a\u3057\u306a\u3044\u65ad\u98df\u3092\u884c\u3046\u3082\u306e\u304c\u3042\u308a\u3001\u305d\u308c\u305e\u308c\u4e00\u822c\u306b6:1\u30c0\u30a4\u30a8\u30c3\u30c8\u30685:2\u30c0\u30a4\u30a8\u30c3\u30c8\u3068\u3057\u3066\u77e5\u3089\u308c\u3066\u3044\u308b\u3002\u591a\u304f\u306e\u65ad\u98df\u30d7\u30ed\u30b0\u30e9\u30e0\u3067\u306f\u3001\u65ad\u98df\u671f\u9593\u4e2d\u306f\u6700\u5c0f\u9650\u306e\u30ab\u30ed\u30ea\u30fc\u6442\u53d6\uff08\u4f8b\uff1a1\u65e5500kcal\uff09\u3092\u63a8\u5968\u3057\u3066\u304a\u308a\u3001\u30ab\u30ed\u30ea\u30fc\u30bc\u30ed\u306e\u98f2\u307f\u7269\u306f\u7121\u5236\u9650\u306b\u6442\u53d6\u3067\u304d\u308b\u3002\u5225\u306e\u30a2\u30d7\u30ed\u30fc\u30c1\u3067\u3042\u308b\u6642\u9593\u5236\u9650\u6442\u98df\uff08TRF\uff09\u3067\u306f\u30011\u65e5\u306e\u7279\u5b9a\u306e\u6642\u9593\u67a0\uff08\u901a\u5e38\u306f4\uff5e12\u6642\u9593\uff09\u306b\u30ab\u30ed\u30ea\u30fc\u6442\u53d6\u3092\u5236\u9650\u3059\u308b\u3002TRF\u3067\u306f\u3001\u65ad\u98df\u3057\u3066\u3044\u306a\u3044\u671f\u9593\u306b\u3082\u30ab\u30ed\u30ea\u30fc\u5236\u9650\u3092\u884c\u3046\u53ef\u80fd\u6027\u304c\u3042\u308a\u3001\u6982\u65e5\u30ea\u30ba\u30e0\u306e\u6539\u5584\u306a\u3069\u306e\u8ffd\u52a0\u306e\u5229\u70b9\u304c\u5f97\u3089\u308c\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002<\/span><\/p>\n
\nIF \u306f\u3001HbA1c \u3084\u30a4\u30f3\u30b9\u30ea\u30f3\u62b5\u6297\u6027\u306a\u3069\u306e\u30d0\u30a4\u30aa\u30de\u30fc\u30ab\u30fc\u306e\u6539\u5584\u3092\u793a\u3057\u3001\u5316\u5b66\u7642\u6cd5\u4e2d\u306e\u526f\u4f5c\u7528\u3092\u8efd\u6e1b\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u305f\u3081\u3001\u795e\u7d4c\u81a0\u816b\u3084\u65e9\u671f\u4e73\u304c\u3093\u306a\u3069\u306e\u304c\u3093\u60a3\u8005\u306b\u30e1\u30ea\u30c3\u30c8\u3092\u3082\u305f\u3089\u3059\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u8003\u3048\u3089\u308c\u308b\u8efd\u5ea6\u306e\u526f\u4f5c\u7528\u306b\u306f\u3001\u75b2\u52b4\u3001\u982d\u75db\u3001\u3081\u307e\u3044\u306a\u3069\u304c\u3042\u308b\u3002IF \u306f\u4e00\u822c\u306b\u5927\u5e45\u306a\u4f53\u91cd\u6e1b\u5c11\u3084\u200b\u200b\u6804\u990a\u5931\u8abf\u3092\u5f15\u304d\u8d77\u3053\u3055\u306a\u3044\u304c\u3001\u7d99\u7d9a\u7684\u306a\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u304c\u4e0d\u53ef\u6b20\u3067\u3042\u308b\u3002IF \u3067\u306f\u901a\u5e38\u3001\u7d76\u98df\u671f\u9593\u4e2d\u306b\u30ab\u30ed\u30ea\u30fc\u6442\u53d6\u3092\u6700\u5c0f\u9650\u306b\u6291\u3048 (\u4f8b: 1 \u65e5 500 kcal)\u3001\u30ab\u30ed\u30ea\u30fc\u30bc\u30ed\u306e\u98f2\u307f\u7269\u3092\u7121\u5236\u9650\u306b\u98f2\u3080\u3002TRF \u3067\u306f\u7279\u5b9a\u306e\u6642\u9593\u306b\u30ab\u30ed\u30ea\u30fc\u6442\u53d6\u3092\u5236\u9650\u3059\u308b\u304c\u3001\u8a73\u7d30\u306a\u4e3b\u8981\u6804\u990a\u7d20\u306e\u69cb\u6210\u306f\u5909\u5316\u3059\u308b\u305f\u3081\u3001\u500b\u4eba\u306e\u30cb\u30fc\u30ba\u306b\u5408\u308f\u305b\u3066\u8abf\u6574\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3002<\/span>\u300d<\/span><\/p>\n