Reacción a "Reactions: a ketogenic diet could improve the low platelet count caused by chemotherapy"

This study employs a variety of techniques in live mice, along with molecular and cellular studies, to demonstrate that a low-carbohydrate, high-fat diet increases platelet generation. The biochemical data are very well analysed and the study is very comprehensive, with a variety of molecular technologies to link the ketogenic diet with circulating beta-hydroxybutyrate levels and the activation of megakaryocyte maturation and differentiation programmes to produce platelets. Likewise, the ketogenic diet is able to maintain high platelet levels in chemotherapy-treated mice in a well-controlled and analysed study, which adds therapeutic interest in various thrombocytopenia (low platelet count) conditions. Overall, it is important to note that the study describes specific activity in controlled trials that may have impact and utility, but does not claim to advocate ketogenic diets over other diets as a regular lifestyle, which requires long-term studies. 

This work joins a trend in recent years to analyse the effect of nutritional interventions on multiple health parameters and even on the response to aggressive therapeutic treatments such as cancer chemotherapy. Ketogenic diets have been much discussed in recent years and have been shown to have some specific advantages in controlled situations. This study adds a new parameter not previously studied: the effect on platelet levels. The study shows that a ketogenic diet produces high levels of hydroxybutyrate. This compound is currently used as a nutritional supplement to gain muscle mass, among other things. The paper adds a new utility of this chemical compound to increase platelet levels. This increase is not necessary in most people, but may be very relevant for certain types of diseases, as well as in chemotherapy treatments that often result in thrombocytopenia (poor platelet count).  

Trials in mice and humans have examined the effect of the ketogenic diet in the short term. In these trials, the diet decreases body weight, increases ketone bodies in the blood, and results in an increase in circulating platelets. It is perhaps difficult to predict longer-term effects, as it has been reported in humans that ketogenic diets can lead to long-term weight gain. It is also unclear whether there are data to support that hydroxybutyrate supplementation, to what extent and under what nutritional conditions, could improve platelet counts. On the other hand, the data analysing the effect of the ketogenic diet in response to chemotherapy are retrospective, and although statistical differences were found showing higher platelet counts in patients on the ketogenic diet, this part of the work has important limitations in the number of patients and the lack of control for various parameters that are difficult to analyse in these retrospective studies. Undoubtedly, the published data suggest the need for such controlled studies in people on either ketogenic diet or hydroxybutyrate supplementation.