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Author: Rositsa Tashkova, Master of Molecular Biology and Microbiology

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In recent decades, the value of stem cells and in particular - in the fight against certain cancers has been assessed. Treatment of cancer through stem cell transplantation has gained great popularity and success. In this article, we will look at when such treatment is needed and when it is even possible to perform such treatment, for which types of cancer is appropriate, what exactly is a stem cell transplant, and how it works.

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In the article you will read:

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<ul>
<li>What are stem cells</li>
<li>When stem cell transplantation can be used to treat cancer</li>
<li>How stem cell transplantation helps treat cancer</li>
<li>What types of stem cell transplantation are there</li>
<li>What are the risks of stem cell transplantation</li>
<li>What to expect during treatment</li>
<li>What happens during the recovery period</li>
<li>What happens if stem cell transplantation fails</li>
</ul>

What-are-stem-cells

What are stem cells

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To understand how this treatment can help patients with certain cancers, we must first <a href="https://www.bioseek.eu/bg/eng/research/pubmed/Stem_cells_19896546" target="_blank" rel="noopener"></a> understand what stem cells are [ref. 1].

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Stem cells do not specialize in performing a specific function, unlike, for example, red blood cells (erythrocytes), which carry oxygen to all parts of the body, or cells of the immune system that, in complex mechanisms, fight infections , or platelets, the only function of which is to participate in blood clotting, thereby protecting the body from major blood loss.

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The process in which a stem cell develops in a strictly specialized cell similar to those described above is called differentiation. Thus, stem cells are undifferentiated, and erythrocytes are differentiated.

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When stem cell transplantation can be used to treat cancer

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Currently, stem cell transplantation is mainly used to treat blood cancer or one that affects the bone marrow - leukemia, lymphoma, multiple myeloma (also called multiple myeloma and Kaler's disease) or neuroblastoma (a disease that most often affects children).

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Clinical trials are <a href="https://www.bioseek.eu/bg/eng/research/search?q=stem%20cell%20transplant%20cancer&amp;p=1&amp;st=1&amp;tp=e&amp;s=x&amp;as=NCT00112645" target="_blank" rel="noopener">being</a> carried out [ref. 2]in search of treatment and other cancers using stem cell transplantation, but no approved therapies have yet been established.

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How-stem-cell-transplantation-helps-treat-cancer

How stem cell transplantation helps treat cancer

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Immediately before performing the transplant itself, the patient receives high doses of chemotherapy or radiotherapy for about a week. The goal is to destroy all cancer cells, including stem cells in the bone marrow, where blood cells are formed.

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Previously, healthy stem cells were taken from the patient or from a donor to be transplanted immediately after chemo or radiotherapy. This occurs by instilling stem cells back into the bloodstream - intravenously.

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After a while, they reach the bone marrow, where they occupy the place of the destroyed cells. There they begin to produce healthy blood cells, and with a successful transplant the patient is cured of cancer.

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When stem cells are taken from a donor (<a href="https://www.cancercenter.com/treatment-options/hematologic-oncology/allogenic-stem-cell-transplant" target="_blank" rel="noopener"></a> allogeneic transplant [ref. 3]) - usually brother, sister, parent, and are used to treat multiple myeloma or certain types of leukemia, an additional therapeutic effectcalled "graft vs. tumor" (GvT) may occur. With this effect, the white blood cells obtained in the transplant from the donor attack and destroy the rest after chemo- and radiotherapy cancer cells.

What-types-of-stem-cell-transplantation-are-there

What types of stem cell transplantation are there

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Stem cell transplantation is three types [ref. 4], depending on the source of the cells: <a href="https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant" target="_blank" rel="noopener"></a>

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<ul>
<li style="font-weight: 400;"><a href="https://www.bioseek.eu/bg/eng/research/pubmed/A_Review_of_Autologous_Stem_Cell_Transplantation_in_Lymphoma_28478586" target="_blank" rel="noopener">Autologous transplantation</a> [ref. 5] - when the stem cells are taken from the blood of the patient himself, before chemo- or radiotherapy. In this case, there is no risk of rejection of the transplant, since these are the own cells of the treatee.</li>
<li style="font-weight: 400;">Allogeneic transplantation - when stem cells from a donor are used for transplantation. The donor must have similar molecules on his cells to those of the patient in order to reduce the risk of rejection. Therefore, most often a donor becomes the patient's brother, sister or parent, but a non-related donor from a registry whose cells must be compatible with the patient's organism can also be used.</li>
<li style="font-weight: 400;">Syngenta transplantation - in rare cases, when the patient has a healthy single-day twin, stem cells are taken from it.</li>
</ul>

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What-are-the-risks-of-stem-cell-transplantation

What are the risks of stem cell transplantation

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Like any treatment, stem cell transplantation for cancer treatment hides its risks and has side effects [ref. 6]. <a href="https://www.bioseek.eu/bg/eng/research/pubmed/Cytokine_serum_levels_during_post_transplant_adverse_events_in_61_pediatric_patients_after_hematopoietic_stem_cell_transplantation_26315105" target="_blank" rel="noopener"></a>

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Due to large doses of chemo- or radiotherapy that kill the patient's cells, problems with blood clotting and the immune system occur. This is because a large proportion of platelets and leukocytes have died. There is a risk of bleeding and infections.

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Contrary to the effect "graft against tumor", another effect may occur, which is highly undesirable - <a href="https://www.bioseek.eu/bg/eng/research/pubmed/Bone_Marrow_GvHD_after_Allogeneic_Hematopoietic_Stem_Cell_Transplantation_27066008" target="_blank" rel="noopener">"graft</a> vs. host" [ref. 7] (GvHD).

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This immune reaction can affect and damage many tissues and organs in the body - skin, liver, small intestine and others. In this case, it is necessary to take medications that suppress the immune system - immunosuppressants, which makes the patient susceptible to infections.

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This effect can manifest itself a few weeks after transplantation or much later. Therefore, it is important that the stem cells that will be transplanted to the patient are as close as possible to his own.

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All risks should be discussed in advance with the attending physician.

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What to expect during treatment

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Stem cell transplantation is a complex treatment and it should be taken into account that its cost can be very <a href="http://www.chernomore.bg/obshtestvo/2019-10-23/izgrazhdat-unikalen-tsentar-za-rabota-sas-stvolovi-kletki-vav-varna" target="_blank" rel="noopener"></a> high. At the moment a modern stem marrow transplant is being performed in Varna, <a href="https://nova.bg/news/view/2014/12/22/96448/%D0%BE%D1%82%D0%BA%D1%80%D0%B8%D1%85%D0%B0-%D1%86%D0%B5%D0%BD%D1%82%D1%8A%D1%80-%D0%B7%D0%B0-%D1%82%D1%80%D0%B0%D0%BD%D1%81%D0%BF%D0%BB%D0%B0%D0%BD%D1%82%D0%B0%D1%86%D0%B8%D1%8F-%D0%BD%D0%B0-%D1%81%D1%82%D0%B2%D0%BE%D0%BB%D0%BE%D0%B2%D0%B8-%D0%BA%D0%BB%D0%B5%D1%82%D0%BA%D0%B8-%D0%B2%D1%8A%D0%B2-%D0%B2%D0%B0%D1%80%D0%BD%D0%B0" target="_blank" rel="noopener"></a> in the stem cell transplant center atSt. Marina Hospital [ref. 8].

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Once an appropriate medical facility has been opened, the patient may be accommodated in the hospital or not, but frequent visits may be required. The whole treatment takes several months.

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Before starting the course of chemo- or radiotherapy, it is necessary to secure the stem cells for the transplant. They are extracted from blood, bone marrow or umbilical cord and frozen. They thaw again before the transplant itself.

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Chemo- or radiotherapy (can be administered and a combination between the two) take about 1-2 weeks, after which the patient rests a few days before transplantation.

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The transplant itself takes between 1 and 5 hours, during which, with the help of a catheter, stem cells flow through a vein into the bloodstream - similar to an infusion of blood. Sometimes two insations are made at a certain interval of time.

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The longest <a href="https://www.bioseek.eu/bg/eng/research/pubmed/Biobehavioral_influences_on_recovery_following_hematopoietic_stem_cell_transplantation_22820408" target="_blank" rel="noopener"></a> recovery process [ref. 10]. Its first phase is associated with the formation of new blood cells from the transplanted stemcells.

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Since each organism reacts differently to transplantation, doctors can not predict exactly how the patient will feel as a result of treatment. It depends on many factors. For example, what state of health he was in before the transplant, how advanced the stage of cancer is, what type of cancer it is, what doses of chemo and radiotherapy had to be imied the patient, how they are perceived by the particular organism and other factors.

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What happens during the recovery period

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During the recovery period, the patient will remain for a long time under the supervision of doctors, who will monitor how his blood indicators change in time after the stem cell transplant. For the first three weeks, the number of blood cells will need to be counted every day or at least once a week.

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Until the indicators return to normal, it should be vigorously guarded from infections and will feel weak and dropped. Negative and positive emotions can be intertwined in it - because of the relative isolation and physical malaise, but also in the hope of a successful outcome of the transplant.

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In <a href="https://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/stem-cell-transplant/after-stem-cell-transplant/?region=on" target="_blank" rel="noopener"></a> the first three months [ref. 11] blood or platelet insations may be required.

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After a year or two, it is necessary to give the vaccines, which are usually put into childhood, because as a result of treatment with immune cells, immunity to pathogens acquired with these vaccines has gone before.

What-happens-if-stem-cell-transplantation-fails

What happens if stem cell transplantation fails

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Transplantation can fail <a href="https://www.webmd.com/cancer/features/stem-cell-transplant-complications#2" target="_blank" rel="noopener">for two reasons</a> [ref. 12] - if our body rejects donor transplants or if the cancer returns.

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In the event that our immune system recognizes foreign cells as hostile and attacks them, a new transplant or infusion of special white blood cells (lymphocytes) from the same donor can be undertaken.

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Sometimes, years after the transplant, the cancer can return. In some aggressive cancers, when using the patient's own stem cells, relapse is observed in up to 50% of patients.

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The most common cause of relapse remained in the body or in the transplant cancer cells. In this case, the effect "graft against tumor" is relied upon, in which the donor immune cells recognize and kill cancer cells. This effect can be strengthened if, together with stem cells, immune cells from the donor are also infused during transplantation.

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In case of relapse, the condition can be treated by different chemotherapy, from the first time used, by a second transplant or both. If a re-transplant is selected and the first time the patient's own cells are used, then in this second transplant, donors can be used.

<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Stem_cells_19896546" target="_blank" rel="noopener">Stem cells.</a> Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation. 2010

<a href="https://www.bioseek.eu/bg/eng/research/search?q=stem%20cell%20transplant%20cancer&amp;p=1&amp;st=1&amp;tp=e&amp;s=x&amp;as=NCT00112645" target="_blank" rel="noopener">Clinical trials for stem cell transplantation as treatment of various cancers</a>

Allogeneic stem cell transplant. www.cancercenter.com

Stem Cell Transplants in Cancer Treatment. www.cancer.gov

<a href="https://www.bioseek.eu/bg/eng/research/pubmed/A_Review_of_Autologous_Stem_Cell_Transplantation_in_Lymphoma_28478586" target="_blank" rel="noopener"> A Review of Autologous Stem Cell Transplantation in Lymphoma. </a> Current hematologic malignancy reports. 2017

<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Cytokine_serum_levels_during_post_transplant_adverse_events_in_61_pediatric_patients_after_hematopoietic_stem_cell_transplantation_26315105" target="_blank" rel="noopener"> Cytokine serum levels during post-transplant adverse events in 61 pediatric patients after hematopoietic stem cell transplantation. </a> BMC cancer. 2016

<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Bone_Marrow_GvHD_after_Allogeneic_Hematopoietic_Stem_Cell_Transplantation_27066008" target="_blank" rel="noopener">Bone Marrow GvHD after Allogeneic Hematopoietic Stem Cell Transplantation.</a> Frontiers in immunology. 2016

They opened a stem cell transplant center in Varna, 2014. nova.bg

They are building a unique stem cell work center in Varna. www.chernomore.bg

<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Biobehavioral_influences_on_recovery_following_hematopoietic_stem_cell_transplantation_22820408" target="_blank" rel="noopener"> Biobehavioral influences on recovery following hematopoietic stem cell transplantation. </a> Brain, behavior, and immunity. 2013

After the stem cell transplant. www.cancer.ca

Complications of Stem Cell Transplants. www.webmd.com

Tea is the second most common drink after water. Tea, which is prepared from the leaves of the Camellia sinensis plant is 3 types: green, oolong and black - depending on the degree of oxidation of the leaves. The most oxidized are the leaves of black tea, not so much of the oolong tea and the leafs of green tea are not oxidized at all.

9 unexpected health benefits of green tea and how to prepare it

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Chillies owe their effect to a compound called capsaicin, which can help control inflammation and other harmful processes in the body associated with the accumulation of fatty plaques in the arteries (atherosclerosis), for example.

Are chili peppers healthy - find out what science has to say

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Studies have suggested that ginseng reduces physical, chemical and biological stress, while increasing overall vitality and immune function, including physical and mental capacity.

8 reasons why the Chinese call ginseng The King of Herbs

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The most common diseases of this organ are viral hepatitis (hepatitis B and C), cirrhosis, non-alcoholic fatty liver disease, steatosis, fibrosis, alcoholic liver disease (alcoholic hepatitis), liver cancer, liver failure.

The liver does not hurt. Which are the herbs that can improve its health in the case of hepatitis, steatosis, and cirrhosis

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For years, we have associated hair loss with disease and lack of femininity. Today, shaved heads are first associated with cancer. Celebrities demonstrate civic positions and cause sensations with it.

How to take care of your hair and skin in the summer

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Silymarin has been used as a healing agent since ancient times. How its healing properties are manifested in the organism and what they are, you can find out in this article.

Silymarin - a well-known ancient herb - for the benefits in humans and animals

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Hops is well known as it is a major raw material in the production of beer. Interest in this plant is growing not only due to the search and creation of beer with new different flavors, but also for discovering and proving new beneficial properties for our health.

Healing Properties of Hops - The Essential Ingredient of Beer

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In recent years omega-3 fatty acids have gained popularity due to their numerous health benefits. They are an important part of lipid metabolism of animals and play a significant role in human health.

Omega-3 fatty acids: health benefits and sources

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Stem cell transplantation as cancer treatment

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 Stem cell transplantation as cancer treatment

Rositsa Tashkova-Kacharova

Author: Rositsa Tashkova, MSc in Molecular Biology and Microbiology

There’s a diet whose popularity skyrocketed only recently, thanks to celebrities like Kim Kardashian, Gwyneth Paltrow, Halle Berry, and Adriana Lima. Yes, we’re talking about the ketogenic diet — or keto diet if it sounds better to you.

Opinions on this type of nutrition are controversial. There are fierce supporters and skeptics who focus on the potential harms of ketogenic diet. All the buzz is being supported by numerous new books about keto emerging.

In this article we’ll try to pinpoint the pros and cons — should you go keto or not.

What-is-ketogenic-diet-and-who-is-Atkins

What is ketogenic diet and who is Atkins

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Ketosis — that is what the keto diet aims for. In other words — when in a state of ketosis, our body uses only fat for energy and not carbohydrates. In order to achieve this, we need to say goodbye to carbs and add enough proteins and a lot of fat to our menu. Carbs should be reduced to a maximum of 30 to 50 grams per day, which is extremely low.

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You can also use a&nbsp;<a href="https://www.ruled.me/keto-calculator/" target="_blank" rel="noopener">keto calculator&nbsp;</a>[ref.1]&nbsp;to find out what types of food and in what quantities are optimal for you — considering body fat and other specifics.

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Originally, ketogenic diet required about 80–90% of what you eat to be fat. Recently the diet has been modified and fat is supposed to be one-third of our menu. Protein intake should be moderate.

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The Keto diet is very similar to other types of nutrition regimes that are low in carbs. One of them is the Atkins diet, that was originally promoted by the physician Dr. Robert Atkins in 1972. But back then the idea was not very well accepted as other physicians and scientists were certain it would rise bad cholesterol levels.

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The Atkins diet allows you to eat as much as you want, without counting calories. That’s because excluding carbohydrates from your menu instantly lowers your calorie intake. Another reason is that high protein intake leads to decreased appetite.

How-is-your-Big-Boss-affected?-Yes,-it’s-all-about-the-brain

How is your Big Boss affected? Yes, it’s all about the brain

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Since we know that our brain feeds on glucose — a carbohydrate for sure, how are we supposed to ensure its energy supply if we put no carbs in our system?

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The answer is: ketones. And this is where the name of ketogenic diet comes from. The liver plays a key role in the process of metabolizing fat into fatty acids and ketone bodies or ketones. The latter is what your brain uses for energy source.

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Even if you were not that good at chemistry, what you need to know is that there are&nbsp;<a href="https://www.ncbi.nlm.nih.gov/books/NBK209323/" target="_blank" rel="noopener">three types</a>&nbsp;[ref. 2]&nbsp;of ketone bodies: β-hydroxybutyrate, acetoacetate, and acetone. All three of these are able to cross the blood-brain barrier, and the fatty acids stay out. When they reach the brain, it starts using them for its energy needs.

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There’s a huge amount of research that proves the beneficial impact of the ketogenic diet on&nbsp;<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Neurobiochemical_mechanisms_of_a_ketogenic_diet_in_refractory_epilepsy_25518023" target="_blank" rel="noopener">epilepsy in children</a>&nbsp;[ref. 3]. This type of nutrition has been used as a therapy for these patients since 1921. It’s been observed that the keto diet may decrease the number of seizures by up to 50%.

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Research on the topic continues until now and scientists do their best to understand the underlying mechanisms of this phenomenon.

What-are-the-chances-of-losing-weight-if-you-go-keto

What are the chances of losing weight if you go keto

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Most people find the ketogenic diet to be an effective way of losing weight. And that doesn’t come as a surprise — high-fat diet requires less food to make you feel full and stop eating.

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Here are other reasons why keto diet leads to weight loss:

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<ul>
<li id="30e2" class="ih ii gu ij b ik rp gw il im rq gz in io rr ip iq ir rs is it iu rt iv iw iy sg sh si fy" data-selectable-paragraph="">Less carbs on the menu means less junk or processed food;</li>
<li id="1050" class="ih ii gu ij b ik sj gw il im sk gz in io sl ip iq ir sm is it iu sn iv iw iy sg sh si fy" data-selectable-paragraph="">Improved insulin resistance has a direct effect on your metabolism;</li>
<li id="8977" class="ih ii gu ij b ik sj gw il im sk gz in io sl ip iq ir sm is it iu sn iv iw iy sg sh si fy" data-selectable-paragraph="">The Keto diet improves your body’s ability to burn fats;</li>
<li id="05d6" class="ih ii gu ij b ik sj gw il im sk gz in io sl ip iq ir sm is it iu sn iv iw iy sg sh si fy" data-selectable-paragraph="">Some&nbsp;<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Fuel_metabolism_in_starvation_16848698" target="_blank" rel="noopener">research</a>&nbsp;[ref. 4]&nbsp;suggests that ketogenic diet lowers fat storage in our body.</li>
</ul>

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<figure><img class="tinyMCEImg" src="https://d20hztklr4qnvi.cloudfront.net/0e7f170a-8b20-4daf-b6fd-1646c57fd962_middle.jpeg" border="0" alt="Goodbye chips!" title="Goodbye chips!">
<figcaption>Goodbye chips!</figcaption>
</figure>

What-is-the-effect-of-keto-diet-on-diabetes

What is the effect of keto diet on diabetes

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It’s widely known that diabetes,&nbsp;<a href="https://www.bioseek.eu/bg/eng/research/pubmed/A_comprehensive_review_on_metabolic_syndrome_24711954" target="_blank" rel="noopener">metabolic syndrome</a>&nbsp;[ref. 5], insulin resistance, and being overweight are&nbsp;interconnected. Losing weight usually improves the health of those who suffer from one of these conditions.

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This type of nutrition is especially good for people who need&nbsp;<a href="https://www.bioseek.eu/bg/eng/research/pubmed/The_effect_of_a_low_carbohydrate_ketogenic_diet_versus_a_low_glycemic_index_diet_on_glycemic_control_in_type_2_diabetes_mellitus_19099589" target="_blank" rel="noopener">lower levels of insulin</a>&nbsp;[ref. 6]&nbsp;and carbohydrates.

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One&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/15767618" target="_blank" rel="noopener">research</a>&nbsp;[ref. 7]&nbsp;shows that ketogenic diet improves insulin sensitivity with the staggering 75%.

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<figure><img class="tinyMCEImg" src="https://d20hztklr4qnvi.cloudfront.net/276f76b4-a0da-4ed8-91e2-02357df4233f_middle.jpeg" border="0" alt="Weight loss may normalise your insulin levels" title="Weight loss may normalise your insulin levels">
<figcaption>Weight loss may normalise your insulin levels</figcaption>
</figure>

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Is keto diet a good idea if you have cancer

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Cancer has one of the highest mortality and morbidity rates among all known diseases. Lung and breast cancers are the most prevalent forms of carcinoma.

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Scientists are putting tremendous effort to find a cure for oncological diseases. But the worst characteristic of cancer is that each type is different and requires a different type of therapy. That’s why there is no one single way to cure all the types.

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There is a lot of research on the potential of keto diet to&nbsp;<a href="https://www.bioseek.eu/bg/eng/research/pubmed/Ketogenic_diets_as_an_adjuvant_cancer_therapy_History_and_potential_mechanism_25460731" target="_blank" rel="noopener">support</a>&nbsp;[ref. 8]&nbsp;chemo and radiation therapy.

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One of the&nbsp;<a href="https://cancerres.aacrjournals.org/content/79/2/331" target="_blank" rel="noopener">possible mechanisms</a>&nbsp;[ref. 9]&nbsp;of action of keto diet on cancer is by starving it. Certain types of cancer depend on glucose for their growth and therefore ketogenic diet may help by reducing carbohydrate intake.

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<figure><img class="tinyMCEImg" src="https://d20hztklr4qnvi.cloudfront.net/95774c23-fb6d-49de-ac5d-395fc8d74d51_middle.jpeg" border="0" alt="Only future will show if keto diet becomes a good way to treat cancer" title="Only future will show if keto diet becomes a good way to treat cancer">
<figcaption>Only future will show if keto diet becomes a good way to treat cancer</figcaption>
</figure>

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There’s also a&nbsp;<a href="https://www.bioseek.eu/bg/eng/research/patent/Targeting_cancer_with_metabolic_therapy_and_hyperbaric_oxygen_9801903" target="_blank" rel="noopener">patent</a>&nbsp;[ref. 10]&nbsp;from 2017 that describes a method of treating cancer using ketogenic diet, while concurrently subjecting the patient to a hyperbaric, oxygen-enriched environment.

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There are also dozens of&nbsp;<a href="https://www.bioseek.eu/bg/eng/research/search?q=Ketogenic%20diets%20cancer&amp;p=1&amp;st=1&amp;ps=24&amp;tp=e&amp;s=0&amp;as=NCT03535701" target="_blank" rel="noopener">clinical trials</a>&nbsp;[ref. 11]&nbsp;that aim to find out if ketogenic diet could support the treatment of different types of cancer, including breast cancer and brain tumors in children.

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