Perspectives on the metabolic management of brain cancer through a dietary reduction of glucose and elevation of ketone bodies. A dietary reduction in circulating glucose will increase ketone utilization for energy in normal neurons and glia. This will induce an energy transition from glycolysis to respiration. Cancer cells however, may be unable to transition from glucose to ketones due to alterations in mitochondrial structure or function (dashed lines). The double slash indicates a disconnection between glycolysis and respiration according to the Warburg hypothesis. Abbreviations: GLUT-1 (glucose transporter), MCT-1 (monocarboxylate transporter), SCOT (succinyl-CoA-acetoacetate-CoA transferase), β-OHB (β-hydroxybutyrate), β-HBDH (β-hydroxybutyrate dehydrogenase).
Seyfried and Mukherjee Nutrition & Metabolism 2005 2:30 doi:10.1186/1743-7075-2-30