Glioma Atkins-Based Diet in Treating Patients with Grade II-IV Astrocytoma

Inclusion Criteria

• Patients must have a clinical and histopathologic diagnosis of diffuse astrocytoma (World Health Organization, WHO, grade II, III or IV astrocytoma), have completed > 80% of prescribed concurrent radiation therapy and adjuvant temozolomide without Common Terminology Criteria for Adverse Events (CTCAE) grade 4 leukopenia, neutropenia, or thrombocytopenia, and be greater than 3 months from the time of completion of concurrent chemoradiotherapy, with stable disease by neuroimaging
• Karnofsky performance status >= 60
• Patients must be eligible to undergo a ketogenic or Atkins based diet according to baseline body mass index (BMI), comorbid medical conditions, and baseline laboratory assessment
• Patients must be of appropriate mental capacities with sufficient social support so as to be able to complete required study activities (i.e. diet record, etc) and able to provide written informed consent

Exclusion Criteria

• Patients with a history of a metabolic disorder including documented defect in urea metabolism (including documented history of gout), carnitine deficiency (primary carnitine deficiency, carnitine palmitoyltransferase I or II deficiency, carnitine translocase deficiency), fatty acid metabolism, beta-oxidation defects, pyruvate carboxylase deficiency, mitochondrial function, porphyria, or treatment refractory nephrolithiasis
• Severe acute infection
• Body mass index (BMI) < 20.0
• Active bowel obstruction, ileus, or active or remote pancreatitis
• Clinically significant heart failure (New York Heart Association [NYHA] > 2), recent myocardial infarction, or symptomatic atrial fibrillation
• Clinically significant renal disease (creatinine > 2.0 mg/dL, urea > 100 mg/dL)
• Clinically significant hepatic dysfunction (alanine or aspartate aminotransferase > 7 times the upper limit of normal)
• Patients with insulin-dependent diabetes mellitus
• Conditions that may increase the risk of the diet or significantly reduce compliance (i.e. cognitive impairment, frank dementia, etc)
• Other concurrent experimental therapies
• Milk allergy
• Treatment with the modified Atkins diet (MAD) for any cause within the 9 months prior to study enrollment
• Patient inability to complete baseline screening 3-day diet record