This study examine the effects of very low carbohydrate diet (in which the calories requirements are mostly from fat) to the level of systemic inflammation (measured by Glasgow Prognostic Score), serum lactate and TNF Alpha levels

This study examine the effects of very low carbohydrate diet (in which the calories requirements are mostly from fat) to the level of systemic inflammation (measured by Glasgow Prognostic Score), serum lactate and TNF Alpha levels. The subjects are colorectal adenocarcinoma patients who were decided by experts to be managed by best supportive care. These patients are not deemed to be suitable for surgical intervention , chemotherapy or radiotherapy anymore. The main treatment is supportive. We would like to examined the effect of very low carbohydrate diet on these patients, in which theoretically tumtor cells of the colorectal adenocarcinoma needed glucose to replicate and increases the systemic inflammation response.

Inclusion Criteria:

• Diagnosed as colorectal adenocarcinoma pathologically
• Decided by a digestive surgery consultant to be managed with best supportive care
• More than 17 years old and capable of making informed consent
• Karnofsky score > 50% or ECOG performance status <=2
• No clinical signs of infection, with one or more of these criteria : fever, leukocytosis, local sign of infection (eg.abscess,ulcer)
• AST < 2 times normal limit
• ALT < 2 times normal limit
• Serum Creatinine < 1,5 times normal limit
• Not pregnant (for women)
• Able to understand and willing participate and to sign informed consent form
• No Diabetes Mellitus
• No fat intolerance
• No severe malnutrition or cancer cachexia

Exclusion Criteria:

• Patient is still on other therapy for the tumour
• Patient with coexisting diseases which prohibits the patient to follow the study protocols

Care provider are not told whether the patient belongs to intervention or control group