However, it is important to note that a KD might not be beneficial in all circumstances or cancer histologies, as other groups have noted that changing to a high protein intake can increase insulin signalling through IGF-1.220,221 There remains ambiguity regarding which diets can effectively reverse tumorigenesis mechanisms, and future studies should aim to identify the appropriate populations and tumour phenotypes for rational dietary intervention. The gene discussed is IGF1; the disease is neoplasm.