Caring4Cancer

Recently, I received an excellent question on whether eating sugar is bad for the health of individuals with cancer. I wanted to share this question and my comments with the group.

Question: "Is eating sugar,or anything sweet not good for you if you have cancer? Another question is if you have stage 4 cancer, and the cancer is in your liver, is there any hope?"

Sugar and Cancer

The concept that sugar is bad for the health of individuals living with cancer is discussed passionately in books, on websites, and in health seminars. In fact, among cancer patients with whom I've worked, "Does sugar feed cancer?" is one of the most commonly asked questions I've heard.

This question is so important that I've posted an answer to it in the Nutrition area of the Caring4Cancer.com website. You can read this information by clicking on the link

http://www.caring4cancer.com/go/cancer/nutrition/questions/sugar-and-cancer-is-there-a-connection.htm.

I hope this information will address all of you concerns regarding sugar, sweet foods, and cancer.

Stage 4 Cancer

Regarding your second question about stage 4 cancer, I strongly encourage you to explore all treatment options with your medical care team. I truly believe that there is always hope.

While a cure for your cancer may not be possible, there are many options for managing advanced cancer. Exploring all of these options can help you gain a sense of control. You can ask your doctor about clinical trials and other treatment plans for someone in your situation.

Beyond pursuing medical treatment, be sure to talk to your medical care team about ways to get through this difficult diagnosis. This might include support groups, counseling, pastoral care,and other options such as art and music therapy.

Whatever you decide is right for you in terms of medical treatment, also talk to your medical team about the best ways to ensure that your mental, spiritual, and emotional health is as strong as it can be.

Nutritionist Suzanne
Suzanne Dixon, MPH, MS, RD

Thank you for the information about sugar.  You are so good at providing complex information in a way that's easy to understand. 

I hear conflicting information about different kinds of sugar.  Some people say sugar is sugar is sugar.  Others say less processed forms are better.  I've put considerable effort into avoiding corn syrup based on my belief that corn syrup enters the bloodstream faster than other types of sugar  and therefore other types of sugar, such as brown sugar, is better because it metabolizes slower. 

Could you please weigh in on this?  I value your opinion.

Hi Althea,

You raise an excellent question about whether type of sugar really matters in terms of the sugar's effect on metabolism and health.

It is true that as far as total calories, one sugar is exactly the same as another sugar. All sugars are carbohydrates and all carbohydrates have 4 calories per gram. So in terms of how your body sees those calories, it is going to see the same number regardless of whether that sugar is white, brown, or corn syrup.

However, even though the calorie count is the same, the effects these different sugars can have on the body may vary. There is some research suggesting that certain types of processed sugars, especially high fructose corn syrup (HFCS), may have negative health effects. In this regard, you are exactly right. High fructose corn syrup is "less healthy" than other, more natural sweeteners, including brown, and even white table sugar.

High fructose corn syrup is everywhere in our food supply. From bread to crackers to cereal, and beverages to dessert items, baked goods, and candy bars, if you shop in a regular grocery store, chances are high that you eat HFCS every day. HFCS is so abundant in our food supply because it is a very inexpensive way to sweeten food. HFCS is much cheaper and much more readily available than even white table sugar and this is why it turns up in so much of our food.

But while the food manufacturer gets to make a product more cheaply, research is showing that the consumer is the one who may end up paying a higher price. That price is the potential damage that consumption of HFCS can do to our long term health.

One of the main problems with HFCS is that it may promote a type of obesity called central adiposity or the “apple” pattern of weight gain. Central adiposity is exactly what it sounds like. It is gaining adipose tissue, also known as fat, in the center or midsection of the body.

When health experts talk about the potential health consequences of being an “apple” or a “pear” this is the situation to which they are referring. Carrying excess weight in the stomach, abdomen, chest, and upper body is more detrimental to health than gaining weight in the lower body (legs, thighs, and butt).

Being an “apple” shape substantially raises risk of diabetes, hypertension, heart attack, stroke, and certain types of cancer. This means that if HFCS increases the likelihood of gaining weight in the midsection, then indirectly, HFCS also may contribute to increased risk of these other diseases as well.

Beyond the potential problem with how HFCS may negatively affect pattern of weight gain, there may be other problems with this sweetener. There is some preliminary evidence that HFCS may change the way the liver regulates cholesterol and fat in the body. This may lead to higher total cholesterol, higher levels of LDL, the so-called “bad” cholesterol, and higher levels of triglycerides (fat) in the blood. None of these situations is desirable or good for health.

Another issue with HFCS, as with any type of sweetener, is their use in beverages. Many health experts and researchers believe that our bodies do not perceive liquid calories in the same way as solid calories. When you drink your calories, your body doesn’t account for them in the same way that it accounts for calories you’ve eaten. In this way, if you have a lot of high calorie beverages in your diet, it’s easy to overeat because your body isn’t aware that the liquid calories “count”. This holds true for items sweetened with sugar, brown sugar, or high fructose corn syrup.

Finally, I believe that by its very high level of sweetness, HFCS conditions people to expect to have all food taste sweet. It seems to me that all of the high fructose corn syrup in the food supply has completely "reset" people's taste buds and taste expectations. For example, nearly all commercially-prepared bread on the supermarket shelf has high fructose corn syrup as the 2nd or 3rd ingredient. This is really strange, to say the least. Why put corn syrup in bread?

Personally, I would like my bread to taste like grains, not sugar. A touch of honey, molasses, or maple syrup in a loaf of bread is fine. Having a major ingredient of bread be processed sugar (HFCS) is not good for health.

Along these lines, I believe it’s important for people to “relearn” how to enjoy real food that tastes like REAL food. We can learn to enjoy the earthy, slightly bitter tastes, the pungent flavors, the natural sweetness (not added) in things like fruit, carrots, and corn. I’ve said this before and I’ll say it again, I'm no food police and I love dessert. However, I expect dessert to taste sweet, not my bread. Or my vegetables. They should taste like grains and plants.

As a final note, white and brown sugar essentially are the same. Your body sees them as simple carbohydrates and processes them similarly. I believe it’s perfectly ok to have some sugar (not HFCS) in the diet. As I mentioned, dessert is sweet and that is where a little sugar can fit into a healthy diet. As long as it is eaten in moderation, sugar is fine for most people, in small quantities.

The trick is to be a label reader and begin to be more picky about the “staples” in your diet. Look for bread and cereal that doesn’t contain HFCS. Eliminate the regular soda pop. Avoid “fruit” drinks that are mostly sugar-water. Stop eating crackers and chips and instead enjoy the natural sweetness of fruit as a snack. The choices are endless and if you want to cut back on the amount of added sugar in the diet, especially HFCS, it can be done!

Nutritionist Suzanne
Suzanne Dixon, MPH, MS, RD

To - Stage 4 patient

Don't give up!  I received a diagnosis 2 1/2 years ago of extremely advanced stage 4 breast cancer that had emcompassed both breasts and had spread across my chest (interior and exterior), and into bone, lungs and liver.  My survival chance was a paltry 13%, and the future looked grim.  But I took the opportunity to conduct extensive research on evidence-based nutritional approaches to healing.  I transformed my diet from the ground up to remove most sugar and include cruciferous vegetables, green tea, whole grains, and a host of herbs, spices and other nutritional compounds that have demonstrated proactive effects against cancer.  Not only did I feel great throughout chemo, but I am going on my third year and the cancer is gone from lungs, liver, breasts, and much of my bone.  No one can claim with certainty whether it was the nutritional approach or solely the conventional treatment that led to this surprising outcome, but I firmly believe that nutrition interacts synergistically with standard therapy to create the fertile soil in which the healing process can take place.  In any case, it can't hurt you to embark upon a healthy diet that will reduce inflammation and decrease the risk of cachexia (chemo-induced malnutrition) which is a cause of 20 - 40% of all cancer deaths according to the NCI. And if nothing else, it will make you feel good.  So keep your head up and push forward - you can do it (yes, we can!)
 

Thank you for your words of encouragement. I have Stage IV primary lung cancer and the statistics for survival are very scary. I am trying not to think as myself as a statistic, but as an individual with a lot of positive things going for me. I just finished my chemo (I hope for) and feel I should change my eating life style. You have given me hope not to give up and keep fighting. Thank you, Janet

Hi, I am very confused about sugar and the foods we should consume.  I have stage IV breast cancer.  My original was 15 years ago, invasive lobular br ca.  Never thought it would come back but here it is.  I am receiving a clinical trial of avastin + arimidex and my onc just started me on zometa.  I am losing approx 2-3 lbs a week.  At first I didn't have an appetite at all but as of about 2-3 weeks ago my appetite is back.  I read about staying away from anything white, sugar, flour, rice pasta etc.  Then red meat, then meat in general,  Then eat only organic vegs.  Finally I just got so confused I didn't know what to eat.  So decided to eat a sensible diet of everything in moderation.  I asked my doc about sugar and he said cancer does not feed on sugar.  Wish I had the money to have a nutritionist/cook shop and cook for me!! I am trying to limit myself to anything white and no junk food and eat as healthy as possible but I'm at a loss as to the best diet.  I think I've lost at least 20 pounds since Nov. and I didn't need to lose any.  I have also lost a lot of muscle tone as well.  I am drinking smoothies with protein and I like them but then I don't want to eat as they fill me up.  Any ideas will be greatly appreciated because I am very concerned about the loss of weight.    Thanks and blessings to all

Hello Sunrizes2,

It's not surprising that you're confused about sugar. There is a lot of misinformation about sugar and cancer on the web (internet) and in popular diet books. Even more frightening is how this information is presented to us. The phrase "sugar feeds cancer" is very scary and it is intended to get your attention. If you are concerned about cancer and you read that some particular food or nutrient "feeds" cancer, this certainly gets your attention!

Fortunately, it's not true.

Your doctor is right. The sugar that you eat does not "feed" cancer. Technically, it is true that cancer cells can use sugar for energy, but so can all of your healthy cells. Furthermore, cancer cells can use fat and protein for energy too. For this reason, avoiding all sugar is not the answer to eating well when you have cancer.

You are absolutely right that a balanced diet is the best way to eat. A diet that gives you plenty of high quality, healthy calories is the best way to nourish your body and stay strong when living with cancer. You want to focus on high calorie foods that give you the most “bang for your buck”. This includes foods that naturally contain some sugar, such as fruit and juice. Remember, these foods do contain some sugar, but these are naturally occurring sugars and they come along with nutrients, vitamins, minerals, and fiber, all of which are healthy and important for the body to have whether fighting cancer or not.

You also want to eat as many calorie- and protein-dense foods as you can. Calorie dense foods are those that have a lot of calories packed into a small volume. Protein dense foods pack a lot of protein into a small volume. Examples of calorie and protein-dense foods include nuts; seeds; peanut butter and other nut butters; cottage cheese and yogurt; whole grain breads, crackers, and pretzels; and chicken, fish, and eggs.

Try fruit smoothies made with frozen berries, milk or soy milk, and a scoop of any plain or vanilla protein powder. Any brand of protein powder will work. Whey protein is a good one to try. You want to build your diet around these natural foods that give both good nutrition and calories.

Also, be sure you snack as often as you can. Since you probably will feel full quickly when you eat, you want to aim for 6-7 mini-meals per day, rather than 3 larger meals. Forget about “breakfast, lunch, and dinner” and instead make it a priority to eat small amounts often, throughout the day. You can even scramble up a couple of eggs as a snack if the mood strikes.

When you drink liquids, stick to those with calories such as soy or rice milk, regular milk, smoothies, and juice. You don’t want to fill up on empty liquids that provide no calories such as water and coffee. Some water is ok, but as often as possible, use your drinks to provide calories too.

There are lots of other things you can do to squeeze more calories into your diet and you can read about some of these in our articles on Avoiding Weight Loss and Recipes for High Calorie Eating.

Just remember, the bottom line is that sugar does not feed cancer and avoiding all sugar is not healthy or practical. Make it a priority to eat whatever it takes to get your weight stabilized so you can feel well and function better.

Sincerely,
Nutritionist Suzanne
Suzanne Dixon, MPH, MS, RD