Highlights from Sugar & Cancer with Elise B. Cushman, MS, RD, CSO, LD

Sugar & cancer template

The information I share in this class will hopefully help you decide if you want to include sugar in your diet, what types of sugar you will have and how much, based on nutritional recommendations.

Elise Cushman, RD

As an oncology dietician at Norris Cotton Cancer Center (NCCC), I frequently get asked about sugar and cancer: What is the relationship between sugar and cancer? What is the recommended sugar intake? What is sugar? Where is it found? We've all likely heard the phrase “sugar feeds cancer.” The information I share in this class will hopefully help you decide if you want to include sugar in your diet, what types of sugar you will have and how much, based on nutritional recommendations.

How cells process sugar

A normal healthy cell has two insulin receptor sites. Picture the “rabbit ear” antennae on old console television sets. That's how cells pull in energy. Energy in its basic form is glucose. Every cell in the body needs glucose. So just like the television pulls energy from the rabbit-ear antennae, a healthy cell pulls energy from those two insulin receptor sites.

Cancer cells can have 40 or more insulin receptor sites, like a mega antenna. This means that cancer cells respond more than normal cells do to insulin. So on a very basic level, cancer thrives on glucose. But, as I said, every cell in the body needs glucose to function.

Does this mean that sugar feeds cancer? Research continues to look for a connection between sugar and cancer as well as evaluate certain diets, such as a very strict and low-carbohydrate ketogenic diet. In this class I discuss what we know about effects of a ketogenic diet and reactions in the body that may reduce the possible benefit—if there is any—of removing sugar from the diet. If you are interested in following a diet like this, talk to your oncology team and make sure there is a dietician on board who will guide you through the hurdles that go along with this diet.

Nutritional recommendations

Primary nutritional recommendations from the American Institute of Cancer Research and the World Cancer Research Fund International include limiting consumption of energy-dense foods (typically means processed foods in our country), avoiding sugary drinks and eating mostly plant-based foods.

The average American consumes about 150 to 170 pounds of sugar in a year. The American Heart Association recommends that men consume no more than 36 grams and women 25 grams of added sugar per day. This translates to nine teaspoons a day for men and six teaspoons a day for women. One teaspoon of sugar is about four grams or 16 calories. One easy way to cut your added sugar intake is to trim out sugary drinks and sodas, including diet sodas.

What’s in a food?

Sugar can come in all forms that aren't exactly clear and spelled out on ingredient labels as “sugar.” It's not always brown sugar, molasses, honey, those types of ingredients; It's maltodextrin, maltose, fructose etc. Those still count as sugar. In this class we look at some common sugary drinks and I explain how to read the ingredient and nutritional labels.

There is also glucose or carbohydrates in whole grains, fruits, vegetables and legumes. However, these foods contain fiber, vitamins, minerals, phytonutrients, sometimes fat and protein and they're healthy. These are what we want on your plate and in your day. We also know that these are the very same foods that help reduce chronic inflammation, support the immune system and reduce your risk of cancer and cancer recurrence.

Protein helps to avoid lows in blood sugar levels and control appetite because it takes fat and protein longer to break down than carbohydrates. Adding fat, protein and fiber to your carbohydrate, such as an apple with peanut butter, slows down the stomach emptying and lowers the overall glycemic index of the snack or the meal.

The glycemic index indicates how quickly a carbohydrate food or an ingredient is absorbed within the body as glucose. Research suggests that the benefits of a low glycemic diet for many chronic diseases is very beneficial, however, studies looking at glycemic index diets and cancer tend to be mixed. In this class I demonstrate an example of carrots, but a registered dietician can help you make sense of the glycemic index for all foods.

The NCCC dieticians are here to offer full nutritional guidance to patients with cancer. There's a lot of information out there—not all of it is true or evidence-based. That's where we can help navigate those murky waters.

A link to the full recorded Sugar & Cancer session and other oncology nutrition classes for cancer patients and care partners is available here. To make an appointment with an oncology dietician, please visit Oncology Nutrition Services.