Sugar
is
not recommended for breast cancer
By sugar, we mean ordinary table sugar (sucrose). This category also includes extremely sweet foods such as candy and desserts incorporating high levels of sugar. A high sugar intake can contribute to high body mass index (BMI) and type 2 diabetes, which in themselves can increase breast cancer risk for some women. The question we have attempted to answer in this web page is whether consumption of added sugar, sugary sweets, and high-sugar desserts are associated with increased breast cancer risk, including for women who are not overweight and presumably not insulin resistant.
A sucrose-rich diet has been found to increase the mutation frequency in rat colon cells in a dose-dependent manner. Consumption of simple sugars has been shown to have a strong positive association with markers of oxidative DNA damage in healthy adults. Added sugar has been found to be associated with increased risks of pancreatic, gastric, colorectal and prostate cancer.
Breast cancer-related effects of
eating
sugar
In one study, carcinogen-induced mammary tumors in rats fed diets containing high levels of either sugar (dextrose or sucrose) or starch (wheat, rice or potato starch) were evaluated. Rats fed sugar diets were found to develop significantly more mammary tumors than those fed starch diets, at both low and high levels of dietary fat.
A U.S. case-control study found that consumption of sweets, particularly desserts, was associated with an increased risk of breast cancer. An Italian case-control study found that women with the highest intake of desserts (including cookies, brioches, cakes, pastry puffs and ice-cream) and sugars (including sugar, honey, jam, marmalade and chocolate) had increased risk of breast cancer. The results held when adjusted for body mass index and total calorie intake. A Mexican case-control study found that carbohydrate intake was positively associated with risk of breast cancer for both premenopausal and postmenopausal women after adjusting for total calorie intake. The strongest associations were observed for sucrose and fructose intake. Another Italian case-control study found that breast cancer risk increased with increasing consumption of bread, pasta and refined sugar. A Japanese case-control study found that breast cancer risk was positively associated with higher intakes of bread, cake, and soft drinks with sugar.
A Canadian prospective study found higher risk of breast cancer among postmenopausal women consuming high glycemic index foods, an association that was not change when adjusted for body mass. On the other hand, a Danish prospective study found no associations between intake of glucose, fructose, sucrose, maltose, lactose, or starch and breast cancer risk. However, a borderline significant positive association between high glycemic index foods and estrogen receptor negative (ER-) breast cancer was found in this study.
Additional comments
Using honey as a sweetener instead of table sugar could be beneficial to overall health and reduce breast cancer risk.
Confectioners' sugar (also know as powdered sugar and icing sugar) consists primarily of sucrose. It is granulated sugar which has been ground into a very fine powder with a small amount of cornstarch added to prevent lumping.
The idea that breast cancer is "fed by sugar" is not the correct explanation for the association between sugar consumption and breast cancer risk. Sucrose is converted to glucose by enzymes in the digestive tract. All of our cells require energy in the form of glucose to survive. It is true that cancer cells typically consume glucose at a much higher rate than normal cells and compounds that cause inhibition of glucose uptake by tumor cells may inhibit their growth and viability. However, this does not necessarily mean that consuming a great deal of sugar will stimulate cancer growth since cancer cells will obtain glucose from a variety of foods in the diet.
Tags:
,
,
BMI,
ER-,
Japanese,
bread,
chocolate,
glycemicIndexLoad,
honey,
insulinResistance,
lactose,
overweight,
potatoes,
southernEurope,
sugar,
type2Diabetes
Selected studies
Consumption of sweet foods and breast cancer risk: a case–control study of women on Long Island, New York
Cancer Causes and Control, October 2009
The current case-control study was designed to investigate the association between risk of breast cancer and high intake of sweets. The study included 1,434 breast cancer cases and 1,440 controls from Long Island, New York. The women with breast cancer were interviewed in person shortly after diagnosis to assess potential breast cancer risk factors. They also completed a food frequency questionnaire that included 11 items relating to the consumption of sweets (sweet beverages, added sugars, and various desserts) during the previous year. Unconditional logistic regression models were used to estimate the association between intake of sweets and breast cancer. Consumption of a food grouping that included dessert foods, sweet beverages, and added sugars was found to be positively associated with breast cancer risk: adjusted odds ratio (OR) comparing the highest to the lowest quartile = 1.27, 95% confidence interval (CI): 1.00 - 1.61. The OR was somewhat higher for dessert foods alone: OR = 1.55, 95% CI: 1.23 - 1.96. The association between risk of breast cancer and consumption of desserts was stronger among pre-menopausal women: OR = 2.00, 95% CI: 1.32 - 3.04 than post-menopausal women: OR = 1.40, 95% CI: 1.07 - 1.83), however the interaction with menopause was not statistically significant. The authors conclude that frequent consumption of sweets, particularly desserts, may be associated with an increased risk of breast cancer.
Consumption of sweet foods and breast cancer risk in Italy
Annals of Oncology, February 2006
The current case-control study was designed to assess the relationship between the intake of sweets and sugar and the risk of breast cancer. The cases were 2,569 Italian women with histologically confirmed incident breast cancer recruited between 1991 and 1994. Controls were 2,588 women admitted to hospital for acute, non-cancer, and non-hormone-related conditions. A questionnaire was used to collect information on diet. Compared to women in the lowest third of intake, women in the highest tertile of intake of desserts (including cookies, brioches, cakes, pastry puffs and ice-cream) and sugars (including sugar, honey, jam, marmalade and chocolate) had multivariate odds ratios (ORs) of 1.19 (95% CI 1.02–1.39) and 1.19 (95% CI 1.02–1.38), respectively. The results were similar when adjusted for age, body mass index, total energy intake and other cofactors. The authors conclude that there is a direct association between the consumption of sweet foods with high glycemic index and glycemic load and the risk of breast cancer.
Dietary Carbohydrate Intake Is Not Associated with the Breast Cancer Incidence Rate Ratio in Postmenopausal Danish Women
Journal of Nutrition, January 2005
The current study was designed to assess the effects of consumption of different carbohydrates, glycemic index, and glycemic load on breast cancer risk in Danish postmenopausal women while taking into consideration tumor estrogen receptor (ER) status. Study participants included 23,870 women aged 50 to 65 years who took part in the Diet, Cancer, and Health study and provided information about their diets and established breast cancer risk factors. 634 incidents of breast cancer occurred during follow up. No associations were found for intake of glucose, fructose, sucrose, maltose, lactose, or starch and breast cancer risk, and no associations were found for glycemic index or glycemic load after adjusting for confounding factors. Consumption of various types of carbohydrate was not associated with estrogen receptor positive (ER+) or ER- breast cancer. Similarly, glycemic index and glycemic load were not found to be associated with the risk of ER+ breast cancer after adjusting for confounding factors. A borderline significant positive association between glycemic index and ER– breast cancer was found (P = 0.05). The authors conclude that there was no clear associations between intake of different carbohydrates, total carbohydrate consumption, glycemic index, or glycemic load and breast cancer in postmenopausal women. Furthermore, no clear associations were observed when ER+ and ER– breast cancer cases were analyzed separately.
Dietary carbohydrates and breast cancer risk: A prospective study of the roles of overall glycemic index and glycemic load
International Journal of Cancer, December 2004
This prospective population study was undertaken to examine the associations between risk of breast cancer and overall glycemic index, glycemic load, and dietary carbohydrate and sugar intake. Study participants included 49,613 Canadian women enrolled in the National Breast Screening Study between 1980 and 1985 who completed a self-administered food questionnaire. Cancer incidence and deaths were derived from national mortality and cancer databases. During an average follow-up period of 16.6 years, 1,461 new breast cancer cases were found. Glycemic index, glycemic load, total carbohydrate and total sugar intake were found not to be associated with breast cancer risk in the study population overall. However, when analyzed by menopausal status, there was evidence of an association between glycemic index and breast cancer risk. The hazard ratio for the highest versus the lowest quintile level of glycemic index was found to be 0.78 (95% CI = 0.52-1.16; ptrend = 0.12) for premenopausal women and 1.87 (95% CI = 1.18-2.97; ptrend = 0.01) for postmenopausal women. The associations between glycemic index and glycemic load did not prove to be modified by body mass index or by vigorous physical activity, regardless of menopausal status. Also, the association between glycemic index/glycemic load and risk in postmenopausal women was not modified by ever use of hormone replacement therapy. However, the associations were slightly stronger among those who reported no vigorous physical activity, among those who reported ever using hormone replacement therapy, and among normal-weight women (body mass index < 25 kg/m2). The authors conclude that consumption of diets with high glycemic index values may be associated with increased risk of breast cancer among postmenopausal women, and possibly more so among those who participate in vigorous physical activity, had ever used hormone replacement therapy, and those not overweight.
Carbohydrates and the Risk of Breast Cancer among Mexican Women
Cancer Epidemiology, Biomarkers & Prevention, August 2004
The present Mexican population-based case-control study was designed to examine the association between high carbohydrate intake and risk of breast cancer. The study included 475 breast cancer cases aged 20 to 75 years old, identified through six hospitals in Mexico City, and 1,391 cancer-free controls selected from the Mexico City population. The women were interviewed to obtain information concerning diet (using a food frequency questionnaire) and breast cancer risk factors. Carbohydrate intake was found to be positively associated with risk of breast cancer. Compared to women in the lowest fourth of total carbohydrate intake, the relative risk of breast cancer for women in the highest quartile was 2.22 (95% confidence interval (95% CI) 1.63 - 3.04), adjusting for total energy intake and potential confounding variables (P for trend < 0.0001). This association was found in both premenopausal and postmenopausal women: for the highest versus the lowest quartile of consumption, OR = 2.31, 95% CI 1.36 - 3.91 in premenopausal women and OR = 2.22, 95% CI 1.49 - 3.30 in postmenopausal women. The strongest associations were observed for found for sucrose and fructose. No relationship was found with total fat intake. The authors conclude that, in this population, a high percentage of calories from carbohydrate, but not from fat, was associated with increased risk of breast cancer risk.
The role of energy and fat in cancers of the breast and colon-rectum in a Southern European population
Annals of Oncology, June 1999
The present Italian population study was designed to investigate the relationship between intake of fat and total energy and the risks of breast and colorectal cancers. During the period 1991 to 1996, 2,569 women with breast cancer (median age: 55 years), 1,953 people with colorectal cancer (median age: 62), and 5,155 hospital controls were interviewed using a food frequency questionnaire that included questions on 78 foods and recipes, as well as specific questions on individual fat intake. Significant trends of increasing breast and colorectal cancer risk with increasing consumption of bread, pasta and refined sugar were found. Breast cancer risk also was found to increase with increasing consumption of pork, processed meats and potatoes. Colorectal cancer risk also was found to increase with increasing consumption of cakes and desserts. Most vegetables were inversely associated with colorectal cancer, whereas only carrots and raw vegetables appeared to lower breast cancer risk. High fruit intake was found to be associated only with a reduction in rectal cancer. Total calorie intake was directly associated with all the cancer sites studied. With regard to macronutrients, high intake of starch and saturated fat appeared also to lead to an increase in cancer risk. High consumption of polyunsaturated fatty acids (mainly from olive oil and seed oils) was associated with reduced cancer risk. With regard to micronutrients, β-carotene, vitamin E, and calcium had inverse associations with both breast and colorectal cancer risk. The authors conclude that an excess of energy intake, particularly from refined bread and pasta, can be an unfavorable feature of the Mediterranean diet in the presence of a sedentary lifestyle.
