GLUCOSE: A monosaccharide is found in all carbohydrates as well as starchy foods. It is the key source of energy for animals and humans during cellular metabolism.
FRUCTOSE: Also a monosaccharide. it is a natural ingredient of fruit and is also used as a main added caloric sweetener in many foods and drinks. Fructose tends to be metabolized differently from glucose. The metabolism of fructose favors DE NOVO LIOPGENESIS - a complex process in which carbohydrates in circulation are converted to fatty acids which are then used for synthesizing triglycerides or other lipid molecules.
Some common examples of the usage of sugar include the following:
TOTAL SUGAR-which includes natural and added sugar: Breads, cereals, fruits, sweet foods and drinks
NATURAL SUGAR- found in food and drinks. fruit, honey, milk, and other dairy products. 100% fruit juice.
ADDED SUGAR-sugar or syrups added during the processing of food/drinks sugary drinks, cakes, sweet foods, sweetened fruit products, candy, baked goods, and cereals.
FRUCTOSE- It is the main source of the sugary food and drinks we consume with added artificial sweeteners from high fructose corn syrup, fruit juices, fruits, vegetables, and nuts.
SUCROSE are disaccharides made of glucose and fructose also called table sugar sugar beet, cane sugar, etc.
SWEET FOODS. Desserts, candy, and chocolates.
SWEEET DRINKS: Fizzy drinks, non-soda sweet drinks. fruit/veg juices, liquid and powder concentrates, flavoured drinks, sports, and energy drinks, ready-to-drink teas and coffee, milk with added sugar or flavours, and sweetened juices.
CONSUMPTION OF SUGAR: IT CAUSES MORE THAN JUST OBESITY
THE SPREAD OF CANCER
The highest rates of cancer historically. have been in high-income countries. However, the spread of American fast and processed foods (energy-dense and sugary) leading to the westernization of diets all over the world has led to the increased incidence of non-communicable diseases in lower and middle-income countries (LMIC), They now make up 57% of cancer cases worldwide. The LMICS, where the sugar consumption has spiked surprisingly high are more in Asia. Latin America, and Africa.
By 2040. global cancer cases will increase by more than 40% and two-thirds of these, it is estimated will be in LMICs. According to the WHO estimation, in two decades, the rates will reach 22 million new cancer cases. and 13 million cancer deaths every year, which is about a 57% increase in new cancer cases yearly and a 65% increase in yearly cancer deaths This is more specifically true of lifestyle-related cancers which include breast, colon, and rectal kidney. liver pancreas, uterine and ovarian.
SUGAR AND CANCER
There are multiple studies linking excessive sugar consumption with increased cancer incidence and mortality.
Extensive research has been done which supports the role of multiple mechanisms where sugar increases cancer risk.
Independent of obesity this includes inflammation, glucose/fructose metabolism, lipid metabolic pathways, and immune modulation.
SURPRISING FACT
A longitudinal and observational study found that the daily Odds consumption of as little as 100ml of sugary drinks, (which includes fruit ass juices) significantly increases the risk of overall cancer by 18%. Lower cancer incidence and mortality were seen when the liquid sugars were replaced by MUFA's, solid sugars or complex carbohydrates.
CURRENT GUIDELINES
The American Heart Association currently recommends a daily consumption of 6 teaspoons (30g/ 120 calories) of added sugar for women and 9 teaspoons (45g or 180 calories) for men.
The current WHO guidelines recommend a dietary sugar intake of less than 10% of daily energy intake. which is 50g per 2000 calories. In addition, it also states that less than 5% should consist of added sugar.
CONSUMPTION OF SUGAR: IT CAUSES MORE THAN JUST OBESITY
Added sugar intake has increased globally over the years and in the US, its consumption has overtaken the ACS, AHA, and WHO recommendations for maximum intake. An average US person consumes over 350 calories - which translated to 21 teaspoons of sugar daily.
Other calorie sources which come from high GL. refined fast-dieting carbohydrate foods have also increased and when they are combined with added sugar intake. it is nearly goo calories per day.
Excess Sugar intake is linked with not only obesity but also with DIABETES CARDIOVASCULAR DISEASE ALZHEIMER AND OTHER FORMS OF DEMENTIA AND MANY DIFFERENT CANCERS
Sugar-sweetened beverages (SSB) are one of the most common contributors to the "diabesity epidemic and they promote weight gain more drastically as energy compensation does not work as well with liquids as it does with solid foods
The current nutritional guidelines for cancer prevention till now are silent on the harm caused by sugar and fructose intake outside of the context of weight gain
WHEN FAT WAS MADE THE VILLAIN
The research on how added sugar leads to non communicable diseases goes as far back as over 50 years. Physiologist Jon Yudkin (1960-70s) identified sugar as a key cause of coronary heart disease. The Sugar Research Foundation paid two scientists at the Harvard School of Public Health Nutrition Department to write a literature review for the New England Journal of Medicine debunking any such theories and steered the pain towards food high in saturated fat and cholesterol Thanks to this, came the era of low fat and fat-free processed foods. Fat was replaced with sugar and the consumption increased even more. The sugar industry till date continues to fund research on CHD and other chronic diseases thus indirectly influencing decades of American policy and Activate Windows health.
SUGAR AND CANCER
A review of 15 epidemiological studies examining sugar intake and cancer discovered positive associations between added simple-sugar and pancreatic, prostate, and liver cancer, hepatocellular carcinoma, lymphoma, and leukaemia, cancer of the colon. breast and small intestine cancer.
In another prospective study of 435.674 participants, added sugars were shown to be significantly associated with an increased risk of oesophageal adenocarcinoma.
In a meta-analysis of 10 cohort studies, fructose intake was associated with pancreatic cancer risk There was a 53% increase in pancreatic cancer due to high carbohydrate and sucrose intake. A higher consumption of sugar soft drinks, and sweetened fruit soups or stewed fruit were also associated with a high risk of pancreatic cancer of 69%, 93%, and 51% respectively.
Added Fructose has been associated with a greater risk of small intestinal cancer.
A large number of epidemiological studies have shown an association between sugar and breast cancer. Also, sucrose consumption during adolescence was correlated with a higher percentage of dense breast volume, which is a known risk factor for breast cancer A case-control study in Malaysia found a two-fold increase in breast cancer risk with high sugar intake for both premenopausal and postmenopausal participants
In a cohort study of colon cancer patients who consumed two or more servings a day of SSB every day were at high increased risk of recurrence by 75% as well as a risk of mortality
Sucrose has been positively associating with an increased risk of lung cancer.
There was a 70 000-person prospective study done which found that both men and women experienced significantly increased risk for extrahepatic biliary tract cancer and gallbladder cancer when they consumed excess sugar-sweetened and artificially sweetened beverages
Stephen found that people who consumed more than six soft drinks per day. Warden to than a significantly increased risk of developing hepatocellular carcinoma
A population se-control study shows that excess, sugar consumption is associated with shorter survival time among oesophageal cancer patients.
THE WAYS IN WHICH SUGAR CAN LEAD TO CANCER PROGRESSION:
MetS (METABOLIC SYNDROME) refers to a cluster of medical risk factors that include high triglycerides, low high-density lipoprotein, high blood pressure, high fasting glucose, and central obesity.
MetS is only diagnosed if a patient has three of the five factors.
It is not only associated with an increased risk for cardiovascular diseases. diabetes, cognitive disorders, and other health conditions, but also for a number of common cancers, including breast, liver, and pancreatic. colorectal endometrial, and more.
There are substantial studies that show a causal link between MetS and added sugar (including fructose), thus supporting the association between excess sugar consumption and cancer.
It is due to the increased underlying inflammatory processes or alteration of metabolic pathways that drive the sugar-induced tumorigenesis and progression.
CHORIC INFLAMMATORY states that over-expression of cyclooxygenase or lipoxygenases is associated with many cancer types and chronic diseases.
Cyclooxygenase (COX), is like a worker in your body helping in the process of making prostaglandins, which in turn plays an important role in various bodily functions, for example causing inflammation when you're injured or regulating pain and fever Lipoxygenases are the body's chemical messengers that help create leukotrienes. These are involved in various processes, like inflammation as well as immune responses Thus they are important in your body's defence and signalling systems. Studies show that there is a strong association between 12-lipoxygenase (12-LOXI and its metabolites 12-hydroxy eicosatetraenoic acid (12-HETE), and a variety of cancers. The spike in 12-LOX/12-HETE levels due to the sugar-rich diets shows that inflammation, independent of weight gain or metabolism, is an independent cause in the link between sugar and cancer.
THE WAYS IN WHICH SUGAR CAN CAUSE CANCER:
According to a 2019, study. HFCS - high fructose corn syrup accelerates GLYCOLYSIS by upregulating ketohexokinase. Ketohexokinase is similar to a "traffic cop. It is an enzyme in your body that helps control the use of fructose.
There is an increase in the de novo activation of the lipogenic pathway. - DE NOVO LIPOGENISIS
The effects of fructose on colon cancer liver metastases: Upon study, it has been found that aldolase B (ALDOB), an enzyme that is involved in fructose metabolism, becomes upregulated in liver metastases. Cancer metastasis is the most common form of cancer-related death and liver metastases are common for almost every type of cancer. Similar preclinical research supports specific carbohydrate metabolic pathways linking fructose and liver metastases.
THE WAYS IN WHICH SUGAR CAN CAUSE CANCER:
A study published in 2017. in the Journal of Nature Communications showed a link between a key sugar molecule and a GENE called RAS Ras is an oncogene so when it mutates, it can turn a regular cell into a malignant one. Sugar activates Ras (via the intermediate fructose 1.6-biophosphate), thus locking the cancer cells in a vicious cycle causing both persistent stimulation of cell proliferation and continued maintenance of overactive glycolysis, in other words making the tumor more aggressive.
Sugar intake and cancer are linked to each other through the mechanism of INSULIN and IGF-1 in the blood. The IGF system (Insulin-like Growth Factor system). are a set of signals in the body and they help control growth and development. Long-term hyperinsulinemia will reduce the production of growth-promoting factors - IGFBP-1 and IGFBP-2. who are meant to bind to and inhibit the action of IGF-I. The result is an increase in the levels of free, bio-active IGF-I. There are also accompanying changes in the cellular environment that favor cancer development. proliferation, and metastatic cancer cells.
There are various cellular actions of IGF-I that are supportive of tumor growth These include mitogenic in most of the human cells, inhibiting apoptosis induced by gamma radiation, cytotoxic agents and TNFa IGF-I also induces the production of VEGF (hypoxia-inducible factor-1-mediated vascular endothelial growth factor), induces tumor-associated lymph angiogenesis, and promotes integrin- and E-cadherin-mediated cell migration.
It is imperative to understand that reducing sugar does not mean stopping carbohydrates completely because carbohydrates are an important part of the human diet. Reduced consumption means less IGF is secreted, thus allowing a lower risk of cancer growth. Consumption of protein, fat, and fiber is important for the body.
A balanced nutritional diet with reduced sugar consumption and an increased intake of healthier foods along with increased physical activity can reduce the risk of cancer.
REFERENCES
Peeters K, Van Leemputte F, Fischer B, Bonini BM, Quezada H,
Tsytlonok M, Haesen D, Vanthienen W, Bernardes N, Gonzalez-Blas CB, Janssens V, Tompa P, Versées W, Thevelein JM. uctose-1,6-bisphosphate couples glycolytic flux to activation of Ras. Nature Communications. 2017:8(1). doi:10.1038/s41467-017-01019-2.
Laguna JC, Alegret M, Cofán M, Portu JJ, Estruch R, Ros E. Simple sugar intake and cancer incidence, cancer mortality and all-cause mortality: A cohort study from the PREDIMED trial. Clinical Nutrition. 2021:40(10):5269-5277. doi:10.1016/j.clnu.2021.07.031.
Dewi NU, Diana R. Asupan Gula dan Kanker: A Literature Review (Sugar Intake and Cancer: A Literature Reviewl. Amerta Nutr. 2021;5(4):387-394. doi:10.20473/amnt.v5i4.2021.387-394.
Epner M, Yang P, Wagner RW, Cohen L. Understanding the Link between Sugar and Cancer: An Examination of the Preclinical and Clinical Evidence. Cancers. 2022:14(24):6042. doi:10.3390/cancers14246042.
Dr. Axe. How Sugar Can Cause Cancer, draxe.com. https://draxe.com/health/how-sugar-can-cause-cancer/. Published January 30, 2018.