Sugar: An Essential Macronutrient

Blueberries in a blue cupSUSIE YOUNG, R.D. | JULY 3 2015

“Does sugar feed cancer cells?” This is the most common question cancer patients ask me, my colleagues, and my peers. Sugar or glucose is an essential macronutrient and is the main energy source for every cell in our body. The brain, central nervous system, red blood cells, and muscle tissue depend on glucose to function properly. Despite all of the benefits of glucose, it continues to receive an image of being “the bad guy.” As Andrew Weil, MD states in a recent article, “I think there is a tendency to demonize whole groups of foods and macronutrients, such as carbs, grains and sugar. I don’t think that is a good trend.” The human body can break down a protein or a fat into glucose if glycogen levels run low. So what is the best dietary approach cancer survivors can adopt? To return to a healthy eating pattern and reduce undue stress, consider following these five steps:

1. Eat fruits and vegetables. Avoiding fruit or limiting vegetables because of the sugar content misses the point of a healthy diet. Fruits and vegetables contain antioxidants and other cancer fighting compounds which is exactly what the body needs to fight off disease. This fear and restriction may increase stress, which in turn can increase blood sugar levels and decrease immunity.  Judith Payne, PhD RN, AOCN FAAN, from the University of Wisconsin Hospital and Clinics in Madison published an article in the September 2014 Oncology Nursing Forum connecting stress and inflammation to cancer development and progression. Obsessing over the sugar content found in a potato or in an apple has the potential to increase glucose levels, increase inflammation, which in turn may increase the risk of some cancers.

2. Consume a balanced amount of fructose and glucose in the natural sugars used in cooking and preparing dishes. Some survivors limit glucose by using a high fructose sugar such as agave. Kimber Stanhope, PhD researcher at UC Davis, is a leading expert on the metabolic effects of sugars. She recommends taking a broad view of natural sugars. “It’s not always appropriate to look at one outcome when talking about sweeteners because different sugar molecules have different effects.” Fructose is digested by the liver and stored as glycogen or fat (triglycerides). A diet that contains too much fructose has been linked to non-alcoholic fatty liver disease, gout, insulin resistance, abdominal obesity, and elevated triglycerides. To reduce stress on the liver and to provide fuel for the brain, use a sugar source that has an equal amount of fructose to glucose. This comparison table “Sugar as an Essential Macronutrient” breaks down the sugar content found in commonly used natural sugars and sugar substitutes.

3. Reduce the number of calories in beverages. According to, a 15 ounce carton of Berry Vegetable “Naked” Juice has 260 calories but eating the whole fruit and vegetables provides a mere 100 calories and fewer carbohydrates. Think of it this way: it takes 2-4 medium oranges to fill a 4 ounce glass of orange juice. Orange juice has approximately 60 grams of carbohydrates which can affect blood sugar levels in 5 to 10 minutes, as cited by the Diabetes Action Research and Education Foundation. One medium orange contains 15 grams of carbohydrates and will affect blood sugar levels in 30 minutes.

4. Become more active and promote muscle mass. Muscle tissue uses glucose as its main source of energy, and increasing muscle mass will decrease glucose levels and stabilize blood sugar. Muscle is the most “hungry” tissue in the human body, and the more muscle mass a person has, the more calories a person will burn.

5. Focus on eating unprocessed whole foods that have one or more of the following; fat, fiber, protein. These key elements slow down digestion which slows down the release of insulin.

Our guest blogger,  Susie Young, RD is a registered dietician and nutritionist with Durango Cancer Center and Southwest Oncology at Mercy Regional Medical Center in Durango, Colorado.

Today’s Dietitian, Dec 2014; Up Close and Personal with Andrew Weil, MD, Sharon Palmer, RD
Today’s Dietitian, Jan 2015; Alternative Natural Sweeteners, Judith Thalheimer, RD LDN
Dana-Farber Cancer Institute; Sugar and Cancer Cells
Diabetes Action Research and Education Foundation
Oncology Nutrition for Clinical Practice, 2013, Oncology Nutrition Dietetic Practice Group
Oncology Nursing Forum, September 2014; Is there a connection between stress and cancer progression, Judith Payne, PhD RN, AOCN FAAN, University of Wisconsin Hospital and Clinic

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