Diet after a diagnosis of cancer can affect outcome, according to a study that followed colon cancer patients,  researchers found that the patients who ate a starchy high-carbohydrate diet were nearly twice as likely to have a recurrence as those who ate a better balance of foods, and the effect was most pronounced in patients who were obese or overweight.

Myrmicaria brunnea

It is believed that a starchy high-carbohydrate diet increases insulin levels, and insulin and insulin-like growth factors are known to promote cellular growth and spread.

Naturopaths and alternative health practitioners often encourage cancer patients to avoid all sugar, but Dr. Meyerhardt explained that it is “not that simple,” and that “total avoidance of sugar is not necessary.” It is the glycemic load appears to be important here, and complex sugars, starchy foods, and carbohydrates have higher glycemic loads, he said.

The editorialists suggest that  patients should follow the advice of an American Cancer Society expert panel ( CA Cancer J Clin 2012;62:243-274), which recommends that colon cancer survivors “maintain a healthy weight, participate in regular physical activity, and eat a well-balanced diet consistent with guidelines for cancer and heart disease prevention.”

Data From Dietary Questionnaire

Previous findings from the CALGB showed that colon cancer patients with the highest consumption of a Western diet (characterized by a high intake of meat, fat, refined grains, and sugary desserts) had a 3-fold increase in cancer recurrence and death, compared with patients with the lowest consumption ( JAMA. 2007;298:754-764).

In this CALGB follow-up study, the researchers analyzed data on 1011 patients, looking at total carbohydrate intake, glycemic index, and glycemic load.

Overall, patients with the highest glycemic load and carbohydrate intake had an increase in colon cancer recurrence or death of 80%, compared with those with the lowest levels However, this effect differed significantly by body mass index (BMI), the researchers note. The association was significant in patients who were overweight and obese, but not in those who had a normal body weight (BMI below 25 kg/m²).

The editorialists note that the magnitude of the associations between dietary glycemic load and carbohydrate intake and poorer disease-free, recurrence-free, and overall survival were “clinically meaningful.” However, they add that the interaction observed suggests that the association is restricted to patients with a higher BMI.

J Natl Cancer Inst. Published online November 7, 2012.


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