In recent years, the anti-sugar abstinence propaganda has been rampant, and sugar intake has gradually decreased in the diet list of ordinary people, is it really so terrible to eat sugar? Can breast cancer patients eat sugar? Will eating sugar cause relapse and metastasis?
Sugar is an important risk factor for caries, obesity, cardiovascular and cerebrovascular diseases, diabetes and other metabolic diseases, for breast cancer patients, obesity can promote cancer development, and as a high incidence of cardiovascular and cerebrovascular diseases, excessive sugar intake is to add fuel to the fire, increasing the risk of cardiovascular and cerebrovascular diseases.
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Since sugar can't be eaten more, is it okay to eat something with 0 sugar and 0 calories?
Soft drinks and foods with 0 sugar and 0 calories are quite popular in the recent consumer market, and the mainland's "General Principles for Nutrition Labeling of Prepackaged Foods" points out that in the case of sugar content in food less than 0.5g/100g (solid) or 100mL (liquid), it can be marked "sugar-free food" on the production label; if the calorie does not exceed 17 kJ, it can be marked as "zero".
That is to say, the truth of 0 sugar 0 calorie is that the merchant adds sugar substitutes that are lower in calories or not absorbed by the human body.
There are many types of sugar substitutes, including synthetic sucralose, acesulfame potassium, aspartame, and naturally occurring, such as steviol glycosides, monk fruit glycosides, and partial sugar alcohols.
NO.1
Benefits of sugar substitutes
1. Compared with sugar sweeteners such as sucrose, most sugar substitutes are cheaper in price and less in amount, and under the same weight, the sweetness of some sugar substitutes is hundreds of times that of sugar, and only a small amount of sugar can be added to achieve the sweetness of a large amount of sugar, which is more favored by manufacturers.
2. Most sugar substitutes themselves do not participate in the body's metabolism, are excreted locally after oral intake, do not provide energy, and are suitable for special consumer groups that need to control energy and carbohydrate intake such as diabetics, obese people and the elderly.
3. Sugar substitute will not be decomposed by bacteria in the mouth, and will not cause caries, which is why many fresh breath candy, chewing gum and other products will choose sugar substitute.
Can sugar substitutes completely replace sugar foods? Is sugar substitute really safe? Below we will answer the question of sugar substitutes that breast cancer patients are concerned about.
NO.2
Is sugar substitute really safe?
Latest research: aspartame, acesulfame potassium or associated with breast cancer development
Recently, the latest research from the University of Paris XIII in France has attracted a lot of attention, and the study shows that a large intake of artificial sweeteners, especially aspartame, can increase the risk of breast cancer by 22% and the risk of obesity-related cancers by 15%. People who consume more acesulfame potassium have a 17% increased risk of breast cancer, and their overall risk of cancer and obesity-related cancers increased by 13% [1].
In many beverages, yogurts, canned foods on the market, aspartame and acesulfame potassium are found in the ingredient list, and in addition, to improve palatability, manufacturers add aspartame to some foods that traditionally do not contain added sugar (e.g., flavored potato chips).
Heavy consumption of sugar alcohols may cause diarrhea
Last year's Mid-Autumn Festival, the diarrhea caused by the mooncake was related to the sugar alcohol in the sugar substitute family. Sugar alcohols are both natural and synthetic, and the result of eating a large number of sugar alcohols is that they will ferment under the action of the intestinal flora to produce gas, while increasing the osmotic pressure in the intestine leads to thinning of stools and forming diarrhea.
The sweetness of sugar alcohols is mostly lower than or equal to sucrose, for the mooncake this dessert, in order to achieve a better taste, you need to add more amounts, will cause diarrhea. In addition, studies have found that other sugar substitutes may also cause gastrointestinal intolerances such as diarrhea and bloating.
Breast cancer itself and its treatment methods are often easy to cause diarrhea in breast cancer patients, eating a large amount of sugar alcohols, is likely to aggravate or induce diarrhea, is not conducive to cancer treatment, serious may even cause a variety of gastrointestinal tract, urinary system and other inflammation.
There is an increased risk of developing type 2 diabetes
Studies have found that healthy people with normal weight and normal metabolic system have significantly increased their blood sugar and glycosylated hemoglobin after taking artificial sugar substitutes without calories. The results of a large cohort study of nearly 200,000 people at Harvard University showed that people who drank artificial sugar substitutes every day had a 19 percent higher risk of diabetes than those who drank sugar-sweetened beverages [2].
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Poor glycemic control can affect the treatment effect of breast cancer patients, and the control of blood glucose is closely related to their prognosis. Hyperglycemia can exacerbate the risk of postoperative or post-chemotherapy infection in breast cancer patients, and may also lead to a deterioration in the patient's nutritional status (e.g., the patient is emaciated), poor glycemic control, and pain and fatigue will be more pronounced.
Neurological disorders
Animal and human experiments have shown that artificial sweeteners can have an effect on neurobehavior and function, taking aspartame as an example, its metabolite ——— methanol increases the oxidative stress of the brain and the rate of memory decline, which is closely related to the onset of Alzheimer's disease.
In the chemotherapy of breast cancer patients, one of the most common adverse reactions is the damage of the god-level system, so we must also maintain a certain vigilance against artificial sweeteners that may affect the nervous system.
Lindseth et al. divided healthy adults into two groups, adding high and low levels of aspartame to their daily diets, and the results showed that people who consumed high levels of aspartame showed more irritability, depression, and poor performance on spatially oriented cognitive tests.
However, at this time, aspartame intake did not exceed the allowable daily intake (40 mg/(kg·bw)) assessed by the Food and Agriculture Organization of the United Nations and the Joint Expert Committee on Food Additives of the World Health Organization, which also suggests that further research is still needed to control the intake of artificial sweeteners and avoid long-term intake accumulation [3].
Cardiovascular and cerebrovascular diseases
In a 20-year follow-up survey of 120,000 people, it was found that more than 3,000 stroke patients were recorded, and the risk ratio of stroke from daily intake of beverages containing artificial sweeteners was similar to that of daily intake of sugary drinks, indicating that although artificial sweeteners are mostly not involved in metabolism and do not provide calories, they may induce cardiovascular and cerebrovascular diseases like sugar [4].
Endocrine therapy in breast cancer patients is often prone to high blood lipids, increasing the risk of cardiovascular and cerebrovascular diseases, and some chemotherapy drugs also have a certain degree of cardiotoxicity, so it is also prudent to be cautious about the intake of artificial sweeteners that may induce such diseases.
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Are you frightened after watching so much? Can't eat more sugar, can't eat sugar substitutes?
In fact, the relevant departments of the state have formulated safe dosage standards for all food additives, including sugar substitutes, and if you buy products with quality assurance and national standards through formal channels, at least there is no need to worry about the problem of sugar substitutes exceeding the standard.
However, if you often and long-term consumption of sugar-containing beverages and foods, especially foods with more artificial sweetener content and mainly sweeteners to provide sweetness, you need to be extra cautious, and everyone can also tend to choose a safer sugar substitute to eat in moderation.
NO.3
Relatively safe sugar substitutes
Compared with artificial sweeteners, natural sugar substitutes are more suitable for human health. Natural sugar substitutes include stevia, monk fruit glycosides, and glycyrrhizin.
Among them, the more recommended natural sugar substitute stevia, which is a glycoside extracted from the leaves of the asteraceae plant stevia, the sweetness is 200-300 times that of sucrose, the calorific value is only 1/300 of sucrose, there is no sufficient research to prove the relevant side effects of stevia, and the research on it still needs to be further carried out. But stevia has a bitter aftertaste, so the market is made of stevia and other ingredients to make a compound sweetener to balance and eliminate this bitterness.
Sugar alcohols are both natural and synthetic, in addition to excessive intake can cause diarrhea, sugar alcohols are still a relatively safe substitute sugar substitute that can be selected, and the general name with xx sugar alcohols belongs to the sugar alcohol class, similar to xylitol, sorbitol, maltitol and the like.
Among them, the recent sugar substitute new pet erythritol is the most, this sugar alcohol extracted from corn seeds, almost does not cause blood sugar fluctuations, energy content is also very low, belongs to the sugar alcohol is not easy to appear diarrhea category, more suitable for controlling blood sugar, sugar intake of people to eat.
It is important to note that xylitol as we know it actually causes a small increase in blood sugar (GI: 13), is as sweet as sucrose, and contains 40% of the energy of the same amount of sugar.
NO.4
Can sugar substitutes replace normal sugars for weight control?
The truth is...
01
You may eat more
Unlike obesity caused by excessive intake of high-calorie sugars, artificial sweeteners, although stimulating the sweetening receptors of the oropharynx and satisfying sensory needs, do not provide energy or participate in metabolism, so that blood sugar and insulin secretion cannot reach the same level [5], thus causing greater food and energy cravings [6], that is, the intake of artificial sweeteners may prompt us to eat more to meet the needs of the body.
02
The satisfaction of eating sugar cannot be achieved by eating sugar substitutes
Studies have found that the perception of sugar pleasure comes from the nerve foot cells of the intestine, which are sensory cells of the nervous system, similar to the taste buds in the tongue, and can taste. Such cells can distinguish between sugars and sugar substitutes, and then release different neurotransmitters (true sugars for glutamic acid and sugar substitutes for ATP) into the vagus nerve. Ultimately, the human brain is able to distinguish between true sugar and sugar substitutes.
To put it simply, although it can get over the mouth, the sugar substitute is ultimately the identity of the substitute, which is not the same as the happiness brought by real sugar.
In summary, want to replace the drink through sugar to achieve weight loss is not reliable, occasionally drink over the mouth addiction is OK, but the mouth addiction is easy to pass, the heart addiction is difficult to get rid of, want to control the weight, diet is only one aspect, exercise should also keep up, self-discipline to develop good eating habits, eat less is OK.
NO.5
How do breast cancer patients eat sugar correctly?
✓ Eat less foods that contain artificial sweeteners
Reduce the long-term intake of artificial sweetener foods, you can also choose natural sweeteners, sugar alcohols and other safer sweeteners, but still need to control the intake.
✓ Control sugar intake
Ensure the minimum intake of sugar in the human body, do not eat or try to eat as little sugar food as possible. The World Health Organization recommends that the intake of sugar per person per day should be less than 50 grams.
✓ Eat less with high sugar content
Some foods do not feel sweet to eat, but the sugar content is amazingly high. In addition to sucrose, lactose, and fructose syrup, there are also the names of sugar substitutes we mentioned earlier, and the more ingredients are listed in front of the food ingredient list, the higher their content.
✓ Mainly low-sugar foods
Low-sugar foods mainly refer to the staple foods that we consume starchy polysaccharides, as well as the whole grains and fruits and vegetables that consume dietary fiber. Starch and dietary fiber are also known as polysaccharides.
Although the staple food class also contains sugar, but it belongs to the starch polysaccharide, not as fast as refined sugar to raise blood sugar, it is still recommended that everyone eat the amount of healthy people, breast cancer patients if you arbitrarily reduce the consumption of staple food can easily cause such as drowsiness, drowsiness, hypoglycemia, nausea, vomiting, dyslipidemia and other side effects, endangering health.
✓ Please be merciful when cooking with sugar
The main ingredient of white sugar, brown sugar, rock sugar, brown sugar, etc. in the kitchen is sucrose, and sucrose will be broken down into glucose and fructose after entering the digestive tract. Therefore, if these sugars are added too much during cooking, they will also invisibly increase the intake of fructose. Therefore, when cooking, you can not add sugar without adding, even if you want to add, you should add a small amount and an appropriate amount
Cover image source: Draft design
Editor-in-Charge: Breast Cancer Mutual Aid
Resources:
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[2] Changes in Consumption of Sugary Beverages and Artificially Sweetened Beverages and Subsequent Risk of Type 2 Diabetes: Results From Three Large Prospective U.S. Cohorts of Women and Men” Diabetes Care 2019; 42: 2181 — 2189
[3] LINDSETH G N, COOLAHAN S E, PETROS T V, et al. Neurobehavioral effects of aspartame consumption [J]. Research in Nursing and Health,2014, 37 (3): 185 - 193.
[4] BERNSTEIN A M, DE KONING L, FLINT A J, et al. Soda consumption and the risk of stroke in men and women [ J ]. American Journal of Clinical Nutrition, 2012, 95(5): 1190 - 1199.
[5] SMEETS PA M, DE GRAAF C, STAFLEU A, et al. Functional magnetic resonance imaging of human hypo thalamic responses to sweet taste and calories [ J ]. American Journal of Clinical Nutrition, 2005, 82 (5): 1011 - 1016.
[6] STICE E, SPOOR S, BOHON C, et al. Relation of reward from food intake and anticipated food intake to obesity: a functional magnetic resonance imaging study [J]. Journal of Abnormal Psychology, 2008, 117(4): 924 - 935.
[7] CHIA C W,SHARDELL M,TANAKA T, et al. Chronic low鄄calorie sweetener use and risk of abdominal obesity among older adults: a cohort study [ J ]. Plos One, 2016, 11(11):e167241.
[8] Buchanan, Kelly L., et al. The preference for sugar over sweetener depends on a gut sensor cell [J]. Nature Neuroscience 2022-01-13