Revisiting the Warburg-Based “Sugar Feeds Cancer” Hypothesis: A Critical Appraisal of Epidemiological, Experimental and Mechanistic Evidence
Many clinical care professionals receive queries from cancer patients about whether they should modify their diet to reduce consumed sugar. This concern is based on a misunderstanding of some basic medical research known as the Warburg effect. Research from 1956 showed that cancer cells alter their metabolism to enable increased glucose uptake and increase energy production.
A misunderstanding of this effect has led to incorrect dietary advice to cancer patients suggesting sugar restriction may be beneficial. As a result, malnutrition, which is already a significant cause of morbidity for cancer patients, can be exacerbated. No hard evidence that low sugar diets alter survival exists. Some anecdotal reports suggest a slight correlation with risk. This study is an appraisal of all credible reports which link cancer risk and sugar restriction.
Data was collected for multiple different cancer types. No evidence of any increased cancer risk was found when high sugar consumers are compared to those whose diet fits within the WHO guidelines with sugar, being 10% or less of energy intake. Similarly, no evidence of any survival benefit was shown for cancer patients who restrict sugar intake. It is however important to recognise that obesity does increase cancer risk, possibly due to inflammation.
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