association of sugar intake and inflammation in newly diagnosed colorectal cancer patients
Creators: name: Stewart, Kelly Louise
Publisher: name: University of Utah
Year: 2019
Subjects: Nutrition

description: Colorectal cancer (CRC) is a global health problem. In the United States, approximately 1 in 20 people will be diagnosed with CRC in their lifetime. Typically, CRC is associated with inflammation. Many factors influence CRC risk and development, most of which work through an inflammation connection. While genetics can play a role in CRC risk, lifestyle factors that promote inflammation seem to largely influence CRC risk and development. CRC inflammation factors mainly result from diet. Cancer is consistently linked with inflammation. Furthermore, increased systemic inflammation, as evaluated by chemokines, is consistently related to increased recurrence and decreased survival of CRC. The purpose of this study is to assess sugar intake (specifically fructose, glucose, and sucrose) and its association with systemic inflammatory and angiogenesis markers in colorectal cancer patients. ColoCare is a multicenter, international prospective cohort study with the goal of following over 5,000 patients who are newly diagnosed with CRC. The study employs longitudinal assessment of biomarkers and health behaviors and repeated sampling at multiple time points of multiple biological specimens. Specifically, the blood samples analyzed for this paper were from baseline blood samples collected pre- or peri-surgery. At 6-months post-baseline, the EPIC food frequency questionnaire (FFQ) was administered. This food frequency questionnaire covered the year prior, which means it assessed diet 6-months pre-diagnosis and the 6-months post-diagnosis. To evaluate inflammation, we measured blood plasma inflammatory markers associated with cancer: C-reactive protein (CRP), serum amyloid A (SAA), intercellular adhesion molecule (SICAM), vascular cell adhesion molecule (SVCAM), interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemoattractant protein 1 (MCP1), and tumor necrosis factor α (TNFα) and blood plasma angiogenesis markers associated with cancer: vascular endothelial growth factor-a (VEGFA) and vascular endothelial growth factor-d (VEGFD). Overall, no significant associations between sugar intake and systemic inflammatory and angiogenesis markers were observed. With body mass index (BMI(kg/m 2)) stratification, there were significant inverse correlations between sugar intake and VEGFD and MCP1 levels in those with a BMI &lt; 25kg/m 2 and a significant positive association between sugar intake and SVCAM in those with a BMI ≥ 25kg/m2, as measured by Pearson's correlation. Additionally, there was a significant association between higher sugar intake, as a percentage of total kcals, and lower VEGFD levels in those with a BMI &lt; 25kg/m2, as measured by Spearman's correlation. These results are contrary to the popular slogan "sugar feeds cancer." Many cancer patients wish to use diet to improve their prognosis, yet research is lacking in this field. This study helps to improve the understanding between diet and colorectal cancer; further research is warranted.