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A study tracking meals and gut microbiomes in 173 hospitalized blood cancer patients found that higher sugar intake in the 48 hours before antibiotic treatment was associated with a greater decline in bacterial diversity. The results do not show that reducing sugar improves patient outcomes, and the researchers say clinical trials are needed.
A study of 173 hospitalized blood cancer patients found that greater sugar intake in the 48 hours before antibiotic treatment was associated with a larger decline in gut bacterial diversity. The research, published online Sept. 30 in Nature, also linked sugary diets combined with antibiotics to increases in Enterococcus faecium, a bacterium associated with infections that can be difficult to treat. The study does not establish that sugar caused the changes or that cutting sugar improves clinical outcomes.
Researchers from NYU Langone Health, City of Hope and Memorial Sloan Kettering analyzed 9,419 recorded meals and tracked participants’ gut microbiomes during hospitalization. For each additional 100 grams of sugar consumed in the 48 hours before treatment, they observed an additional 21% decline in alpha diversity, a measure of the variety of bacterial species in the gut. That figure describes the study’s observed association; it is not a measure of disease risk or an estimate of how much an individual’s health would change.
The team also reported an association between sugary diets combined with antibiotic treatment and increases in Enterococcus faecium in patients. Experiments in mice produced a similar pattern: animals given the antibiotic biapenem while consuming sucrose had a gut Enterococcus population 16.3 times higher by the third day of the study and 33.4 times higher by day six. These mouse results are separate from the observations in patients and do not show that the same effects occur at the same scale in people.
The research team said surviving bacteria may be able to use dietary sugars to expand after antibiotics reduce other gut microbes. But the study did not establish the mechanism. It also did not test whether changing patients’ diets would prevent infections, reduce complications or improve recovery.
Sugar and Antibiotic Effects on Gut Bacteria
Antibiotics can affect bacteria beyond the infection being treated, including beneficial microbes in the gut. A reduction in microbial diversity may leave more room for some potentially harmful bacteria to grow. The study draws attention to diet during antibiotic treatment as a possible factor in that disruption, particularly for patients whose treatment already places them at high risk of complications.
The population studied had blood cancers and was hospitalized, so its findings may be relevant to care teams monitoring diet and microbiome changes in that setting. They do not establish a general dietary rule for everyone taking antibiotics. For patients and clinicians, the current result is a research signal, not proof that avoiding sugar will protect the microbiome. The practical value of a dietary change depends on whether future trials show it improves meaningful health outcomes.
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Why Blood Cancer Patients Were Studied
The researchers focused on hospitalized people with blood cancers because they often receive antibiotics and their meals and microbiome samples can be tracked closely. The team recorded food intake at each meal and collected microbiome samples daily, allowing it to compare recent diets with changes in gut bacteria during treatment. The report describes 9,419 meals from 173 patients, a detailed dataset for studying diet and microbiome changes in this clinical setting.
Some patients with blood cancers undergo stem cell transplants and spend weeks in hospital receiving intensive treatment, including chemotherapy and antibiotics. Both treatment and hospitalization can coincide with substantial changes in diet and gut microbes. The researchers say microbiome injury in this patient group has been associated with worse outcomes, including infections and higher overall mortality; the study reported here examined diet and microbiome patterns, rather than testing whether sugar reduction changes those outcomes.
“Whether sugar directly supports Enterococcus, weakens competing bacteria, or acts through another mechanism in patients remains to be seen.”
— William Jogia, study second author and doctoral student at NYU Langone Health
Cause and Patient Benefits Remain Unclear
The patient findings show an association between sugar intake and microbiome changes; they do not prove that sugar caused the changes. The researchers said it is not yet known whether sugar directly fuels Enterococcus, reduces competing bacteria, or affects the microbiome through another process. The mouse experiment offers supporting evidence for further investigation but cannot establish what happens in people.
The study also does not show that reducing sugar during or after antibiotics prevents infections or improves recovery. Its participants were hospitalized blood cancer patients, so the results may not apply in the same way to people taking antibiotics in other circumstances. The report does not establish a specific sugar limit or dietary plan for patients.
Clinical Trials Are the Next Test
The researchers say the next step is to test short-term dietary changes in clinical trials, including whether reducing simple sugars during or after antibiotic treatment can improve patient outcomes. Those studies would need to establish whether a change in diet affects microbiome diversity, harmful bacterial growth and clinical measures such as infections or recovery.
Until such evidence is available, the findings are not proof that patients should change their diet or alter prescribed antibiotic treatment. People receiving cancer care should discuss dietary questions with their clinical team, which can account for their treatment and nutritional needs. The study report does not recommend stopping or delaying antibiotics.
Key Questions
Does this study prove sugar makes antibiotics more damaging?
No. The patient data show an association between higher sugar intake and a steeper decline in gut bacterial diversity around antibiotic treatment. The study does not prove that sugar caused the decline.
How many patients were included?
The researchers tracked meals and gut microbiomes in 173 hospitalized blood cancer patients, recording 9,419 meals. The findings should be interpreted in light of that specific patient group.
Should I stop eating sugar while taking antibiotics?
The study did not test a dietary recommendation or establish a sugar limit. Ask a healthcare professional about dietary changes, particularly if you are receiving cancer treatment or have specific nutritional needs. Do not stop or change prescribed antibiotics without medical advice.
What does the study say about Enterococcus faecium?
The researchers reported that sugary diets combined with antibiotics were associated with increases in Enterococcus faecium among patients. This bacterium has been linked to infections that can be difficult to treat, but the study did not establish that the observed changes caused infections.
What evidence is still needed?
Clinical trials are needed to determine whether reducing simple sugars during or after antibiotic treatment changes microbiome damage and improves outcomes such as infection rates or recovery. The mechanism behind the patient findings also remains uncertain.
Source: rss
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