Researchers tracking more than 9,400 meals among hospitalized cancer patients found that higher sugar consumption before and during antibiotic treatment was associated with greater losses of beneficial gut bacteria and increased growth of potentially harmful microbes.

By yourNEWS Media Newsroom

A diet high in sugar may worsen the disruption antibiotics cause to the gut microbiome, according to new research suggesting that everyday food choices could influence how the digestive system responds to medications used to treat bacterial infections.

The study, published September 30 in the journal Nature, found that patients consuming more sugar around the time of antibiotic treatment experienced greater reductions in intestinal bacterial diversity. Researchers also observed increased growth of Enterococcus faecium, a bacterium associated with difficult-to-treat infections, particularly in hospitalized patients.

The findings introduce a potential dietary consideration for patients receiving antibiotics, although researchers caution that additional clinical trials are necessary before reducing sugar can be established as a proven strategy for protecting gut health.

Scientists from NYU Langone Health, Memorial Sloan Kettering Cancer Center and City of Hope analyzed 9,419 meals consumed by 173 hospitalized patients receiving treatment for blood cancers. They also collected 1,009 evaluable stool samples to examine how bacterial populations changed during hospitalization.

The unusually detailed records allowed researchers to compare specific dietary patterns with changes in the microbiome before and after antibiotic exposure.

Their analysis found that every additional 100 grams of sugar consumed during the 48 hours preceding antibiotic treatment was associated with a further 21% reduction in bacterial alpha diversity, a measure of the variety and relative abundance of microorganisms in the intestine.

That quantity of sugar is roughly comparable to the amount found in a large sugary beverage and a substantial dessert, although actual sugar content varies among products.

The association suggests that higher sugar intake may amplify the disruption antibiotics already cause to intestinal microorganisms.

Antibiotics work by killing bacteria or preventing their growth, making them essential treatments for many infections. However, some medications also affect beneficial organisms that normally inhabit the digestive tract.

These microorganisms contribute to digestion, nutrient metabolism and immune function while helping prevent potentially harmful bacteria from becoming dominant.

When antibiotic treatment significantly reduces microbial diversity, organisms that survive may encounter less competition for nutrients and space.

That altered environment can create opportunities for opportunistic bacteria to multiply.

The new research identified dietary sugar as a possible contributing factor in that process.

Researchers observed that patients consuming more sugar during treatment were more likely to experience an expansion of Enterococcus faecium populations in their intestines.

Although this bacterial species can inhabit the human digestive tract without causing disease, certain strains can produce serious infections, especially among hospitalized patients with weakened immune systems.

Some strains have developed resistance to multiple antibiotics, including vancomycin, making infections particularly difficult to manage.

The researchers sought to understand whether sugar might provide surviving bacteria with a competitive advantage after antibiotics disrupt the normal microbial community.

To investigate that possibility, they conducted follow-up experiments using laboratory mice.

Animals receiving the antibiotic biapenem while consuming additional sucrose experienced a substantial increase in intestinal Enterococcus populations compared with animals receiving the antibiotic without the sugar-enriched diet.

By the third day, bacterial levels were approximately 16.3 times higher. By the sixth day, they were 33.4 times higher.

The findings supported the researchers’ hypothesis that dietary sugar can intensify antibiotic-associated bacterial imbalances under controlled experimental conditions.

However, mouse experiments cannot establish that identical effects occur in people, and the mechanisms responsible for the observed bacterial expansion remain under investigation.

Scientists have not determined whether sugar directly feeds resistant bacteria, alters the availability of nutrients for competing organisms or influences other processes within the intestinal environment.

Jonas Schluter, an assistant professor of microbiology at NYU Langone and co-senior author of the study, said understanding the factors that worsen microbiome disruption could help researchers identify ways to reduce unwanted consequences of antibiotic treatment.

“As we are learning how collateral damage of antibiotics to the microbiome are linked with long-term health problems, it’s important to identify factors that limit these unintended health risks,” Schluter said in a September 30 statement from NYU Langone Health.

“Our study, which used more than 9,000 recorded meals, suggests that modifying diet during and after antibiotics, specifically by reducing sweets intake, could help with that.”

The research was conducted among patients undergoing hematopoietic stem cell transplantation, a treatment commonly used for certain blood cancers.

These patients frequently receive chemotherapy and broad-spectrum antibiotics while hospitalized. Their underlying illnesses, medical treatments and weakened immune defenses can produce substantial changes in the gut microbiome.

Because the study population was medically vulnerable, researchers emphasized that the results cannot automatically be generalized to otherwise healthy adults receiving short antibiotic courses.

The human component was also observational. Although researchers recorded dietary intake in unusual detail and accounted for several treatment-related variables, they did not randomly assign patients to high-sugar and low-sugar diets.

Consequently, the findings establish an association rather than proving that sugar consumption caused the additional loss of microbial diversity.

The severity of illness, differences in appetite and other factors affecting food consumption may also have influenced the results.

Nevertheless, the investigation adds to existing evidence that diet can affect how the microbiome responds to medication.

Earlier studies have shown that antibiotic exposure can temporarily or persistently change intestinal bacterial populations, sometimes reducing microbial diversity for weeks or months.

The duration of recovery depends on factors including the antibiotic used, treatment length, baseline microbiome composition, diet and individual health.

Broad-spectrum antibiotics can produce particularly substantial changes because they affect a wide range of bacterial species.

In vulnerable patients, significant microbiome disruption has been associated with increased susceptibility to certain infections and other adverse outcomes.

Jonathan Peled, a study co-senior author at Memorial Sloan Kettering, emphasized the importance of investigating whether dietary interventions could improve those outcomes.

“Especially in blood cancer patients, microbiome injury is associated with worse outcomes, including higher overall mortality and infections,” Peled said.

“An important next step will be to design clinical trials to test whether short-term dietary changes can improve clinical outcomes in patients.”

The study has also renewed discussion about practical nutritional measures during and after antibiotic treatment.

Reducing foods and beverages high in added sugars may be a reasonable dietary choice for many people, particularly because excessive added sugar consumption is already associated with broader metabolic health concerns.

However, researchers have not established a specific sugar threshold that patients must remain below to protect their intestinal bacteria.

Nor have they determined whether cutting sugar immediately before treatment will reliably prevent antibiotic-related microbiome changes in the general population.

Maintaining a balanced diet containing sufficient calories, protein and other nutrients remains important, especially during recovery from infection or serious illness.

Foods containing dietary fiber, including vegetables, beans, oats, whole grains and fruit, provide nutrients that intestinal microorganisms can use during fermentation.

Some research suggests that fiber-rich diets may support microbial diversity and recovery, although evidence for particular foods during specific antibiotic treatments remains limited.

Fermented foods such as yogurt, kefir, kimchi and sauerkraut can also contain live microorganisms.

Their potential benefits depend on the product, microbial strains and individual medical circumstances. Fermented foods do not necessarily restore all bacterial species lost during antibiotic treatment.

For patients undergoing chemotherapy, stem cell transplantation or other treatments that suppress immune function, unpasteurized fermented foods and probiotic supplements may present additional risks and should be discussed with medical professionals.

Probiotics are sometimes recommended for particular antibiotic-associated complications, but their effects vary by bacterial strain and patient population. They are not universally appropriate or proven to restore the microbiome after every antibiotic course.

Patients should also avoid changing prescribed antibiotic doses or stopping treatment early in an attempt to protect intestinal bacteria.

Untreated bacterial infections can cause serious complications, and antibiotics remain essential when appropriately prescribed.

The new findings instead suggest that dietary patterns may eventually become part of more individualized strategies for reducing unwanted treatment effects.

Researchers are particularly interested in whether modifying sugar consumption can limit the expansion of opportunistic bacteria without interfering with medical nutrition or infection treatment.

Further trials will need to determine whether such changes reduce actual infections, shorten hospital stays or improve recovery rather than simply altering laboratory measurements of gut bacteria.

For now, the investigation identifies sugar consumption as a potentially modifiable factor associated with antibiotic-related microbiome disruption.

The strongest evidence comes from the detailed observations among hospitalized cancer patients and supporting laboratory experiments, while the clinical benefits of dietary changes remain unproven.

The research nevertheless broadens scientific understanding of how medication and nutrition interact, suggesting that protecting gut health during antibiotic treatment may depend not only on the drugs administered but also on the surrounding dietary environment.

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Source: Natural News
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