A dietary trial with a short‐term low‐sucrose diet in an Italian population: Effects on colorectal mucosal proliferation

Abstract

Colorectal mucosal proliferation is supposed to predict colon cancer risk. We investigated whether a low‐sucrose diet might reduce colorectal mucosal proliferation in a group of patients at higher risk of colorectal cancer after at least two colon adenoma resections. In a pilot phase, 14 patients [12 men and 2 women, 60.3 + 5 (SD) yr] were instructed to adopt a low‐sucrose diet for one month. Colorectal biopsies were taken twice in the same patients, at the start and the end of the intervention period, and mucosal proliferation was measured by [³H]thymidine uptake in vitro and autoradiography. Although compliance of study participants to dietary modification was high, only a few agreed to two consecutive endoscopies; thus we carried out a randomized study, and 107 patients were assigned to a low‐sucrose diet (50 treated patients: 31 men and 19 women, 59.7 ± 7.5 yr) or instructed to continue their usual diet for one month (55 control patients: 32 men and 23 women, 59.6 ± 7.7 yr). At the end of this period, colorectal biopsies were obtained. The results of the pilot phase and the randomized study showed that a low‐sucrose diet for one‐month did not affect proliferation or the distribution of proliferative activity along the crypt. The food‐frequency questionnaires indicated that treated patients consumed significantly less sucrose (and fewer total calories) during the dietary modification. Urinary fructose, a measure of dietary sucrose intake, was also reduced at the end of the intervention period. In conclusion, we found no evidence that a low‐sucrose diet for one month influences colorectal mucosal proliferation.