Dietary Sugar Exacerbates Antibiotic Gut Disruption in Transplant Patients
Consuming sugar-rich diets during broad-spectrum antibiotic exposure increases gut microbial disruption and fuels the expansion of antibiotic-resistant pathogens, according to a study published in Nature. Researchers tracking 9,419 meals across 173 hematopoietic cell transplantation (HCT) recipients at Memorial Sloan Kettering Cancer Center found that higher sugar intake reduces gut microbial diversity during antibiotic treatment.
How Hospital Meals and Stool Samples Were Tracked
Adult allo-HCT recipients hospitalized between 2017 and 2022 documented every meal using standardized bedside forms. Foods were categorized by eight-digit FNDDS codes to quantify macronutrients and food groups. These dietary records were paired with serial stool samples for microbiome profiling via 16S ribosomal RNA sequencing. Patients’ intake of carbohydrates, fat, fiber, protein, and sugars declined from hospitalization to day 12.
Statistical Models Reveal Microbiome Diversity Drops
A Bayesian model assessed clinical variables, antibiotics, and dietary intake during the two days prior to fecal sampling. While sweets alone were not significantly associated with reduced microbial diversity, every additional 100 grams of sweets consumed during antibiotic exposure resulted in an estimated 24% further reduction in gut microbial alpha-diversity. Other data estimated a 24.1% decrease in mean alpha diversity for every additional 100 grams of sweets following antibiotic exposure.
Mouse Models Confirm Enterococcal Expansion
To test causality, researchers administered the antibiotic biapenem to mice along with dietary interventions including sucrose, glucose, or fructose. Mice receiving antibiotics and supplemental sucrose experienced a 16.3-fold increase in gut Enterococcus by day three compared to antibiotic-treated mice receiving no additional sugar. By day six, the bacterial burden reached 33.4-fold higher. In human patients, each additional 100 grams of sweets after antibiotic exposure was associated with an increased relative abundance of Enterococcus faecium, a key antibiotic-resistant pathogen.
Jonas Schluter, PhD, assistant professor in the Department of Microbiology at NYU Langone, suggested modifying diets during and after antibiotics by reducing sweets intake to limit unintended health risks.
What Types of Sugary Foods Drove Microbiome Disruption?
What types of sugary foods drove the microbiome disruption in the study?
The reduction in microbial diversity was linked to the consumption of sweets and sugar during broad-spectrum antibiotic treatment.
How much did bacterial levels increase in the mouse experiments?
Mice treated with antibiotics and supplemental sucrose experienced a 16.3-fold increase in gut Enterococcus by day three, which rose to 33.4-fold higher by day six compared to mice receiving antibiotics without extra sugar.
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