"While the data for Mexico seems alarming, for women in the United States, there should be little concern, since statistics show that per capita consumption of sucrose in the United States has been on the decline over the past three decades, yet breast cancer cases have remained comparatively steady," stated Dr. David McCarron.

The Association would like to point out that the following shortcomings do not support the authors' theories:

According to the Institutes of Medicine's 2002 report which analyzed the diets of over 25,000 individuals, "Based on the data available on dental caries, behavior, cancer, risk of obesity and risk of hyperlipidemia, there is insufficient evidence to set an upper limit for added sugars." Sucrose was part of the added sugars considered in the IoM report. Although the percent of energy from fat was lower in the women with verified breast cancer, the actual number of calories from fat was greater than for women in the control group. This point is critical because the vast majority of breast cancer studies like this have repeatedly shown the significantly positive association between dietary fat and breast cancer, not carbohydrates, in particular, sucrose. World breast cancer statistics in the world Health Organization Databank show that Mexico with its "historically high level of carbohydrate intake" has breast cancer mortality rates far lower than countries that historically have a diet rich in mono-saturated fat (the good fats).

"We encourage consumers to maintain a healthy lifestyle by eating balanced diets and being active on a regular basis," said Andy Briscoe, President and CEO of the Sugar Association. "Sugar (sucrose) is all natural and only 15 calories per teaspoon. It has played an important role in our food supply for centuries, from taste to food safety to making food palatable. And sugar will continue to be an important ingredient in the food supply."

The Sugar Association is a trade organization representing the nation's sugar cane growers and refiners and sugar beet growers and processors whose primary mission is to inform and educate the consuming public about the role of sugar (sucrose) in nutrition and health.

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"The patient's medication profile should be reviewed and drugs discontinued that impair excretion of potassium in the kidney, such as over-the-counter non-steroidal anti-inflammatory drugs like ibuprofen and naproxen," he said. "Patients should be asked about the use of herbal remedies, as herbs can be a hidden source of potassium."

Also, a low-potassium diet - avoiding orange juice, melons, bananas and salt substitutes with potassium - should be prescribed. If treatment with an ACE inhibitor or an angiotensin-receptor blocker is needed, it is best to begin with low doses, Dr. Palmer said. Implementing these measures will allow patients at increased risk for hyperkalemia to enjoy the cardiovascular benefits of these drugs rather than unnecessarily being labeled intolerant as a result of the disorder.

The review article, intended as a guide for physicians, accompanies a study by researchers from the University of Toronto and the Institute for Clinical Evaluative Sciences in Toronto. The study documents a multifold increase in the incidence of hyperkalemia in congestive heart patients following the publication of a trial in 1999 that reported use of an aldosterone-receptor blocker and an ACE inhibitor together reduces death rates in such patients.

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