Sugars in Diet and Risk of Cancer in the NIH-AARP Diet and Health Study

Overview

Journal Int J Cancer

Specialty Oncology

Date 2011 Feb 18

PMID 21328345

Citations 49

Authors

Natasa Tasevska

Li Jiao

Amanda J Cross

Victor Kipnis

Amy F Subar

Albert Hollenbeck

Arthur Schatzkin

Nancy Potischman

Affiliations

Soon will be listed here.

Abstract

Prospective epidemiologic data on the effects of different types of dietary sugars on cancer incidence have been limited. In this report, we investigated the association of total sugars, sucrose, fructose, added sugars, added sucrose and added fructose in the diet with risk of 24 malignancies. Participants (n = 435,674) aged 50-71 years from the NIH-AARP Diet and Health Study were followed for 7.2 years. The intake of individual sugars was assessed using a 124-item food frequency questionnaire (FFQ). Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) in multivariable models adjusted for confounding factors pertinent to individual cancers. We identified 29,099 cancer cases in men and 13,355 cases in women. In gender-combined analyses, added sugars were positively associated with risk of esophageal adenocarcinoma (HR(Q5 vs. Q1) : 1.62, 95% CI: 1.07-2.45; p(trend) = 0.01), added fructose was associated with risk of small intestine cancer (HR(Q5 vs. Q1) : 2.20, 95% CI: 1.16-4.16; p(trend) = 0.009) and all investigated sugars were associated with increased risk of pleural cancer. In women, all investigated sugars were inversely associated with ovarian cancer. We found no association between dietary sugars and risk of colorectal or any other major cancer. Measurement error in FFQ-reported dietary sugars may have limited our ability to obtain more conclusive findings. Statistically significant associations observed for the rare cancers are of interest and warrant further investigation.

Citing Articles

Essential Nutrients, Added Sugar Intake, and Epigenetic Age in Midlife Black and White Women: NIMHD Social Epigenomics Program.

Chiu D, Hamlat E, Zhang J, Epel E, Laraia B JAMA Netw Open. 2024; 7(7):e2422749.

PMID: 39073813 PMC: 11287388. DOI: 10.1001/jamanetworkopen.2024.22749.

Intake of Sugar and Food Sources of Sugar and Colorectal Cancer Risk in the Multiethnic Cohort Study.

Kanehara R, Park S, Okada Y, Iwasaki M, Tsugane S, Sawada N J Nutr. 2024; 154(8):2481-2492.

PMID: 38795743 PMC: 11375464. DOI: 10.1016/j.tjnut.2024.05.016.

Nutritional modulation of antitumor immunity.

Jeong M, Collins N Curr Opin Immunol. 2024; 87:102422.

PMID: 38728931 PMC: 11288377. DOI: 10.1016/j.coi.2024.102422.

GLUT5: structure, functions, diseases and potential applications.

Song A, Mao Y, Wei H Acta Biochim Biophys Sin (Shanghai). 2023; 55(10):1519-1538.

PMID: 37674366 PMC: 10582729. DOI: 10.3724/abbs.2023158.

SGLT2 Inhibitors as Potential Anticancer Agents.

Basak D, Gamez D, Deb S Biomedicines. 2023; 11(7).

PMID: 37509506 PMC: 10376602. DOI: 10.3390/biomedicines11071867.

References

Subar A, Midthune D, Kulldorff M, Brown C, Thompson F, Kipnis V . Evaluation of alternative approaches to assign nutrient values to food groups in food frequency questionnaires. Am J Epidemiol. 2000; 152(3):279-86. DOI: 10.1093/aje/152.3.279. View

Thompson C, Khiani V, Chak A, Berger N, Li L . Carbohydrate consumption and esophageal cancer:an ecological assessment. Am J Gastroenterol. 2007; 103(3):555-61. DOI: 10.1111/j.1572-0241.2007.01613.x. View

Mouw T, Koster A, Wright M, Blank M, Moore S, Hollenbeck A . Education and risk of cancer in a large cohort of men and women in the United States. PLoS One. 2008; 3(11):e3639. PMC: 2572908. DOI: 10.1371/journal.pone.0003639. View

Michaud D, Fuchs C, Liu S, Willett W, Colditz G, Giovannucci E . Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. Cancer Epidemiol Biomarkers Prev. 2005; 14(1):138-47. View

Howarth N, Murphy S, Wilkens L, Henderson B, Kolonel L . The association of glycemic load and carbohydrate intake with colorectal cancer risk in the Multiethnic Cohort Study. Am J Clin Nutr. 2008; 88(4):1074-82. PMC: 4482108. DOI: 10.1093/ajcn/88.4.1074. View

Levi B, Werman M . Fructose and related phosphate derivatives impose DNA damage and apoptosis in L5178Y mouse lymphoma cells. J Nutr Biochem. 2003; 14(1):49-60. DOI: 10.1016/s0955-2863(02)00254-1. View

Meinhold C, Dodd K, Jiao L, Flood A, Shikany J, Genkinger J . Available carbohydrates, glycemic load, and pancreatic cancer: is there a link?. Am J Epidemiol. 2010; 171(11):1174-82. PMC: 2915491. DOI: 10.1093/aje/kwq061. View

Silvera S, Jain M, Howe G, Miller A, Rohan T . Glycaemic index, glycaemic load and ovarian cancer risk: a prospective cohort study. Public Health Nutr. 2007; 10(10):1076-81. DOI: 10.1017/S1368980007696360. View

Key T, Spencer E . Carbohydrates and cancer: an overview of the epidemiological evidence. Eur J Clin Nutr. 2007; 61 Suppl 1:S112-21. DOI: 10.1038/sj.ejcn.1602941. View

10.

Riboli E, Gonzalez C, Lopez-Abente G, Errezola M, Izarzugaza I, Escolar A . Diet and bladder cancer in Spain: a multi-centre case-control study. Int J Cancer. 1991; 49(2):214-9. DOI: 10.1002/ijc.2910490212. View

11.

Ceriello A, Bortolotti N, Motz E, Pieri C, Marra M, Tonutti L . Meal-induced oxidative stress and low-density lipoprotein oxidation in diabetes: the possible role of hyperglycemia. Metabolism. 1999; 48(12):1503-8. DOI: 10.1016/s0026-0495(99)90237-8. View

12.

Burley V . Sugar consumption and human cancer in sites other than the digestive tract. Eur J Cancer Prev. 1998; 7(4):253-77. DOI: 10.1097/00008469-199808000-00002. View

13.

Schatzkin A, Subar A, Thompson F, Harlan L, Tangrea J, Hollenbeck A . Design and serendipity in establishing a large cohort with wide dietary intake distributions : the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol. 2001; 154(12):1119-25. DOI: 10.1093/aje/154.12.1119. View

14.

Nothlings U, Murphy S, Wilkens L, Henderson B, Kolonel L . Dietary glycemic load, added sugars, and carbohydrates as risk factors for pancreatic cancer: the Multiethnic Cohort Study. Am J Clin Nutr. 2007; 86(5):1495-501. DOI: 10.1093/ajcn/86.5.1495. View

15.

Poppitt S, Swann D, Black A, Prentice A . Assessment of selective under-reporting of food intake by both obese and non-obese women in a metabolic facility. Int J Obes Relat Metab Disord. 1998; 22(4):303-11. DOI: 10.1038/sj.ijo.0800584. View

16.

Abnet C, Freedman N, Hollenbeck A, Fraumeni Jr J, Leitzmann M, Schatzkin A . A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma. Eur J Cancer. 2008; 44(3):465-71. PMC: 2350215. DOI: 10.1016/j.ejca.2007.12.009. View

17.

Kabat G, Shikany J, Beresford S, Caan B, Neuhouser M, Tinker L . Dietary carbohydrate, glycemic index, and glycemic load in relation to colorectal cancer risk in the Women's Health Initiative. Cancer Causes Control. 2008; 19(10):1291-8. PMC: 3856717. DOI: 10.1007/s10552-008-9200-3. View

18.

Renehan A, Tyson M, Egger M, Heller R, Zwahlen M . Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008; 371(9612):569-78. DOI: 10.1016/S0140-6736(08)60269-X. View

19.

Thompson F, McNeel T, Dowling E, Midthune D, Morrissette M, Zeruto C . Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005. J Am Diet Assoc. 2009; 109(8):1376-83. PMC: 2743027. DOI: 10.1016/j.jada.2009.05.002. View

20.

Popkin B, Nielsen S . The sweetening of the world's diet. Obes Res. 2003; 11(11):1325-32. DOI: 10.1038/oby.2003.179. View