TY - JOUR
T1 - Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women
AU - Hur, Jinhee
AU - Otegbeye, Ebunoluwa
AU - Joh, Hee Kyung
AU - Nimptsch, Katharina
AU - Ng, Kimmie
AU - Ogino, Shuji
AU - Meyerhardt, Jeffrey A.
AU - Chan, Andrew T.
AU - Willett, Walter C.
AU - Wu, Kana
AU - Giovannucci, Edward
AU - Cao, Yin
N1 - Funding Information:
Contributors JH and YC had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. KW, EG and YC contributed equally. Concept and design: JH, EG and YC. Acquisition, analysis or interpretation of data: JH, KNg, SO, JAM, ATC, WCW, KW, EG and YC. Drafting of the manuscript: JH and YC. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: JH. Obtained funding: KNg, SO, ATC, WCW, KW, EG and YC. Administrative, technical or material support: KW, EG and YC. Supervision: EG and YC. Funding This work was supported by grants U01 CA176726 (WCW), R01 CA205406 (KNg), R21 CA230873 (SO, KW), R01 CA151993 (SO), R35 CA197735 (SO), R35 CA253185 (ATC), R03 CA197879 (KW), R21 CA222940 (KW), R37 CA246175 (YC) and K07 CA218377 (YC) from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. EO is supported by T32 CA009621. KNg is supported in part by Department of Defense CA160344 and the Project P Fund. ATC is the Stuart and Suzanne Steele MGH Research Scholar. KW is supported in part by an Investigator Initiated Grant from the American Institute for Cancer Research.
Funding Information:
Competing interests KNg has received institutional research funding from
Publisher Copyright:
© 2021 American Society of Civil Engineers.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Objective Sugar-sweetened beverage (SSB) consumption had substantially increased across successive US birth cohorts until 2000, and adolescents and young adults under age 50 years have the highest consumption. However, the link between SSBs and early-onset colorectal cancer (EO-CRC) remains unexamined. Design In the Nurses' Health Study II (1991-2015), we prospectively investigated the association of SSB intake in adulthood and adolescence with EO-CRC risk among 95 464 women who had reported adulthood beverage intake using validated food frequency questionnaires (FFQs) every 4 years. A subset of 41 272 participants reported beverage intake at age 13-18 years using a validated high school-FFQ in 1998. Cox proportional hazards models were used to estimate relative risks (RRs) with 95% CIs. Results We documented 109 EO-CRC cases. Compared with individuals who consumed <1 serving/week of SSBs in adulthood, women who consumed ≥2 servings/day had a more than doubled risk of EO-CRC (RR 2.18; 95% CI 1.10 to 4.35; p trend =0.02), with a 16% higher risk (RR 1.16; 95% CI 1.00 to 1.36) per serving/day increase. Each serving/day increment of SSB intake at age 13-18 years was associated with a 32% higher risk of EO-CRC (RR 1.32; 95% CI 1.00 to 1.75). Replacing each serving/day of adulthood SSB intake with that of artificially sweetened beverages, coffee, reduced fat milk or total milk was associated with a 17%-36% lower risk of EO-CRC. Conclusion Higher SSB intake in adulthood and adolescence was associated with a higher risk of EO-CRC among women. Reduction of SSB consumption among adolescents and young adults may serve as a potential strategy to alleviate the growing burden of EO-CRC.
AB - Objective Sugar-sweetened beverage (SSB) consumption had substantially increased across successive US birth cohorts until 2000, and adolescents and young adults under age 50 years have the highest consumption. However, the link between SSBs and early-onset colorectal cancer (EO-CRC) remains unexamined. Design In the Nurses' Health Study II (1991-2015), we prospectively investigated the association of SSB intake in adulthood and adolescence with EO-CRC risk among 95 464 women who had reported adulthood beverage intake using validated food frequency questionnaires (FFQs) every 4 years. A subset of 41 272 participants reported beverage intake at age 13-18 years using a validated high school-FFQ in 1998. Cox proportional hazards models were used to estimate relative risks (RRs) with 95% CIs. Results We documented 109 EO-CRC cases. Compared with individuals who consumed <1 serving/week of SSBs in adulthood, women who consumed ≥2 servings/day had a more than doubled risk of EO-CRC (RR 2.18; 95% CI 1.10 to 4.35; p trend =0.02), with a 16% higher risk (RR 1.16; 95% CI 1.00 to 1.36) per serving/day increase. Each serving/day increment of SSB intake at age 13-18 years was associated with a 32% higher risk of EO-CRC (RR 1.32; 95% CI 1.00 to 1.75). Replacing each serving/day of adulthood SSB intake with that of artificially sweetened beverages, coffee, reduced fat milk or total milk was associated with a 17%-36% lower risk of EO-CRC. Conclusion Higher SSB intake in adulthood and adolescence was associated with a higher risk of EO-CRC among women. Reduction of SSB consumption among adolescents and young adults may serve as a potential strategy to alleviate the growing burden of EO-CRC.
KW - cancer epidemiology
KW - colorectal cancer
KW - dietary - colon cancer
KW - gastrointestinal cancer
UR - http://www.scopus.com/inward/record.url?scp=85105580044&partnerID=8YFLogxK
U2 - 10.1136/gutjnl-2020-323450
DO - 10.1136/gutjnl-2020-323450
M3 - Article
C2 - 33958435
AN - SCOPUS:85105580044
SN - 0017-5749
VL - 70
SP - 2330
EP - 2336
JO - Gut
JF - Gut
IS - 12
ER -