含糖饮料、人工甜味饮料与乳腺癌风险：来自两项前瞻性美国队列研究的结果。

Sugar-Sweetened Beverages, Artificially Sweetened Beverages, and Breast Cancer Risk: Results From 2 Prospective US Cohorts.

机构信息

Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.

Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.

出版信息

J Nutr. 2021 Sep 4;151(9):2768-2779. doi: 10.1093/jn/nxab172.

DOI:10.1093/jn/nxab172

PMID:34114021

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8417930/

Abstract

BACKGROUND

Whether consumption of sugar-sweetened beverages (SSBs) or artificially sweetened beverages (ASBs) is associated with the risk of breast cancer is of public health interest.

OBJECTIVES

We sought to evaluate associations between consumption of SSBs and ASBs and risks of total and subtype-specific breast cancer.

METHODS

We followed 82,713 women from the Nurses' Health Study (1980 to 2016) and 93,085 women from the Nurses' Health Study II (1991 to 2017). Cumulatively averaged intakes of SSBs and ASBs from FFQs were tested for associations with incident breast cancer cases and subtypes using Cox regression models. We also evaluated the associations stratified by menopausal status, physical activity, BMI, and alcohol intake.

RESULTS

We documented 11,379 breast cancer cases during 4,655,153 person-years of follow-up. Consumption of SSBs or ASBs was not associated with total breast cancer risk: pooled HRs comparing extreme categories (≥1/day compared with <1/month) were 1.03 (95% CI, 0.95-1.12) and 0.96 (95% CI, 0.91-1.02), respectively. We observed a suggestive interaction by BMI using pooled data (P-interaction = 0.08), where a modestly higher risk of breast cancer with each serving per day increment of SSBs was found in lean women (HR, 1.06; 95% CI, 1.01-1.11) but not among overweight or obese women (HR, 1.00; 95% CI, 0.95-1.06). Moreover, in the pooled, fully adjusted analysis, compared to infrequent consumers (<1/month), those who consumed ≥1 serving of ASBs per day had a lower risk of luminal A breast tumors (HR, 0.90; 95% CI, 0.80-1.01; P-trend = 0.02).

CONCLUSIONS

Although no significant associations were observed overall, consumption of SSBs was associated with a slightly higher risk of breast cancer among lean women. This finding could have occurred by chance and needs confirmation. Our findings also suggest no substantial increase in the risk of breast cancer with consumption of ASBs.

摘要

背景

糖饮料（SSB）或人工加糖饮料（ASB）的摄入与乳腺癌风险相关，这是公众健康关注的问题。

目的

我们旨在评估 SSB 和 ASB 的摄入与总乳腺癌和特定亚型乳腺癌风险之间的关联。

方法

我们随访了来自护士健康研究（1980 年至 2016 年）的 82713 名女性和来自护士健康研究 II（1991 年至 2017 年）的 93085 名女性。使用 Cox 回归模型检验来自 FFQ 的 SSB 和 ASB 的累积平均摄入量与乳腺癌病例和亚型之间的关联。我们还根据绝经状态、体力活动、BMI 和酒精摄入量对这些关联进行了分层评估。

结果

我们在 4655153 人年的随访期间记录了 11379 例乳腺癌病例。SSB 或 ASB 的摄入与总乳腺癌风险无关：比较极端类别（每天≥1 份与每月<1 份）的合并 HR 分别为 1.03（95%CI，0.95-1.12）和 0.96（95%CI，0.91-1.02）。使用合并数据观察到 BMI 的提示性交互作用（P 交互作用=0.08），每天每增加一份 SSB 会使 BMI 较低的女性乳腺癌风险适度增加（HR，1.06；95%CI，1.01-1.11），但 BMI 超重或肥胖的女性则不然（HR，1.00；95%CI，0.95-1.06）。此外，在合并的完全调整分析中，与不常摄入者（<每月 1 份）相比，每天摄入≥1 份 ASB 的女性患管腔 A 型乳腺癌的风险较低（HR，0.90；95%CI，0.80-1.01；P 趋势=0.02）。