Department of Pharmacology, Toxicology, and Therapeutic Chemistry, School of Pharmacy and Food Sciences, Institute of Biomedicine, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
Department of Pharmacology, Toxicology, and Therapeutic Chemistry, School of Pharmacy and Food Sciences, Institute of Biomedicine, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
Clin Nutr. 2021 Oct;40(10):5269-5277. doi: 10.1016/j.clnu.2021.07.031. Epub 2021 Aug 10.
To examine associations between intake of simple sugars and cancer incidence, cancer mortality, and total mortality in a prospective cohort study based on the PREDIMED trial conducted from 2003 to 2010.
Participants were older individuals at high cardiovascular risk. Exposures were total sugar, glucose and fructose from solid or liquid sources, and fructose from fruit and 100% fruit juice. Cancer incidence was the primary outcome; cancer mortality and all-cause mortality were secondary outcomes. Multivariable-adjusted, time-dependent Cox proportional hazard models were used.
Of 7447 individuals enrolled, 7056 (94.7%) were included (57.6% women, aged 67.0 ± 6.2 years). 534 incident cancers with 152 cancer deaths and 409 all-cause deaths were recorded after a median follow-up of 6 years. Intake of simple sugars in solid form was unrelated to outcomes. Higher cancer incidence was found per 5 g/day increase in intake of liquid sugars, with multivariable-adjusted HR of 1.08 (95% CI, 1.03-1.13) for total liquid sugar, 1.19 (95% CI, 1.07-1.31) for liquid glucose, 1.14 (95% CI, 1.05-1.23) for liquid fructose, and 1.39 (95% CI, 1.10-1.74) for fructose from fruit juice. Cancer and all-cause mortality increased to a similar extent with intake of all sugars in liquid form. In categorical models, cancer risk was dose-related for all liquid sugars.
Simple sugar intake in drinks and fruit juice was associated with an increased risk of overall cancer incidence and mortality and all-cause mortality. This suggests that sugary beverages are a modifiable risk factor for cancer and all-cause mortality.
在一项基于 2003 年至 2010 年进行的 PREDIMED 试验的前瞻性队列研究中，研究简单糖摄入量与癌症发病率、癌症死亡率和总死亡率之间的关系。
参与者为心血管疾病风险较高的老年人。暴露因素为固体或液体来源的总糖、葡萄糖和果糖，以及水果和 100%果汁中的果糖。癌症发病率为主要结局；癌症死亡率和全因死亡率为次要结局。使用多变量调整的、时间依赖性 Cox 比例风险模型。
在纳入的 7447 名参与者中，有 7056 名（94.7%）参与者（57.6%为女性，年龄 67.0±6.2 岁）被纳入分析。中位随访 6 年后，共记录了 534 例癌症发病，152 例癌症死亡和 409 例全因死亡。固体形式的简单糖摄入量与结局无关。液体糖摄入量每增加 5 克/天，癌症发病率就会相应增加，多变量调整后的 HR 分别为总液体糖 1.08（95%CI，1.03-1.13）、液体葡萄糖 1.19（95%CI，1.07-1.31）、液体果糖 1.14（95%CI，1.05-1.23）和果汁中的果糖 1.39（95%CI，1.10-1.74）。以同样的方式，所有液体糖的摄入都与癌症和全因死亡率的增加有关。在分类模型中，所有液体糖的癌症风险均呈剂量相关性。
饮料和果汁中简单糖的摄入与整体癌症发病率和死亡率以及全因死亡率的增加有关。这表明含糖饮料是癌症和全因死亡率的一个可改变的危险因素。
