Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Nutrients. 2022 Oct 22;14(21):4445. doi: 10.3390/nu14214445.
The impact of artificially sweetened beverages (ASBs), alternatives to sugar-sweetened beverages, on cancer incidence remains controversial. We conducted a meta-analysis of prospective studies to assess the association of daily ASB intake with cancer risk. A systematic search was performed between January 1967 and September 2022. Risk ratios (RR) or hazard ratios (HR) were extracted and pooled. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used for the assessment of the certainty of evidence. The study was registered at PROSPERO (CRD42022312171). Overall, 14 articles with 17 cohorts were included. There was no significant association between daily ASB consumption and risk of overall cancer (highest versus lowest category: = 17, = 1.03, 95% CI: 0.96-1.11, = 0.407). For site-specific cancer analysis, the risk of non-lymphoid leukemia was elevated with high ASB intake ( = 3, = 1.35, 95% CI: 1.03-1.77, = 0.030), while risk of colorectal cancer was decreased ( = 3, = 0.78, 95% CI: 0.62-0.99, = 0.037). Dose-response analysis indicated a positive linear association between ASB intake and the risk of leukemia ( = 0.027). The risk increased by 15% per one serving (355 mL) daily ASB intake increment ( = 1.15, 95% CI: 1.02-1.30). In conclusion, ASB consumption might be positively associated with the risk of leukemia and negatively associated with the risk of colorectal cancer.
人工甜味饮料（ASB）作为含糖饮料的替代品，其对癌症发病率的影响仍存在争议。我们对前瞻性研究进行了荟萃分析，以评估每日 ASB 摄入量与癌症风险的相关性。在 1967 年 1 月至 2022 年 9 月期间进行了系统搜索。提取并汇总了风险比（RR）或风险比（HR）。采用推荐评估、制定与评价分级（GRADE）方法评估证据的确定性。该研究已在 PROSPERO（CRD42022312171）上注册。共有 14 篇文章和 17 个队列被纳入研究。每日 ASB 消费与总体癌症风险之间无显著关联（最高与最低类别相比： = 17， = 1.03，95%CI：0.96-1.11， = 0.407）。对于特定部位癌症分析，高 ASB 摄入与非淋巴性白血病风险升高相关（ = 3， = 1.35，95%CI：1.03-1.77， = 0.030），而结直肠癌风险降低（ = 3， = 0.78，95%CI：0.62-0.99， = 0.037）。剂量反应分析表明 ASB 摄入量与白血病风险之间存在正线性关联（ = 0.027）。ASB 摄入量每增加一份（355 毫升），风险增加 15%（ = 1.15，95%CI：1.02-1.30）。总之，ASB 消费可能与白血病风险呈正相关，与结直肠癌风险呈负相关。
