Consumption of Sugars, Sugary Foods, and Sugary Beverages in Relation to Cancer Risk: A Systematic Review of Longitudinal Studies

High sugar intake may increase cancer risk by promoting insulin–glucose dysregulation, oxidative stress, inflammation, and body adiposity, but epidemiologic evidence is unclear. Associations between dietary sugars and lifestyle-related cancer risk from longitudinal studies were evaluated. We systematically searched PubMed, Embase, and CINAHL and identified 37 prospective cohort studies (1990–2017) reporting multivariable adjusted risk estimates for dietary sugars in relation to cancer. Of 15 and 14 studies on total sugar and sucrose respectively, 11 reported a null association in relation to cancer. Of 14 studies on fructose, 8 reported null associations, and 2 reported protective and 4 reported detrimental associations. In two of five studies on added sugars, a 60–95% increased cancer risk was observed with higher intakes. In 8 of 15 studies on sugary foods and beverages, a 23–200% higher cancer risk was observed with higher sugary beverage consumption. In conclusion, most studies were indicative of a null association, but suggestive detrimental associations were reported for added sugars and sugary beverages.

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Ethylene Oxide Exposure in U.S. Populations Residing Near Sterilization and Other Industrial Facilities: Context Based on Endogenous and Total Equivalent Concentration Exposures

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020607 ◽

2021 ◽

Vol 18 (2) ◽

pp. 607

Author(s):

Patrick J. Sheehan ◽

Ryan C. Lewis ◽

Christopher R. Kirman ◽

Heather N. Watson ◽

Eric D. Winegar ◽

...

Keyword(s):

Cancer Risk ◽

Ethylene Oxide ◽

Environmental Protection Agency ◽

Cancer Risk Assessment ◽

Exposure Concentration ◽

Increase Cancer Risk ◽

Total Exposure ◽

Industrial Facilities ◽

Equivalent Concentration ◽

Current Risk

Given ubiquitous human exposure to ethylene oxide (EO), regardless of occupation or geography, the current risk-specific concentrations (RSCs: 0.0001–0.01 ppb) from the U.S. Environmental Protection Agency (EPA) cancer risk assessment for EO are not useful metrics for managing EO exposures to the general U.S. population. The magnitude of the RSCs for EO are so low, relative to typical endogenous equivalent metabolic concentrations (1.1–5.5 ppb) that contribute ~93% of total exposure, that the RSCs provide little utility in identifying excess environmental exposures that might increase cancer risk. EO monitoring data collected in the vicinity of eight EO-emitting facilities and corresponding background locations were used to characterize potential excess exogenous concentrations. Both 50th and 90th percentile exogenous exposure concentrations were combined with the 50th percentile endogenous exposure concentration for the nonsmoking population, and then compared to percentiles of total equivalent concentration for this population. No potential total exposure concentration for these local populations exceeded the normal total equivalent concentration 95th percentile, indicating that excess facility-related exposures are unlikely to require additional management to protect public health.

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Alcohol Drinking and Lung Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyl146 ◽

2007 ◽

Vol 37 (3) ◽

pp. 168-174 ◽

Cited By ~ 12

Author(s):

Kenji Wakai ◽

Chisato Nagata ◽

Tetsuya Mizoue ◽

Keitaro Tanaka ◽

Yoshikazu Nishino ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Cancer Risk ◽

Alcohol Drinking ◽

Japanese Population ◽

Lung Cancer Risk ◽

Epidemiologic Evidence

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Cancer Susceptibility Genes and Common Gene Variants That Increase Cancer Risk

Cancer Risk Assessment ◽

10.1201/b14140-10 ◽

2005 ◽

pp. 181-204

Author(s):

Ragnhild A. Lothe ◽

Anne-Lise Børresen-Dale

Keyword(s):

Cancer Risk ◽

Cancer Susceptibility ◽

Susceptibility Genes ◽

Gene Variants ◽

Increase Cancer Risk ◽

Common Gene ◽

Cancer Susceptibility Genes

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Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Santé cohort

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa246 ◽

2020 ◽

Vol 112 (5) ◽

pp. 1267-1279 ◽

Cited By ~ 1

Author(s):

Charlotte Debras ◽

Eloi Chazelas ◽

Bernard Srour ◽

Emmanuelle Kesse-Guyot ◽

Chantal Julia ◽

...

Keyword(s):

Risk Factor ◽

Weight Gain ◽

Cancer Risk ◽

Current Debate ◽

Cancer Etiology ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake ◽

Sugary Drinks

ABSTRACT Background Excessive sugar intake is now recognized as a key risk factor for obesity, type 2 diabetes, and cardiovascular diseases. In contrast, evidence on the sugar–cancer link is less consistent. Experimental data suggest that sugars could play a role in cancer etiology through obesity but also through inflammatory and oxidative mechanisms and insulin resistance, even in the absence of weight gain. Objective The objective was to study the associations between total and added sugar intake and cancer risk (overall, breast, and prostate), taking into account sugar types and sources. Methods In total, 101,279 participants aged >18 y (median age, 40.8 y) from the French NutriNet-Santé prospective cohort study (2009–2019) were included (median follow-up time, 5.9 y). Sugar intake was assessed using repeated and validated 24-h dietary records, designed to register participants’ usual consumption for >3500 food and beverage items. Associations between sugar intake and cancer risk were assessed by Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). Results Total sugar intake was associated with higher overall cancer risk (n = 2503 cases; HR for quartile 4 compared with quartile 1: 1.17; 95% CI: 1.00, 1.37; Ptrend = 0.02). Breast cancer risks were increased (n = 783 cases; HRQ4vs.Q1 = 1.51; 95% CI: 1.14, 2.00; Ptrend = 0.0007). Results remained significant when weight gain during follow-up was adjusted for. In addition, significant associations with cancer risk were also observed for added sugars, free sugars, sucrose, sugars from milk-based desserts, dairy products, and sugary drinks (Ptrend ≤ 0.01). Conclusions These results suggest that sugars may represent a modifiable risk factor for cancer prevention (breast in particular), contributing to the current debate on the implementation of sugar taxation, marketing regulation, and other sugar-related policies. This trial was registered at clinicaltrials.gov as NCT03335644.

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Effects of Physical Activity on the Performance of 24-h Urinary Sucrose and Fructose as a Biomarker of Total Sugars Intake (P18-128-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.p18-128-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Chitra Mohan ◽

Barbara Ainsworth ◽

Susana Pama Duran ◽

Virag Sagi-Kiss ◽

Carol Johnston ◽

...

Keyword(s):

Physical Activity ◽

Adult Population ◽

Linear Regression Analysis ◽

Predictive Biomarker ◽

P Value ◽

Activity Levels ◽

Total Sugars ◽

Added Sugars ◽

Funding Sources ◽

Dietary Sugars

Abstract Objectives Urinary sucrose and fructose has been suggested as a predictive biomarker of total sugars intake based on research involving UK adults. The purpose of this study was to determine the association between sugars consumption and 24-hour urinary sucrose and fructose (24uSF) in US adult population and to investigate the effect of physical activity on this association. Methods Fifty seven free-living healthy subjects 20 to 68 years old, participated in a 15-day highly controlled feeding study, consuming their habitual diet, provided by the research metabolic kitchen. Dietary sugars were estimated using Nutrition Data System for Research (NDSR). Subjects collected eight 24-hour urine samples measured for urinary sucrose and fructose. Physical activity was assessed daily using a validated 15-day log that inquired about 38 physical activities across six domains; home activities, transportation, occupation, conditioning, sports and leisure. Results The 15-d mean total sugars and added sugars intake (SD) of the study population was 112.2 (33.1) g/day and 65.8 (29.0) g/day (9.7%EI), respectively. Significant moderate positive correlation was found between 15-d mean total sugars intake and 8-day mean 24uSF (r = 0.56, P < 0.001). Similarly, added sugars were moderately correlated with 24uSF (r = 0.56, P < 0.001), while no correlation was found between naturally-occurring sugars and 24uSF (r = 0.070, P < 0.001). In a linear multiple regression, total and added sugars each explained 30% of variability in 24uSF (Adjusted R2, p value; total sugars: 0.297, 0.001; added sugars: 0.301, P < 0.001). We found no effect of physical activity on the association between dietary and urinary sugars in neither the correlation nor the linear regression analysis. Conclusions 24uSF showed moderate association with both total and added sugars consumption in US adults. No evidence was found showing that physical activity levels affect the association between 24uSF and sugars intake in US adults. Funding Sources National Cancer Institute.

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Consumption of sugars, saturated fat, and sodium among US children from infancy through preschool age, NHANES 2009–2014

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy168 ◽

2018 ◽

Vol 108 (4) ◽

pp. 868-877 ◽

Cited By ~ 9

Author(s):

Yu Wang ◽

Dana Guglielmo ◽

Jean A Welsh

Keyword(s):

Saturated Fat ◽

Preschool Age ◽

Older Children ◽

Sampling Weights ◽

Cross Sectional ◽

Free Sugars ◽

Added Sugars ◽

Saturated Fats ◽

Sugary Beverages ◽

Us Children

Abstract Background Expert guidelines advise that intake of added sugars (ASs), free sugars, and saturated fats be limited to <10% total energy (TE), and that children's sodium not exceed 1500–1900 mg, yet intake among many older children and adolecents exceeds these limits. Although research suggests young children's diets influence future eating patterns, little is known about the intake of these nutrients throughout early childhood. Objective The objective of this study was to describe intake and leading sources of sugars, saturated fats, and sodium among US children from infancy through preschool age. Design Cross-sectional data from the NHANES 2009–2014 were used to estimate 1) mean intake of sugars [%TE from ASs, naturally occurring sugars (NOSs), and free sugars], saturated fats (%TE), and sodium (milligrams), 2) the proportion exceeding recommended limits, and 3) the leading sources of these nutrients in the diets of US (nonbreastfeeding) children <5 y old (n = 3345). Sampling weights and procedures to account for the complex sampling design were used to estimate intake by age and to compare across race/ethnicity, sex, and income subgroups. Results Nonbreastfeeding children <5 y old consumed a mean ± SE %TE of 10.1% ± 0.2% from ASs, 13.9% ± 0.2% from free sugars, 12.8% ± 0.1% from saturated fats, and 1804 ± 26 mg Na . Sugary beverages (sugar-sweetened beverages + 100% juices) contributed 6.7% ± 0.2% TE, with consumption lowest among higher-income children. AS and sodium consumption rose rapidly from infancy to age 1–<2 y and gradually thereafter. Saturated fat intake was highest in infancy and decreased to a mean ± SE of 11.3% ± 0.3% TE among 4–<5-y-olds. Intake exceeded recommended limits for ASs, free sugars, saturated fats, and sodium for 45%, 63%, 72%, and 67% of all children, respectively. Conclusion The consumption of sugars, fats, and sodium exceeds recommended guidelines before many US children reach school age.

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