含糖饮料可能会增加癌症的风险 Study suggests possible link between sugary drinks and cancer

BMJ今天发表的一项研究报告了含糖饮料的更高消费和癌症风险增加之间的可能关联。

虽然需要谨慎的解释,但研究结果增加了越来越多的证据,表明限制含糖饮料消费以及税收和营销限制可能有助于减少癌症病例。

含糖饮料的消费量在过去几十年中在全球范围内有所增加,令人信服地与肥胖的风险相关联,肥胖反过来被认为是许多癌症的一个强大的风险因素。 但对含糖饮料和癌症风险的研究仍然有限。

因此,法国的一个研究小组着手评估含糖饮料(含糖饮料和100%果汁),人工增甜(饮食)饮料和整体癌症风险之间的关联,以及乳腺癌,前列腺癌和肠癌(结肠直肠)

他们的研究结果是基于101,257健康的法国成年人(21%的男性;79%的女性),平均年龄为42岁,纳入时间从NutriNet-Santé队列研究。

参与者完成了至少两个24小时在线验证的膳食问卷,旨在测量通常摄入的3,300不同的食物和饮料项目,并跟进了最多9年(2009-2018)。

每天饮用含糖饮料(含糖饮料和100%果汁)和人工增甜(饮食)饮料进行计算,参与者报告的第一例癌症病例通过医疗记录进行验证,并与医疗保险国家数据库

考虑了几种众所周知的癌症风险因素,如年龄、性别、教育水平、癌症家族史、吸烟状况和身体活动水平。

含糖饮料的平均每日消费量是男性比女性更大(90.3毫升v74.6毫升,分别). 在随访期间,2193例癌症首先被诊断和验证(693例乳腺癌,291例前列腺癌和166例结肠直肠癌)。 癌症诊断的平均年龄为59岁。

结果表明,每天增加100毫升含糖饮料的消费量与18%的整体癌症风险增加和22%的乳腺癌风险增加有关。 当含糖饮料被分成果汁和其他含糖饮料时,两种饮料类型的消费与整体癌症的风险较高有关。 前列腺癌和结直肠癌没有发现关联,但这些癌症位置的病例数量更为有限。

相比之下,人工增甜(饮食)饮料的消费并没有与癌症的风险有关,但作者警告说,由于该样品的消费水平相对较低,因此在解释这一发现时需要谨慎。

这些结果的可能解释包括含糖饮料中含有的糖对内脏脂肪(储存在肝脏和胰腺等重要器官周围),血糖水平和炎症标记物的影响,所有这些都与癌症风险增加有关。

其他的化学化合物,如添加剂在一些苏打水也可能发挥作用,他们添加。

这是一项观察性研究,因此无法确定病因,作者说,他们不能排除某些错误分类的饮料或保证检测每个新的癌症病例。

然而,研究样本很大,他们能够调整范围广泛的潜在影响因素。 更重要的是,在进一步测试后,结果基本上没有变化,这表明这些结果经受了审查。

作者说,这些结果需要在其他大规模研究中复制。

“这些数据支持现有营养建议的相关性,以限制含糖饮料的消费,包括100%果汁,以及针对含糖饮料的税收和营销限制等政策措施,这可能有助于减少癌症发生。

NEWS RELEASE 

Study suggests possible link between sugary drinks and cancer

Findings suggest limiting sugary drinks might contribute to a reduction in cancer cases, say researchers

BMJ

A study published by The BMJ today reports a possible association between higher consumption of sugary drinks and and an increased risk of cancer.

While cautious interpretation is needed, the findings add to a growing body of evidence indicating that limiting sugary drink consumption, together with taxation and marketing restrictions, might contribute to a reduction in cancer cases.

The consumption of sugary drinks has increased worldwide during the last few decades and is convincingly associated with the risk of obesity, which in turn is recognised as a strong risk factor for many cancers. But research on sugary drinks and the risk of cancer is still limited.

So a team of researchers based in France set out to assess the associations between the consumption of sugary drinks (sugar sweetened beverages and 100% fruit juices), artificially sweetened (diet) beverages, and risk of overall cancer, as well as breast, prostate, and bowel (colorectal) cancers.

Their findings are based on 101,257 healthy French adults (21% men; 79% women) with an average age of 42 years at inclusion time from the NutriNet-Santé cohort study.

Participants completed at least two 24-hour online validated dietary questionnaires, designed to measure usual intake of 3,300 different food and beverage items and were followed up for a maximum of 9 years (2009-2018).

Daily consumption of sugary drinks (sugar sweetened beverages and 100% fruit juices) and artificially sweetened (diet) beverages were calculated and first cases of cancer reported by participants were validated by medical records and linked with health insurance national databases.

Several well known risk factors for cancer, such as age, sex, educational level, family history of cancer, smoking status and physical activity levels, were taken into account.

Average daily consumption of sugary drinks was greater in men than in women (90.3 mL v 74.6 mL, respectively). During follow-up 2,193 first cases of cancer were diagnosed and validated (693 breast cancers, 291 prostate cancers, and 166 colorectal cancers). Average age at cancer diagnosis was 59 years.

The results show that a 100 mL per day increase in the consumption of sugary drinks was associated with an 18% increased risk of overall cancer and a 22% increased risk of breast cancer. When the group of sugary drinks was split into fruit juices and other sugary drinks, the consumption of both beverage types was associated with a higher risk of overall cancer. No association was found for prostate and colorectal cancers, but numbers of cases were more limited for these cancer locations.

In contrast, the consumption of artificially sweetened (diet) beverages was not associated with a risk of cancer, but the authors warn that caution is needed in interpreting this finding owing to a relatively low consumption level in this sample.

Possible explanations for these results include the effect of the sugar contained in sugary drinks on visceral fat (stored around vital organs such as the liver and pancreas), blood sugar levels, and inflammatory markers, all of which are linked to increased cancer risk.

Other chemical compounds, such as additives in some sodas might also play a role, they add.

This is an observational study, so can’t establish cause, and the authors say they cannot rule out some misclassification of beverages or guarantee detection of every new cancer case.

Nevertheless, the study sample was large and they were able to adjust for a wide range of potentially influential factors. What’s more, the results were largely unchanged after further testing, suggesting that the findings withstand scrutiny.

These results need replication in other large scale studies, say the authors.

“These data support the relevance of existing nutritional recommendations to limit sugary drink consumption, including 100% fruit juice, as well as policy actions, such as taxation and marketing restrictions targeting sugary drinks, which might potentially contribute to the reduction of cancer incidence,” they conclude.

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Peer-reviewed? Yes
Evidence type: Observational
Subjects: People

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