Children and adolescents today derive 10% to 15% of total calories from sugar-sweetened beverages and 100% fruit juice. Our analysis indicates increasing consumption in all ages. Schools are a limited source for sugar-sweetened beverages, suggesting that initiatives to restrict sugar-sweetened beverage sales in schools may have an only marginal impact on overall consumption. Pediatricians' awareness of these trends is critical for helping children and parents target suboptimal dietary patterns that may contribute to excess calories and obesity.
Background
The US has experienced an alarming and unexplained increase in the incidence of esophageal adenocarcinoma (EAC) since the 1970s. A concurrent increase in obesity has led some to suggest a relationship between the two trends. We explore the extent of this relationship.
Methods
Using a previously validated disease simulation model of white males in the US, we estimated esophageal adenocarcinoma incidence 1973–2005 given constant obesity prevalence and low population progression rates consistent with the early 1970s. Introducing only the observed, rising obesity prevalence we calculated the incremental incidence caused by obesity. We compared these to esophageal adenocarcinoma incidence data from the National Cancer Institute’s SEER registry to determine obesity's contribution to the rise therein. Incidences were converted to absolute numbers of cases using US population data.
Results
Using constant obesity prevalence we projected a total of 30,555 EAC cases cumulatively over 1973–2005 and 1,151 in 2005 alone. Incorporating the observed obesity trend resulted in 35,767 cumulative EACs and 1,608 in 2005. Estimates derived from SEER data showed 111,223 cumulative and 7,173 cases in 2005. We conclude that the rise in obesity accounted for 6.5% of the increase in EAC cases that occurred from 1973–2005 and 7.6% in the year 2005.
Conclusion
Using published odds ratios for EAC among obese individuals, we found that only a small percentage of the rise in EAC incidence is attributable to secular trends in obesity.
Impact
Other factors, alone and in combination, should be explored as causes of the EAC epidemic.
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