Sugar-Sweetened Beverage Intake and Cancer Recurrence and Survival in CALGB 89803 (Alliance)

Abstract

BackgroundIn colon cancer patients, obesity, sedentary lifestyle, and high dietary glycemic load have been associated with increased risk of cancer recurrence. High sugar-sweetened beverage intake has been associated with obesity, diabetes, and cardio-metabolic diseases, but the influence on colon cancer survival is unknown.MethodsWe assessed the association between sugar-sweetened beverage consumption on cancer recurrence and mortality in 1,011 stage III colon cancer patients who completed food frequency questionnaires as part of a U.S. National Cancer Institute-sponsored adjuvant chemotherapy trial. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with Cox proportional hazard models.ResultsPatients consuming ≥2 servings of sugar-sweetened beverages per day experienced an adjusted HR for disease recurrence or mortality of 1.67 (95% CI, 1.04–2.68), compared with those consuming <2 servings per month (P trend = 0.02). The association of sugar-sweetened beverages on cancer recurrence or mortality appeared greater among patients who were both overweight (body mass index ≥25 kg/m2) and less physically active (metabolic equivalent task-hours per week <18) (HR = 2.22; 95% CI, 1.29–3.81, P trend = 0.0025).ConclusionHigher sugar-sweetened beverage intake was associated with a significantly increased risk of cancer recurrence and mortality in stage III colon cancer patients.

Mortality outcomes associated with intake of fast-food items and sugar-sweetened drinks among older adults in the Vitamins and Lifestyle (VITAL) study

“…We also found a positive association between SSD and total mortality only among individuals with greater morbidity at baseline. Interestingly, these findings are consistent with the positive association found with total cancer mortality (26) among cancer survivors. Clearly, more research is needed to understand these complex relationships.…”

“…The evidence supporting associations between SSD and mortality is only slightly larger (10,25,26,38) . In a large pooling study by Singh and colleagues, global cause-specific population-attributable fractions for SSD were calculated and multiplied by cause-specific mortality estimates which resulted in an estimated 184 000 total deaths, 45 000 CVD deaths and 6450 cancer deaths per year due to SSD intake (25) .…”

“…Yet, studies which actually link the intake of FFI (24) or SSD (10,25,26) to total or disease-specific mortality outcomes are relatively few (9) . Recent guidelines to reduce fast food and sugared drink consumption as a cancer preventive strategy have been issued (27) , despite limited information as to whether this action may impact disease burden.…”

Association of Coloproctology of Great Britain & Ireland (ACPGBI): Guidelines for the Management of Cancer of the Colon, Rectum and Anus (2017) – Follow Up, Lifestyle and Survivorship

“…McCullough et al suggested that ongoing high consumption of red and processed meat before, and after, the diagnosis of colorectal cancer was associated with a 79% increased risk of cancer specific mortality (McCullough et al, 2013). High carbohydrate intake including sugar-sweetened beverages is associated with an increased risk of disease recurrence and mortality (Meyerhardt et al, 2012) (Fuchs et al, 2014).…”

The Importance of the World Health Organization Sugar Guidelines for Dental Health and Obesity Prevention

“…In addition to dental caries and body weight, excessive sugar consumption from foods and beverages high in added sugars has been associated with an increased risk of type 2 diabetes [de Koning et al, 2011], cardiovascular diseases [Malik et al, 2010;Yu et al, 2018;Keller et al, 2014] cancers [Fuchs et al, 2014;Van Blarigan, and Meyerhardt, 2015;Port et al, 2012] as well as non-alcoholic fatty liver disease [Wijarnpreecha et al,2016]. In addition, emerging research suggest that diet high in sugars may increase the risk of developing dementia such as Alzheimer disease Pase et al, 2017].…”