Sugar-Sweetened Soft Drink Consumption and Risk of Pancreatic Cancer in Two Prospective Cohorts

Schernhammer, Eva; Hu, Frank B.; Giovannucci, E; Michaud, Dominique S.; Colditz, Graham A.; Stampfer, Meir J.; Fuchs, Charles S.

doi:10.1158/1055-9965.epi-05-0059

Cited by 95 publications

(91 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While responses of individual consumers may vary (e.g. due to their personal genetic susceptibility (48,63) or that of their resident gut microbes (131) ), there is good reason to believe that rapidly absorbable carbohydrates tend to promote obesity, and diseases commonly associated with it, in general (45,48,63,(132)(133)(134)(135)(136)(137) . The problem for public health is that continuing to focus on quantifying calories may misdirect thinking on obesity and related diseases and promote destructive messages.…”

Section: More-nuanced Thinking About Obesity and Related Diseasesmentioning

confidence: 99%

How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative

Lucan

DiNicolantonio

2014

Public Health Nutr.

View full text Add to dashboard Cite

Prevailing thinking about obesity and related diseases holds that quantifying calories should be a principal concern and target for intervention. Part of this thinking is that consumed calories -regardless of their sources -are equivalent; i.e. 'a calorie is a calorie'. The present commentary discusses various problems with the idea that 'a calorie is a calorie' and with a primarily quantitative focus on food calories. Instead, the authors argue for a greater qualitative focus on the sources of calories consumed (i.e. a greater focus on types of foods) and on the metabolic changes that result from consuming foods of different types. In particular, the authors consider how calorie-focused thinking is inherently biased against high-fat foods, many of which may be protective against obesity and related diseases, and supportive of starchy and sugary replacements, which are likely detrimental. Shifting the focus to qualitative food distinctions, a central argument of the paper is that obesity and related diseases are problems due largely to food-induced physiology (e.g. neurohormonal pathways) not addressable through arithmetic dieting (i.e. calorie counting). The paper considers potential harms of public health initiatives framed around calorie balance sheetstargeting 'calories in' and/or 'calories out' -that reinforce messages of overeating and inactivity as underlying causes, rather than intermediate effects, of obesity. Finally, the paper concludes that public health should work primarily to support the consumption of whole foods that help protect against obesity-promoting energy imbalance and metabolic dysfunction and not continue to promote caloriedirected messages that may create and blame victims and possibly exacerbate epidemics of obesity and related diseases. KeywordsObesity Calories Carbohydrates Public health Chronic diseaseWith worldwide concerns about obesity and diseases related to it (e.g. diabetes and CVD), there is substantial interest in shifting populations to healthier weights and better health. More precisely, there is interest in reducing body fat since fat -particularly visceral or abdominal fat -may matter more than weight when it comes to health (1)(2)(3) . Nevertheless, much of the evidence regarding obesity and related diseases focuses on body weight, rather than body fat. In reviewing such evidence, therefore, the present paper will therefore also often use the imprecise term 'weight' as opposed to 'fat', pointing out when such imprecision might mislead thinking.One way such imprecision might mislead thinking is in supporting the notions that (i) 'a calorie is a calorie' † and (ii) intervening on calories is the best way to address obesity (i.e. the quantitative problem of excess pounds or kilograms on a scale as opposed to the qualitative problem † 'Calorie' -or more correctly kilocalorie (kcal), for which the word often imprecisely substitutes -is the main unit of energy used to discuss food and obesity-related issues in the USA. It is also the word used in common expressions l...

show abstract

Section: More-nuanced Thinking About Obesity and Related Diseasesmentioning

confidence: 99%

How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative

Lucan

DiNicolantonio

2014

Public Health Nutr.

View full text Add to dashboard Cite

show abstract

“…To date, there have been no consensus in the literature regarding risk of various cancers and intake of soft drinks and/or juices [18][19][20][21][22][23], and associations for cancers of the liver and biliary tract have not been well studied. Given the rising consumption of sweetened non-alcoholic beverages and their likely link to several metabolic disorders that play a role in the development of these cancers, we present here an analysis of soft drinks and fruit and vegetable juices, in association with HCC, IHBC and GBTC in the EPIC cohort.…”

Section: Introductionmentioning

confidence: 99%

Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort

et al. 2014

View full text Add to dashboard Cite

using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries. Methods After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95 % confidence intervals (HR; 95 % CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical activity, AbstractPurpose The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) Results No risk associations were observed for IHBC or GBTC. Combined soft drinks consumption of >6 servings/ week was positively associated with HCC risk: HR 1.83; 95 % CI 1.11-3.02, p trend = 0.01 versus non-consumers. In sub-group analyses available for 91 % of the cohort artificially sweetened soft drinks increased HCC risk by 6 % per 1 serving increment (HR 1.06, 95 % CI 1.03-1.09, n cases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95-1.06; n cases = 127, p heterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (<1 serving/week: HR 0.60; 95 % CI 0.38-0.95; p trend = 0.02 vs. non-consumers). Conclusions Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted. This study provides some insight into possible associations of HCC with sugary drinks intake. Further exploration in other settings is required.

show abstract

“…Based on the association with diabetes, it has been proposed that the risk for cancer of the pancreas may be increased by a diet with a high glycaemic load and by impaired glucose tolerance, insulin resistance and hyperinsulinaemia. Three prospective studies have examined the associations of sugar, sugar-sweetened soft drinks, glycaemic index and glycaemic load with the risk for pancreatic cancer: sucrose itself was not associated with risk and the results for glycaemic index and load were inconsistent (Michaud et al, 2002;Johnson et al, 2005;Silvera et al, 2005a), whereas there was some evidence that risk increased with a high intake of sugar-sweetened soft drinks in women (Schernhammer et al, 2005). Case-control studies have suggested that high intakes of dietary fibre might reduce risk (World Cancer Research Fund, 1997), but few data are available from prospective studies (StolzenbergSolomon et al, 2002).…”

Section: Cancer Of the Pancreasmentioning

confidence: 99%

Carbohydrates and cancer: an overview of the epidemiological evidence

Key

Spencer

2007

Eur J Clin Nutr

View full text Add to dashboard Cite

Objective: To assess the epidemiological evidence on dietary carbohydrates and the risk of developing cancer. Method: Review of published studies, concentrating on recent systematic reviews, meta-analyses and large prospective studies. Conclusions: Carbohydrates have not been intensively investigated in epidemiological studies of diet and cancer. There is a moderately large amount of data on the possible association between dietary fibre and the risk for colorectal cancer; the results of studies have varied and no firm conclusion can be drawn, but the available data suggest that high intakes of dietary fibre possibly reduce the risk for colorectal cancer. There are also limited data which suggest that high intakes of sucrose might increase the risk for colorectal cancer and that high intakes of lactose might increase the risk for ovarian cancer. For other components of carbohydrates and other types of cancer, the available data are too sparse to draw even tentative conclusions. Further research is needed on the possible associations of carbohydrates with cancer risk.

show abstract

Sugar-Sweetened Soft Drink Consumption and Risk of Pancreatic Cancer in Two Prospective Cohorts

Cited by 95 publications

References 31 publications

How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative

How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative

Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort

Carbohydrates and cancer: an overview of the epidemiological evidence

Contact Info

Product

Resources

About