Simple sugar intake and cancer incidence, cancer mortality and all- cause mortality: A cohort study from the PREDIMED trial

Identifier:  imarina:9230612

Handle: https://hdl.handle.net/20.500.11797/imarina9230612

Authors:  Laguna, Juan C; Alegret, Marta; Cofan, Montserrat; Sanchez-Tainta, Ana; Diaz-Lopez, Andres; Martinez-Gonzalez, Miguel A; V Sorli, Jose; Salas-Salvado, Jordi; Fito, Montserrat; Alonso-Gomez, Angel M; Serra-Majem, Lluis; Laperra, Jose; Fiol, Miquel; Gomez-Gracia, Enrique; Pinto, Xavier; Munoz, Miguel A; Castaner, Olga; Ramirez-Sabio, Judith B; Portu, Jose J; Estruch, Ramon; Ros, Emilio

Abstract:
Objective: To examine associations between intake of simple sugars and cancer incidence, cancer mor-tality, and total mortality in a prospective cohort study based on the PREDIMED trial conducted from 2003 to 2010. Methods: Participants were older individuals at high cardiovascular risk. Exposures were total sugar, glucose and fructose from solid or liquid sources, and fructose from fruit and 100% fruit juice. Cancer incidence was the primary outcome; cancer mortality and all-cause mortality were secondary outcomes. Multivariable-adjusted, time-dependent Cox proportional hazard models were used. Results: Of 7447 individuals enrolled, 7056 (94.7%) were included (57.6% women, aged 67.0 +/- 6.2 years). 534 incident cancers with 152 cancer deaths and 409 all-cause deaths were recorded after a median follow-up of 6 years. Intake of simple sugars in solid form was unrelated to outcomes. Higher cancer incidence was found per 5 g/day increase in intake of liquid sugars, with multivariable-adjusted HR of 1.08 (95% CI, 1.03-1.13) for total liquid sugar, 1.19 (95% CI, 1.07-1.31) for liquid glucose, 1.14 (95% CI, 1.05-1.23) for liquid fructose, and 1.39 (95% CI, 1.10-1.74) for fructose from fruit juice. Cancer and all-cause mortality increased to a similar extent with intake of all sugars in liquid form. In categorical models, cancer risk was dose-related for all liquid sugars. Conclusions: Simple sugar intake in drinks and fruit juice was associated with an increased risk of overall cancer incidence and mortality and all-cause mortality. This suggests that sugary beverages are a modifiable risk factor for cancer and all-cause mortality. (c) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).