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Sugar-sweetened beverage and sugar intake during adolescence and risk of colorectal cancer precursors: a large prospective U.S. cohort study
Item Type: | Preprint |
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Title: | Sugar-sweetened beverage and sugar intake during adolescence and risk of colorectal cancer precursors: a large prospective U.S. cohort study |
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Creators Name: | Joh, H.K. and Lee, D.H. and Hur, J. and Nimptsch, K. and Chang, Y. and Joung, H. and Zhang, X. and Rezende, L.F.M. and Lee, J.E. and Ng, K. and Chen, Y. and Meyerhardt, J.A. and Chan, A.T and Pischon, T. and Song, M. and Fuchs, C.S. and Willett, W.C. and Cao, Y. and Ogino, S. and Giovannucci, E. and Wu, K. |
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Abstract: | OBJECTIVE: To examine the associations of adolescent sugar-sweetened beverage (SSB) and sugar intake with risk of colorectal cancer (CRC) precursors. DESIGN: Prospective cohort study. SETTING: Nurses' Health Study II (1998-2015), United States. PARTICIPANTS: 33106 women who completed a validated high school food frequency questionnaire about adolescent diet in 1998 and underwent lower gastrointestinal endoscopy between 1999 and 2015. MAIN OUTCOME MEASURES: Incident CRC precursors confirmed by medical record review. RESULTS: During follow-up, 2909 conventional adenoma, 1082 high-risk adenoma (≥1 cm in size, villous, high-grade dysplasia, or number ≥2), and 2355 serrated lesions were identified. Independent of adult intake, adolescent SSB and sugar intake was positively associated with risk of total and high-risk adenoma. Comparing ≥2 servings/day v <1 serving/week of SSB intake, multivariable odds ratios were 1.21 (95% confidence interval 1.00 to 1.47) for total and 1.21 (0.88 to 1.65) for high-risk adenoma. Per each 5% increment in calorie/day of total fructose intake, odds ratios were 1.17 (1.05 to 1.31) for total and 1.36 (1.14 to 1.62) for high-risk adenoma. By subsite, odds ratios were 1.25 (0.99 to 1.58) for proximal, 1.44 (1.12 to 1.84) for distal, and 1.74 (1.19 to 2.54) for rectal high-risk adenoma. Positive associations were stronger among women with low adolescent fruit, vegetable, or fiber intake. Among women with low fruit intake (<1.3 servings/day), odds ratios of total adenoma were 1.33 (1.11 to 1.59) for SSBs (≥1 serving/day v <1 serving/week) and 1.51 (1.26 to 1.82) for the highest quintile of total fructose (P≤0.024 for interaction). Neither SSB nor sugar intake during adolescence was associated with risk of serrated lesions. CONCLUSIONS: Independent of adult intake, adolescent SSB and sugar intake was positively associated with colorectal adenoma, especially high-risk rectal adenoma. Our findings suggest that adolescence may be a critical developmental period of enhanced susceptibility to high sugar intake, possibly promoting precancerous lesions of CRC arising through the adenoma-carcinoma sequence. |
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Keywords: | Adolescence, Added Sugar, Colorectal Cancer Precursor, Colorectal Adenoma, Fructose, Sugar-Sweetened Beverage, Sugar |
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Source: | medRxiv |
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Publisher: | Cold Spring Harbor Laboratory Press |
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Article Number: | 2020.11.08.20227827 |
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Date: | 12 November 2020 |
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Official Publication: | https://doi.org/10.1101/2020.11.08.20227827 |
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