Abstract
Background & aims: Recent increasing trends in early-onset colorectal cancer (CRC) strongly supports that early-life diet is involved in CRC development. However, data are lacking on the relationship with high sugar intake during early life. Methods: We prospectively investigated the association of adolescent simple sugar (fructose, glucose, added sugar, total sugar) and sugar-sweetened beverage (SSB) intake with CRC precursor risk in 33,106 participants of the Nurses’ Health Study II who provided adolescent dietary information in 1998 and subsequently underwent lower gastrointestinal endoscopy between 1999 and 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression for clustered data. Results: During follow-up, 2909 conventional adenomas (758 high-risk) and 2355 serrated lesions were identified (mean age at diagnoses, 52.2 ± 4.3 years). High sugar and SSB intake during adolescence was positively associated with risk of adenoma, but not serrated lesions. Per each increment of 5% of calories from total fructose intake, multivariable ORs were 1.17 (95% CI, 1.05–1.31) for total and 1.30 (95% CI, 1.06–1.60) for high-risk adenoma. By subsite, ORs were 1.12 (95% CI, 0.96–1.30) for proximal, 1.24 (95% CI, 1.05–1.47) for distal, and 1.43 (95% CI, 1.10–1.86) for rectal adenoma. Per 1 serving/day increment in SSB intake, ORs were 1.11 (95% CI, 1.02–1.20) for total and 1.30 (95% CI, 1.08–1.55) for rectal adenoma. Contrary to adolescent intake, sugar and SSB intake during adulthood was not associated with adenoma risk. Conclusions: High intake of simple sugars and SSBs during adolescence was associated with increased risk of conventional adenoma, especially rectal adenoma.
| Original language | English |
|---|---|
| Pages (from-to) | 128-142.e20 |
| Journal | Gastroenterology |
| Volume | 161 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2021 Jul |
Bibliographical note
Funding Information:Conflict of interest These authors disclose the following: All authors have completed the ICMJE uniform disclosure form and declare support from the National Institutes of Health and American Cancer Society for the submitted work. Kimmie Ng has received institutional research funding from Pharmavite, Revolution Medicines, and Evergrande Group; has served on an advisory board for Seattle Genetics and Array Biopharma; and served as a consultant to X-Biotix Therapeutics. Jeffrey A. Meyerhardt has received institutional research funding from Boston Biomedical, has served as an advisor/consultant to Ignyta and COTA Healthcare, and served on a grant review panel for the National Comprehensive Cancer Network funded by Taiho Pharmaceutical. Andrew T. Chan has previously served as a consultant to Bayer Pharma AG, Pfizer Inc., and Boehringer Ingelheim for topics unrelated to this manuscript. Charles S. Fuchs reports consulting role for Agios, Amylin Pharmaceuticals, Bain Capital, CytomX Therapeutics, Daiichi-Sankyo, Eli Lilly, Entrinsic Health, Evolveimmune Therapeutics, Genentech, Merck, Taiho, and Unum Therapeutics. He also serves as a Director for CytomX Therapeutics and owns unexercised stock options for CytomX and Entrinsic Health. He is a co-Founder of Evolveimmune Therapeutics and has equity in this private company. He had provided expert testimony for Amylin Pharmaceuticals and Eli Lilly. The remaining authors disclose no conflicts.
Funding Information:
Funding The Nurses’ Health Study II was funded by the National Cancer Institute, National Institutes of Health ( U01 CA176726 , R01 CA67262 , and U01 HL145386 ) and this project was funded by research grants R03 CA197879 (Kana Wu), R21 CA222940 (Kana Wu and Marios Giannakis), R21 CA230873 (Kana Wu, Shuji Ogino), R01 CA151993 (Shuji Ogino), R35 CA197735 (Shuji Ogino), R01 CA205406 (Kimmie Ng), K24 DK098311 (Andrew T. Chan), R35 CA253185 (Andrew T. Chan), K99 CA215314 (Mingyang Song), R00 CA215314 (Mingyang Song), and K07 CA188126 (Xuehong Zhang). This work was also in part supported by an Investigator Initiated Grant from the American Institute for Cancer Research ( AICR ) to Kana Wu. In addition, this work was supported by American Cancer Society Research Scholar Grant ( RSG130476 to Xuehong Zhang and RSG-20-124-01-CCE to Fred K. Tabung), the American Cancer Society Research Mentored Research Scholar Grant ( MRSG-17-220-01 to Mingyang Song), and Department of Defense ( CA160344 to Kimmie Ng). The funders had no role in the study design; in the collection, analysis, and interpretation of data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. All authors confirm the independence of researchers from funders and have full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding Information:
Funding The Nurses’ Health Study II was funded by the National Cancer Institute, National Institutes of Health (U01 CA176726, R01 CA67262, and U01 HL145386) and this project was funded by research grants R03 CA197879 (Kana Wu), R21 CA222940 (Kana Wu and Marios Giannakis), R21 CA230873 (Kana Wu, Shuji Ogino), R01 CA151993 (Shuji Ogino), R35 CA197735 (Shuji Ogino), R01 CA205406 (Kimmie Ng), K24 DK098311 (Andrew T. Chan), R35 CA253185 (Andrew T. Chan), K99 CA215314 (Mingyang Song), R00 CA215314 (Mingyang Song), and K07 CA188126 (Xuehong Zhang). This work was also in part supported by an Investigator Initiated Grant from the American Institute for Cancer Research (AICR) to Kana Wu. In addition, this work was supported by American Cancer Society Research Scholar Grant (RSG130476 to Xuehong Zhang and RSG-20-124-01-CCE to Fred K. Tabung), the American Cancer Society Research Mentored Research Scholar Grant (MRSG-17-220-01 to Mingyang Song), and Department of Defense (CA160344 to Kimmie Ng). The funders had no role in the study design; in the collection, analysis, and interpretation of data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. All authors confirm the independence of researchers from funders and have full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Conflict of interest These authors disclose the following: All authors have completed the ICMJE uniform disclosure form and declare support from the National Institutes of Health and American Cancer Society for the submitted work. Kimmie Ng has received institutional research funding from Pharmavite, Revolution Medicines, and Evergrande Group; has served on an advisory board for Seattle Genetics and Array Biopharma; and served as a consultant to X-Biotix Therapeutics. Jeffrey A. Meyerhardt has received institutional research funding from Boston Biomedical, has served as an advisor/consultant to Ignyta and COTA Healthcare, and served on a grant review panel for the National Comprehensive Cancer Network funded by Taiho Pharmaceutical. Andrew T. Chan has previously served as a consultant to Bayer Pharma AG, Pfizer Inc., and Boehringer Ingelheim for topics unrelated to this manuscript. Charles S. Fuchs reports consulting role for Agios, Amylin Pharmaceuticals, Bain Capital, CytomX Therapeutics, Daiichi-Sankyo, Eli Lilly, Entrinsic Health, Evolveimmune Therapeutics, Genentech, Merck, Taiho, and Unum Therapeutics. He also serves as a Director for CytomX Therapeutics and owns unexercised stock options for CytomX and Entrinsic Health. He is a co-Founder of Evolveimmune Therapeutics and has equity in this private company. He had provided expert testimony for Amylin Pharmaceuticals and Eli Lilly. The remaining authors disclose no conflicts.
Publisher Copyright:
© 2021 AGA Institute
All Science Journal Classification (ASJC) codes
- Hepatology
- Gastroenterology
