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Skapinker E, Aldbai R, Aucoin E, Clarke E, Clark M, Ghokasian D, Kombargi H, Abraham MJ, Li Y, Bunsick DA, Baghaie L, Szewczuk MR. Artificial and Natural Sweeteners Biased T1R2/T1R3 Taste Receptors Transactivate Glycosylated Receptors on Cancer Cells to Induce Epithelial-Mesenchymal Transition of Metastatic Phenotype. Nutrients 2024; 16:1840. [PMID: 38931195 PMCID: PMC11206856 DOI: 10.3390/nu16121840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Understanding the role of biased taste T1R2/T1R3 G protein-coupled receptors (GPCR) agonists on glycosylated receptor signaling may provide insights into the opposing effects mediated by artificial and natural sweeteners, particularly in cancer and metastasis. Sweetener-taste GPCRs can be activated by several active states involving either biased agonism, functional selectivity, or ligand-directed signaling. However, there are increasing arrays of sweetener ligands with different degrees of allosteric biased modulation that can vary dramatically in binding- and signaling-specific manners. Here, emerging evidence proposes the involvement of taste GPCRs in a biased GPCR signaling crosstalk involving matrix metalloproteinase-9 (MMP-9) and neuraminidase-1 (Neu-1) activating glycosylated receptors by modifying sialic acids. The findings revealed that most natural and artificial sweeteners significantly activate Neu-1 sialidase in a dose-dependent fashion in RAW-Blue and PANC-1 cells. To confirm this biased GPCR signaling crosstalk, BIM-23127 (neuromedin B receptor inhibitor, MMP-9i (specific MMP-9 inhibitor), and oseltamivir phosphate (specific Neu-1 inhibitor) significantly block sweetener agonist-induced Neu-1 sialidase activity. To assess the effect of artificial and natural sweeteners on the key survival pathways critical for pancreatic cancer progression, we analyzed the expression of epithelial-mesenchymal markers, CD24, ADLH-1, E-cadherin, and N-cadherin in PANC-1 cells, and assess the cellular migration invasiveness in a scratch wound closure assay, and the tunneling nanotubes (TNTs) in staging the migratory intercellular communication. The artificial and natural sweeteners induced metastatic phenotype of PANC-1 pancreatic cancer cells to promote migratory intercellular communication and invasion. The sweeteners also induced the downstream NFκB activation using the secretory alkaline phosphatase (SEAP) assay. These findings elucidate a novel taste T1R2/T1R3 GPCR functional selectivity of a signaling platform in which sweeteners activate downstream signaling, contributing to tumorigenesis and metastasis via a proposed NFκB-induced epigenetic reprogramming modeling.
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Affiliation(s)
- Elizabeth Skapinker
- Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N9, Canada; (E.S.); (R.A.); (E.C.); (D.G.); (H.K.); (M.J.A.)
| | - Rashelle Aldbai
- Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N9, Canada; (E.S.); (R.A.); (E.C.); (D.G.); (H.K.); (M.J.A.)
- Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada; (D.A.B.); (L.B.)
| | - Emilyn Aucoin
- Faculty of Science, Biology (Biomedical Science), York University, Toronto, ON M3J 1P3, Canada;
| | - Elizabeth Clarke
- Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N9, Canada; (E.S.); (R.A.); (E.C.); (D.G.); (H.K.); (M.J.A.)
| | - Mira Clark
- Faculty of Arts and Science, Queen’s University, Kingston, ON K7L 3N9, Canada; (M.C.); (Y.L.)
| | - Daniella Ghokasian
- Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N9, Canada; (E.S.); (R.A.); (E.C.); (D.G.); (H.K.); (M.J.A.)
| | - Haley Kombargi
- Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N9, Canada; (E.S.); (R.A.); (E.C.); (D.G.); (H.K.); (M.J.A.)
| | - Merlin J. Abraham
- Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N9, Canada; (E.S.); (R.A.); (E.C.); (D.G.); (H.K.); (M.J.A.)
| | - Yunfan Li
- Faculty of Arts and Science, Queen’s University, Kingston, ON K7L 3N9, Canada; (M.C.); (Y.L.)
| | - David A. Bunsick
- Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada; (D.A.B.); (L.B.)
| | - Leili Baghaie
- Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada; (D.A.B.); (L.B.)
| | - Myron R. Szewczuk
- Department of Biomedical & Molecular Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada; (D.A.B.); (L.B.)
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Jatho A, Myung SK, Kim J, Han SS, Kim SY, Ju W. Consumption of Sugar-Sweetened Soft Drinks and Risk of Gastrointestinal Cancer: A Systematic Review and Meta-Analysis of Observational Studies. Oncology 2023; 102:141-156. [PMID: 37651986 DOI: 10.1159/000531110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/02/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Previous observational studies have reported inconsistent findings on the association between consumption of sugar-sweetened soft drinks (SSSDs) and the risk of gastrointestinal (GI) cancer. This study investigated the associations between SSSD consumption and the risk of GI cancer using a systematic review and meta-analysis. METHODS Observational epidemiological studies were searched from the PubMed and EMBASE databases until June 2021. We conducted a meta-analysis of all included studies and subgroup meta-analyses based on various factors. RESULTS In a meta-analysis of 27 studies with nine case-control studies and 18 cohort studies, the consumption of SSSDs was modestly associated with an increased risk of GI cancer (odds ratio [OR]/relative risk [RR]: 1.08; 95% confidence interval [CI]: 1.01-1.16), with a significant positive dose-response relationship. In the subgroup meta-analysis by study design, there was a significant positive association between the consumption of SSSDs and GI cancer in cohort studies (RR: 1.11; 95% CI: 1.03-1.20; n = 18), but not in case-control studies. In the subgroup meta-analysis by type of cancer, consumption of SSSDs was significantly associated with an increased risk of colorectal cancer (OR/RR: 1.13; 95% CI: 1.07-1.19). CONCLUSIONS This meta-analysis suggests that SSSD consumption significantly increases the risk of GI cancer, specifically colorectal cancer.
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Affiliation(s)
- Alfred Jatho
- Department of Cancer Control and Policy, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Directorate of Cancer Research and Training, Uganda Cancer Institute, Kampala, Uganda
| | - Seung-Kwon Myung
- Department of Cancer AI and Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer AI and Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Goyang, Republic of Korea
| | - Sung-Sik Han
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Sun Young Kim
- Department of Cancer AI and Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Woong Ju
- Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
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Schorb S, Gleiss K, Wedekind R, Suonio E, Kull AK, Kuntz M, Walch SG, Lachenmeier DW. Assessment of Aspartame (E951) Occurrence in Selected Foods and Beverages on the German Market 2000-2022. Foods 2023; 12:2156. [PMID: 37297402 PMCID: PMC10252593 DOI: 10.3390/foods12112156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
This study examines the occurrence of the artificial sweetener aspartame (E951) in foods and beverages sampled by food control authorities in Germany between 2000 and 2022. The dataset was obtained through the Consumer Information Act. Out of 53,116 samples analyzed, aspartame was present in 7331 samples (14%), of which 5703 samples (11%) in nine major food groups were further evaluated. The results showed that aspartame was most commonly found in powdered drink bases (84%), flavored milk drinks (78%), chewing gum (77%), and diet soft drinks (72%). In the solid food groups, the highest mean aspartame content was detected in chewing gum (1543 mg/kg, n = 241), followed by sports foods (1453 mg/kg, n = 125), fiber supplements (1248 mg/kg, n = 11), powdered drink bases (1068 mg/kg, n = 162), and candies (437 mg/kg, n = 339). Liquid products generally had the highest aspartame content in diet soft drinks (91 mg/L, n = 2021), followed by regular soft drinks (59 mg/L, n = 574), flavored milk drinks (48 mg/kg, n = 207), and mixed beer drinks (24 mg/L, n = 40). These results suggest that aspartame is commonly used in some foods and beverages in Germany. The levels of aspartame found were generally within the legal limits set by the European Union. These findings provide the first comprehensive overview of aspartame in the German food market and may be particularly useful in informing the forthcoming working groups of the WHO International Agency for Research on Cancer (IARC) and the WHO/FAO Joint Expert Committee on Food Additives (JECFA), which are in the process of evaluating the human health hazards and risks associated with the consumption of aspartame.
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Affiliation(s)
- Sydney Schorb
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187 Karlsruhe, Germany; (S.S.); (K.G.); (M.K.); (S.G.W.)
| | - Katharina Gleiss
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187 Karlsruhe, Germany; (S.S.); (K.G.); (M.K.); (S.G.W.)
| | - Roland Wedekind
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, 25 Avenue Tony Garnier, 69366 Lyon, France; (R.W.); (E.S.)
| | - Eero Suonio
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, 25 Avenue Tony Garnier, 69366 Lyon, France; (R.W.); (E.S.)
| | - Ann-Kathrin Kull
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187 Karlsruhe, Germany; (S.S.); (K.G.); (M.K.); (S.G.W.)
| | - Marcel Kuntz
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187 Karlsruhe, Germany; (S.S.); (K.G.); (M.K.); (S.G.W.)
| | - Stephan G. Walch
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187 Karlsruhe, Germany; (S.S.); (K.G.); (M.K.); (S.G.W.)
| | - Dirk W. Lachenmeier
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187 Karlsruhe, Germany; (S.S.); (K.G.); (M.K.); (S.G.W.)
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Pavanello S, Moretto A, La Vecchia C, Alicandro G. Non-sugar sweeteners and cancer: Toxicological and epidemiological evidence. Regul Toxicol Pharmacol 2023; 139:105369. [PMID: 36870410 DOI: 10.1016/j.yrtph.2023.105369] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
Several toxicological and epidemiological studies were published during the last five decades on non-sugar sweeteners (NSS) and cancer. Despite the large amount of research, the issue still continues to be of interest. In this review, we provided a comprehensive quantitative review of the toxicological and epidemiological evidence on the possible relation between NSS and cancer. The toxicological section includes the evaluation of genotoxicity and carcinogenicity data for acesulfame K, advantame, aspartame, cyclamates, saccharin, steviol glycosides and sucralose. The epidemiological section includes the results of a systematic search of cohort and case-control studies. The majority of the 22 cohort studies and 46 case-control studies showed no associations. Some risks for bladder, pancreas and hematopoietic cancers found in a few studies were not confirmed in other studies. Based on the review of both the experimental data on genotoxicity or carcinogenicity of the specific NSS evaluated, and the epidemiological studies it can be concluded that there is no evidence of cancer risk associated to NSS consumption.
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Affiliation(s)
- Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università degli Studi di Padova, Padua, Italy; University Hospital of Padova, Padua, Italy
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università degli Studi di Padova, Padua, Italy; University Hospital of Padova, Padua, Italy.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Sugar Sweetened and Artificially Sweetened Beverage Consumption and Pancreatic Cancer: A Retrospective Study. Nutrients 2023; 15:nu15020275. [PMID: 36678146 PMCID: PMC9866356 DOI: 10.3390/nu15020275] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/15/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
Pancreatic cancer (PanCa) is a highly fatal malignancy with few modifiable risk and prognostic factors. This study investigates the association between cola, diet cola, and non-cola soft drink consumption and PanCa risk and mortality. A retrospective study was conducted using data from the Patient Epidemiology Data System (1982-1998) at Roswell Park Comprehensive Cancer Center (Buffalo, NY, USA), including 213 PanCa patients and 852 cancer-free controls. Data were collected using a self-administered questionnaire, including a 46-item food frequency questionnaire (FFQ). Multivariable logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (CI) of cola, diet cola, and non-cola soft drink consumption and PanCa risk. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% CIs of cola, diet cola, and non-cola soft drink consumption and PanCa mortality. Stratified analyses were conducted by sex, body mass index (BMI), and smoking status. We observed significant 55% increased odds of PanCa among patients consuming ≥1 regular cola per day (OR: 1.55, 95% CI: 1.01-2.39). We also observed non-significant 38% increased hazard of mortality among patients consuming ≥1 regular cola per day (HR: 1.38, 95% CI: 0.91-2.07). We conclude that regular cola consumption is a modifiable lifestyle that may be associated with PanCa risk and mortality following diagnosis.
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Artificially Sweetened Beverage Consumption and Cancer Risk: A Comprehensive Dose-Response Meta-Analysis of Prospective Studies. Nutrients 2022; 14:nu14214445. [PMID: 36364707 PMCID: PMC9658995 DOI: 10.3390/nu14214445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 01/24/2023] Open
Abstract
The impact of artificially sweetened beverages (ASBs), alternatives to sugar-sweetened beverages, on cancer incidence remains controversial. We conducted a meta-analysis of prospective studies to assess the association of daily ASB intake with cancer risk. A systematic search was performed between January 1967 and September 2022. Risk ratios (RR) or hazard ratios (HR) were extracted and pooled. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used for the assessment of the certainty of evidence. The study was registered at PROSPERO (CRD42022312171). Overall, 14 articles with 17 cohorts were included. There was no significant association between daily ASB consumption and risk of overall cancer (highest versus lowest category: n = 17, RR = 1.03, 95% CI: 0.96-1.11, p = 0.407). For site-specific cancer analysis, the risk of non-lymphoid leukemia was elevated with high ASB intake (n = 3, RR = 1.35, 95% CI: 1.03-1.77, p = 0.030), while risk of colorectal cancer was decreased (n = 3, RR = 0.78, 95% CI: 0.62-0.99, p = 0.037). Dose-response analysis indicated a positive linear association between ASB intake and the risk of leukemia (p-linear = 0.027). The risk increased by 15% per one serving (355 mL) daily ASB intake increment (RR = 1.15, 95% CI: 1.02-1.30). In conclusion, ASB consumption might be positively associated with the risk of leukemia and negatively associated with the risk of colorectal cancer.
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Song M, Lee WS, Moon J. Antecedents and consequences of healthiness in café service: Moderating effect of health concern. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.913291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aims to examine the antecedents of consequences of healthiness in the café business context. Additionally, this study attests to the moderating effect of one's concern for health (health concern) between healthiness and attitude. To attain a more vivid response, this research selected Starbucks coffeehouse as a case study. Hygiene, healthiness, and nutritional disclosure are the determinants of healthiness in the café business area. The consequences of healthiness are attitude and purchase intention for café products. Health concern is the moderating variable between healthiness and attitude in the context of café businesses. In order to test the association between attributes, a survey was used. Amazon Mechanical Turk was chosen to recruit survey participants. The valid observation for data analysis was 455 participants. For hypothesis testing, a structural equation model was implemented. Regarding the results, health concern is positively influenced by hygiene and organicness, but healthiness is negatively affected by nutritional disclosure. Moreover, it was found that health concern significantly moderates the relationship between healthiness and attitude, and attitude exerts a positive effect on purchase intention.
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Arroyo-Quiroz C, Brunauer R, Alavez S. Sugar-Sweetened Beverages and Cancer Risk: A Narrative Review. Nutr Cancer 2022; 74:3077-3095. [PMID: 35486421 DOI: 10.1080/01635581.2022.2069827] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cancer continues to be a major public health challenge worldwide, not only for being one of the leading causes of death but also because the number of incident cases is projected to grow in the next decades. Meanwhile, sugar-sweetened beverages (SSB) consumption has risen since the past century and constitutes a considerable fraction of added sugars in daily diet. Several studies have analyzed the relationship between SSB intake and health and found substantial evidence for effects on obesity, type 2 diabetes and metabolic syndrome. However, there is little knowledge about the relationship of SSB with cancer risk. It may be speculated that there is an indirect relationship between SSB and cancer through obesity and metabolic syndrome, but obesity-independent associations through hormonal imbalances or chronic inflammation could also exist. In this review, we describe the epidemiological evidence of the association of SSB and the risk of cancer in adults. Although the epidemiological evidence linking SSB consumption and cancer risk is still limited, prospective studies suggest that high SSB intake may increase the risk of obesity-related cancers, breast and prostate cancer.
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Affiliation(s)
- Carmen Arroyo-Quiroz
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana, Lerma de Villada, Mexico
| | - Regina Brunauer
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Silvestre Alavez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana, Lerma de Villada, Mexico.,Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México, México City, Mexico
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Chen CH, Tsai MK, Lee JH, Lin RT, Hsu CY, Wen C, Wu X, Chu TW, Wen CP. "Sugar-Sweetened Beverages" Is an Independent Risk From Pancreatic Cancer: Based on Half a Million Asian Cohort Followed for 25 Years. Front Oncol 2022; 12:835901. [PMID: 35463371 PMCID: PMC9022008 DOI: 10.3389/fonc.2022.835901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
Although the link between sugar-sweetened beverages (SSB) and pancreatic cancer has been suggested for its insulin-stimulating connection, most epidemiological studies showed inconclusive relationship. Whether the result was limited by sample size is explored. This prospective study followed 491,929 adults, consisting of 235,427 men and 256,502 women (mean age: 39.9, standard deviation: 13.2), from a health surveillance program and there were 523 pancreatic cancer deaths between 1994 and 2017. The individual identification numbers of the cohort were matched with the National Death file for mortality, and Cox models were used to assess the risk. The amount of SSB intake was recorded based on the average consumption in the month before interview by a structured questionnaire. We classified the amount of SSB intake into 4 categories: 0–<0.5 serving/day, ≥0.5–<1 serving per day, ≥1–<2 servings per day, and ≥2 servings per day. One serving was defined as equivalent to 12 oz and contained 35 g added sugar. We used the age and the variables at cohort enrolment as the reported risks of pancreatic cancers. The cohort was divided into 3 age groups, 20–39, 40–59, and ≥60. We found young people (age <40) had higher prevalence and frequency of sugar-sweetened beverages than the elderly. Those consuming 2 servings/day had a 50% increase in pancreatic cancer mortality (HR = 1.55, 95% CI: 1.08–2.24) for the total cohort, but a 3-fold increase (HR: 3.09, 95% CI: 1.44–6.62) for the young. The risk started at 1 serving every other day, with a dose–response relationship. The association of SSB intake of ≥2 servings/day with pancreatic cancer mortality among the total cohort remained significant after excluding those who smoke or have diabetes (HR: 2.12, 97% CI: 1.26–3.57), are obese (HR: 1.57, 95% CI: 1.08–2.30), have hypertension (HR: 1.90, 95% CI: 1.20–3.00), or excluding who died within 3 years after enrollment (HR: 1.67, 95% CI: 1.15–2.45). Risks remained in the sensitivity analyses, implying its independent nature. We concluded that frequent drinking of SSB increased pancreatic cancer in adults, with highest risk among young people.
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Affiliation(s)
- Chien Hua Chen
- Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.,Department of Food Science and Technology, Hungkuang University, Taichung, Taiwan
| | - Min Kuang Tsai
- Institue of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - June Han Lee
- Institue of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Ro-Ting Lin
- College of Public Health, China Medical University, Taichung, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Christopher Wen
- Long Beach VAMC Hospital, University of Irvine Medical Center, Irvine, CA, United States
| | - Xifeng Wu
- Center for Biostatistics, Bioinformatics and Big Data, The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.,National Institute for Data Science in Health and Medicine, Zhejiang University, Hangzhou, China
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taipei MJ Health Screening Center, Taipei, Taiwan
| | - Chi Pang Wen
- Institue of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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Yeary KHCK, Quisenberry A, Hall MG, Yu H, Henry WAE, Rodriguez EM, Zoellner JM. Sweet Beverages and Cancer: A Scoping Review of Quantitative Studies. Cancer Prev Res (Phila) 2022; 15:377-390. [PMID: 35271710 DOI: 10.1158/1940-6207.capr-21-0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/25/2022] [Accepted: 03/07/2022] [Indexed: 11/16/2022]
Abstract
We conducted a scoping review of sweet beverages (SB) and cancer outcomes to ascertain SB's relationship with cancer by SB type and cancer type. We used the PRISMA Scoping Review Guidelines to review quantitative studies of SB and cancer. Eligible studies included articles reporting a quantitative association between SB intake and a cancer-related health outcome in humans, including adiposity-related vs. non-adiposity-related cancers. Studies included analyses not confounded by artificial sweeteners. SB was defined as beverages with added sugars, 100% fruit juices, or fruit drinks that were not 100% fruit juice. We used a data-charting form to extract study characteristics and results. A total of 38 were included. The sample consisted predominately of adults from European countries outside of the U.S. or predominately White samples in the U.S. Across all conceptualizations of SB, a greater proportion of studies examining carbonated drinks reported SB's relationship with poorer cancer outcomes, which was exacerbated in adiposity-related cancers. The composition of different types of SB (e.g. high fructose corn syrup, natural fructose) as they relate to cancer is important. Studies including more diverse populations that bear a disproportionate burden of both SB intake and cancer are needed.
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Affiliation(s)
| | | | - Marissa G Hall
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Han Yu
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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Jatho A, Cambia JM, Myung SK. Consumption of artificially sweetened soft drinks and risk of gastrointestinal cancer: a meta-analysis of observational studies. Public Health Nutr 2021; 24:6122-6136. [PMID: 33691824 PMCID: PMC11148581 DOI: 10.1017/s136898002100104x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE There remain inconclusive findings from previous observational epidemiological studies on whether consumption of artificially sweetened soft drinks (ASSD) increases the risk of gastrointestinal (GI) cancer. We investigated the associations between the consumption of ASSD and the risk of GI cancer using a meta-analysis. DESIGN Systematic review and meta-analysis. SETTING PubMed and EMBASE were searched using keywords until May 2020 to identify observational epidemiological studies on the association between the consumption of ASSD and the risk of GI cancer. SUBJECTS Twenty-one case-control studies and seventeen cohort studies with 12 397 cancer cases and 2 474 452 controls. RESULTS In the random-effects meta-analysis of all the studies, consumption of ASSD was not significantly associated with the risk of overall GI cancer (OR/relative risk (RR), 1·02; 95 % CI, 0·92, 1·14). There was no significant association between the consumption of ASSD and the risk of overall GI cancer in the subgroup meta-analyses by study design (case-control studies: OR, 0·95; 95 % CI, 0·82, 1·11; cohort studies: RR, 1·14; 95 % CI, 0·97, 1·33). In the subgroup meta-analysis by type of cancer, consumption of ASSD was significantly associated with the increased risk of liver cancer (OR/RR, 1·28; 95 % CI, 1·03, 1·58). CONCLUSIONS The current meta-analysis of observational epidemiological studies suggests that overall, there is no significant association between the consumption of ASSD and the risk of GI cancer.
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Affiliation(s)
- Alfred Jatho
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Jansen Marcos Cambia
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Seung-Kwon Myung
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do10408, Republic of Korea
- Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, Republic of Korea
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12
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Tepler A, Hoffman G, Jindal S, Narula N, Shah SC. Intake of artificial sweeteners among adults is associated with reduced odds of gastrointestinal luminal cancers: a meta-analysis of cohort and case-control studies. Nutr Res 2021; 93:87-98. [PMID: 34461350 PMCID: PMC8818300 DOI: 10.1016/j.nutres.2021.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022]
Abstract
The association between artificial sweetener (AS) consumption and the risk of organ-specific cancers has been debated for decades. We hypothesized that AS consumption is associated with reduced risk of gastrointestinal (GI) cancers. We aimed to test this hypothesis by conducting a systematic review and meta-analysis of the association between AS and GI cancers. We searched 4 databases for comparative studies of AS consumption (exposed) versus no consumption (nonexposed) and the odds or risk of GI luminal or non-luminal cancer (primary outcome). Estimates were pooled using a random-effects model. Studies were evaluated for quality, bias, and heterogeneity. We analyzed 8 (4 prospective, 4 case-control) studies comprising data on 1,043,496 individuals, among whom 3271 pancreatic, 395 gastric, 304 esophageal, 3008 colorectal, and 598 oropharyngeal cancers occurred. While there was no significant association between AS consumption and odds of GI cancer overall, AS consumption was associated with 19% reduced likelihood of luminal GI cancer (OR 0.81, 95% CI:0.68-0.97). There was no association between AS consumption and non-luminal GI cancer. Meta-regression demonstrated no difference in effect estimates based on study type. Based on this first meta-analysis of AS and GI cancer, we demonstrated that AS consumption is associated with a significantly lower likelihood of luminal, but not non-luminal, GI cancer.
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Affiliation(s)
- Adam Tepler
- Department of Medicine, New York University Langone Health, New York City, NY, USA
| | - Gila Hoffman
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Shawn Jindal
- Department of Medicine, Montefiore Medical Center, New York City, NY, USA
| | - Neeraj Narula
- Division of Gastroenterology, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Shailja C Shah
- Section of Gastroenterology, Veterans Affairs San Diego Healthcare System, San Diego, CA, 92161, USA; Division of Gastroenterology, University of California, San Diego, San Diego, CA, 92161, USA; Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA.
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13
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Li Y, Guo L, He K, Huang C, Tang S. Consumption of sugar-sweetened beverages and fruit juice and human cancer: a systematic review and dose-response meta-analysis of observational studies. J Cancer 2021; 12:3077-3088. [PMID: 33854607 PMCID: PMC8040874 DOI: 10.7150/jca.51322] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 03/04/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Several epidemiological studies have assessed the association of sugary drinks consumption with cancer, but the results remain controversial. Objective: We performed this analysis to evaluate possible causal relationship between sugary drinks consumption and cancer risk and mortality. Methods: We searched PubMed, Embase, and Web of Science databases in English. Observational studies evaluating the association of sugary drinks intake with cancer were included. Random-effects meta-analysis was used to calculate the risk estimates. Results: A total of 71 observational articles with 32 case-control and 39 cohort studies were included in the meta-analysis. 60 addressed cancer risk, and 11 reported cancer mortality. Compared with the lowest level, the highest level of sugar-sweetened beverages (SSB) consumption showed an increased overall cancer risk (RR=1.12 95% CI: 1.06-1.19, P=0.000) and mortality (RR=1.07 95% CI: 1.01-1.14, P=0.029), and fruit juice intake showed a positive association with cancer risk in cohort studies (RR=1.06 95% CI: 1.01-1.11, P=0.013). Subgroup analyses based on cancer type indicated that risk of breast cancer, hepatocellular carcinoma, colorectal cancer, and prostatic cancer mortality had a positive association with SSB consumption. For dose-response analysis, evidence of a linear association was found between overall cancer risk and SSB or fruit juice consumption, and the risk increase by 4% for one servings/d increment in SSB intake and 14% in fruit juice. Conclusions: Our findings suggest the consumption of sugary beverages may increase the risk and mortality of cancer, especially risk of breast cancer, hepatocellular carcinoma, colorectal cancer, and prostatic cancer, and mortality of breast cancer, though the evidence was limited.
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Affiliation(s)
- Yuting Li
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Lilianagzi Guo
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Kaiyin He
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Changbing Huang
- Department of Information, Affiliated Hospital (Clinical College) of Xiangnan University, Chenzhou, Hunan, China
| | - Shaohui Tang
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
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14
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Martin MÁ, Ramos S. Impact of cocoa flavanols on human health. Food Chem Toxicol 2021; 151:112121. [PMID: 33722594 DOI: 10.1016/j.fct.2021.112121] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 01/18/2023]
Abstract
Cocoa is a source of flavanols, and these phenolic compounds exert beneficial effects on health and aging, and reduce the risk of suffering chronic diseases (cardiovascular diseases, metabolic disorders, cancer). An increasing body of evidence has emerged to suggest that cocoa flavanols potentially are important chemopreventive natural agents. This review summarizes human studies from the past two decades, providing data related to the effects derived from cocoa intake on health and disease. Most human studies have reported beneficial effects of cocoa consumption on health and chronic diseases; however, outcomes are not unequivocal. Review of human studies enable to identify different mechanisms of action for cocoa, although they are not fully understood at present. In addition, it remains unclear whether cocoa consumption should be recommended to healthy subjects or to patients and what is the appropriate dosage or duration of cocoa consumption. Elucidation of information regarding these crucial issues could lead to cocoa use as an approach for decreasing the risk of certain chronic diseases, as well as improving health and quality of life.
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Affiliation(s)
- María Ángeles Martin
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN-CSIC), José Antonio Novais 10, Ciudad Universitaria, 28040, Madrid, Spain; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Sonia Ramos
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN-CSIC), José Antonio Novais 10, Ciudad Universitaria, 28040, Madrid, Spain.
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15
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Llaha F, Gil-Lespinard M, Unal P, de Villasante I, Castañeda J, Zamora-Ros R. Consumption of Sweet Beverages and Cancer Risk. A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2021; 13:nu13020516. [PMID: 33557387 PMCID: PMC7915548 DOI: 10.3390/nu13020516] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 02/08/2023] Open
Abstract
The consumption of sweet beverages, including sugar-sweetened beverages (SSB), artificial-sweetened beverages (ASB) and fruit juices (FJ), is associated with the risk of different cardiometabolic diseases. It may also be linked to the development of certain types of tumors. We carried out a systematic review and meta-analysis of observational studies aimed at examining the association between sweet beverage intake and cancer risk. Suitable articles published up to June 2020 were sourced through PubMed, Web of Science and SCOPUS databases. Overall, 64 studies were identified, of which 27 were selected for the meta-analysis. This was performed by analyzing the multivariable-adjusted OR, RR or HR of the highest sweet beverage intake categories compared to the lowest one. Random effects showed significant positive association between SSB intake and breast (RR: 1.14, 95% CI: 1.01–1.30) and prostate cancer risk (RR: 1.18, 95% CI: 1.10–1.27) and also between FJs and prostate cancer risk (RR: 1.03, 95% CI: 1.01–1.05). Although the statistically significant threshold was not reached, there tended to be positive associations for the following: SSBs and colorectal and pancreatic cancer risk; FJs and breast, colorectal and pancreatic cancer risk; and ASBs and pancreatic cancer risk. This study recommends limiting sweet beverage consumption. Furthermore, we propose to establish a homogeneous classification of beverages and investigate them separately, to better understand their role in carcinogenesis.
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16
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Milajerdi A, Larijani B, Esmaillzadeh A. Sweetened Beverages Consumption and Pancreatic Cancer: A Meta-Analysis. Nutr Cancer 2019; 71:375-384. [PMID: 30849232 DOI: 10.1080/01635581.2019.1578390] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
No study has summarized earlier findings on the association of sweetened beverages (SBs) consumption and risk of Pancreatic Cancer (PC). This systematic review and meta-analysis was conducted to systematically review available observational studies that examined the association of SB consumption with risk of PC. Relevant papers published up to December 2017 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar databases, using relevant keywords. Cohort and case-control studies that examined the association of SB with PC in adults were included. Overall, 5 cohort studies with 2,041,689 participants (58.68% female, 41.32% male) and 4 case-control studies [enrolled 1,496 cases with PC (55.82% male, 44.18% female) and 3,179 controls (53.32% male, 46.68% female)] were included. Combining effect sizes from cohort studies, we found no significant association between SB consumption and risk of PC (RR: 1.06; 95% CI: 0.87-1.29). Although, stratification by the study location, follow-up duration, exposure and outcome assessment method, and adjustment for physical activity and race/ethnicity removed between-study heterogeneity, it did not affect the association. We found that 50 g/d increment in SB consumption was not linearly associated with risk of PC (RR: 1.00, 95% CI: 0.96, 1.04). No significant nonlinear association was also reached (P-nonlinearity = 0.13). In addition, pooling effect sizes from case-control studies, we did not find significant association between SB consumption and risk of PC (RR: 1.11; 95% CI: 0.92-1.35). We did not find any significant association between SB consumption and risk of PC. Additional studies are required to shed light on this issue.
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Affiliation(s)
- Alireza Milajerdi
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran.,b Students' Scientific Research Center (SSRC) , Tehran University of Medical Sciences (TUMS) , Tehran , Iran
| | - Bagher Larijani
- c Endocrinology and Metabolism Research Center , Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences , Tehran , Iran
| | - Ahmad Esmaillzadeh
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran.,d Obesity and Eating Habits Research Center , Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences , Tehran , Iran.,e Department of Community Nutrition, Food Security Research Center , School of Nutrition and Food Science, Isfahan University of Medical Sciences , Isfahan , Iran
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17
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Haighton L, Roberts A, Jonaitis T, Lynch B. Evaluation of aspartame cancer epidemiology studies based on quality appraisal criteria. Regul Toxicol Pharmacol 2019; 103:352-362. [PMID: 30716379 DOI: 10.1016/j.yrtph.2019.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/23/2019] [Accepted: 01/26/2019] [Indexed: 11/30/2022]
Abstract
Given the widespread use of the low-calorie sweetener aspartame over the last 30 years, the current work was undertaken to evaluate aspartame epidemiology studies looking at cancer endpoints against quality appraisal criteria. The quality appraisal tool used was from the National Heart, Lung and Blood Institute (NHLBI) of the National Institute of Health. Studies identified included nine case-control studies and five prospective cohort studies. Most studies assessed low-calorie or diet beverages rather than aspartame intake specifically; however, common use of aspartame in diet sodas does allow for some general extrapolation of results. Following consideration of study quality, two case-control and five prospective studies were considered to meet the majority of the NHLBI criteria. The primary limitation of the other case-control studies was an inadequate sample size. Overall, the results of the studies do not support that exposures to low and no-calorie sweeteners and beverages, and by extension aspartame, are associated with an increased risk of cancer in humans.
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Affiliation(s)
- Lois Haighton
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada.
| | - Ashley Roberts
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada
| | - Tomas Jonaitis
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada
| | - Barry Lynch
- Intertek Regulatory & Scientific Consultancy, 2233 Argentia Rd., Suite 201, Mississauga, ON, L5N 2X7, Canada
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18
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Abstract
The association between consumption of added or concentrated sugars and prostate cancer risk is unclear. We examined the association between concentrated sugars in beverages and desserts and prostate cancer risk among 22 720 men in the usual-care arm of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, enrolled during 1993-2001. After a median follow-up of 9 years, 1996 men were diagnosed with prostate cancer. Cox proportional hazards regression models were used to estimate hazard ratios (HR) for prostate cancer risk and 95 % CI, adjusting for potential confounding factors. Increased consumption of sugars from sugar-sweetened beverages was associated with increased risk of prostate cancer for men in the highest quartile of sugar consumption (HR: 1·21; 95 % CI 1·06, 1·39), and there was a linear trend (P<0·01). There were no linear associations between prostate cancer risk and consumption of sugars from fruit juices or dessert foods. In conclusion, in this prospective substudy within the PLCO trial, consumption of sugars from sugar-sweetened beverages was associated with increased risk of prostate cancer among men receiving standard medical care. Our study suggests that limiting intake of sugars from beverages may be important in the prevention of prostate cancer.
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Zheng J, Guinter MA, Merchant AT, Wirth MD, Zhang J, Stolzenberg-Solomon RZ, Steck SE. Dietary patterns and risk of pancreatic cancer: a systematic review. Nutr Rev 2018; 75:883-908. [PMID: 29025004 DOI: 10.1093/nutrit/nux038] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Context Pancreatic cancer has the highest case fatality rate of all major cancers. Objective A systematic review using PRISMA guidelines was conducted to summarize the associations between dietary patterns and risk of pancreatic cancer. Data Sources PubMed and Web of Science databases were searched for case-control and cohort studies published up to June 15, 2016. Study Selection Eligible studies included a dietary pattern as exposure and pancreatic cancer incidence or mortality as outcome and reported odds ratios, hazard ratios, or relative risks, along with corresponding 95%CIs. Data Extraction Important characteristics of each study, along with the dietary assessment instrument, the component foods or nutrients included in each dietary pattern or the scoring algorithm of a priori dietary patterns, were presented. For each dietary pattern identified, the estimate of association and the 95%CI comparing the highest versus the lowest category from the model with the most covariate adjustment were reported. Results A total of 16 studies were identified. Among the 8 studies that examined data-driven dietary patterns, significant positive associations were found between pancreatic cancer risk and the Animal Products, Starch Rich, and Western dietary patterns, with effect estimates ranging from 1.69 to 2.40. Significant inverse relationships were found between risk of pancreatic cancer and dietary patterns designated as Fruits and Vegetables, Vitamins and Fiber, and Prudent, with effect estimates ranging from 0.51 to 0.55. Eight studies of a priori dietary patterns consistently suggested that improved dietary quality was associated with reduced risk of pancreatic cancer. Conclusions Better diet quality is associated with reduced risk of pancreatic cancer. The associations between dietary patterns and pancreatic cancer were stronger in case-control studies than in cohort studies and were stronger among men than among women.
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Affiliation(s)
- Jiali Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Mark A Guinter
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA.,Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute, Rockville, Maryland, USA
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
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20
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Lohner S, Toews I, Meerpohl JJ. Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Nutr J 2017; 16:55. [PMID: 28886707 PMCID: PMC5591507 DOI: 10.1186/s12937-017-0278-x] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 09/04/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Food products containing non-nutritive sweeteners (NNSs) instead of sugar have become increasingly popular in the last decades. Their appeal is obviously related to their calorie-free sweet taste. However, with the dramatic increase in their consumption, it is reasonable and timely to evaluate their potential health benefits and, more importantly, potential adverse effects. The main aim of this scoping review was to map the evidence about health outcomes possibly associated with regular NNS consumption by examining the extent, range, and nature of research activity in this area. METHODS We systematically searched Ovid MEDLINE, EMBASE and the Cochrane CENTRAL databases for studies on NNSs (artificial sweeteners or natural, non-caloric sweeteners, either used individually or in combination) using text terms with appropriate truncation and relevant indexing terms. All human studies investigating any health outcomes of a NNS intervention or exposure were eligible for inclusion. No studies were excluded based on language, study design or methodological quality. Data for each health outcome were summarized in tabular form and were discussed narratively. RESULTS Finally, we included 372 studies in our scoping review, comprising 15 systematic reviews, 155 randomized controlled trials (RCTs), 23 non-randomized controlled trials, 57 cohort studies, 52 case-control studies, 28 cross sectional studies and 42 case series/case reports. In healthy subjects, appetite and short term food intake, risk of cancer, risk of diabetes, risk of dental caries, weight gain and risk of obesity are the most investigated health outcomes. Overall there is no conclusive evidence for beneficial and harmful effects on those outcomes. Numerous health outcomes including headaches, depression, behavioral and cognitive effects, neurological effects, risk of preterm delivery, cardiovascular effects or risk of chronic kidney disease were investigated in fewer studies and further research is needed. In subjects with diabetes and hypertension, the evidence regarding health outcomes of NNS use is also inconsistent. CONCLUSIONS This scoping review identifies the needs for future research to address the numerous evidence gaps related to health effects of NNSs use.It also specifies the research questions and areas where a systematic review with meta-analyses is required for the proper evaluation of health outcomes associated to regular NNSs consumption.
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Affiliation(s)
| | - Ingrid Toews
- Cochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 153, Freiburg, 79110 Germany
| | - Joerg J. Meerpohl
- Cochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 153, Freiburg, 79110 Germany
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité – U1153, Inserm / Université Paris Descartes, Cochrane France, Hôpital Hôtel-Dieu, 1 place du Parvis Notre Dame, 75181 Paris, Cedex 04 France
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21
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Pelucchi C, Rosato V, Bracci PM, Li D, Neale RE, Lucenteforte E, Serraino D, Anderson KE, Fontham E, Holly EA, Hassan MM, Polesel J, Bosetti C, Strayer L, Su J, Boffetta P, Duell EJ, La Vecchia C. Dietary acrylamide and the risk of pancreatic cancer in the International Pancreatic Cancer Case-Control Consortium (PanC4). Ann Oncol 2017; 28:408-414. [PMID: 27836886 PMCID: PMC6246541 DOI: 10.1093/annonc/mdw618] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Occupational exposure to acrylamide was associated with excess mortality from pancreatic cancer, though in the absence of dose-risk relationship. Few epidemiological studies have examined the association between acrylamide from diet and pancreatic cancer risk. Patients and methods We considered this issue in a combined set of 1975 cases of pancreatic cancer and 4239 controls enrolled in six studies of the Pancreatic Cancer Case-Control Consortium (PanC4). We calculated pooled odds ratios (ORs) and their 95% confidence intervals (CI) by estimating study-specific ORs through multivariate unconditional logistic regression models and pooling the obtained estimates using random-effects models. Results Compared with the lowest level of estimated dietary acrylamide intake, the pooled ORs were 0.97 (95% CI, 0.79-1.19) for the second, 0.91 (95% CI, 0.71-1.16) for the third, and 0.92 (95% CI, 0.66-1.28) for the fourth (highest) quartile of intake. For an increase of 10 µg/day of acrylamide intake, the pooled OR was 0.96 (95% CI, 0.87-1.06), with heterogeneity between estimates (I2 = 67%). Results were similar across various subgroups, and were confirmed when using a one-stage modelling approach. Conclusions This PanC4 pooled-analysis found no association between dietary acrylamide and pancreatic cancer.
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Affiliation(s)
- C. Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - V. Rosato
- Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P. M. Bracci
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco
| | - D. Li
- Department of Gastrointestinal Medical Oncology, M.D. Anderson Cancer Center, University of Texas, Houston, USA
| | - R. E. Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - E. Lucenteforte
- Department of Neurosciences, Psychology, Drug Research and Children’s Health, University of Florence, Florence
| | - D. Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano (PN), Italy
| | - K. E. Anderson
- School of Public Health, University of Minnesota, Minneapolis
| | - E. Fontham
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, USA
| | - E. A. Holly
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco
| | - M. M. Hassan
- Department of Gastrointestinal Medical Oncology, M.D. Anderson Cancer Center, University of Texas, Houston, USA
| | - J. Polesel
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano (PN), Italy
| | - C. Bosetti
- Department of Epidemiology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - L. Strayer
- School of Public Health, University of Minnesota, Minneapolis
| | - J. Su
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock
| | - P. Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - E. J. Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - C. La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan
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22
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Miles FL, Chang SC, Morgenstern H, Tashkin D, Rao JY, Cozen W, Mack T, Lu QY, Zhang ZF. Association of sugary beverages with survival among patients with cancers of the upper aerodigestive tract. Cancer Causes Control 2016; 27:1293-1300. [PMID: 27539643 PMCID: PMC5552047 DOI: 10.1007/s10552-016-0792-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 07/22/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The role of consumption of added sugars in cancers of the upper aerodigestive tract (UADT) is unclear. We examined associations between sugary beverages and susceptibility to UADT cancer as well as overall survival among UADT cancer patients. METHODS The association between dietary added sugar and susceptibility to UADT cancers or overall survival among 601 UADT cancer cases was evaluated using data from a population-based case-control study conducted in Los Angeles County. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals (CI) for cancer susceptibility, and Cox regression was used to estimate hazards ratios (HRs) with 95 % CIs for survival, adjusting for relevant confounders. RESULTS A total of 248 deaths were observed during follow-up (median 12.1 years). A positive association was observed with consumption of grams of sugar from beverages, including soft drinks and fruit juices, and poorer survival among UADT cancer cases (aHR, Q4 vs. Q1:1.88; 95 % CI 1.29, 2.72; p for trend = 0.002), as well as servings of sugary beverages (aHR, Q4 vs. Q1: 95 % CI 1.97, 95 % CI 1.32-2.93). This was due largely to consumption of sugars from soft drinks. Particularly, high consumption of sugary beverages was associated with poorer survival among esophageal cancer cases, driven by squamous cancers. No association was observed between sugary beverages and cancer susceptibility. CONCLUSION These findings suggest that consumption of sugary beverages may decrease survival associated with UADT cancers. Additional studies should be conducted to examine survival among cancer patients consuming high amounts of added or refined sugars. Such studies may highlight prognostic factors for UADT cancers.
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Affiliation(s)
- Fayth L Miles
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA
| | - Shen-Chih Chang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Donald Tashkin
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jian-Yu Rao
- Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Wendy Cozen
- Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Thomas Mack
- Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Qing-Yi Lu
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA.
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
- Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA.
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Simple sugar intake and hepatocellular carcinoma: epidemiological and mechanistic insight. Nutrients 2014; 6:5933-54. [PMID: 25533006 PMCID: PMC4277008 DOI: 10.3390/nu6125933] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 11/28/2014] [Accepted: 12/01/2014] [Indexed: 12/12/2022] Open
Abstract
Sugar intake has dramatically increased during the last few decades. Specifically, there has been a clear trend towards higher consumption of fructose and high fructose corn syrup, which are the most common added sugars in processed food, soft drinks and other sweetened beverages. Although still controversial, this rising trend in simple sugar consumption has been positively associated with weight gain and obesity, insulin resistance and type 2 diabetes mellitus and non-alcoholic fatty liver disease. Interestingly, all of these metabolic alterations have also been related to the development of hepatocellular carcinoma. The purpose of this review is to discuss the evidence coming from epidemiological studies and data from animal models relating the consumption of simple sugars, and specifically fructose, with an increased risk of hepatocellular carcinoma and to gain insight into the putative molecular mechanisms involved.
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24
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Aspartame, low-calorie sweeteners and disease: Regulatory safety and epidemiological issues. Food Chem Toxicol 2013; 60:109-15. [DOI: 10.1016/j.fct.2013.07.040] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/09/2013] [Accepted: 07/14/2013] [Indexed: 12/15/2022]
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25
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Henry SA, Prizment AE, Anderson KE. Duration of diabetes and pancreatic cancer in a case-control study in the Midwest and the Iowa Women's Health Study (IWHS) cohort. JOP : JOURNAL OF THE PANCREAS 2013; 14:243-9. [PMID: 23669472 DOI: 10.6092/1590-8577/1317] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 04/03/2013] [Accepted: 04/11/2013] [Indexed: 12/28/2022]
Abstract
CONTEXT Studies have shown a relationship between history of diabetes and the risk of pancreatic cancer; however, the temporal relation between diabetes and pancreatic cancer is not clearly established. OBJECTIVES Diabetes and diabetes duration were examined in relation to pancreatic cancer in a population-based case-control study and prospective cohort. METHODS Case-control study: pancreatic cancer cases (n=200) from the Midwest were frequency matched by age and sex to population controls (n=673). Logistic regression yielded odds ratios (ORs) and 95% confidence intervals (95% CI). Iowa Women's Health Study (IWHS) cohort: 292 incident pancreatic cancer cases occurred between 1986-2008 among 36,084 post-menopausal, initially cancer-free women. Diabetes status and diagnosis age were ascertained at baseline and follow-ups. Proportional hazards regression yielded hazard ratios (HR, 95% CI) for pancreatic cancer in relation to baseline diabetes. Time-dependent analyses accounted for diabetes diagnosed after baseline. A nested-case control analysis assessed diabetes duration as a risk factor. RESULTS In the case-control study, compared to participants without diabetes, the multivariate ORs (95% CI) for pancreatic cancer were 2.35 (1.24-4.47) for those with diabetes and 4.00 (0.94-16.9), 2.79 (0.97-8.04), and 2.40 (0.97-5.98) for diabetes durations of 2-5 years, 5.1-10 years, and more than 10 years, respectively. In IWHS, compared to no diabetes, multivariate-adjusted HRs for pancreatic cancer were 1.86 (1.23-2.83) for baseline diabetes and 1.94 (1.40-2.69) adding diabetes during follow-up. In an IWHS nested case-control analysis, ORs were 1.70 (0.78-3.67), 2.62 (1.48-4.65), and 2.10 (1.36-3.24) for diabetes durations of 2-5 years, 5.1-10 years and more than 10 years, respectively, versus no diabetes. CONCLUSIONS Diabetes is associated with pancreatic cancer risk and this is similar across different duration categories.
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Affiliation(s)
- Sarah A Henry
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, University of Minnesota Masonic Cancer Center, Minneapolis, MN 55455, USA
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26
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Bosetti C, Lucenteforte E, Silverman DT, Petersen G, Bracci PM, Ji BT, Negri E, Li D, Risch HA, Olson SH, Gallinger S, Miller AB, Bueno-de-Mesquita HB, Talamini R, Polesel J, Ghadirian P, Baghurst PA, Zatonski W, Fontham E, Bamlet WR, Holly EA, Bertuccio P, Gao YT, Hassan M, Yu H, Kurtz RC, Cotterchio M, Su J, Maisonneuve P, Duell EJ, Boffetta P, La Vecchia C. Cigarette smoking and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (Panc4). Ann Oncol 2012; 23:1880-8. [PMID: 22104574 PMCID: PMC3387822 DOI: 10.1093/annonc/mdr541] [Citation(s) in RCA: 252] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 10/06/2011] [Accepted: 10/10/2011] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To evaluate the dose-response relationship between cigarette smoking and pancreatic cancer and to examine the effects of temporal variables. METHODS We analyzed data from 12 case-control studies within the International Pancreatic Cancer Case-Control Consortium (PanC4), including 6507 pancreatic cases and 12 890 controls. We estimated summary odds ratios (ORs) by pooling study-specific ORs using random-effects models. RESULTS Compared with never smokers, the OR was 1.2 (95% confidence interval [CI] 1.0-1.3) for former smokers and 2.2 (95% CI 1.7-2.8) for current cigarette smokers, with a significant increasing trend in risk with increasing number of cigarettes among current smokers (OR=3.4 for ≥35 cigarettes per day, P for trend<0.0001). Risk increased in relation to duration of cigarette smoking up to 40 years of smoking (OR=2.4). No trend in risk was observed for age at starting cigarette smoking, whereas risk decreased with increasing time since cigarette cessation, the OR being 0.98 after 20 years. CONCLUSIONS This uniquely large pooled analysis confirms that current cigarette smoking is associated with a twofold increased risk of pancreatic cancer and that the risk increases with the number of cigarettes smoked and duration of smoking. Risk of pancreatic cancer reaches the level of never smokers ∼20 years after quitting.
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Affiliation(s)
- C Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
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27
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Lucenteforte E, La Vecchia C, Silverman D, Petersen GM, Bracci PM, Ji BT, Bosetti C, Li D, Gallinger S, Miller AB, Bueno-de-Mesquita HB, Talamini R, Polesel J, Ghadirian P, Baghurst PA, Zatonski W, Fontham E, Bamlet WR, Holly EA, Gao YT, Negri E, Hassan M, Cotterchio M, Su J, Maisonneuve P, Boffetta P, Duell EJ. Alcohol consumption and pancreatic cancer: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4). Ann Oncol 2012; 23:374-82. [PMID: 21536662 PMCID: PMC3265544 DOI: 10.1093/annonc/mdr120] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 02/25/2011] [Accepted: 02/28/2011] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Heavy alcohol drinking has been related to pancreatic cancer, but the issue is still unsolved. METHODS To evaluate the role of alcohol consumption in relation to pancreatic cancer, we conducted a pooled analysis of 10 case-control studies (5585 cases and 11,827 controls) participating in the International Pancreatic Cancer Case-Control Consortium. We computed pooled odds ratios (ORs) by estimating study-specific ORs adjusted for selected covariates and pooling them using random effects models. RESULTS Compared with abstainers and occasional drinkers (< 1 drink per day), we observed no association for light-to-moderate alcohol consumption (≤ 4 drinks per day) and pancreatic cancer risk; however, associations were above unity for higher consumption levels (OR = 1.6, 95% confidence interval 1.2-2.2 for subjects drinking ≥ 9 drinks per day). Results did not change substantially when we evaluated associations by tobacco smoking status, or when we excluded participants who reported a history of pancreatitis, or participants whose data were based upon proxy responses. Further, no notable differences in pooled risk estimates emerged across strata of sex, age, race, study type, and study area. CONCLUSION This collaborative-pooled analysis provides additional evidence for a positive association between heavy alcohol consumption and the risk of pancreatic cancer.
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Affiliation(s)
- E. Lucenteforte
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
- Department of Occupational Health, University of Milan, Milan, Italy
| | - C. La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
- Department of Occupational Health, University of Milan, Milan, Italy
| | | | | | - P. M. Bracci
- University of California – San Francisco, San Francisco
| | - B. T. Ji
- National Cancer Institute, Bethesda
| | - C. Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
| | - D. Li
- MD Anderson Cancer Center, Houston, USA
| | | | - A. B. Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - H. B. Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - R. Talamini
- Centro di Riferimento Oncologico (CRO) – National Cancer Institute, Aviano (PN), Italy
| | - J. Polesel
- Centro di Riferimento Oncologico (CRO) – National Cancer Institute, Aviano (PN), Italy
| | - P. Ghadirian
- Epidemiology Research Unit, Research Center of the University of Montreal Hospital Centre (CRCHUM), Montreal, Canada
| | - P. A. Baghurst
- Public Health, Women's and Children's Hospital, Adelaide, Australia
| | - W. Zatonski
- Cancer Center & Institute of Oncology, Warsaw, Poland
| | - E. Fontham
- Louisiana State University, New Orleans, USA
| | | | - E. A. Holly
- University of California – San Francisco, San Francisco
| | - Y. T. Gao
- Shanghai Cancer Institute, Shanghai, China
| | - E. Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
| | - M. Hassan
- MD Anderson Cancer Center, Houston, USA
| | - M. Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Population Studies and Surveillance, Cancer Care Ontario, Toronto, Canada
| | - J. Su
- National Cancer Institute, Bethesda
| | | | - P. Boffetta
- International Prevention Research Institute, Lyon, France
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - E. J. Duell
- International Agency for Research on Cancer, Lyon, France
- Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
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Genkinger JM, Li R, Spiegelman D, Anderson KE, Albanes D, Bergkvist L, Bernstein L, Black A, van den Brandt PA, English DR, Freudenheim JL, Fuchs CS, Giles GG, Giovannucci E, Goldbohm RA, Horn-Ross PL, Jacobs EJ, Koushik A, Männistö S, Marshall JR, Miller AB, Patel AV, Robien K, Rohan TE, Schairer C, Stolzenberg-Solomon R, Wolk A, Ziegler RG, Smith-Warner SA. Coffee, tea, and sugar-sweetened carbonated soft drink intake and pancreatic cancer risk: a pooled analysis of 14 cohort studies. Cancer Epidemiol Biomarkers Prev 2011; 21:305-18. [PMID: 22194529 DOI: 10.1158/1055-9965.epi-11-0945-t] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Coffee has been hypothesized to have pro- and anticarcinogenic properties, whereas tea may contain anticarcinogenic compounds. Studies assessing coffee intake and pancreatic cancer risk have yielded mixed results, whereas findings for tea intake have mostly been null. Sugar-sweetened carbonated soft drink (SSB) intake has been associated with higher circulating levels of insulin, which may promote carcinogenesis. Few prospective studies have examined SSB intake and pancreatic cancer risk; results have been heterogeneous. METHODS In this pooled analysis from 14 prospective cohort studies, 2,185 incident pancreatic cancer cases were identified among 853,894 individuals during follow-up. Multivariate (MV) study-specific relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models and then pooled using a random-effects model. RESULTS No statistically significant associations were observed between pancreatic cancer risk and intake of coffee (MVRR = 1.10; 95% CI, 0.81-1.48 comparing ≥900 to <0 g/d; 237g ≈ 8oz), tea (MVRR = 0.96; 95% CI, 0.78-1.16 comparing ≥400 to 0 g/d; 237g ≈ 8oz), or SSB (MVRR = 1.19; 95% CI, 0.98-1.46 comparing ≥250 to 0 g/d; 355g ≈ 12oz; P value, test for between-studies heterogeneity > 0.05). These associations were consistent across levels of sex, smoking status, and body mass index. When modeled as a continuous variable, a positive association was evident for SSB (MVRR = 1.06; 95% CI, 1.02-1.12). CONCLUSION AND IMPACT Overall, no associations were observed for intakes of coffee or tea during adulthood and pancreatic cancer risk. Although we were only able to examine modest intake of SSB, there was a suggestive, modest positive association for risk of pancreatic cancer for intakes of SSB.
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Affiliation(s)
- Jeanine M Genkinger
- Mailman School of Public Health, 722 w 168th St, Rm 803, New York, NY 10032, USA.
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29
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Rossi M, Lugo A, Lagiou P, Zucchetto A, Polesel J, Serraino D, Negri E, Trichopoulos D, La Vecchia C. Proanthocyanidins and other flavonoids in relation to pancreatic cancer: a case-control study in Italy. Ann Oncol 2011; 23:1488-93. [PMID: 22052986 DOI: 10.1093/annonc/mdr475] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Four cohort studies have examined the relation between flavonoids and pancreatic cancer risk providing inconsistent results. PATIENTS AND METHODS We conducted a case-control study between 1991 and 2008 in Northern Italy. Subjects were 326 cases with incident pancreatic cancer and 652 frequency-matched controls (admitted to the same hospitals as cases for acute non-neoplastic conditions) who answered a reproducible and valid food-frequency questionnaire. We computed odds ratios (ORs) using logistic regression models conditioned on gender, age and study center, and adjusted for education, history of diabetes, tobacco smoking, alcohol drinking and energy intake. RESULTS Proanthocyanidins with three or more mers were inversely related to pancreatic cancer risk. The ORs were similar in all classes of polymers with three or more mers and in their combination (OR for the highest versus the lowest quintile of intake, 0.41; 95% confidence interval 0.24-0.69), and did not substantially change after adjustment for fruit and vegetable consumption, and for vitamin C and folate intakes. Eating an additional portion of fruits rich in proanthocyanidins every day reduced the risk of pancreatic cancer by 25%. CONCLUSION Dietary proanthocyanidins-mostly present in apples, pears and pulses-may convey some protection against pancreatic cancer risk.
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Affiliation(s)
- M Rossi
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan, Italy.
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30
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Bertuccio P, La Vecchia C, Silverman DT, Petersen GM, Bracci PM, Negri E, Li D, Risch HA, Olson SH, Gallinger S, Miller AB, Bueno-de-Mesquita HB, Talamini R, Polesel J, Ghadirian P, Baghurst PA, Zatonski W, Fontham ET, Bamlet WR, Holly EA, Lucenteforte E, Hassan M, Yu H, Kurtz RC, Cotterchio M, Su J, Maisonneuve P, Duell EJ, Bosetti C, Boffetta P. Cigar and pipe smoking, smokeless tobacco use and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (PanC4). Ann Oncol 2011; 22:1420-1426. [PMID: 21245160 PMCID: PMC3139985 DOI: 10.1093/annonc/mdq613] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 09/08/2010] [Accepted: 09/10/2010] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cigarette smoking is the best-characterized risk factor for pancreatic cancer. However, data are limited for other tobacco smoking products and smokeless tobacco. MATERIALS AND METHODS We conducted a pooled analysis of cigar and pipe smoking and smokeless tobacco use and risk of pancreatic cancer using data from 11 case-control studies (6056 cases and 11,338 controls) within the International Pancreatic Cancer Case-Control Consortium (PanC4). Pooled odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated by unconditional multiple logistic regression models adjusted for study center and selected covariates. RESULTS Compared with never tobacco users, the OR for cigar-only smokers was 1.6 (95% CI: 1.2-2.3), i.e. comparable to that of cigarette-only smokers (OR 1.5; 95% CI 1.4-1.6). The OR was 1.1 (95% CI 0.69-1.6) for pipe-only smokers. There was some evidence of increasing risk with increasing amount of cigar smoked per day (OR 1.82 for ≥ 10 grams of tobacco), although not with duration. The OR for ever smokeless tobacco users as compared with never tobacco users was 0.98 (95% CI 0.75-1.3). CONCLUSION This collaborative analysis provides evidence that cigar smoking is associated with an excess risk of pancreatic cancer, while no significant association emerged for pipe smoking and smokeless tobacco use.
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Affiliation(s)
- P Bertuccio
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; Department of Occupational Health, Section of Medical Statistics, University of Milan, Milan, Italy
| | - C La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; Department of Occupational Health, Section of Medical Statistics, University of Milan, Milan, Italy
| | | | | | | | - E Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - D Li
- The University of Texas M.D Anderson Cancer Center, Houston
| | - H A Risch
- Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven
| | - S H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | | | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven; Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - R Talamini
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico (CRO), Aviano, Italy
| | - J Polesel
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico (CRO), Aviano, Italy
| | - P Ghadirian
- Epidemiology Research Unit, Research Centre (CRCHUM), Montréal, Canada
| | - P A Baghurst
- Public Health, Women's and Children's Hospital, Adelaide, Australia
| | - W Zatonski
- Cancer Center & Institute of Oncology, Warsaw, Poland
| | - E T Fontham
- Louisiana State University, School of Public Health, New Orleans
| | | | - E A Holly
- University of California, San Francisco
| | - E Lucenteforte
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; Department of Occupational Health, Section of Medical Statistics, University of Milan, Milan, Italy
| | - M Hassan
- The University of Texas M.D Anderson Cancer Center, Houston
| | - H Yu
- Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven
| | - R C Kurtz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - M Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Cancer Care Ontario, Toronto, Canada
| | - J Su
- National Cancer Institute, Bethesda
| | | | - E J Duell
- Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - C Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - P Boffetta
- International Prevention Research Institute, Lyon, France; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA.
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Tranah GJ, Holly EA, Wang F, Bracci PM. Cigarette, cigar and pipe smoking, passive smoke exposure, and risk of pancreatic cancer: a population-based study in the San Francisco Bay Area. BMC Cancer 2011; 11:138. [PMID: 21496267 PMCID: PMC3094325 DOI: 10.1186/1471-2407-11-138] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 04/15/2011] [Indexed: 01/29/2023] Open
Abstract
Background To examine the influence of cigarette, cigar and pipe smoking, cessation of cigarette smoking and passive smoke exposure on the risk of pancreatic cancer. Methods Exposure data were collected during in-person interviews in a population-based case-control study of pancreatic cancer (N = 532 cases, N = 1701 controls) in the San Francisco Bay Area. Odds ratios (ORs) were adjusted for potential confounders. Results The adjusted odds ratio (OR) of pancreatic cancer among current smokers was 1.9 (95% confidence interval (CI), 1.4-2.7). A significant, positive trend in risk with increasing pack-years of smoking was observed (P-trend <0.0001). Compared with participants who continued to smoke, former smokers had no statistically significant elevation in risk of pancreatic cancer 10 years after smoking cessation, with risk reduced to that of never smokers regardless of prior smoking intensity. Both men and women experienced similar increased risk of pancreatic cancer with increasing smoking duration. Cigar and pipe smoking and exposure to passive smoke were not associated with pancreatic cancer. Conclusions Cigarette smoking is associated with an increased risk of pancreatic cancer. Smokers who had quit for ≥10 years no longer experienced an increased risk. Future work will help to determine the effect of declining smoking rates on pancreatic cancer incidence.
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Affiliation(s)
- Gregory J Tranah
- California Pacific Medical Center Research Institute, 94107, USA.
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Role of vitamin d in the prevention of pancreatic cancer. J Nutr Metab 2011; 2010:721365. [PMID: 21274445 PMCID: PMC3025373 DOI: 10.1155/2010/721365] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 11/12/2010] [Accepted: 12/14/2010] [Indexed: 12/20/2022] Open
Abstract
Pancreatic cancer is a malignancy of poor prognosis which is mostly diagnosed at advanced stages. Current treatment modalities are very limited creating great interest for novel preventive and therapeutic options. Vitamin D seems to have a protective effect against pancreatic cancer by participating in numerous proapoptotic, antiangiogenic, anti-inflammatory, prodifferentiating, and immunomodulating mechanisms. 25-hydroxyvitamin D [25(OH)D] serum concentrations are currently the best indicator of vitamin D status. There are three main sources of vitamin D: sun exposure, diet,and dietary supplements. Sun exposure has been associated with lower incidence of pancreatic cancer in ecological studies. Increased vitamin D levels seem to protect against pancreatic cancer, but caution is needed as excessive dietary intake may have opposite results. Future studies will verify the role of vitamin D in the prevention and therapy of pancreatic cancer and will lead to guidelines on adequate sun exposure and vitamin D dietary intake.
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Soft drinks, sweetened beverages and risk of pancreatic cancer. Cancer Causes Control 2010; 22:33-9. [DOI: 10.1007/s10552-010-9665-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 10/07/2010] [Indexed: 10/18/2022]
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34
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Rossi M, Lipworth L, Polesel J, Negri E, Bosetti C, Talamini R, McLaughlin JK, La Vecchia C. Dietary Glycemic Index and Glycemic Load and Risk of Pancreatic Cancer: A Case-Control Study. Ann Epidemiol 2010; 20:460-5. [DOI: 10.1016/j.annepidem.2010.03.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Revised: 02/19/2010] [Accepted: 03/15/2010] [Indexed: 12/12/2022]
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Mueller NT, Odegaard A, Anderson K, Yuan JM, Gross M, Koh WP, Pereira MA. Soft drink and juice consumption and risk of pancreatic cancer: the Singapore Chinese Health Study. Cancer Epidemiol Biomarkers Prev 2010; 19:447-55. [PMID: 20142243 DOI: 10.1158/1055-9965.epi-09-0862] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sugar-sweetened carbonated beverages (called soft drinks) and juices, which have a high glycemic load relative to other foods and beverages, have been hypothesized as pancreatic cancer risk factors. However, data thus far are scarce, especially from non-European descent populations. We investigated whether higher consumption of soft drinks and juice increases the risk of pancreatic cancer in Chinese men and women. METHODS A prospective cohort analysis was done to examine the association between soft drink and juice consumption and the risk of pancreatic cancer in 60,524 participants of the Singapore Chinese Health Study with up to 14 years of follow-up. Information on consumption of soft drinks, juice, and other dietary items, as well as lifestyle and environmental exposures, was collected through in-person interviews at recruitment. Pancreatic cancer cases and deaths were ascertained by record linkage of the cohort database with records of population-based Singapore Cancer Registry and the Singapore Registry of Births and Deaths. RESULTS The first 14 years for the cohort resulted in cumulative 648,387 person-years and 140 incident pancreatic cancer cases. Individuals consuming > or = 2 soft drinks/wk experienced a statistically significant increased risk of pancreatic cancer (hazard ratio, 1.87; 95% confidence interval, 1.10-3.15) compared with individuals who did not consume soft drinks after adjustment for potential confounders. There was no statistically significant association between juice consumption and risk of pancreatic cancer. CONCLUSION Regular consumption of soft drinks may play an independent role in the development of pancreatic cancer.
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Affiliation(s)
- Noel T Mueller
- Cancer Control Program, Georgetown University Medical Center, Washington, District of Columbia, USA
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Polesel J, Talamini R, Negri E, Bosetti C, Boz G, Lucenteforte E, Franceschi S, Serraino D, La Vecchia C. Dietary habits and risk of pancreatic cancer: an Italian case–control study. Cancer Causes Control 2009; 21:493-500. [DOI: 10.1007/s10552-009-9480-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Accepted: 11/12/2009] [Indexed: 11/29/2022]
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