The Dose-Response Associations of Sugar-Sweetened Beverage Intake with the Risk of Stroke, Depression, Cancer, and Cause-Specific Mortality: A Systematic Review and Meta-Analysis of Prospective Studies

Associations of black and sugar-sweetened coffee consumption with depressive symptoms: A longitudinal study of Chinese adolescents

BACKGROUND

Previous research revealed an association between coffee consumption and depressive symptoms. However, the results differed between studies in adults and adolescents. Additionally, limited research on coffee and depressive symptoms has distinguished between black and sugar-sweetened coffee. Furthermore, few studies have examined the potential sex differences in the abovementioned association. This longitudinal study aimed to explore the associations of black and sugar-sweetened coffee consumption with subsequent depressive symptoms in adolescents while also investigating sex disparities within these associations.

METHODS

In this longitudinal study, 10,770 individuals completing standardized questionnaires at baseline and follow-up were included in the main analysis. The data were analyzed using generalized linear mixed-effects models, and subgroup analyses were grouped according to sex.

RESULTS

After adjusting for covariates and baseline depressive symptoms status, adolescents who consumed black coffee daily (OR, 1.45; 95 % CI, 1.14-1.84) had a greater risk of experiencing depressive symptoms compared with those who did not consume it or consumed it monthly. Similarly, in comparison with none or monthly consumers, those who consumed sugar-sweetened coffee weekly (OR, 1.22; 95 % CI, 1.03-1.44) and daily (OR, 1.32; 95 % CI, 1.02-1.73) demonstrated an elevated risk of having depressive symptoms. Subgroup analyses showed that black and sugar-sweetened coffee consumption was associated with depressive symptoms only in males.

LIMITATIONS

Self-reported data on coffee consumption and depressive symptoms.

CONCLUSIONS

Adolescents who consume black or sugar-sweetened coffee weekly or daily are at a higher risk of developing depressive symptoms, with this association appearing to be more pronounced in male adolescents. Future studies are needed to confirm these findings.

Bread Consumption and Cancer Risk: Systematic Review and Meta-Analysis of Prospective Cohort Studies

Because bread can contain potential carcinogens such as acrylamide, and is widely consumed, we conducted a systematic review and meta-analysis to determine whether bread consumption is associated with increased cancer risk. PubMed and Medline databases were searched up to 1 March 2024, for studies that provided hazard ratios (HRs) (or similar) for bread consumption and cancer incidence or mortality. Only prospective cohort studies were included. We used the Preferred Reporting Items of Systematic reviews and Meta-Analyses checklist. Meta-analysis was performed with Cochrane's RevMan 5.4.1 software using a DerSimonian-Laird random-effects model. Heterogeneity was assessed with Cochrane's Q (χ2) and I 2 statistics, and publication bias was assessed with Egger's test. Twenty-four publications met inclusion criteria, including 1,887,074 adults, and were included in the systematic review. Ten publications that provided HRs were included in the meta-analysis for highest compared with lowest intakes, and an additional 7 publications that provided mortality or incident rate ratios or relative risks were included in supplemental meta-analyses. Of 108 reported HRs (or similar), 97 (79%) were either not statistically significant (n = 86) or indicated lower cancer risk (n = 11) associated with the highest intakes of bread. The meta-analysis indicated that bread intake was not associated with site-specific cancer risk [HR: 1.01; 95% confidence interval (CI): 0.89, 1.14; P = 0.92; 8 publications] or total cancer mortality (HR: 0.90; 95% CI: 0.73, 1.11; P = 0.32; 2 publications). Supplemental meta-analyses using all risk estimates in addition to HRs confirmed these findings. Whole-grain bread was associated with a lower site-specific cancer risk, mainly because of reduced colorectal cancer risk. Results of the systematic review and meta-analysis indicate that bread consumption is not associated with increased site-specific cancer risk, whereas high whole-grain/nonwhite bread consumption is associated with lower total cancer mortality and colorectal cancer risk. This study was registered at Clinical Trials Registry of PROSPERO as registration number CRD42023414156.

Temporal changes and educational disparities in the frequent consumption of sugar-sweetened beverages among Estonian adults during 2006-2022

Objectives

Excessive consumption of sugar-sweetened beverages (SSBs) contributes to adverse health outcomes but is differentiated by socio-economic indicators. The study analyses the educational disparities in adults frequent consumption of sugar-sweetened beverages (SSBs) in Estonia and its temporal changes between 2006 and 2022.

Study design

Repeated cross-sectional survey.

Methods

Nationally representative data from 9 biennial cross-sectional surveys on 25-64-year-old Estonian residents (n = 20396) was used for the study. Changes in frequent (on 6-7 days per week) consumption of SSBs by study year, sex, age, and education is analysed using descriptive statistics and binomial logistic regression. Prevalence and odds ratios (OR) with 95 % confidence intervals (CIs) are presented focusing on temporal and educational patterns in frequent SSB consumption.

Results

The prevalence of frequent SSB consumption among Estonian adults declined consistently from 2006 (14.0 %) to 2018 (5.2 %), followed by statistically non-significant increases in 2020 (6.8 %) and 2022 (7.1 %). Prevalence of frequent SSB consumption was significantly (p < 0.01) higher among adults with primary or lower education (12.4 %) compared to tertiary education group (4.8 %). The educational differences in SSB consumption (12.4 % in primary or lower vs. 4.8 % in tertiary education) were nearly three-fold after adjusting for sex, age, and period effects (OR 2.84, 95 % CI 1.71-4.74) and have been consistent since 2010.

Conclusions

Although frequent consumption of SSBs has been generally decreasing among Estonian adults, the findings illustrate the persisting educational gradients in exposure that expectedly translates into socio-economic inequalities in adverse health outcomes resulting from excessive SSB consumption.

Association of plain water intake with risk of all-cause and cause-specific mortality in individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease

Non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD)-related mortality have increased dramatically in past decades. Our study aims to investigate the association between plain water and this prevalent metabolic disease, as water plays a crucial role in regulating metabolic processes. A total of 3,543/3,428 individuals with NAFLD/MASLD were included in this study from National Health and Nutrition Examination Survey (NHANES). Daily plain water intake was recorded, and mortality status was tracked until December 31, 2019. Multivariate Cox regression models and restricted cubic spline (RCS) regression models were used to assess the association between plain water intake and long-term all-cause as well as cause-specific mortality among participants with NAFLD/MASLD. Furthermore, we investigated the relationship between substituting other beverages with plain water intake and the risk of mortality. The multivariate Cox regression analyses revealed a significant association between higher plain water intake and lower all-cause mortality, cerebrovascular diseases mortality, and cancer mortality in both NAFLD or MASLD patients. Dose-response analyses revealed a non-linear trend between plain water intake and mortality among NAFLD/MASLD patients. Additionally, replacing sugar or artificial beverages with plain water was linked to reduced all-cause mortality, cerebrovascular diseases mortality, and cancer mortality in patients with NAFLD/MASLD. Higher plain water intake is independently linked to lower risk of all-cause, cerebrovascular diseases mortality, and cancer mortality in NAFLD/MASLD patients. Increasing plain water intake may be an effective way for these patients to reduce their risk of mortality.

Obesity, Metabolic Syndrome, and Sugar-Sweetened Beverages (SSBs) in America: A Novel Bioethical Argument for a Radical Public Health Proposal

The prevalence of obesity, metabolic syndrome, and the associated long-term chronic diseases (cardiovascular disease, type II diabetes, cancer, Alzheimer's disease, depression) have reached epidemic levels in the United States and Western nations. In response to this public health calamity, the author of this paper presents and defends a novel bioethical argument: the consistency argument for outlawing SSBs (sugar-sweetened beverages) for child consumption (the "consistency argument"). This argument's radical conclusion states that the government is justified in outlawing SSBs consumption for child consumption. The reasoning is as follows: if one accepts that the physical harm caused by chronic alcohol consumption justifies the government outlawing alcoholic beverages for child consumption, and there is strong evidence that comparable physical harms result from chronic SSBs consumption, then, mutatis mutandis, the government is also justified in outlawing child consumption of SSBs. To support this argument, the author provides extensive evidence based on epidemiological observational studies, interventional studies, controlled trials, large meta-analyses, and the pathophysiology and biological mechanisms of action behind SSBs and chronic disease. Chronic consumption of large doses of SSBs and alcoholic beverages both drive the same diseases: obesity and insulin resistance, cardiovascular disease, hypertension, and cancer. Chronic SSB consumption carries the additional risk of Alzheimer's disease, dementia, and depression. The author concludes this paper by considering prominent objections to the consistency argument, and then demonstrating that each objection is unsound.

Modeling the potential impact of a sugar-sweetened beverage tax on ischemic heart disease and stroke in Brazil

BACKGROUND

A high intake of sugar-sweetened beverages (SSBs) is associated with the risk of several chronic diseases, including ischemic heart disease (IHD) and stroke. This study aimed to model the impact of a 20% tax on all SSBs for IHD and stroke among Brazilian adults.

METHODS

This was an ex-ante risk comparative study. The model applied a 20% tax on SSBs and projected the incidence, prevalence and mortality of IHD and stroke over a 20-year period (2019-39). Using data on consumption, previously published cross- and own-price elasticities of SSBs, and relative risk, we estimated changes in IHD and stroke burden.

RESULTS

Our model predicts that a 20% SSB tax may reduce new cases of IHD by ~13%, especially among women, and avert ~8% of the deaths attributable to IHD over 20 years. These results represent a decrease of 19 543 new cases and 8466 and 7274 fewer deaths in the period for men and women, respectively. Estimates of reduction in incidence, prevalence and deaths from stroke were not significant over 20 years.

CONCLUSIONS

Even under conservative assumptions, our study found that a small reduction in SSB consumption led to a substantial decrease in IHD incidence and mortality in Brazil.

Sugar-Sweetened Beverages and Adverse Human Health Outcomes: An Umbrella Review of Meta-Analyses of Observational Studies

Our aim was to conduct an umbrella review of evidence from meta-analyses of observational studies investigating the link between sugar-sweetened beverage consumption and human health outcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these analyses indicated direct associations between greater sugar-sweetened beverage consumption and higher risks of adverse health outcomes. Convincing evidence (class I) supported direct associations between sugar-sweetened beverage consumption and risks of depression, cardiovascular disease, nephrolithiasis, type 2 diabetes mellitus, and higher uric acid concentrations. Highly suggestive evidence (class II) supported associations with risks of nonalcoholic fatty liver disease and dental caries. Out of the remaining 40 meta-analyses, 29 were graded as suggestive or weak in the strength of evidence (classes III and IV), and 11 showed no evidence (class V). These findings inform and provide support for population-based and public health strategies aimed at reducing sugary drink consumption for improved health.

Redesigning Pharmacy to Improve Public Health Outcomes: Expanding Retail Spaces for Digital Therapeutics to Replace Consumer Products That Increase Mortality and Morbidity Risks

United States healthcare outcomes, including avoidable mortality rates, are among the worst of high-income countries despite the highest healthcare spending per capita. While community pharmacies contribute to chronic disease management and preventive medicine, they also offer consumer products that increase mortality risks and the prevalence of cardiovascular diseases, diabetes, cancer, and depression. To resolve these contradictions, our perspective article describes opportunities for major pharmacy chains (e.g., CVS Pharmacy and Walgreens) to introduce digital health aisles dedicated to prescription and over-the-counter digital therapeutics (DTx), together with mobile apps and wearables that support disease self-management, wellness, and well-being. We provide an evidence-based rationale for digital health aisles to replace spaces devoted to sugar-sweetened beverages and other unhealthy commodities (alcohol, tobacco) that may increase risks for premature death. We discuss how digital health aisles can serve as marketing and patient education resources, informing customers about commercially available DTx and other technologies that support healthy lifestyles. Since pharmacy practice requires symbiotic balancing between profit margins and patient-centered, value-based care, replacing health-harming products with health-promoting technologies could positively impact prevention of chronic diseases, as well as the physical and mental health of patients and caregivers who visit neighborhood pharmacies in order to pick up medicines.

Quality of plant-based diets and frailty incidence: a prospective analysis of UK biobank participants

BACKGROUND

Substantial evidence supports the inverse association between adherence to healthy dietary patterns and frailty risk. However, the role of plant-based diets, particularly their quality, is poorly known.

OBJECTIVE

To examine the association of two plant-based diets with incidence of physical frailty in middle-aged and older adults.

DESIGN

Prospective cohort.

SETTING

United Kingdom.

SUBJECTS

24,996 individuals aged 40-70 years, followed from 2009-12 to 2019-22.

METHODS

Based on at least two 24-h diet assessments, we built two diet indices: (i) the healthful Plant-based Diet Index (hPDI) and (ii) the unhealthful Plant-based Diet Index (uPDI). Incident frailty was defined as developing ≥3 out of 5 of the Fried criteria. We used Cox models to estimate relative risks (RR), and their 95% confidence interval (CI), of incident frailty adjusted for the main potential confounders.

RESULTS

After a median follow-up of 6.72 years, 428 cases of frailty were ascertained. The RR (95% CI) of frailty was 0.62 (0.48-0.80) for the highest versus lowest tertile of the hPDI and 1.61 (1.26-2.05) for the uPDI. The consumption of healthy plant foods was associated with lower frailty risk (RR per serving 0.93 (0.90-0.96)). The hPDI was directly, and the uPDI inversely, associated with higher risk of low physical activity, slow walking speed and weak hand grip, and the uPDI with higher risk of exhaustion.

CONCLUSIONS

In British middle-age and older adults, greater adherence to the hPDI was associated with lower risk of frailty, whereas greater adherence to the uPDI was associated with higher risk.

Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use

Background

There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however.

Objective

The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons.

Methods

Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency.

Results

From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses.

Conclusion

This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.

Review of electrospun microtube array membrane (MTAM)-a novel new class of hollow fiber for encapsulated cell therapy (ECT) in clinical applications

Encapsulated cell therapy (ECT) shows significant potential for treating neurodegenerative disorders including Alzheimer's and Parkinson's, which currently lack curative medicines and must be managed symptomatically. This novel technique encapsulates functional cells with a semi-permeable membrane, providing protection while enabling critical nutrients and therapeutic substances to pass through. Traditional ECT procedures, on the other hand, pose difficulties in terms of cell survival and retrieval. We introduce the Microtube Array Membrane (MTAM), a revolutionary technology that solves these constraints, in this comprehensive overview. Microtube Array Membrane has distinct microstructures that improve encapsulated cells' long-term viability by combining the advantages of macro and micron scales. Importantly, the MTAM platform improves biosafety by allowing the entire encapsulated unit to be retrieved in the event of an adverse reaction. Our findings show that MTAM-based ECT has a great potential in a variety of illness situations. For cancer treatment, hybridoma cells secreting anti-CEACAM 6 antibodies inhibit triple-negative breast cancer cell lines for an extended period of time. In animal brain models of Alzheimer's disease, hybridoma cells secreting anti-pTau antibodies successfully reduce pTau buildup, accompanied by improvements in memory performance. In mouse models, MTAM-encapsulated primary cardiac mesenchymal stem cells dramatically improve overall survival and heart function. These findings illustrate the efficacy and adaptability of MTAM-based ECT in addressing major issues such as immunological isolation, cell viability, and patient safety. We provide new possibilities for the treatment of neurodegenerative illnesses and other conditions by combining the potential of ECT with MTAM. Continued research and development in this subject has a lot of promise for developing cell therapy and giving hope to people suffering from chronic diseases.

Sugar sweetened beverages, natural fruit juices, and cancer: what we know and what still needs to be assessed

Cancer is known as one of the leading causes of death in the world. In addition to early mortality, cancer is associated with disability in affected patients. Among environmental risk factors, special attention has been paid to the role of dietary factors. In recent decades, the consumption of sugar-sweetened beverages (SSBs) and natural fruit juices has increased. Several studies have assessed the effects of these beverages on human health and found that a higher intake of SSBs is associated with a greater risk of obesity, diabetes, cardiovascular diseases, hypertension, and non-alcoholic fatty liver disease. However, current evidence for cancer incidence and mortality is not conclusive. In the current review, we concluded that SSBs intake might be positively associated with cancer incidence/mortality through their increasing effects on obesity, inflammatory biomarkers, serum levels of insulin-like growth factor-I (IGF-I), and advanced glycation end-products. Such a positive association was also seen for natural fruit juices. However, types of natural fruit juices were not considered in most previous studies. In addition, some types of cancer including brain, lung, and renal cancers were not assessed in relation to SSBs and natural fruit juices. Therefore, further studies are needed in this regard.

Towards planetary oral health

It is time to consider the protection of our environment as a major public health issue in oral medicine. Evidence shows that activities related to dental practice, such as patient transportation, use of rare materials and chemicals, or energy consumption, affect our ecosystems and contribute to the global degradation we are increasingly observing. The degradation of our environment is considered the greatest threat to our health. Exposure of oral tissues to multiple environmental factors can lead to pathological conditions. In addition to these direct effects, there are more complex phenomena, leading to co-deficits in the health of populations. The example of the sugar industry illustrates the systemic failures resulting in the double degradation of the environment and the health of individuals. Face with these dynamically interacting phenomena, human communities must consider systemic responses such as those described in this article. The dental community will need to do its part and consider global oral health as a central issue. This conceptual work will help define the innovations and action needed to ensure equitable practice that respects planetary limits.

Mental Health Conditions, Including Depression and Stress, Are Associated with Increased Odds of Gastric Cancer-Insights into the Role of Diet: A Case-Control Study

Several risk factors, including nutritional/lifestyle ones, play a role in gastric cancer etiology. Further interactions with mental health have also been emphasized. We hypothesized that individuals with mental disorders would exhibit compromised nutrient intake, increasing their risk of gastric cancer. The state of mental health was evaluated in 82 patients with gastric cancer and 95 healthy controls using the 21-item Depression-Anxiety-Stress Scale. The participants' dietary intakes were evaluated by a 168-item food frequency questionnaire. Based on fully adjusted logistic regressions, there was a significant association between depression (OR = 1.938, CI 95%: 1.009-3.723) and stress (OR = 2.630, CI 95%: 1.014-6.819) with increased odds of gastric cancer. According to fully adjusted multinomial regressions, vitamins A and B6, beta-carotene, and black tea decreased the odds of depression, based on comparing the control group with cases of depression, while sugar and salt increased its odds. The highest significant association was found for salt intake and anxiety in cases with present anxiety (OR = 4.899, 95% CI: 2.218-10.819), and the highest significant protective effect was found for vitamin B6 and depression in cases with present depression (OR = 0.132, 95% CI: 0.055-0.320). However, considering causal relationships and clarifying the underlying mechanisms is imperative and requires further investigation. Advising healthy dietary patterns, e.g., a Mediterranean diet rich in vitamins, minerals, and phytochemicals such as vitamin A, B6, beta-carotene, and fiber, is expected to reduce the odds of gastric cancer, possibly related to lower levels of anxiety and depression.

Lifestyle, clinical and histological indices-based prediction models for survival in cancer patients: a city-wide prospective cohort study in China

PURPOSE

We developed a nomogram to predict 3-year, 5-year and 7-year cancer survival rates of cancer patients.

METHODS

This prospective cohort study included 20,491 surviving patients first diagnosed with cancer in Guangzhou from 2010 to 2019. They were divided into a training and a validation group. Lifestyle, clinical and histological parameters (LCH) were included in multivariable Cox regression. Akaike information criterion was used to select prediction factors for the nomogram. The discrimination and calibration of models were assessed by concordance index (C-index), area under time-dependent receiver operating characteristic curve (time-dependent AUC), and calibration plots. We used net reclassification index (NRI) and integrated discrimination improvement (IDI) to compare the clinical utility of LCH prediction model with the prediction model based on lifestyle factors (LF).

RESULTS

13 prediction factors including age, sex, BMI, smoking status, physical activity, sleep duration, regular diet, tumor grading, TNM stage, multiple primary cancer and anatomical site were included in the LCH model. The LCH model showed satisfactory discrimination and calibration (C-index = 0.81 (95% CI 0.80-0.82) for training group and 0.80 (0.79-0.81) for validation group, both time-dependent AUC > 0.70). The LF model including smoking status, physical activity, sleep duration, regular diet, and BMI showed less satisfactory discrimination (C-index = 0.60 (95% CI 0.59-0.61) for training and 0.60 (0.58-0.62) for validation group). The LCH model had better accuracy and discriminative ability than the LF model, as indicated by positive NRI and IDI values.

CONCLUSIONS

The LCH model shows good accuracy, clinical utility and precise prognosis prediction, and may serve as a tool to predict cancer survival of cancer patients.

Associations between Knowledge of Health Risks and Sugar-Sweetened Beverage Intake among US Adolescents

BACKGROUND

Sugar-sweetened beverage (SSB) intake is associated with adverse health outcomes.

OBJECTIVE

We examined associations between the knowledge of health risks related to SSB and SSB intake among adolescents.

DESIGN

A cross-sectional study using 2021 YouthStyles survey data.

PARTICIPANTS/SETTINGS

831 US adolescents (12-17 years old).

MAIN OUTCOME MEASURES

The outcome variable was SSB intake (none, 1-6 times/week, and ≥1 time/day). Exposure variables were knowledge of seven SSB-related health risks.

STATISTICAL ANALYSES PERFORMED

Seven multinomial regressions were used to estimate adjusted odds ratios (AOR) for drinking SSB, according to knowledge of SSB-related health risks and after controlling for sociodemographics.

RESULTS

Overall, 29% of adolescents consumed SSB ≥1 time/day. Although most adolescents identified cavities (75.4%), weight gain (74.6%), and diabetes (69.7%) as being related to drinking SSB, fewer adolescents identified related conditions such as high blood pressure (31.7%), high cholesterol (25.8%), heart disease (24.6%), and some cancers (18.0%). Compared to non-SSB consumers, drinking SSB ≥1 time/day was significantly higher among adolescents who lacked knowledge of associations between SSB intake and weight gain (AOR = 2.0), heart disease (AOR = 1.9), or some cancers (AOR = 2.3) after controlling for covariates.

CONCLUSIONS

Among US adolescents, knowledge of SSB-related health risks varied by condition, ranging from 18% (some cancers) to 75% (cavities and weight gain). There were increased odds of drinking SSB among those unaware that weight gain, heart disease, and some cancers are associated with SSB intake. Intervention could evaluate whether increasing certain types of knowledge may influence youth SSB intake.

Plant-based dietary patterns and the risk of digestive system cancers in 3 large prospective cohort studies

Little is known about the relation between plant-based dietary patterns and digestive system cancers. This study investigated the prospective association between 3 pre-defined indices of plant-based dietary pattern and risk of digestive system cancers, as a whole or individually. We utilized data from 3 prospective cohorts, the Nurses' Health Study (1984-2018, 74,496 women aged 65 ± 10.9 years), Nurses' Health Study II (1991-2017, 91,705 women aged 49.3 ± 8.3 years), and Health Professionals Follow up Study (1986-2016, 45,472 men aged 65.4 ± 11.0 years). We used Cox proportional hazards regression models to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) of digestive system cancers across 3 plant-based diet index scores: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). During a follow-up of 4,914,985 person-years, we identified 6,518 cases of digestive system cancers. In the pooled analysis of 3 cohorts, the HRs (95% CIs) per 10-point increase in hPDI score were 0.93 (0.89, 0.97) for total digestive system cancer, 0.94 (0.89, 0.99) for gastrointestinal tract cancer, 0.89 (0.81, 0.98) for accessory organ cancer, and 0.68 (0.52, 0.91) for liver cancer. In contrast, the HRs (95% CIs) per 10-point increase in uPDI score was 1.06 (1.01, 1.11) for gastrointestinal tract cancer and 1.07 (1.01, 1.13) for colorectal cancer. A healthy plant-based dietary pattern was associated with reduced risks of total digestive system cancers as well as individual cancers in the gastrointestinal tract and the accessory organs. Emphasizing the healthiness and quality of plant-based diets may be important for the prevention of developing cancers in the digestive system.

Comparing Lifestyle Modifications and the Magnitude of Their Associated Benefit on Cancer Mortality

Many cancers are associated with poor diet, lack of physical activity, and excess weight. Improving any of these three lifestyle factors would likely reduce cancer deaths. However, modifications to each of these-better nutrition, enhanced activity and fitness, and loss of extra body fat-have different effect sizes on cancer mortality. This review will highlight the relative benefit that each lifestyle change, enacted prior to a diagnosis of cancer, might impart on cancer-related deaths, as well as attempt to quantify the changes required to derive such a benefit. The review relies primarily on epidemiological data, with meta-analyses serving as the backbone for comparisons across interventions and individual studies within the larger meta-analyses providing the data necessary to form more quantitative conclusions. The reader can then use this information to better understand, recommend, and implement behaviors that might ultimately reduce cancer mortality. Of all the interventions, it seems clear that exercise, specifically improving cardiorespiratory fitness, is the best way to decrease the risk of dying from cancer.

Sugar-sweetened beverage consumption retarded weight gain but not induced depression and anxiety-like behaviors in mice

AIMS

To assess the effects of sugar-sweetened beverage (SSB) consumption and exercise on behaviors.

METHODS

Twenty-four male mice were divided into four groups: the water + sedentary (WS), the SSB + sedentary (CS), the water + exercise (WE), and the SSB + exercise (CE). After three-month of interventions, forced swim test (FST), open field test (OFT), and morris water maze (MWM) were conducted. Then, mRNA levels of MAO-A, COMT, and 5-HT1A and protein levels of synapsin, STAT3, A2AR, CRTC1, CREB, and BDNF were measured.

RESULTS

Under a similar baseline body weight condition, SSB consumption reduced the weight gain from the 3rd week (p < 0.05, or p < 0.01). Exercise decreased the escape latency in the CE group when compared to the CS group on day5 (p < 0.01) and increased the time in the target quadrant in the WE group than the WS group on day4 (p < 0.05) and 5 (p < 0.01) during MWM. No significant differences were found during the FST and OFT. COMT mRNA level was increased after SSB consumption (p < 0.05), but no differences were found in the MAO-A and 5-HT1A mRNA levels and the concerned biomarkers, all of which were previously reported to be associated with depression and anxiety-like behaviors.

CONCLUSION

SSB consumption reduced weight gain but not result in depression and anxiety-like behaviors in mice. Therefore, the behavioral effects of exercise were not significant. This is not consistent with the results of previous epidemiological surveys of humans.

The Impacts of Sugar-Sweetened Beverages (SSB) on Cardiovascular Health

Cardiovascular disease (CVD) has been a prominent global health challenge in the last decade, and many risk factors and outcomes of CVD have been studied in that timeframe. Recent research has explored the association between sugar-sweetened beverage (SSB) consumption and CVD; however, there is a lack of updated reviews regarding SSB consumption impacts on CVD outcomes and the possible mechanisms affecting the disease state. In turn, this review aims to summarize the relevant published research from the last decade regarding linkages between SSB consumption and CVD outcomes and the potential underlying mechanisms, as well as to highlight opportunities for future exploration with respect to those outcomes and mechanisms. In this review, we searched PubMed, Embase, and Web of Science for peer-reviewed articles published from January 2012 to March 2022 regarding SSB consumption and its association with CVD.

The results of our search reveal strong evidence that the consumption of SSB is positively associated with increased risks of CVD and that the magnitude of that risk is increased in a dose-dependent manner. These increased risks range from elevated triglyceride levels to inclined risk of CVD-related mortality. Although the depth of the mechanisms responsible for these increased risks have been less explored thus far, there is some evidence supporting SSB implications in cardiovascular factors, including vascular function, coronary artery calcification, triglyceride levels, inflammatory processes, arterial stiffness, and genetic polymorphisms.