含糖饮料消费与癌症风险：NutriNet-Santé 前瞻性队列研究结果。
Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort.
机构信息
Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin F-93017 Bobigny Cedex, France.
Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 74 rue Marcel Cachin F-93017 Bobigny Cedex, France
出版信息
BMJ. 2019 Jul 10;366:l2408. doi: 10.1136/bmj.l2408.
OBJECTIVE
To assess the associations between the consumption of sugary drinks (such as sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages, and the risk of cancer.
DESIGN
Population based prospective cohort study.
SETTING AND PARTICIPANTS
Overall, 101 257 participants aged 18 and over (mean age 42.2, SD 14.4; median follow-up time 5.1 years) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed by using repeated 24 hour dietary records, which were designed to register participants' usual consumption for 3300 different food and beverage items.
MAIN OUTCOME MEASURES
Prospective associations between beverage consumption and the risk of overall, breast, prostate, and colorectal cancer were assessed by multi-adjusted Fine and Gray hazard models, accounting for competing risks. Subdistribution hazard ratios were computed.
RESULTS
The consumption of sugary drinks was significantly associated with the risk of overall cancer (n=2193 cases, subdistribution hazard ratio for a 100mL/d increase 1.18, 95% confidence interval 1.10 to 1.27, P<0.0001) and breast cancer (693, 1.22, 1.07 to 1.39, P=0.004). The consumption of artificially sweetened beverages was not associated with the risk of cancer. In specific subanalyses, the consumption of 100% fruit juice was significantly associated with the risk of overall cancer (2193, 1.12, 1.03 to 1.23, P=0.007).
CONCLUSIONS
In this large prospective study, the consumption of sugary drinks was positively associated with the risk of overall cancer and breast cancer. 100% fruit juices were also positively associated with the risk of overall cancer. These results need replication in other large scale prospective studies. They suggest that sugary drinks, which are widely consumed in Western countries, might represent a modifiable risk factor for cancer prevention.
STUDY REGISTRATION
ClinicalTrials.gov NCT03335644.
目的
评估含糖饮料（如含糖饮料和 100%纯果汁）、人工甜味饮料的消费与癌症风险之间的关联。
设计
基于人群的前瞻性队列研究。
地点和参与者
共纳入了来自法国 NutriNet-Santé 队列（2009-2017 年）的 101257 名年龄在 18 岁及以上（平均年龄 42.2，SD 14.4；中位随访时间 5.1 年）的参与者。通过使用重复的 24 小时饮食记录来评估含糖饮料和人工甜味饮料的消费情况，该记录旨在记录参与者对 3300 种不同食物和饮料的日常消费情况。
主要观察指标
通过多因素 Fine-Gray 风险模型评估饮料消费与总体、乳腺癌、前列腺癌和结直肠癌风险之间的前瞻性关联，同时考虑到竞争风险。计算亚分布风险比。
结果
含糖饮料的消费与总体癌症风险显著相关（n=2193 例，每增加 100mL/d 的亚分布风险比为 1.18，95%置信区间为 1.10 至 1.27，P<0.0001）和乳腺癌（693 例，1.22，1.07 至 1.39，P=0.004）。人工甜味饮料的消费与癌症风险无关。在特定的亚分析中，100%纯果汁的消费与总体癌症风险显著相关（2193 例，1.12，1.03 至 1.23，P=0.007）。
结论
在这项大型前瞻性研究中，含糖饮料的消费与总体癌症和乳腺癌风险呈正相关。100%纯果汁也与总体癌症风险呈正相关。这些结果需要在其他大规模前瞻性研究中进行复制。它们表明，在西方国家广泛消费的含糖饮料可能是癌症预防的一个可改变的风险因素。
研究注册
ClinicalTrials.gov NCT03335644。
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