Edward L Giovannucci1,2,3, Kana Wu4, Emilie S Zoltick5, Stephanie A Smith-Warner1,2, Chen Yuan6, Molin Wang2,7,3, Charles S Fuchs8,9, Jeffrey A Meyerhardt6, Andrew T Chan3,10,11,12, Kimmie Ng6, Shuji Ogino2,6,11,13, Meir J Stampfer1,2,3. 1. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 2. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. 4. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA. kana.wu@channing.harvard.edu. 5. Center for Healthcare Research in Pediatrics, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA. 6. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. 7. Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 8. Yale Cancer Center, New Haven, CT, USA. 9. Genentech, San Francisco, CA, USA. 10. Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 11. Broad Institute of MIT and Harvard, Cambridge, MA, USA. 12. Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 13. Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Abstract
BACKGROUND: The influence of a high sugar diet on colorectal cancer (CRC) survival is unclear. METHODS: Among 1463 stage I-III CRC patients from the Nurses' Health Study and Health Professionals Follow-up Study, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC-specific and all-cause mortality in relation to intake of post-diagnosis sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), fruit juice, fructose and other sugars. RESULTS: Over a median 8.0 years, 781 cases died (173 CRC-specific deaths). Multivariable-adjusted HRs for post-diagnosis intake and CRC-specific mortality were 1.21 (95% CI: 0.87-1.68) per 1 serving SSBs per day (serving/day) and 1.24 (95% CI: 0.95-1.63) per 20 grams fructose per day. Significant positive associations for CRC-specific mortality were primarily observed ≤5 years from diagnosis (HR per 1 serving/day of SSBs = 1.59, 95% CI: 1.06-2.38). Significant inverse associations were observed between ASBs and CRC-specific and all-cause mortality (HR for ≥5 versus <1 serving/week = 0.44, 95% CI: 0.26-0.75 and 0.70, 95% CI: 0.55-0.89, respectively). CONCLUSIONS: Higher post-diagnosis intake of SSBs and sugars may be associated with higher CRC-specific mortality, but only up to 5 years from diagnosis, when more deaths were due to CRC. The inverse association between ASBs and CRC-specific mortality warrants further examination.
BACKGROUND: The influence of a high sugar diet on colorectal cancer (CRC) survival is unclear. METHODS: Among 1463 stage I-III CRC patients from the Nurses' Health Study and Health Professionals Follow-up Study, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC-specific and all-cause mortality in relation to intake of post-diagnosis sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), fruit juice, fructose and other sugars. RESULTS: Over a median 8.0 years, 781 cases died (173 CRC-specific deaths). Multivariable-adjusted HRs for post-diagnosis intake and CRC-specific mortality were 1.21 (95% CI: 0.87-1.68) per 1 serving SSBs per day (serving/day) and 1.24 (95% CI: 0.95-1.63) per 20 grams fructose per day. Significant positive associations for CRC-specific mortality were primarily observed ≤5 years from diagnosis (HR per 1 serving/day of SSBs = 1.59, 95% CI: 1.06-2.38). Significant inverse associations were observed between ASBs and CRC-specific and all-cause mortality (HR for ≥5 versus <1 serving/week = 0.44, 95% CI: 0.26-0.75 and 0.70, 95% CI: 0.55-0.89, respectively). CONCLUSIONS: Higher post-diagnosis intake of SSBs and sugars may be associated with higher CRC-specific mortality, but only up to 5 years from diagnosis, when more deaths were due to CRC. The inverse association between ASBs and CRC-specific mortality warrants further examination.
Authors: Jeffrey A Meyerhardt; Donna Niedzwiecki; Donna Hollis; Leonard B Saltz; Frank B Hu; Robert J Mayer; Heidi Nelson; Renaud Whittom; Alexander Hantel; James Thomas; Charles S Fuchs Journal: JAMA Date: 2007-08-15 Impact factor: 56.272
Authors: Jeffrey A Meyerhardt; Kaori Sato; Donna Niedzwiecki; Cynthia Ye; Leonard B Saltz; Robert J Mayer; Rex B Mowat; Renaud Whittom; Alexander Hantel; Al Benson; Devin S Wigler; Alan Venook; Charles S Fuchs Journal: J Natl Cancer Inst Date: 2012-11-07 Impact factor: 13.506
Authors: Teresa T Fung; Rutendo Kashambwa; Kaori Sato; Stephanie E Chiuve; Charles S Fuchs; Kana Wu; Edward Giovannucci; Shuji Ogino; Frank B Hu; Jeffrey A Meyerhardt Journal: PLoS One Date: 2014-12-15 Impact factor: 3.240
Authors: Chen Yuan; Ying Bao; Kaori Sato; Katharina Nimptsch; Mingyang Song; Jennie C Brand-Miller; Vicente Morales-Oyarvide; Emilie S Zoltick; NaNa Keum; Brian M Wolpin; Jeffrey A Meyerhardt; Andrew T Chan; Walter C Willett; Meir J Stampfer; Kana Wu; Edward L Giovannucci; Charles S Fuchs; Kimmie Ng Journal: Br J Cancer Date: 2017-08-17 Impact factor: 7.640