Journal
EUROPEAN JOURNAL OF NUTRITION
Volume 55, Issue 1, Pages 7-20Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00394-014-0818-5
Keywords
Hepatocellular carcinoma; Biliary tract cancers; Soft drink; Fruit and vegetable juice; Prospective cohort
Categories
Funding
- French National Cancer Institute (L'Institut National du Cancer
- INCA) [2009-139]
- European Commission (DG-SANCO)
- International Agency for Research on Cancer
- Danish Cancer Society (Denmark)
- Ligue Contre le Cancer
- Institut Gustave Roussy
- Mutuelle Generale de l'Education Nationale
- Institut National de la Sante et de la Recherche Medicale (INSERM) (France)
- Deutsche Krebshilfe
- Deutsches Krebsforschungszentrum (DKFZ)
- Federal Ministry of Education and Research (Germany)
- Stavros Niarchos Foundation
- Hellenic Health Foundation
- Ministry of Health and Social Solidarity (Greece)
- Italian Association for Research on Cancer (AIRC)
- National Research Council
- AIRE-ONLUS Ragusa
- AIRE-ONLUS Ragusa, AVIS Ragusa, Sicilian Government (Italy)
- Dutch Ministry of Public Health, Welfare and Sports (VWS)
- Netherlands Cancer Registry (NKR)
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (WCRF)
- Statistics Netherlands (the Netherlands)
- European Research Council (ERC) [ERC-2009-AdG 232997]
- Nordforsk
- Nordic Center of Excellence Programme on Food, Nutrition and Health (Norway)
- Health Research Fund (FIS)
- Regional Government of Andalucia
- Regional Government of Asturias
- Regional Government of Basque Country
- Regional Government of Murcia [6236]
- Regional Government of Navarra
- ISCIII RETIC [RD06/0020]
- Catalan Institute of Oncology. (Spain)
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane and Vasterbotten (Sweden)
- Cancer Research UK
- Medical Research Council
- Stroke Association
- British Heart Foundation
- Department of Health
- Food Standards Agency
- Wellcome Trust (UK)
- MRC [MC_UU_12015/1] Funding Source: UKRI
- Cancer Research UK [14136, 16491] Funding Source: researchfish
- Medical Research Council [MC_U106179471, MC_UU_12015/1, G0401527, G1000143] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114, NF-SI-0512-10135] Funding Source: researchfish
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The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries. After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95 % confidence intervals (HR; 95 % CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical activity, level of educational attainment and self-reported diabetes status). No risk associations were observed for IHBC or GBTC. Combined soft drinks consumption of > 6 servings/week was positively associated with HCC risk: HR 1.83; 95 % CI 1.11-3.02, p (trend) = 0.01 versus non-consumers. In sub-group analyses available for 91 % of the cohort artificially sweetened soft drinks increased HCC risk by 6 % per 1 serving increment (HR 1.06, 95 % CI 1.03-1.09, n (cases) = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95-1.06; n (cases) = 127, p (heterogeneity) = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (< 1 serving/week: HR 0.60; 95 % CI 0.38-0.95; p (trend) = 0.02 vs. non-consumers). Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted. This study provides some insight into possible associations of HCC with sugary drinks intake. Further exploration in other settings is required.
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