Sweet-beverage consumption and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)123

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Abstract

Background: The consumption of sweet beverages has been associated with greater risk of type 2 diabetes and obesity, which may be involved in the development of pancreatic cancer. Therefore, it has been hypothesized that sweet beverages may increase pancreatic cancer risk as well.

Objective: We examined the association between sweet-beverage consumption (including total, sugar-sweetened, and artificially sweetened soft drink and juice and nectar consumption) and pancreatic cancer risk.

Design: The study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. A total of 477,199 participants (70.2% women) with a mean age of 51 y at baseline were included, and 865 exocrine pancreatic cancers were diagnosed after a median follow-up of 11.60 y (IQR: 10.10-12.60 y). Sweet-beverage consumption was assessed with the use of validated dietary questionnaires at baseline. HRs and 95% CIs were obtained with the use of multivariable Cox regression models that were stratified by age, sex, and center and adjusted for educational level, physical activity, smoking status, and alcohol consumption. Associations with total soft-drink consumption were adjusted for juice and nectar consumption and vice versa.

Results: Total soft-drink consumption (HR per 100 g/d: 1.03; 95% CI: 0.99, 1.07), sugar-sweetened soft-drink consumption (HR per 100 g/d: 1.02; 95% CI: 0.97, 1.08), and artificially sweetened soft-drink consumption (HR per 100 g/d: 1.04; 95% CI: 0.98, 1.10) were not associated with pancreatic cancer risk. Juice and nectar consumption was inversely associated with pancreatic cancer risk (HR per 100 g/d: 0.91; 95% CI: 0.84, 0.99); this association remained statistically significant after adjustment for body size, type 2 diabetes, and energy intake.

Conclusions: Soft-drink consumption does not seem to be associated with pancreatic cancer risk. Juice and nectar consumption might be associated with a modest decreased pancreatic cancer risk. Additional studies with specific information on juice and nectar subtypes are warranted to clarify these results.

Keywords

epidemiology
juice and nectar
pancreatic cancer
prevention
risk factors
soft drinks
sweet beverages
sugary drinks

Cited by (0)

1

Supported by the Europe Against Cancer Program of the European Commission; German Cancer Aid; the German Cancer Research Center; the German Federal Ministry of Education and Research; the Danish Cancer Society; the Health Research Fund of the Spanish Ministry of Health; the Spanish Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, Health Research Institute Carlos III, grant RCESP C03/09, Spain; the Cancer Research UK Medical Research Council, United Kingdom; The Hellenic Health Foundation, Greece; the Italian Association for Research on Cancer; the Italian National Research Council; the Fondazione-Istituto Banco Napoli, Italy; the Dutch Ministry of Public Health, Welfare and Sports; Dutch Prevention Funds; LK Research Funds; Dutch Zorg Onderzoek Nederland; the World Cancer Research Fund (Netherlands); the Swedish Cancer Society; the Swedish Scientific Council, Regional Government of Skåne, Sweden; the Helga—Nordic Center of Excellence Programme in Nutrition and Health; the French League Against Cancer; the National Institute for Health and Medical Research, France; the Mutuelle Générale de l'Education Nationale, France; the 3M Co., France; the Gustave Roussy Institute, France; the General Councils of France, Compagnia di San Paolo, Torino, Italy; and the Ministerio de Economía y Competitividad, Spain and European Regional Development Fund (Ramon y Cajal contract RYC-2011-08796; to DR).

2

The funders had no role in the study design, the data collection and analysis, the decision to publish, or the preparation of the manuscript.

3

Supplemental Tables 15 and Supplemental Figures 17 are available from the “Online Supporting Material” link in the online posting of the article and from the same link in the online table of contents at http://ajcn.nutrition.org.