Early-life sugar, sugary drinks intake in adolescence may promote adenoma

24 Mar 2021
Early-life sugar, sugary drinks intake in adolescence may promote adenoma

High intake of simple sugars and sugar-sweetened beverages (SSBs) during adolescence appears to contribute to an increased risk of conventional adenoma, especially rectal adenoma, a study has found.

Researchers examined the effect of consuming simple sugar (fructose, glucose, added sugar, total sugar) and SSB on the incidence of colorectal cancer (CRC) precursors in 33,106 participants of the Nurses’ Health Study II who provided adolescent dietary information in 1998. All participants subsequently underwent lower gastrointestinal endoscopy between 1999 and 2015.

A total of 2,909 conventional adenomas (758 high-risk) and 2,355 serrated lesions were documented over the follow-up. The mean age at diagnoses was 52.2 years.

Multivariable logistic regression for clustered data showed that high sugar and SSB intake during adolescence had a positive association with the risk of adenoma but not serrated lesions. Specifically, each 5-percent increment in calorie/day of total fructose intake conferred a 17- to 30-percent increase in the risks of total adenoma (odds ratio [OR], 1.17, 95 percent confidence interval [CI], 1.05–1.31) and high-risk adenoma (OR, 1.30, 95 percent CI, 1.06–1.60).

In a subgroup analysis by subsite, each 5-percent increment in calorie/day of total fructose intake upped the risk of proximal (OR, 1.12, 95 percent CI, 0.96–1.30), distal (OR, 1.24, 95 percent CI, 1.05–1.47), and rectal adenoma (OR, 1.43, 95 percent CI, 1.10–1.86).

Meanwhile, every 1 serving/day increment in SSB intake increased the risk of total adenoma by 11 percent (OR, 1.11, 95 percent CI, 1.02–1.20) and of rectal adenoma by 30 percent (OR, 1.30, 95 percent CI, 1.08–1.55).

Conversely, sugar and SSB intake during adulthood did not influence adenoma risk.

Gastroenterology 2021;doi:10.1053/j.gastro.2021.03.028