Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort

Magdalena Stepien, Talita Duarte-Salles, Veronika Fedirko, Antonia Trichopoulou, Pagona Lagiou, Christina Bamia, Kim Overvad, Anne Tjønneland, Louise Hansen, Marie Christine Boutron-Ruault, Guy Fagherazzi, Gianluca Severi, Tilman Kühn, Rudolf Kaaks, Krasimira Aleksandrova, Heiner Boeing, Eleni Klinaki, Domenico Palli, Sara Grioni, Salvatore PanicoRosario Tumino, Alessio Naccarati, H. Bas Bueno-de-Mesquita, Petra H. Peeters, Guri Skeie, Elisabete Weiderpass, Christine L. Parr, José Ramón Quirós, Genevieve Buckland, Esther Molina-Montes, Pilar Amiano, Maria Dolores Chirlaque, Eva Ardanaz, Emily Sonestedt, Ulrika Ericson, Maria Wennberg, Lena Maria Nilsson, Kay Tee Khaw, Nick Wareham, Kathryn E. Bradbury, Heather A. Ward, Isabelle Romieu, Mazda Jenab

Research output: Contribution to journalArticle

Abstract

Purpose: 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. Methods: 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). Results: 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, ptrend = 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, ncases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95–1.06; ncases = 127, pheterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (trend = 0.02 vs. non-consumers). Conclusions: 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.

Original languageEnglish
Pages (from-to)7-20
Number of pages14
JournalEuropean Journal of Nutrition
Volume55
Issue number1
DOIs
Publication statusPublished - Feb 1 2016

Fingerprint

Biliary Tract Neoplasms
Carbonated Beverages
Hepatocellular Carcinoma
Liver
Intrahepatic Bile Ducts
Social Adjustment
Energy Intake
Proportional Hazards Models
Alcohol Drinking
Body Mass Index
Confidence Intervals

Keywords

  • Biliary tract cancers
  • Fruit and vegetable juice
  • Hepatocellular carcinoma
  • Prospective cohort
  • Soft drink

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Stepien, M., Duarte-Salles, T., Fedirko, V., Trichopoulou, A., Lagiou, P., Bamia, C., ... Jenab, M. (2016). Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort. European Journal of Nutrition, 55(1), 7-20. https://doi.org/10.1007/s00394-014-0818-5

Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort. / Stepien, Magdalena; Duarte-Salles, Talita; Fedirko, Veronika; Trichopoulou, Antonia; Lagiou, Pagona; Bamia, Christina; Overvad, Kim; Tjønneland, Anne; Hansen, Louise; Boutron-Ruault, Marie Christine; Fagherazzi, Guy; Severi, Gianluca; Kühn, Tilman; Kaaks, Rudolf; Aleksandrova, Krasimira; Boeing, Heiner; Klinaki, Eleni; Palli, Domenico; Grioni, Sara; Panico, Salvatore; Tumino, Rosario; Naccarati, Alessio; Bueno-de-Mesquita, H. Bas; Peeters, Petra H.; Skeie, Guri; Weiderpass, Elisabete; Parr, Christine L.; Quirós, José Ramón; Buckland, Genevieve; Molina-Montes, Esther; Amiano, Pilar; Chirlaque, Maria Dolores; Ardanaz, Eva; Sonestedt, Emily; Ericson, Ulrika; Wennberg, Maria; Nilsson, Lena Maria; Khaw, Kay Tee; Wareham, Nick; Bradbury, Kathryn E.; Ward, Heather A.; Romieu, Isabelle; Jenab, Mazda.

In: European Journal of Nutrition, Vol. 55, No. 1, 01.02.2016, p. 7-20.

Research output: Contribution to journalArticle

Stepien, M, Duarte-Salles, T, Fedirko, V, Trichopoulou, A, Lagiou, P, Bamia, C, Overvad, K, Tjønneland, A, Hansen, L, Boutron-Ruault, MC, Fagherazzi, G, Severi, G, Kühn, T, Kaaks, R, Aleksandrova, K, Boeing, H, Klinaki, E, Palli, D, Grioni, S, Panico, S, Tumino, R, Naccarati, A, Bueno-de-Mesquita, HB, Peeters, PH, Skeie, G, Weiderpass, E, Parr, CL, Quirós, JR, Buckland, G, Molina-Montes, E, Amiano, P, Chirlaque, MD, Ardanaz, E, Sonestedt, E, Ericson, U, Wennberg, M, Nilsson, LM, Khaw, KT, Wareham, N, Bradbury, KE, Ward, HA, Romieu, I & Jenab, M 2016, 'Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort', European Journal of Nutrition, vol. 55, no. 1, pp. 7-20. https://doi.org/10.1007/s00394-014-0818-5
Stepien, Magdalena ; Duarte-Salles, Talita ; Fedirko, Veronika ; Trichopoulou, Antonia ; Lagiou, Pagona ; Bamia, Christina ; Overvad, Kim ; Tjønneland, Anne ; Hansen, Louise ; Boutron-Ruault, Marie Christine ; Fagherazzi, Guy ; Severi, Gianluca ; Kühn, Tilman ; Kaaks, Rudolf ; Aleksandrova, Krasimira ; Boeing, Heiner ; Klinaki, Eleni ; Palli, Domenico ; Grioni, Sara ; Panico, Salvatore ; Tumino, Rosario ; Naccarati, Alessio ; Bueno-de-Mesquita, H. Bas ; Peeters, Petra H. ; Skeie, Guri ; Weiderpass, Elisabete ; Parr, Christine L. ; Quirós, José Ramón ; Buckland, Genevieve ; Molina-Montes, Esther ; Amiano, Pilar ; Chirlaque, Maria Dolores ; Ardanaz, Eva ; Sonestedt, Emily ; Ericson, Ulrika ; Wennberg, Maria ; Nilsson, Lena Maria ; Khaw, Kay Tee ; Wareham, Nick ; Bradbury, Kathryn E. ; Ward, Heather A. ; Romieu, Isabelle ; Jenab, Mazda. / Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort. In: European Journal of Nutrition. 2016 ; Vol. 55, No. 1. pp. 7-20.
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T1 - Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort

AU - Stepien, Magdalena

AU - Duarte-Salles, Talita

AU - Fedirko, Veronika

AU - Trichopoulou, Antonia

AU - Lagiou, Pagona

AU - Bamia, Christina

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Hansen, Louise

AU - Boutron-Ruault, Marie Christine

AU - Fagherazzi, Guy

AU - Severi, Gianluca

AU - Kühn, Tilman

AU - Kaaks, Rudolf

AU - Aleksandrova, Krasimira

AU - Boeing, Heiner

AU - Klinaki, Eleni

AU - Palli, Domenico

AU - Grioni, Sara

AU - Panico, Salvatore

AU - Tumino, Rosario

AU - Naccarati, Alessio

AU - Bueno-de-Mesquita, H. Bas

AU - Peeters, Petra H.

AU - Skeie, Guri

AU - Weiderpass, Elisabete

AU - Parr, Christine L.

AU - Quirós, José Ramón

AU - Buckland, Genevieve

AU - Molina-Montes, Esther

AU - Amiano, Pilar

AU - Chirlaque, Maria Dolores

AU - Ardanaz, Eva

AU - Sonestedt, Emily

AU - Ericson, Ulrika

AU - Wennberg, Maria

AU - Nilsson, Lena Maria

AU - Khaw, Kay Tee

AU - Wareham, Nick

AU - Bradbury, Kathryn E.

AU - Ward, Heather A.

AU - Romieu, Isabelle

AU - Jenab, Mazda

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Purpose: 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. Methods: 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). Results: 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, ptrend = 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, ncases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95–1.06; ncases = 127, pheterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (trend = 0.02 vs. non-consumers). Conclusions: 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.

AB - Purpose: 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. Methods: 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). Results: 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, ptrend = 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, ncases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95–1.06; ncases = 127, pheterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (trend = 0.02 vs. non-consumers). Conclusions: 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.

KW - Biliary tract cancers

KW - Fruit and vegetable juice

KW - Hepatocellular carcinoma

KW - Prospective cohort

KW - Soft drink

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