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Adolescence Intake of Sugar-Sweetened Beverages Linked to Increased Risk of Early-onset Colon Cancer Interview with:

Dr. Jinhee Hur

Dr. Jinhee Hur

Jinhee Hur, PhD
Research Fellow
Department of Nutrition
Harvard T.H. Chan School of Public Health
Boston, MA 02115 What is the background for this study?

Response: Early-onset colorectal cancer (EO-CRC, age <50 years at diagnosis) is rapidly rising in the US since the mid-1980s, with an unclear understanding of its etiology and contributors to the rise. Sugar-sweetened beverages (SSBs) exert adverse metabolic repercussions throughout the life course, including insulin resistance and inflammation. Higher SSB intake can induce obesity, which has been linked to risk of EO-CRC. A recent experimental study also suggests that high fructose corn syrup, a primary sweetener in SSBs, may promote colon tumor growth, independent of metabolic dysregulation. In the US, SSB consumption has dramatically increased during the 2nd half of the 20th century, and adolescents and young adults have been the heaviest SSB drinkers across all age groups. Thus, we expect SSBs may be an emerging risk factor for EO-CRC and likely contribute to the rising incidence of EO-CRC. What are the main findings?

Response: Compared with women who drank <1 serving (8 oz) per week of sugar-sweetened beverages in adulthood, those who drank ≥2 servings per day had a 2.2-fold higher risk of early-onset colorectal cancer; and each daily serving increase was linked to a 16% higher risk. Moreover, for each daily serving of SSB intake at age 13-18, there was a 32% higher risk of EO-CRC. In turn, replacing adulthood intake of SSBs with that of other beverages, such as artificially sweetened beverages, coffee, reduced fat milk or total milk was associated with a 17-36% lower risk of EO-CRC. What should readers take away from your report?

Response: On top of the well-known adverse metabolic and health consequences of sugar-sweetened beverages, our findings have added another reason to avoid SSBs since earlier life stages. Reducing sugar-sweetened beverages intake and/or replacing SSBs with other healthier beverages, such as unsweetened milk, would be a better and wiser choice for long-term health. What recommendations do you have for future research as a result of this work?

Response: One unique pattern in the growing burden of early-onset colorectal cancer in the US is that the age-specific CRC incidence has increased across subsequent birth cohorts born after 1950, postulating that increasingly prevalent exposures across generations may be driving the incidence upward. Exploring other dietary and lifestyle risk factors that have shown secular trends in parallel with the EO-CRC incidence will be of particular relevance. In the context of our findings, validations in other large epidemiologic studies are necessary. More work is needed to further understand the biological mechanisms underlying the link between sugar-sweetened beverages and EO-CRC. Is there anything else you would like to add?

Response: We are truly excited to share our findings with a broader community. We hope our work helps raise the awareness of the rising incidence of early-onset colorectal cancer among healthcare providers and the general public and advance the current and future understanding of the etiology of EO-CRC.

No disclosures.


Hur et al, Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women,
Gut 2021



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Last Updated on May 7, 2021 by Marie Benz MD FAAD