Table 3.
Multivariable HR1 and 95% CI across quintiles (Q)/tertiles (T) of total sugars, added sugars, total fructose and sucrose intake in 179,990 women in the NIH-AARP Diet and Health Study for all cancers, oral, esophageal, lung, pleural, bladder, ovarian cancer and leukemia2
| N cases |
Multivariable HRs (95% CI) by quintiles3 or tertiles4 of intake |
Ptrend | ||||
|---|---|---|---|---|---|---|
| Q2/T2 | Q3/T3 | Q4 | Q5 | |||
| All cancers6 | 13,209 | |||||
| Total sugars | 1.02 (0.97 – 1.08) | 1.02 (0.96 – 1.09) | 1.01 (0.95 – 1.09) | 1.00 (0.91 – 1.08) | 0.75 | |
| Added sugars5 | 1.01 (0.96 – 1.07) | 1.00 (0.95 – 1.06) | 1.01 (0.95 – 1.07) | 1.00 (0.94 – 1.07) | 0.99 | |
| Total fructose | 1.00 (0.95 – 1.06) | 1.01 (0.95 – 1.08) | 1.02 (0.95 – 1.09) | 0.98 (0.90 – 1.06) | 0.59 | |
| Sucrose | 1.01 (0.96 – 1.07) | 0.98 (0.92 – 1.04) | 1.02 (0.96 – 1.08) | 1.00 (0.94 – 1.07) | 0.94 | |
| Oral cancer7 | 205 | |||||
| Total sugars | 0.90 (0.58 – 1.39) | 1.15 (0.75 – 1.75) | 1.06 (0.68 – 1.65) | 1.10 (0.70 – 1.73) | 0.54 | |
| Added sugars5 | 1.08 (0.69 – 1.69) | 1.15 (0.73 – 1.81) | 1.21 (0.77 – 1.90) | 1.19 (0.75 – 1.88) | 0.49 | |
| Total fructose | 1.36 (0.91 – 2.05) | 0.88 (0.55 – 1.41) | 1.16 (0.74 – 1.82) | 1.26 (0.81 – 1.97) | 0.48 | |
| Sucrose | 0.85 (0.55 – 1.33) | 0.99 (0.64 – 1.54) | 1.21 (0.80 – 1.85) | 1.00 (0.64 – 1.56) | 0.64 | |
| Esophageal cancer8 | 68 | |||||
| Total sugars | 1.27 (0.68 – 2.36) | 1.41 (0.69 – 2.91) | 0.35 | |||
| Added sugars5 | 0.71 (0.38 – 1.34) | 1.04 (0.56 – 1.93) | 0.80 | |||
| Total fructose | 1.82 (0.98 – 3.36) | 1.71 (0.83 – 3.54) | 0.17 | |||
| Sucrose | 1.33 (0.74 – 2.41) | 1.13 (0.58 – 2.20) | 0.75 | |||
| Lung cancer9 | 2,008 | |||||
| Total sugars | 0.94 (0.83 – 1.07) | 0.99 (0.86 – 1.14) | 0.86 (0.74 – 1.00) | 0.89 (0.76 – 1.05) | 0.10 | |
| Added sugars5 | 1.01 (0.88 – 1.16) | 1.03 (0.89 – 1.19) | 0.94 (0.81 – 1.09) | 1.00 (0.86 – 1.16) | 0.83 | |
| Total fructose | 0.93 (0.82 – 1.06) | 1.00 (0.88 – 1.15) | 0.83 (0.71 – 0.96) | 0.86 (0.73 – 1.01) | 0.03 | |
| Sucrose | 0.94 (0.82 – 1.07) | 0.87 (0.75 – 1.00) | 0.98 (0.85 – 1.13) | 0.90 (0.78 – 1.04) | 0.26 | |
| Bladder cancer10 | 202 | |||||
| Total sugars | 1.23 (0.79 – 1.92) | 1.05 (0.65 – 1.71) | 1.47 (0.92 – 2.33) | 1.47 (0.90 – 2.41) | 0.10 | |
| Added sugars5 | 1.38 (0.89 – 2.14) | 1.38 (0.88 – 2.16) | 0.97 (0.58 – 1.60) | 1.41 (0.87 – 2.29) | 0.45 | |
| Total fructose | 1.29 (0.83 – 1.99) | 0.96 (0.59 – 1.56) | 1.30 (0.82 – 2.07) | 1.66 (1.05 – 2.65) | 0.03 | |
| Sucrose | 1.38 (0.89 – 2.15) | 1.27 (0.80 – 2.03) | 1.17 (0.72 – 1.90) | 1.59 (1.00 – 2.53) | 0.12 | |
| Leukemia7 | 226 | |||||
| Total sugars | 1.11 (0.72 – 1.72) | 1.03 (0.65 – 1.62) | 1.46 (0.96 – 2.24) | 1.49 (0.96 – 2.31) | 0.03 | |
| Added sugars5 | 0.99 (0.64 – 1.53) | 1.07 (0.69 – 1.67) | 1.01 (0.64 – 1.60) | 1.60 (1.03 – 2.48) | 0.02 | |
| Total fructose | 1.00 (0.64 – 1.55) | 1.14 (0.74 – 1.76) | 1.46 (0.96 – 2.21) | 1.34 (0.87 – 2.08) | 0.07 | |
| Sucrose | 1.03 (0.67 – 1.59) | 1.33 (0.88 – 2.01) | 1.28 (0.84 – 1.95) | 1.03 (0.66 – 1.63) | 0.77 | |
| Ovarian cancer7 | 457 | |||||
| Total sugars | 0.95 (0.71 – 1.26) | 0.82 (0.61 – 1.11) | 0.90 (0.67 – 1.21) | 0.70 (0.51 – 0.97) | 0.03 | |
| Added sugars5 | 1.07 (0.81 – 1.41) | 0.84 (0.62 – 1.13) | 0.84 (0.62 – 1.15) | 0.72 (0.51 – 1.00) | 0.02 | |
| Total fructose | 0.96 (0.72 – 1.28) | 0.91 (0.68 – 1.22) | 0.90 (0.67 – 1.21) | 0.68 (0.49 – 0.95) | 0.02 | |
| Sucrose | 0.93 (0.70 – 1.23) | 0.88 (0.66 – 1.17) | 0.77 (0.57 – 1.04) | 0.65 (0.47 – 0.89) | 0.004 | |
Cox proportional hazards regression model adjusted for age, BMI (<18.5, ≥18.5 to <25, ≥25 to <30, ≥30 to <35, ≥35, or missing), family history of cancer, marital status, smoking (never smoker, quit >=10 yrs ago, quit 5–9 yrs ago, quit 1–4 yrs ago, quit <1yr ago <=20 cigs/d, quit <1yr ago >20 cigs/d, current <=20 cigs/d, current 20–40 cigs/d, current >40 cigs/d, or missing), race (Caucasian, Black, Hispanic/Asian/Pacific Islander/American Indian/Alaskan native, or unknown), education (less than high school/unknown, high school graduate, some college, or college graduate), physical activity (never/rarely/missing, 1–3 times per month, 1–2 times per week, 3–4 times per week, or ≥5 times per week), energy intake (kcal, continuous) and alcohol intake (grams, quintiles).
Only findings for cancer sites which were statistically significantly associated with dietary sugars either in men or women are reported in this table. Findings for the remaining 17 cancers are reported as an additional material.
Medians by quintile of intake were: 38.7, 51.6, 61.5, 72.5 and 91.5 g/1000 kcal for total sugars; 2.4, 3.7, 5.0, 6.9 and 11.0 tsp/1000 kcal for added sugars; 14.8, 20.5, 25.0, 30.4 and 40.6 g/1000 kcal for total fructose; and 13.6, 18.7, 22.9, 28.0 and 37.5 g/1000 kcal for sucrose.
Medians by tertile of intake were: 43.9, 61.4 and 83.1 g/1000 kcal for total sugars; 2.9, 5.0 and 9.0 tsp/1000 kcal for added sugars; 17.0, 25.0 and 35.9 g/1000 kcal for total fructose; and 15.6, 22.9 and 33.2 g/1000 kcal for sucrose.
Additionally adjusted for fruit without juice (g/1000 kcal, quintiles) and for fruit juice (g/1000 kcal, quintiles) to separate the effect of fruit juice and whole fruits.
Additionally adjusted for vegetables (g/1000 kcal, quintiles), red meat (g/1000 kcal, quintiles), total fat (g/1000 kcal, quintiles), protein (g/1000 kcal, quintiles), fiber (g/1000 kcal, quintiles), folate (µg/1000 kcal, quintiles), beta-carotene (µg/1000 kcal, quintiles), vitamin C (mg/1000 kcal, quintiles) and calcium intake (mg/1000 kcal, quintiles), use of supplemental calcium (mg, quintiles) and height (cm, continuous).
Additionally adjusted for vegetables intake.
Additionally adjusted for vegetables, red meat, beta-carotene and vitamin C intake.
Additionally adjusted for vegetables and red meat intake.
Additionally adjusted for vegetables and protein intake.