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Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l2408 (Published 10 July 2019) Cite this as: BMJ 2019;366:l2408

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Re: Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort

Dear Dr Dinerstein,

Thank you for your interest.

Higher consumers of sugary drinks (Q4) are younger than lower consumers (Q1).

Age is a very important risk factor for cancer, this is why the number of cancer cases (in univariate non adjusted-analyses) in Q1 is greater than in Q4. It is an observation artefact linked to the age of participants.

However, in order to compute sHRs and estimate risk changes, we used multi-adjusted models, with adjustments for several confounding factors, including age. In these multivariate anayses (adjusted for age, sex, energy intake, sugar intake from other dietary sources, alcohol, sodium, lipid and fruit and vegetable intakes, body mass index, height, physical activity, smoking status, number of 24 hour dietary records, family history of cancer, educational level, and the following prevalent conditions at baseline: type 2 diabetes, hypertension, major cardiovascular event and dyslipidaemia), we observed a higher cancer risk in Q4 compared with Q1 (sHR Q4 vs Q1 = 1.30 (1.17 to 1.52), p-trend<0.001).

We hope this helps.

Best wishes,

Dr Bernard Srour, on behalf of the authors

Competing interests: No competing interests

11 July 2019
Bernard Srour
Epidemiologist, doctoral researcher
Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN)
Paris Area