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.
Dr Bernard Srour, on behalf of the authors
Competing interests: No competing interests