f13.net

February 16, 2010 - Abstract

The regular consumption of sugar-laden soft drinks could boost a person's risk of developing pancreatic cancer. The results of a new study found that individuals who consumed 2 or more soft drinks per week had an 87% increased risk for pancreatic cancer, compared with those who did not.

Even after taking factors such as smoking, caloric intake, and type 2 diabetes mellitus into account, the authors found that consuming soft drinks might play an independent role in the development of pancreatic cancer.

Both soft drinks and fruit juices have a high glycemic load relative to other foods and drinks, and it has been hypothesized that both are risk factors for pancreatic cancer. The high levels of sugar can increase levels of insulin in the body, and this can contribute to pancreatic cancer cell growth, the researchers explain.

Results Statistically Significant for Soft Drinks

The current study examined the association between the consumption of soft drinks and juice and the risk for pancreatic cancer among Chinese people residing in Singapore. The data came from the Singapore Chinese Health Study (n = 60,524), and information regarding the consumption of soft drinks, juice, and other dietary items, along with lifestyle factors and environmental exposures, was collected at recruitment to the study. The participants were followed for up to 14 years.

At the start of the study, 9.7% of the participants consumed at least 2 soft drinks per week and 10.2% consumed at least 2 servings of juice per week. The authors note that, compared with those who did not consume soft drinks, those who consumed 2 or more soft drinks per week were younger, were more likely to be men, and were more likely to smoke cigarettes. They also had higher levels of education, alcohol consumption, and total energy intake; lower levels of physical activity; and consumed more total carbohydrates, fat, added sugar, and red meat.

Individuals who reported consuming 2 or more juice drinks a week had lifestyle and dietary habits that were similar to those who consumed soft drinks. However, there was no association between juice intake and cigarette smoking, and body mass index (BMI) was comparable across different categories of soft drink and juice consumption.

At 14 years and a cumulative 648,387 person-years of follow-up, 140 incident pancreatic cancers developed in people who were cancer free at baseline. After adjustment for confounders such as BMI, type 2 diabetes mellitus, and fruit juice intake, the authors found that those consuming 2 or more soft drinks per week experienced a statistically significant increased risk for pancreatic cancer (hazard ratio

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, 1.87; 95% confidence interval [CI], 1.10 - 3.15).

Although people who consumed 2 or more juice drinks a week had an increased risk for pancreatic cancer of approximately 30%, elevated HR was not statistically significant after adjustment for variables.

However, in an age-adjusted analysis, smoking was also a risk factor. After excluding former smokers, the authors found that current smokers had a 49% increased risk for pancreatic cancer, compared with never smokers (HR, 1.49; 95% CI, 0.98 - 2.27). This risk factor remained unaffected after adjustment for diabetes and BMI.

Can Be Extrapolated to United States and Europe

Singapore is a highly industrialized nation with lifestyle and nutritional patterns reminiscent of many westernized countries. In that sense, these findings could be extrapolated to the United States and Europe, explained Mr. Mueller. Soft drinks are the leading source of added sugar in the American diet, the authors note.

"However, there are inherent differences between Singaporean Chinese and Caucasians, which is why one must be cautious when generalizing these results to the United States and Europe," he said. "But it is important to note that other studies in Caucasian populations have suggested that soft drink intake may increase risk for pancreatic cancer."

Because pancreatic cancer is a relatively rare disease, the number of cases in this study was relatively small, the authors point out. This limited the statistical power of the study. Another limitation was the inability to collect repeated dietary measurements during the course of the study; therefore, they could not account for changes in consumption of soft drinks and juices.

However, this study adds to the evidence that soft drink consumption plays a role in the development of pancreatic cancer, they conclude, and that "clinical studies examining biomarkers for glycemia and insulinemia and taking a mechanistic approach to the question of soft drink consumption and pancreatic cancer are warranted."

There is "still much to understand on the link between sugar-sweetened beverages and pancreatic cancer," the authors write.

The study was supported by a grant from the National Cancer Institute. The researchers have disclosed no relevant financial relationships.

Do they make a distinction between sugar and HFCS? Or is that irrelevant in this case?

Study Highlights

    * The Singapore Chinese Health Study is a population-based, prospective cohort study of diet and cancer risk conducted in permanent residents from government-built housing estates where 86% of the population resided.
    * This study involved 2 dialect groups: the Hokkien and Cantonese originating from the southern part of China.
    * Participants were men and women aged 45 to 74 years without preexisting pancreatic cancer.
    * Recruitment was by letter, and staff went from door to door inviting participation with each subject.
    * A trained interviewer then interviewed the participants face-to-face using a structured scanner-readable questionnaire.
    * The interviewer asked subjects about demographics, lifestyle, diet, and medical history.
    * Diet was elicited with a semiquantitative 165-item food frequency questionnaire.
    * The questionnaire included commonly eaten food from Singapore, with 3 portion sizes and frequency in 8 categories ranging from never or hardly ever to 6 or more times daily.
    * Photographs of foods were presented to identify the food groups.
    * The questionnaire was validated against 24-hour recall in at least 1000 participants.
    * Soft drink portions were defined as 1 glass.
    * 1 glass was designated as 237 mL and was equivalent to 1 cup.
    * Juices were categorized into specific drinks that included sugarcane, honeydew melon, apple, watermelon, carrot, pineapple, star fruit, and lemon juices.
    * The Singapore Food Composition Table was developed to analyze the nutritional content of food types.
    * Other risk factors for pancreatic cancer were assessed, including BMI, smoking, and physical activity.
    * Pancreatic cancer cases were ascertained by linkage to the population-based cancer registry and registry of births and deaths.
    * 142 incident cases were identified, of which 56.4% were histologically confirmed, 38.8% were by clinical and radiologic findings, and 4.8% were identified by death certificates.
    * Rate of loss to follow-up was only 0.03%.
    * Mean age was 56 years, 55% were women, mean BMI was 23 kg/m2, 30% were ever-smokers, and 10% had type 2 diabetes.
    * At baseline, 9.7% of participants consumed at least 2 soft drinks per week and 10.2% consumed at least 2 servings of juice per week.
    * Those who consumed 2 or more soft drinks or juices weekly were likely to be younger, men, smoke, have higher levels of education, consume alcohol, and have higher energy intake and lower physical activity vs those who consumed no soft drinks or juices.
    * They also had a higher consumption of total carbohydrates, sugar, and red meat.
    * After 14 years and 648,387 person-years of follow-up, invasive exocrine pancreatic cancer developed in 140 persons .
    * Smokers had a 49% increased risk for pancreatic cancer.
    * BMI and a history of diabetes were not associated with an increased risk for pancreatic cancer.
    * Results for all risks were similar for men and women, and analysis was combined for the 2 sexes.
    * Drinking 2 or more soft drinks per week was associated with more than 80% increase in risk for pancreatic cancer after adjustment for other risks (HR, 1.87).
    * This risk was independent of diabetes and smoking and persisted after excluding those who had pancreatic cancer within 5 years of baseline.
    * After adjustment, juice intake of 2 or more drinks per week overall was not associated with increased risk, but when smokers were excluded, there was an association between juice intake and pancreatic cancer risk (HR, 1.60).
    * The authors concluded that soft drink consumption was positively associated with pancreatic cancer risk but that juice consumption was associated with risk among nonsmokers only.

Oh, goddammit!  I just had to click this while I was making a Dr. Pepper ice cream float.  Fortunately, I hate life, so it's no big deal.

I get my cancer from phenylalanine, not sugar  :awesome_for_real:

I cut out soda a couple years ago, I don't miss it. I do have the occasional juice or energy drink, but mostly I just drink coffee or water.

Confirming yet again tha one should only drink grain alcohol and rain water.

edit2:  I've also found when trying to switch to non-carbonated stuff that I drink it much faster and my daily intake goes way up so instead of 120oz of soda I would drink 200oz of tea/water/juice/flavored drink.

Singapore is pretty upscale though. Close to Japan/Korea. Everyone's pretty rich, even when they say they aren't. I'm sure their water is fine. Want to rag on water supplies, feel free to use anything else in SE Asia :D

Um?  That may be a question for your doctor at your next checkup....  excessive water/fluid drinking could indicate a mental or medical illness.

I'd say mental, it is just a really bad habit that I need to have a drink at hand when coding.  Sort of a mini reward system, code a block then sit back and review what I just did while taking a few sips.

While I don't believe that drinking lots of soda is good for you, the pancreatic cancer link is possibly a bit overblown.  Pancreatic cancer is very rare and even with their numbers it appears that you are talking about a difference of 45 people out of the 45,000 or so that appeared to be in the study.  I always raise an eyebrow when they say, "you have an X% increased chance of gettting X disease because of doing X."  Increased percentage chance of having something happen is only particularly relevant if the percent increase is very significant or if the numbers were significant in the baseline group.

I agree completely.  Buying two powerball tickets doubles your chances of winning.  

I wasn't attempting to make a political statement here.  I just thought it was an informative study as I ran across it in my weekly journal review.  

Actually, I don't think it does.  I have read somewhere that you have to buy an insane number of tickets to actually increase your chances.  Statistics are strange things.

Beer is a perfectly healthy substitute for soda, right?  Because the same time I cut out soda from my life is around the same time I started drinking beer heavily...

The odds of being a jackpot winner for like Mega Millions are 1 in 175,711,536.  Wouldn't buying two tickets make the odds 2 in 175,711,536 or double?   

I don't claim to be a math wiz. 

Confounding variables be damned! Full speed ahead! What I would like to know is who is at the end of this funding money line...

I don't see what control they were comparing their group against to make the "87% increase" proclamation. 

If you're that interested, you can grab the article and contact the PI by email.  If you have a legitimate reason to ask, I'm sure that they would take the time to respond to your question.  I field questions about my research all the time, particularly as it relates to something that I've published or presented. 

I don't want to debate semantics... that wasn't the reason that I posted the article summary. 

You think having an appropriate control group is "semantics"?

Odds are not necessarily the same as your probability of winning.  Odds do not equal probability.

If it has an ingredient you wouldn't use in your every day language, chances are it isn't good for you.

I thought Nebu might have enjoyed discussing some of the points of the article.

Big Corn

However, this study adds to the evidence that soft drink consumption plays a role in the development of pancreatic cancer, they conclude, and that "clinical studies examining biomarkers for glycemia and insulinemia and taking a mechanistic approach to the question of soft drink consumption and pancreatic cancer are warranted."

Do they make a distinction between sugar and HFCS? Or is that irrelevant in this case? I would also like to know if they made a distinction between fruit juice (100% not from concentrate) and or "Juice drinks" (Typically from concentrate, 10% juice and a ton of HFCS or sugar water)

...even “not from concentrate” orange juice is heated, stripped of flavor, stored for up to a year, and then reflavored before it is packaged and sold.

Talking about a "control group" in this kind of study is nonsensical. 

This isn't that type of study where you are applying outside stimuli and seeing how it works so you need another group who doesn't receive it to measure against. 

The fact that they are all from one area/ethnicity is actually helpful because it is one less independent variable you have to control for in trying to isolate correlation/causation for the dependent variable.  There could always be intervening unaccounted for variables that would skew things, but the fact they are from the same population is somewhat the opposite of such a phenomenon.

As for the small number of cases, you can always run into a "small N" problem, but here it looks like there was statistical significance to the increase and the journal would have likely found any issues in the actual math in the review process.

It is an important piece of research and I hope there is more follow up.  This is what killed my dad and causation for pancreatic cancer is a bit of a mystery (my suspicion was him being downwind of the atomic testing next door in Nevada, but that is just my speculation).

It's funny how in these threads you can always immediately recognise the ex-fatties. They're always the ones who go on this idiotic zealous crusade against sugar, or fat, or preservatives, or plastics, or whatever the latest health fad bullshit is, like they're trying to 'make up' for all the years of being a big fatass.



Being born is statistically 100% correlated with future incidence of death. Deal with that one.

Ghost, have you, uh, had much in the way of formal education regarding statistics?

Go ahead and Den this.  I'm sorry I even posted it. 

Actually, it really isn't at all.  Controlled, randomized trials are the very epitome of good research.  If you think otherwise you are a blithering idiot that knows nothing of research.  They absolutely have to have a "control" group to compare to get their baseline figures.  I am assuming that they are comparing the "haves" to the "have nots" within the study.  This is a problem with a longitudinal observational study.

The control is the group itself, because you split out people who did X from people who did Y and see what the differences are

...even “not from concentrate” orange juice is heated, stripped of flavor, stored for up to a year, and then reflavored before it is packaged and sold.

I quit drinking all sodas about nine months ago and don't miss it.  I do drink a lot of sugary fruit drinks though because OJ and milk can bother my stomach.  Haven't lost any weight and I feel about the same so haven't seen any benefits from it.  

I thought Nebu might have enjoyed discussing some of the points of the article. 

Note for all the people drinking "Fresh, not concentrate" juice: it's not fresh in any sense of the word that you would recognize. (http://books.google.ca/books?id=5AUjN-B4LfsC)

Bottom line: Soda is cheaper - in convenience and $ for the amount you get.

Not in Philadelphia, soon.  Evidently, there will be a really significant tax on soft drinks that will add about 2 cents an ounce.  So tack on about $2.88 to your twelve pack which brings it up to almost $8.50.  So, a twelve pack of Coke, a pack of cigs and a pizza will probably cost you over $25.  Oh, and they're raising the trash removal rates quite a bit, too, so it'll cost you more to have the rubbish you create from it taken away.  That's a pricey Saturday night treat!

On the plus size (no pun intended), a full fifty percent of the children in Philadelphia are considered to be obese and this might do something to help in that respect.  Maybe.  I don't know. 

Diet Coke at walmart used to run about 6.50 a two-four, now it's almost 9 bucks...without any new tax. Getting to be almost as expensive as beer!

I think that WalMart may have entered into some kind of agreement with Pepsico to raise the price fo coke products.  If you go to target, Coke products are much cheaper. 

Ok I checked. I drink Juicy Juice and it claims to have no sugar. 

Yes, I was aware of the pasteurization, side effect of that is "loss of flavor". The rest, I dont know. All I know is I look for the LEAST processed stuff I can find. Typically "Not from concentrate" also means that it lacks non-fruit sugar and other additives, but I also make sure I look at the content of juice, as in the %. This is why I made the distinction in my original post. I would hope that ANY shopper of juice knows what a "Juice drink" is, and how it differs from "100% juice" and "not from concentrate", I happen to look for the combined "100% not from concentrate".

Oranges have a limited growing season, and because there is demand for juice year round, an unspecified quantity of juice (some or potentially all) is deaerated  and then stored for future packaging in chilled tanks to preserve quality. The aseptic tanks protect the juice from oxygen and light and hold the liquid at optimal temperatures just above freezing to maintain nutrition. It has been reported that deaerated juice no longer tastes like oranges, and must be supplemented with flavor packs before consumption which are derived from orange oils and Ethyl butyrate (ethanol and butyric acid). Tropicana also uses small quantities of high-quality orange juice from Brazil to supplement the Florida crop.

It was a dark, dark day when UofA went Pepsi only.

You're not as savvy as you think you are. 

What the FUCK?

When?!?

Ok I checked. I drink Juicy Juice and it claims to have no sugar.

2. What makes Juicy Juice 100% juice?

Regulations allow for the addition of non-juice ingredients to a 100% juice product if they do not decrease the amount of juice soluble solids.

Link (http://www.juicyjuice.com/Products/FAQs.aspx#Question_2)

I know I am making the best choice with my current options. That's all that matters.

Arizona.  Not Alabama.  Don't worry, you're probably safe.

Buy local. I don't drink orange juice much, but I drink a lot of apple juice and cider in the autumn, from the local orchards. Another one of those arguments in favor of seasons (from the snow picture discussion). Even if you could get fresh apple products around the year, it wouldn't be as special. The crisp autumn air, smell of gently decaying leaves, a nice warm mug of cider.

I grew up with very distinct seasons, too, and when I live somewhere that doesn't have them - or at least not the four very different ones - I reluctantly admit that I miss them, too.  Of course, when I do have them (like now), I mostly complain about them.

Of course, when I do have them (like now), I mostly complain about them.

 And any temperature above 80 can just fuck right off, especially if it's humid on top of that.

Forget pancreatic cancer, you're just going to DIE if you drink soda. (http://abcnews.go.com/Health/Wellness/study-sugary-drinks-lead-early-grave/story?id=10019518)

I don't miss the summer much (NJ summer is ass, humid and miserable), but I miss fall and winter so much. NJ winters are not (usually, this year has been crazy) super cold or snowy, in my opinion, so it's not like I'm yearning for blizzards or anything. Ingmar is a delicate flower that can't stand when it dips into the 50's though (he also hates 80+, but so do I, so we're even there), so I doubt very much I will live through another real winter. I find that kinda sad. :(

it's not like I'm yearning for blizzards or anything.

I currently live in the Chicago area, and can't help but marvel at the fact that 8 million other people have chosen to make this place their home.  I mean, the city itself is nice and at least half of the year is pretty nice in terms of weather...but the winter just sucks complete ass.  It's like we're trying to re-experience the ice age, or something.

By Dr Pepper, you two mean scotch, right?

Nope, I mean Dr Pepper.  It's one of my "comfort foods" that I only allow myself to indulge in occasionally any more. :(

I'm a real lightweight when it comes to alcohol in general, I'm afraid.  Spent over 7 years in college and never learned to drink beer of any sort; I still don't.  I used to be able to do shots (tequila mostly) but that ended when I was out of college.  Just never went for the hard liquors at all for whatever reason.  People keep talking about scotch though, like it's this almost mystical drink.  It's tempting but I have no knowledge and the expense of getting a good brand just doesn't encourage me to check it out.

Alcohol tolerance...mine used to be legendary. I honestly have no idea how I'm still alive.