Li N, et al. - This study assessed the impact of sugar/carbohydrate intake on the incidence and survival of US patients with esophageal/gastric cardia adenocarcinoma (EA/GCA). Researchers reported that if corroborated, limiting intake of sucrose (e.g. table sugar), sweetened desserts/beverages, and foods that contribute to a high glycaemic index, have the potential to plausibly attenuate EA risk.

Methods

• Researchers pooled 500 EA cases, 529 GCA cases and 2027 controls from two US population-based case-control studies with cases followed for vital status.
• They harmonized and pooled dietary intake, assessed by study-specific food frequency questionnaires, to estimate 12 measures of sugar/carbohydrate intake.
• They used multinomial logistic regression and Cox proportional hazards regression, respectively to calculate multivariable-adjusted odds ratios (ORs) and hazard ratios [95% confidence intervals (CIs)].

Results

• Findings demonstrated a 51–58% rise in EA incidence in association with sucrose (OR_Q5vs.Q1 = 1.51, 95% CI = 1.01–2.27), sweetened desserts/beverages (OR_Q5vs.Q1 = 1.55, 95% CI = 1.06–2.27) and the dietary glycaemic index (OR_Q5vs.Q1 = 1.58, 95% CI = 1.13–2.21).
• These links were modified by body mass index (BMI) and gastro-esophageal reflux disease (GERD) (P_{multiplicative-interaction} ≤ 0.05).
• Researchers observed that for associations with sucrose and sweetened desserts/beverages, respectively, the OR was elevated for BMI < 25 (OR_{Q4–5vs.Q1–3} = 1.79, 95% CI = 1.26–2.56 and OR_{Q4–5vs.Q1–3} = 1.45, 95% CI = 1.03–2.06), but not BMI ≥ 25 (OR_{Q4–5vs.Q1–3} = 1.05, 95% CI = 0.76–1.44 and OR_{Q4–5vs.Q1–3} = 0.85, 95% CI = 0.62–1.16).
• Data also reported that the EA-glycaemic index association was elevated for BMI ≥ 25 (OR_{Q4–5vs.Q1–3} = 1.38, 95% CI = 1.03–1.85), but not BMI < 25 (OR_{Q4–5vs.Q1–3} = 0.88, 95% CI = 0.62–1.24).
• It was also demonstrated that the sucrose-EA association OR for GERD < weekly was 1.58 (95% CI = 1.16–2.14), but for GERD ≥ weekly was 1.01 (95% CI = 0.70–1.47).
• In addition, no association of sugar/carbohydrate measures with GCA incidence or EA/GCA survival was observed.