饮料|少年们，快放下手里的含糖饮料！每天果糖摄入与结直肠腺瘤有关( 二 )
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需要指出的是，这个研究也有一些局限：例如，青春期饮食回忆可能不准；可能存在残余混杂或未测量因素混杂；研究人群主要为白人女护士；鉴别锯齿状病变有一定困难 。
总的来看，青春期糖尤其是果糖和含糖饮料摄入越多，结直肠腺瘤特别是直肠腺瘤的发病风险越高；二者不影响锯齿状病变的发病风险 。
鉴于过去几十年青少年对糖、含糖饮料摄入的大幅增加，该研究或可在一定程度上解释为何近来结直肠癌发病率呈上升趋势 。由于85%的结直肠癌由腺瘤进展而来[12]，若能证实上述关联，减少青春期糖、含糖饮料摄入对预防结直肠癌有重要意义 。
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参考文献：
1.Joh HK, Lee DH, Hur J, et al. Simple Sugar and Sugar-Sweetened Beverage Intake During Adolescence and Risk of Colorectal Cancer Precursors [published online ahead of print, 2021 Mar 19]. Gastroenterology. 2021;S0016-5085(21)00537-0. doi:10.1053/j.gastro.2021.03.028
2.Siegel RL, Jakubowski CD, Fedewa SA, Davis A, Azad NS. Colorectal Cancer in the Young: Epidemiology, Prevention, Management. Am Soc Clin Oncol Educ Book. 2020;40:1-14. doi:10.1200/EDBK_279901
3.Cavadini C, Siega-Riz AM, Popkin BM. US adolescent food intake trends from 1965 to 1996 [published correction appears in West J Med 2001 Oct;175(4):235]. West J Med. 2000;173(6):378-383. doi:10.1136/ewjm.173.6.378
4.Yang L, Bovet P, Liu Y, et al. Consumption of Carbonated Soft Drinks Among Young Adolescents Aged 12 to 15 Years in 53 Low- and Middle-Income Countries. Am J Public Health. 2017;107(7):1095-1100. doi:10.2105/AJPH.2017.303762
5.Zhang X, Albanes D, Beeson WL, et al. Risk of colon cancer and coffee, tea, and sugar-sweetened soft drink intake: pooled analysis of prospective cohort studies. J Natl Cancer Inst. 2010;102(11):771-783. doi:10.1093/jnci/djq107
6.World Cancer Research Fund/American Institute for Cancer Research. Diet, nutrition, physical activity and cancer: a global perspective. Continuous Update Project Expert Report, 2018. Available at dietandcancerreport.org.
7.Bao Y, Bertoia ML, Lenart EB, et al. Origin, Methods, and Evolution of the Three Nurses' Health Studies. Am J Public Health. 2016;106(9):1573-1581. doi:10.2105/AJPH.2016.303338
8.Malik VS, Hu FB. Sugar-Sweetened Beverages and Cardiometabolic Health: An Update of the Evidence. Nutrients. 2019;11(8):1840. Published 2019 Aug 8. doi:10.3390/nu11081840
9.Wu J, Cai Q, Li H, et al. Circulating C-reactive protein and colorectal cancer risk: a report from the Shanghai Men's Health Study. Carcinogenesis. 2013;34(12):2799-2803. doi:10.1093/carcin/bgt288
10.Bray GA, Nielsen SJ, Popkin BM. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity [published correction appears in Am J Clin Nutr. 2004 Oct;80(4):1090]. Am J Clin Nutr. 2004;79(4):537-543. doi:10.1093/ajcn/79.4.537
11.Wong SH, Yu J. Gut microbiota in colorectal cancer: mechanisms of action and clinical applications. Nat Rev Gastroenterol Hepatol. 2019;16(11):690-704. doi:10.1038/s41575-019-0209-8
12.Strum WB. Colorectal Adenomas. N Engl J Med. 2016;374(11):1065-1075. doi:10.1056/NEJMra1513581
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