BMJ: Studies of over 100,000 people have proved that long-term intake of sugary drinks increases the risk of a variety of cancers, and breast cancer is as high as 22%!

In the past few decades, the global consumption of sugary beverages has been on the rise, accompanied by an increase in the risk of obesity and diabetes
.

According to the 2016 Global Burden of Disease (GBD) study by The Lancet , taking into account the degree of exposure of the risk level and the severity of the impact on the burden of disease, the “summary exposure value” of sugary drinks is An increase of 40% between 1990 and 2016 [1] !

In the past few decades, the global consumption of sugary beverages has been on the rise, accompanied by an increase in the risk of obesity and diabetes

Sugary drinks to heart vascular risk system and metabolic system brings include: the death of obesity, type II diabetes, high blood pressure and heart disease caused by metabolic
.
Heart blood vessels , a study in 2010 showed that there are about 178,000 patients worldwide each year, because sugary drinks intake of diabetes and cardiovascular disease and death caused by excessive [2]
.
Regarding the research on sugar-sweetened beverages and cancer risk, a large population data survey of over 100,000 people published in BMJ in 2019 showed that the average daily intake of 100ml of sugar-sweetened beverages increased the risk of cancer by 18%.
Among them, breast cancer is as high as 22%, and 100% pure juice is no exception to breast cancer [3] .
This study included 101,257 participants (21.
3% males and 78.
7% females), with an average age of 42.
2 years (repetitively recorded 24-hour diet to understand the participants’ sugar-sweetened beverage intake .
During the follow-up survey (which lasted 493884) Person-years, with an average follow-up period of 5.
1 years) A total of 2193 people were diagnosed with cancer for the first time, including 693 cases of breast cancer, 291 cases of prostate cancer, and 166 cases of colon cancer .
Colon cancer consumes an average of 100ml of sugar-sweetened beverages per day, increasing the risk of cancer18 %, of which the risk of breast cancer is increased by 22%.
100% fruit juice is also not immune, and the daily intake of 100ml of fruit juice increases the risk of whole cancer by 12% .
 
 
 
It is worth mentioning that this study failed to find the relationship between the intake of sugar-sweetened beverages and the risk of colon cancer and prostate cancer, while other studies have shown that the intake of sugar-sweetened beverages increases the risk of these two diseases, which may be due to From different studies, there are differences in the intake of sugar-sweetened beverages, which have different effects on cancer outcomes
.
A study published in Gut in 2021 showed that consuming more than two sugar-sweetened beverages a day will increase the risk of early-onset colon cancer in women by 118% .
Ingesting 1 sugar-sweetened beverage a day will cause early onset.
The risk of colon cancer increased by 16% [4] .
A study published in 2018, included 22,720 involved in cancer screening for men assay demonstrating in the daily intake of sugary drinks, the probability of prostate cancer 25 percent of the male population increased by 21% before screening [5] .
There are also some studies that have shown that the intake of sugar-sweetened beverages is related to pancreatic cancer , gallbladder cancer, endometrial cancer, etc.
However, there are also different sounds .
Pancreatic cancer, such as the meta-analysis published by Milajerdi et al.
in 2019, collected and sorted out the relationship between beverage intake and the incidence of pancreatic cancer before 2017, and found that there was no correlation between beverage intake and the incidence of pancreatic cancer [6] .
A meta-analysis of 37 studies published in 2014 found that the intake of carbonated beverages and the incidence of total cancer and cancers at different locations, including pancreatic cancer, gallbladder cancer, kidney cancer, gastrointestinal adenocarcinoma, and breast Cancer and prostate cancer are not related [7] .
 
 
 
 
 
 Researchers speculate that the reason why these meta-analysis failed to find the association between sugar-sweetened beverages and cancer is that these studies did not strictly distinguish between sugar-sweetened beverages and "artificial sweetener-added beverages", because These two beverages may have different effects on the incidence of cancer.
Therefore, in later studies, more and more researchers began to distinguish between the two [8] , just as the BMJ article analyzes sugary beverages and " The effect of “artificial sweetener-added beverages” on cancer shows that sugar-sweetened beverages increase the incidence of cancer, while “artificial sweetener-added beverages” have no significant association with cancer
.
On the other hand, the occurrence of cancer requires years of influence.
The observation period of 5 or 10 years may not be enough to observe the occurrence of the disease.
It is very important to continue to observe the cancer occurrence of these research participants for a long time in the future.
This is also the BMJ.
Study the next 10-year plan .
How can sugary drinks cause cancer? How can sugary drinks cause cancer? Why sugar-sweetened beverages cause cancer should start with obesity, elevated blood sugar, and insulin resistance disorders .
Obesity is a strong risk factor for a variety of cancers, including esophageal cancer, 
 
 Gastric cancer , pancreatic cancer, gallbladder cancer, liver cancer, colon cancer, breast cancer, ovarian cancer , prostate cancer, lung cancerGastric cancer and ovarian cancer [9]
.
However, in this study in the BMJ, BMI and weight change does not seem to drink sugary key carcinogenic materials, the key is to change visceral fat .
Regardless of whether there is a change in body weight, sugary drinks promote the accumulation of visceral fat, change the adipokines secreted by visceral fat, and increase the secretion of inflammatory factors, which are released into the peripheral circulation and promote the formation of distant tumors .
Sugary drinks have a high glycemic index and a blood sugar burden, which can damage insulin resistance and increase blood insulin levels and insulin-like growth factor (IGF) levels .
Insulin and IGF are the main influence factors of cell proliferation and apoptosis , so they may be involved in tumor formation influence factors [10] .
The burden of high blood sugar can also promote the release of pro-inflammatory factors and C-reactive protein in the body, increasing the risk of certain cancers, such as breast cancer .
In addition to obesity and glycemic effects, certain substances in sugar-sweetened beverages, such as 4-methylimidazole, are a typical beverage caramel pigment formed by sugar and amino acids in Maillard reaction, and may also cause cancer.
Happen .
In 2007, the National Toxicology Program (the National Toxicology Program) listed 4-methylimidazole as a carcinogenic compound.
In 2011, California also listed 4-methylimidazole as a carcinogen in Proposition 65 and proposed its safe dose.
At 29ug/day .
Long-term use of 4-methylimidazole is related to the formation of new organisms in the alveoli and bronchus of mice [11] .
   
   How to reduce the intake of sugary drinks? How to reduce the intake of sugary drinks? Increasing the tax on sugar-sweetened beverages has become a favorable policy measure to limit the intake of sugar-sweetened beverages by the population, promote beverage manufacturers to transform their products, and reduce the sugar content in beverages .
The current tax on sugar-sweetened beverages is divided into 3 types, including classification based on beverage liquid volume ($0.
01/oz) and sugar content (<5g/8oz: no tax, 5-20g/8oz: $0.
01/oz, >20g/8oz) : $0.
02/oz), absolute sugar content ($0.
01 per teaspoon of sugar) is taxed .
A study on Circulation compared the health and economic benefits of three taxation methods and found that a sugar tax based on volume can avoid 850,000 cases of cardiovascular disease and 269,000 cases of diabetes each year, resulting in 2.
44 million mass Adjusted life-years (quality-adjusted life-years), and a net increase of $53.
2 billion .
The health benefits and economic benefits of taxation based on sugar content classification and absolute sugar content will be twice as much as the first method [12] ! Currently, the countries that implement levies based on the volume of beverage liquids include the United States, Mexico, Belgium, Brunei, Norway, and the Philippines; the countries that levy taxes based on sugar content are the United Kingdom, Chile, France, Ireland, Portugal, and Spain; they are levied based on absolute sugar content.
Tax countries include South Africa, Sri Lanka, Mauritius and so on .
China has not yet begun to impose sugar tax on sugar-sweetened beverages .
For health, all countries are fighting! In terms of policies, formulate a more appropriate sugar tax system, reduce residents' purchases, and promote the transformation of the beverage industry .
At the same time, strengthen medical and health promotion to make more people aware of the harm of sugary drinks to the body .
After understanding the huge hazards of sugary drinks in promoting obesity, type II diabetes, cardiovascular disease and cancer, by limiting the intake of sugary drinks, we are finally one step closer to health! 
 
 
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, et al.
, Health Impact and Cost-Effectiveness of Volume, Tiered, and Absolute Sugar Content Sugar-Sweetened Beverage Tax Policies in the United States: A Microsimulation Study.
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