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Epidemiology

Sugar and sugar-sweetened beverages in relation to premature aging in adult survivors of childhood cancer

British Journal of Cancer volume 131, pages 1169–1177 (2024)Cite this article

Subjects

Abstract

Background

Premature aging is a significant concern in adult survivors of childhood cancer as they develop aging-related conditions at a younger age than their peers with no history of childhood cancer. Although modifiable lifestyle factors, such as diet, are postulated to affect aging process, supporting evidence is sparse.

Methods

We examined if the consumption of sugar and sugar-sweetened beverages was related to premature aging in 3322 adult survivors of childhood cancer in the St. Jude Lifetime Cohort. Premature aging was assessed using the Deficit Accumulation Index (DAI) that was a ratio of the number of age-related chronic health conditions each survivor had out of 44 conditions total. Multinomial logistic regressions adjusting for confounders were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

There were 46% of childhood cancer survivors consumed SSBs once or more times per day. High intake of sugar, especially sugars added to foods during preparation or processing, and habitual consumption of sugar-sweetened beverage were associated with an increased risk of premature aging.

Discussion

Our findings support a need to include strategies to reduce sugar and sugar-sweetened beverages consumption in lifestyle interventions to promote healthy aging in adult survivors of childhood cancer.

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Fig. 1: Multivariable adjusted odds ratios and 95% confidence intervals of deficit accumulation index (DAI) categories by sugar intake in adult survivors of childhood cancer: St. Jude Lifetime Cohort Study.
Fig. 2: Multivariable adjusted odds ratios and 95% confidence intervals of high deficit accumulation index (DAI) vs. low DAI by sugar intake in subgroups of adult survivors of childhood cancer: St. Jude Lifetime Cohort Study.

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Data availability

Data can be obtained on request. Requests should be directed to the St. Jude LIFE (https://sjlife.stjude.org/) which has a protocol for approving data requests.

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Funding

The study was supported in part by the National Institutes of Health Grants U01CA195547 and P30CA091842, the St. Jude Children’s Research Hospital-Washington University St. Louis Implementation Sciences Collaborative, and the American Lebanese-Syrian Associated Charities (ALSAC).

Author information

Authors and Affiliations

  1. Division of Public Health Sciences, Department of Surgery; Washington University School of Medicine, St. Louis, MO, USA

    Tuo Lan, Mei Wang, Shu Jiang, Graham A. Colditz & Yikyung Park

  2. Department of Surgery, Division of Supportive Care in Cancer, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY, USA

    AnnaLynn M. Williams

  3. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Matthew J. Ehrhardt, I-Chan Huang, Jennifer Q. Lanctot, Kevin R. Krull, Gregory T. Armstrong, Melissa M. Hudson, Leslie L. Robison & Kirsten K. Ness

  4. Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Matthew J. Ehrhardt, Melissa M. Hudson & Kirsten K. Ness

  5. Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA

    Shu Jiang, Graham A. Colditz & Yikyung Park

  6. Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN, USA

    I-Chan Huang, Kevin R. Krull, Gregory T. Armstrong, Melissa M. Hudson & Leslie L. Robison

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  1. Tuo Lan
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Contributions

TL contributed to the formal analysis, investigation, and writing the original draft. MW contributed to the data curation, formal analysis, investigation, and reviewing and editing of the manuscript. JQL contributed to the data curation, investigation, and reviewing and editing of the manuscript. AMW, MJE, SJ, ICH, KRK, and KKN contributed to the investigation and reviewing and editing of the manuscript. GTA contributed to the project administration, investigation, and reviewing and editing of the manuscript. GAC contributed to the funding acquisition, supervision, investigation, and reviewing and editing of the manuscript. MMH and LLR contributed to the conceptualization, funding acquisition, project administration, supervision, investigation, and reviewing and editing of the manuscript. YP contributed to the conceptualization, funding acquisition, project administration, supervision, investigation, and writing the original draft. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yikyung Park.

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The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved by the St. Jude Children’s Research Hospital Institutional Review Board and all participants provided written informed consent.

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Lan, T., Wang, M., Williams, A.M. et al. Sugar and sugar-sweetened beverages in relation to premature aging in adult survivors of childhood cancer. Br J Cancer 131, 1169–1177 (2024). https://doi.org/10.1038/s41416-024-02815-3

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