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We read with interest the findings from the longitudinal study by Hur et al showing that a high consumption of sugar sweetened beverages in adulthood is associated with early-onset colorectal cancer (CRC).1 However, attractive the association, the authors acknowledge that their finding does not establish a causal relationship since residual confounding cannot be excluded.
Biological plausibility for a causal role of fructose, one of the principal added sugars, in the pathogenesis of CRC has recently been provided by Taylor et al, who demonstrated a direct link between fructose 1-phosphate (F1-P) and intestinal tumour growth in mice (figure 1A).2
Contributors AMB and MCGJB: conception or design of the work. CGS, JLJMS, CJHK, SJPME, PCD, MMJG, AW, CDAS, PL and RH: acquisition. GAMB, PL, PIHGS, RH and MW: analysis. AMB, MCGJB, CGS, JLJMS, CJHK, SJPME, PCD, MMJG, AW, CDAS, GAMB, PL, PIHGS, RH and MW: interpretation of data. AMB, MCGJB, CGS, JLJMS, CJHK, SJPME, PCD, MMJG, AW, CDAS, GAMB, PL, PIHGS, RH, MW: draft and/or revision of the manuscript.
Funding This study was supported by the Dutch Diabetes Research Foundation (personal grant #2017.82.004 to MCGJB). The Maastricht Study was supported by the European Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs (grant 31O.041), Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), School for Cardiovascular Diseases (CARIM, Maastricht, the Netherlands), School for Public Health and Primary Care (CAPHRI, Maastricht, the Netherlands), School for Nutrition and Translational Research in Metabolism (NUTRIM, Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands), and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands) and Medtronic (Tolochenaz, Switzerland).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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