April 5, 2026Cancer Research0 citations

Abstract 5037: Liquid and solid fructose intake and colorectal cancer mortality by physical activity in U.S. prospective cohorts

Q: What does this research mean for the field?

Post-diagnostic liquid fructose is associated with higher colorectal cancer mortality in patients with low physical activity, but not in active patients. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

HKHanseul KimThe University of Texas MD Anderson Cancer Center JYJihye YunThe University of Texas MD Anderson Cancer Center CDCarrie R. DanielThe University of Texas MD Anderson Cancer Center

Key Result

Post-diagnostic liquid fructose was associated with higher colorectal cancer mortality (HR 1.18 per 5 g/day) in patients with low physical activity, but not in active patients.

Key Points

This research aims to explore the relationship between liquid and solid fructose intake and colorectal cancer mortality, examining the moderating role of physical activity.
Utilized food frequency questionnaires from two large cohorts: Nurses' Health Study and Health Professionals Follow-Up Study.
Assessments of pre- and post-diagnostic fructose intake were conducted.
Employed Cox proportional hazards models to evaluate relationships with CRC-specific mortality.
Higher post-diagnostic liquid fructose intake was significantly associated with increased CRC-specific mortality, HR 1.18.
Post-diagnostic solid fructose intake showed a weaker association, HR 1.04.
No association was found between fructose intake and mortality in high physical activity individuals.

Structured PICO

Does higher fructose intake increase colorectal cancer-specific mortality in patients with varying levels of physical activity?

Population

1,429 colorectal cancer patients from the Nurses' Health Study (1984-2018) and Health Professionals Follow-Up Study (1990-2018), stratified by pre-diagnostic physical activity (<11.5 vs. ≥11.5 MET-hrs/wk).

Intervention

Higher pre- and post-diagnostic liquid and solid fructose intakes

Comparator

Lower fructose intakes

Outcome

Colorectal cancer-specific mortalityhard clinical

Higher post-diagnostic fructose intake, particularly from liquid sources, is associated with increased colorectal cancer-specific mortality in patients with low physical activity.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background: We recently found that liquid fructose promotes colorectal cancer (CRC) metastasis in preclinical models, including human cancer cell lines and mice (Feng et al., 2025). In humans, fructose is consumed in both liquid and solid forms (Li et al., 2023), but whether these sources relate differently to CRC mortality is unknown. Additionally, physical activity may modify the metabolic effects of fructose (Tappy 11.5 vs. ≥11.5 metabolic equivalent of task MET-hrs/wk) and adjusted for demographics, tumor characteristics, lifestyle factors, and diet. Results: Among 724 CRC patients with low pre-diagnostic physical activity (11.5 MET-hrs/wk), we observed 96 CRC-specific deaths over 7,412 person-years. Higher post-diagnostic, but not pre-diagnostic, liquid and solid fructose intakes were associated with higher CRC-specific mortality. Post-diagnostic liquid fructose showed the strongest association with CRC mortality (Multivariable MV-adjusted HR per 5 g/day, 1.18; 95% CI, 1.04-1.34; P-value, 0.011), whereas post-diagnostic solid fructose showed a more modest association (MV-adjusted HR per 20 g/day, 1.04; 95% CI, 1.01-1.06; P-value, 0.002). Among 705 patients (6,611 person-years; 95 CRC-specific deaths) with high pre-diagnostic physical activity (≥11.5 MET-hrs/wk), neither liquid nor solid fructose intake, pre- or post-diagnostic, was associated with CRC-specific mortality. These findings showed that the positive associations between fructose intake and CRC mortality were observed for individuals with low physical activity, confined to post-diagnostic fructose intake, and stronger for liquid than for solid fructose. Conclusions: Higher post-diagnostic fructose intake, especially from liquid sources, was associated with increased CRC-specific mortality among patients with low physical activity. These findings suggest a potential interaction between physical activity and fructose intake in the context of CRC mortality and highlight the importance of food choices in CRC survivorship. Citation Format: Hanseul Kim, Jihye Yun, Carrie R. Daniel-MacDougall, Long H. Nguyen, Edward L. Giovannucci. Liquid and solid fructose intake and colorectal cancer mortality by physical activity in U.S. prospective cohorts abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 5037.

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