Esophageal thermal exposure to hot beverages: A comparison of metrics to discriminate distinct consumption habits

Daniel R.S. Middleton*, Shuang Hua Xie, Liacine Bouaoun, Graham Byrnes, Guo Hui Song, Joachim Schüz, Wen Qiang Wei, Valerie A. McCormack

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Hot beverage consumption is a probable risk factor for esophageal squamous cell carcinoma (ESCC). No standardized exposure assessment protocol exists. Methods: To compare how alternative metrics discriminate distinct drinking habits, we measured sip temperatures and sizes in an international group of hot beverage drinkers in France (n = 20) and hot porridge consumers (n = 52) in a high ESCC incidence region of China. Building on the knowledge that sip size and temperature affect intraesophageal liquid temperature (IELT), IELTs were predicted by modeling existing data, and compared with first sip temperature and, across all sips, mean temperature and sip-weighted mean temperature. Results: Two contrasting exposure characteristics were observed. Compared with the international group, Chinese porridge consumers took larger first sips [mean difference þ17 g; 95% confidence interval (CI), 13.3-20.7] of hotter (=9.5℃; 95% CI, 6.2-12.7) liquid, and their mean sip size did not vary greatly across sips, but the former groups increased in size as temperature decreased. This resulted in higher predicted IELTs (mean 61℃ vs. 42.4℃) and sip-weighted temperatures (76.9℃ vs. 56℃) in Chinese porridge consumers, and compared with first sip and mean temperature, these two metrics separated the groups to a greater extent. Conclusions: Distinguishing thermal exposure characteristics between these groups was greatly enhanced by measuring sip sizes. Temperature at first sip alone is suboptimal for assessing human exposure to hot foods and beverages, and future studies should include sip size measurements in exposure assessment protocols. Impact: This study provides a logistically feasible framework for assessing human exposure to hot beverages.

Original languageEnglish
Pages (from-to)2005-2013
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Volume28
Issue number12
DOIs
Publication statusPublished - Dec 2019
Externally publishedYes

Bibliographical note

Funding Information:
The authors thank all study participants, and the staff and fieldworkers at the Cancer Institute/Hospital of Ci County for their valuable contributions. Illustrations used in Fig. 2 were produced by Morena Sarzo, a Visual Designer from the IARC Communications Group. The work reported was undertaken during the tenure of a Postdoctoral Fellowship awarded to D.R.S. Middleton from the IARC, partially supported by the European Commission FP7 Marie Curie Actions—People—Co-funding of regional, national and international programmes (COFUND) and the World Cancer Research Fund International (grant no. 2018/1795). Work conducted in China was funded by a grants awarded to W.-Q. Wei by the National Key Research and Development Program (Precision Medicine Research; grant no. 2016YFC0901404) supported by the Ministry of Science and Technology of the People's Republic of China; the National Natural Science Fund (grant no. 81573224) supported by the National Natural Science Foundation of China; and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (grant no. 2016-I2M-3-001).

Funding Information:
Ethical approval for the study was received in China from the Ethics Committee of the Cancer Institute and Hospital, Chinese Academy of Medical Sciences (approval number NCC2017YJZ- 001), and at the IARC (IEC Project No. 17-04-A1). Written-informed consent was provided by all participants, and the study was conducted in accordance with the International Ethical Guidelines for Health-related Research Involving Humans developed by the Council for International Organizations of Medical Sciences.

Funding Information:
Corresponding Authors: Daniel R.S. Middleton, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France. Phone: 33-472-738-310; E-mail: middletond@fellows.iarc.fr; and Wen-Qiang Wei, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan, Chaoyang District, Beijing, 100021 China. Phone: 8610-8778-8661; E-mail: weiwq@cicams.ac.cn

Funding Information:
The authors thank all study participants, and the staff and fieldworkers at the Cancer Institute/Hospital of Ci County for their valuable contributions. Illustrations used in Fig. 2 were produced by Morena Sarzo, a Visual Designer from the IARC Communications Group. The work reported was undertaken during the tenure of a Postdoctoral Fellowship awarded to D.R.S. Middleton from the IARC, partially supported by the European Commission FP7 Marie Curie Actions-People-Co-funding of regional, national and international programmes (COFUND) and the World Cancer Research Fund International (grant no. 2018/1795). Work conducted in China was funded by a grants awarded to W.-Q. Wei by the National Key Research and Development Program (Precision Medicine Research; grant no. 2016YFC0901404) supported by the Ministry of Science and Technology of the People's Republic of China; the National Natural Science Fund (grant no. 81573224) supported by the National Natural Science Foundation of China; and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (grant no. 2016-I2M-3-001).

Publisher Copyright:
© 2019 American Association for Cancer Research.

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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