High daily intake of sugar-sweetened beverages linked to 85% greater risk for liver cancer
Click Here to Manage Email Alerts
Key takeaways:
- Postmenopausal women who drank at least one sugar-sweetened soft drink daily had an 85% higher risk for liver cancer.
- High intake also was associated with 68% greater risk for chronic liver disease mortality.
Postmenopausal women who consumed at least one sugar-sweetened soft drink per day had significantly higher incidence of liver cancer and chronic liver disease mortality, compared with those who drank no more than three beverages per month.
“Intake of sugar-sweetened beverage, a postulated risk factor for obesity, diabetes and cardiovascular disease, may drive insulin resistance and inflammation, which are strongly implicated in liver carcinogenesis and liver health,” Longgang Zhao, PhD, a postdoctoral research fellow at Brigham and Women’s Hospital and Harvard Medical School, told Healio. “Meanwhile, approximately 65% of adults in the U.S. consume sugar-sweetened beverages daily.”
Zhao continued: “On the other hand, epidemiological studies on dietary factors and liver cancer and chronic liver disease mortality are limited. Identification of new dietary factors may inform disease etiology and primary prevention strategies for liver cancer and chronic liver disease mortality.”
To assess the association between sugar-sweetened and artificially sweetened beverages and risk for liver cancer and chronic liver disease mortality, Zhao and colleagues used data from 98,786 postmenopausal women (aged 50-79 years) enrolled in the Women’s Health Initiative from 1993 to 1998.
Researchers determined beverage intake based on a food frequency questionnaire given at baseline, which showed 6.8% of women consumed one or more sugar-sweetened beverage servings per day. At the 3-year follow-up, 13.1% consumed at least one artificially sweetened beverage serving per day.
During a median follow-up of 20.9 years, 207 women developed liver cancer and 148 died from chronic liver disease, according to data reported in JAMA.
Those who consumed at least one serving of sugar-sweetened beverages per day had a significantly higher risk for liver cancer compared with those who consumed three or fewer per month (18 vs. 10.3 per 100,000 person-years; adjusted HR = 1.85; 95% CI, 1.16-2.96). A similar trend was reported for chronic liver disease mortality (17.7 vs. 7.1 per 100,000 person-years; aHR = 1.68; 95% CI, 1.03-2.75).
“Those who consumed at least one sugar-sweetened beverage daily had an 85% higher risk of developing liver cancer and 68% higher risk of chronic liver disease mortality compared with women who consumed three servings or fewer per month of such beverages,” Zhao said.
Conversely, compared with women who consumed three or fewer artificially sweetened beverage per month, those who consumed at least one per day did not have a significantly increased risk for liver cancer (11.8 vs. 10.2 per 100,000 person-years; aHR = 1.17; 95% CI, 0.7-1.94) or chronic liver disease mortality (7.1 vs. 5.3 per 100,000 person-years; aHR = 0.95; 95% CI, 0.49-1.84).
“If our findings confirmed, reducing sugar-sweetened beverage consumption might serve as a public health strategy to reduce liver disease burden,” Zhao said. “However, the positive association between sugar-sweetened beverage and adverse liver outcomes in current study should not be hastily assumed to imply causation.
Zhao added: “Further research is necessary before contemplating any alterations to clinical recommendations.”
Perspective
Back to Top
Dale R. Shepard, MD, PhD, FACP
In this study, Zhao and colleagues reported a statistically significant association between increased consumption of sugar-sweetened beverages and liver cancer compared with those with minimal to no consumption of sugar-sweetened beverages. This study was limited to postmenopausal women.These studies of foods/beverages and the development of cancer are not evidence of causality, but they are important for developing associations and — more importantly — for raising the public’s awareness of the need to be mindful of the consequences of lifestyle choice and risk for cancer.
For perspective, what does an 85% increase in risk for liver cancer in this study really mean? The incidence of liver cancer was very low among these postmenopausal women in both the high-consumption and low-consumption groups. Investigators identified only 207 cases of liver cancer among approximately 100,000 people followed for nearly 20 years.
Although results showed a statistically significant difference in liver cancer incidence between the groups, the practical harm is difficult to determine. The study notes that 65% of adults in the U.S. consume sugar-sweetened beverages daily, but only about 7% of the population in this study had one or more sugar-sweetened beverages daily, with only 23 cases of liver cancer. For comparison, it is important to remember that smoking, excessive alcohol, sun exposure without adequate sunscreen, obesity, not getting vaccines for cancer-associated infections, and inactivity are more likely to increase one's risk for cancer. WHO predicts that 30% to 50% of cancers are preventable with attention to these factors. Unlike the impact of sugar-sweetened beverages on the number of liver cancer cases noted in this study, alterations in these lifestyle factors could lead to nearly a million fewer cancers and about 400,000 fewer deaths.
Collapse
Read more about
Click Here to Manage Email Alerts