High intake of sugar-sweetened beverages increases liver cancer risk

Postmenopausal women who consumed at least one serving of sugar-sweetened beverages per day had a 78% greater risk for developing liver cancer compared with those who consumed less than three servings per month, according to recent data.

“A nonsignificant positive association with [artificially sweetened beverage] intake was also observed,” Longgang Zhao, MS, a PhD candidate at the University of South Carolina, said in a prerecorded presentation at the virtual meeting of the American Society of Nutrition. “Studies in men and diverse populations are needed to examine these associations and elucidate the potential biological mechanisms.”

The incidence of liver cancer has increased over the past 3 decades in the United States, where it is ranked 13th in cancer incidence and sixth in cancer-related mortality.

“Some risk factors of liver cancer have been well investigated, including hepatitis infection, smoking, drinking, aflatoxin, obesity, diabetes and cirrhosis,” Zhao said. “However, there are still more than 40% of liver cancers that cannot be explained by all these known risk factors.”

Sugar-sweetened beverage consumption may drive insulin resistance and inflammation, which are strongly associated with liver carcinogenesis, according to Zhao and colleagues. However, there is limited evidence on the association between sugar-sweetened beverages and liver cancer.

Zhao and colleagues conducted an observational study using data from 90,504 women aged 50 to 79 years who were enrolled in the Women's Health Initiative. The participants completed food frequency questionnaires between 1993 and 1998. The researchers used the questionnaires to assess for sugar-sweetened beverage intake and medical records to identify liver cancer diagnoses over a median follow-up period of 18.7 years.

The researchers considered one serving of a sugar-sweetened beverage, such as soda and fruit drinks, to be equivalent to one 12 fl. oz can or 355 ml. They adjusted their analyses for age, race and ethnicity, education, alcohol intake, smoking status, BMI, NSAID use, physical activity, total caloric intake and diabetes history.

Overall, 7.3% of women consumed more than one sugar-sweetened beverage serving per day, and 205 women developed liver cancer. Zhao said that higher sugar-sweetened beverage intake was significantly associated with a greater risk for liver cancer development (1 serving per day vs. never to < 3 servings per month; HR =1.78; 95% CI, 1.09-2.95).

The researchers investigated whether replacing sugar-sweetened beverages with water or coffee influenced liver cancer risk. They reported that replacing one serving of a sugar-sweetened beverage with water reduced the risk for liver cancer by 29% and replacing one sugar-sweetened beverage serving with non-sugar sweetened coffee or tea reduced the risk by 20%.

“Our findings suggest sugar-sweetened beverage consumption is a potential modifiable risk factor for liver cancer,” Zhao said in a press release. “If our findings are confirmed, reducing sugar-sweetened beverage consumption might serve as a public health strategy to reduce liver cancer burden. Replacing sugar-sweetened beverages with water, and non-sugar-sweetened coffee or tea could significantly lower liver cancer risk.”

References:

• Study links sugar-sweetened beverage consumption with liver cancer. https://www.eurekalert.org/news-releases/954878. Published June 14, 2022. Accessed June 20, 2022.
• Zhao L, et al. Association between sugar-sweetened beverage intake and liver cancer risk in the Women's Health Initiative. Presented at: American Society of Nutrition Scientific Sessions and Annual Meeting; June 14-16, 2022 (virtual meeting).