Approximately 65% of U.S. adults report consuming one or more sugar-sweetened beverages every day. Researchers found that consuming these drinks daily was associated with an increased risk of developing gastric cancer, whereas consumption of artificially sweetened beverages was not associated with an increased risk. These findings were published by Gweon et al in the journal Gastro Hep Advances.
Previous studies have linked sugar-sweetened beverages with an increased risk of colorectal, breast, and liver cancers, but evidence on an association with risk of gastric cancer has been limited. The study analyzed data from 112,284 participants in the Nurses’ Health Study and Health Professionals Follow-Up Study. Both studies gathered detailed diet, lifestyle, and health information on U.S. adults over many decades. During the follow-up period, which spanned decades, 278 participants developed gastric cancer.
“This is the first study to demonstrate an association between sugar-sweetened beverage intake and gastric cancer in a U.S. population,” said senior author Andrew T. Chan, MD, MPH, a gastroenterologist and epidemiologist with the Mass General Brigham Cancer Institute. “Gastric cancer is the fifth-leading cause of cancer death worldwide, but we’ve known very little about how diet might contribute to this cancer.”
After accounting for other potential risk factors, participants who consumed at least one serving of a sugar-sweetened beverage per day had a 2.45 times higher risk of gastric cancer compared with those who consumed less than one serving per month. The association was observed in both women and men.
Higher total fructose intake, the main ingredient in the sugar-sweetened drinks, was also associated with greater gastric cancer incidence. For instance, among women in the Nurses’ Health Study, consuming more than one sugar-sweetened beverage per day was associated with a 3.04-fold higher risk of gastric cancer, compared to those who very rarely consumed sugar-sweetened beverages. In contrast, after controlling for other factors, higher consumption of artificially sweetened beverages was not associated with a higher incidence of gastric cancer.
Researchers defined sugar-sweetened beverages as carbonated beverages, punch, lemonade, and sports drinks, whereas artificially sweetened beverages were defined as low-calorie carbonated beverages.
Because Helicobacter pylori (H pylori) infection increases the risk of gastric cancer, researchers also assessed H pylori status in a subset of 940 participants. Although just over one-third of these participants had evidence of H pylori infection, there was no association between sugar-sweetened beverage consumption and infection with H pylori.
Limitations of the study include its observational design. It is possible that higher rates of gastric cancer in people who consumed more sugar-sweetened beverages were related to other factors. The study had limited information on H pylori status and family history of gastric cancer. In addition, participants were predominantly White, limiting the researchers’ ability to examine differences across racial and ethnic groups.
However, the large study population and detailed health and lifestyle information gathered over many years allowed the researchers to control for many other possible potential risk factors for gastric cancer.
The researchers concluded that further studies are needed to confirm the findings and investigate why these beverages might increase gastric cancer risk.
DISCLOSURE: This work was supported by R35 CA253185, U01 CA261961, R01CA263776, and a Stand Up to Cancer Gastric Cancer Interception Dream Team award. Dr. Chan has served as a consultant for Pfizer Inc. and Boehringer Ingelheim and received grant support from Freenome Holdings outside the submitted work.
