In a large study led by researchers at the American Cancer Society (ACS), men and women who drank two or more servings of sugar-sweetened beverages per day had a 5% increased risk of death from an obesity-related cancer, including gastrointestinal, postmenopausal breast, endometrial, and kidney cancers, compared to people who never drank such beverages. These results appear to be related to the higher body mass index (BMI) of the participants who regularly drank sugar-sweetened beverages. The study was published by McCullough et al in Cancer, Epidemiology, Biomarkers & Prevention.
“Unfortunately, Americans exceed recommended limits on sugar consumption by the U.S. Dietary Guidelines, and sugar-sweetened beverages are known risk factors for weight gain, being overweight, and obesity,” said Marjorie McCullough, ScD, RD, Senior Scientific Director, Epidemiology Research at the ACS and lead author of the study. “Our findings further support the recommendation to limit consumption of sugar-sweetened beverages included in the ACS Guideline on Nutrition and Physical Activity for Cancer Prevention to help decrease the risk of disease.”
Study Methodology
For the study, researchers examined the associations of sugar-sweetened beverages and artificially sweetened beverages with mortality from all cancers combined, obesity-related cancers combined, and 20 cancer types, among men and women in the Cancer Prevention Study-II (CPS-II) prospective cohort. In 1982, more than 900,000 cancer-free participants provided information on usual sugar-sweetened beverage and artificially sweetened beverage consumption. Deaths were identified through 2016. Multivariable Cox proportional hazards regression models examined associations of beverage types with cancer mortality without and with BMI adjustment.
Results
During the study follow-up, 135,093 CPS-II participants died from cancer. Results showed that consumption by men and women of greater than two sugar-sweetened beverages a day vs people who never drank was not associated with all-cancer mortality, but was associated with increased risk of obesity-related cancers combined, which became null after adjustment for BMI.
Sugar-sweetened beverages were associated with increased mortality from colorectal and kidney cancers, which remained after BMI adjustment. A positive association of artificially sweetened beverage consumption with obesity-related cancers was null after controlling for BMI; however, an increased risk of pancreatic cancer remained even with BMI adjustment. Researchers add associations between artificially sweetened beverage consumption and increased pancreatic cancer risk merit further study.
“Future research should consider the role of BMI in studies of sweetened beverages and cancer risk,” Dr. McCullough added. “These results should inform public policy regarding sweetened beverage consumption to decrease the risk of cancer for men and women in the United States.”
Dr. McCullough also added that while most artificial sweeteners are generally thought to be safe, artificial sweetener use in the U.S. is increasing, and whether these exposures are associated with cancer risk in humans remains of interest.
Disclosure: For full disclosures of the study authors, visit aacrjournals.org/cebp.
