Study links sugar-sweetened beverage consumption with liver cancer

Rockville, Maryland: A study of more than 90,000 postmenopausal women found that those who consumed at least one sugar-sweetened beverage daily faced a 78% higher risk of developing liver cancer compared with people who consumed less than three servings per month of such beverages.

"Our findings suggest sugar-sweetened beverage consumption is a potential modifiable risk factor for liver cancer," said Longgang Zhao, a doctoral candidate at the University of South Carolina, the study's lead author. "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."

Zhao will present the findings online at NUTRITION 2022 LIVE ONLINE, the flagship annual meeting of the American Society for Nutrition held June 14-16. Zhao conducted the study with senior author Xuehong Zhang, assistant professor at Harvard Medical School and Harvard T. H. Chan School of Public Health and associate epidemiologist at Brigham and Women's Hospital.

Incidence of liver cancer has risen sharply during the past three decades in the U.S. While risk factors such as chronic hepatitis infections, alcohol consumption and diabetes are implicated in a majority of patients, approximately 40% of liver cancer cases are not explained by known risk factors. The researchers sought to find out if specific dietary factors could play a role.

Regular consumption of sugar-sweetened beverages such as soda and fruit drinks has been linked with a variety of health problems. While sugar-sweetened beverage intake has fallen over the past several decades, it is still common; nearly two-thirds of White adults in the U.S. reported at least some sugar-sweetened beverage consumption on a given day in 2017-2018.

For the new study, researchers analyzed data from 90,504 postmenopausal women who participated in the Women's Health Initiative, a long-term study launched in the early 1990s. Participants completed baseline questionnaires in the mid-1990s and were tracked for a median of 18 years. Researchers assessed sugar-sweetened beverage intake based on validated food frequency questionnaires and confirmed liver cancer diagnoses using participants' medical records.

About 7% of participants reported consuming one or more 12-ounce servings of sugar-sweetened beverages per day and a total of 205 women developed liver cancer. Women consuming one or more sugar-sweetened beverages daily were 78% more likely to develop liver cancer and those consuming at least one soft drink per day were 73% more likely to develop liver cancer compared with those who never consumed these beverages or consumed less than three servings per month.

Although more studies would be needed to determine the factors and mechanisms behind the linkage, researchers said that higher sugar-sweetened beverage consumption might increase the risk of obesity and type 2 diabetes, which are in turn risk factors for liver cancer. These beverages also can contribute to insulin resistance and to the buildup of fat in the liver, both of which influence liver health.

"Intake of sugar-sweetened beverages, a postulated risk factor for obesity, diabetes and cardiovascular disease, may drive insulin resistance and inflammation which are strongly implicated in liver carcinogenesis," Zhao said.

Researchers cautioned that the study is observational and was not designed to determine whether sugar-sweetened beverages actually cause liver cancer or if consumption of sugar-sweetened beverages is an indicator of other lifestyle factors that lead to liver cancer. In addition, since the study focused on postmenopausal women, studies involving men and younger women are needed to examine the associations more comprehensively.