August 9, 2023 – Regular consumption of sugary drinks may significantly increase the chance of postmenopausal women developing liver cancer or dying from chronic liver disease, recent research suggests.
The study found that postmenopausal women who consumed a minimum of one sugar-sweetened beverage per day had an 85 percent higher risk of developing liver cancer and a 68 percent higher risk of dying from chronic liver disease than women who consumed three or fewer servings per 30 days.
But when taking a look at consumption of artificially sweetened beverages, researchers found no strong association between intake and the chance of liver cancer or death from chronic liver disease, in line with Longgang Zhao, PhD, of Brigham and Women's Hospital and Harvard Medical School in Boston. However, Zhao said the sample size for this comparison was small and needs to be “interpreted with caution.”
The recent study was published online Tuesday within the Journal of the American Medical Association.
About 40% of individuals with liver cancer shouldn't have any of the known risk aspects for the disease, equivalent to chronic hepatitis B or C infection, type 2 diabetes or obesity. In the present evaluation, Zhao and colleagues wanted to seek out out whether sugar-sweetened or artificially sweetened beverages might be a risk factor for liver cancer or chronic liver disease.
Two previous studies found only a “potential association” between sugar-sweetened beverages and an individual's risk of developing liver cancer, the authors explained.
Last month, the International Agency for Research on Cancer (IARC) officially classified the synthetic sweetener aspartame as possibly carcinogenic. But cancer epidemiologist Dr. Paul Pharoah said, “The evidence that aspartame causes primary liver cancer or any other cancer in humans is very weak.”
To gain more clarity on a possible link, the study team used the Women's Health Initiative (WHI) to look at sugary beverage consumption in nearly 100,000 postmenopausal women and artificially sweetened beverage consumption in nearly 65,000 women and followed them for nearly 21 years. The study checked out cases of liver cancer and deaths from chronic liver disease, defined as nonalcoholic fatty liver disease, liver fibrosis, liver cirrhosis, alcoholic liver disease and chronic hepatitis.
(The WHI is a series of long-term national studies funded by the National Heart, Lung, and Blood Institute.)
Of these women, almost 7% consumed a minimum of one sugar-sweetened beverage each day and 13% consumed a number of servings of artificially sweetened beverages each day.
During the commentary period, 207 women within the group that consumed sugary drinks developed liver cancer and 148 died from chronic liver disease, while within the group that consumed artificial sugar, 133 women developed liver cancer and 74 died from chronic liver disease.
Compared with women who drank three or fewer servings of sugar-sweetened beverages per 30 days, those that drank a number of servings per day had a significantly higher risk of developing liver cancer and dying from chronic liver disease.
There was no significant difference within the groups that consumed only artificially sweetened beverages.
One of the authors, Xuehong Zhang, a physician of science who also works at Brigham and Women's Hospital and Harvard Medical School, said it was not surprising that sugar-sweetened beverages could increase the chance of negative liver damage.
Sugary drinks may cause obesity, Diabetes and heart and vascular disease, and so they can result in insulin resistance and inflammation, all of which may result in cancer and liver problems, Zhang said.
For Dr. Nancy S. Reau, who was not involved within the research, the link between each day consumption of sugar-sweetened beverages and liver health is crucial finding.
“Whether it's a surrogate marker for risk of liver disease (such as fatty liver disease) or a consequence of alcohol consumption itself, it's a measure that's easy for clinicians to measure and a behavior that's easy for patients to change,” said Reau, a hepatologist at Rush Medical College in Chicago.
However, she said: “I do not believe this article can be used to promote artificially sweetened beverages as a substitute.”
It's possible, she explained, that this population is simply too small to detect a big link between artificially sweetened beverages and liver health. In addition, “natural, low-calorie beverages are always ideal as part of a healthy diet combined with exercise.”
Dale Shepard, MD, PhD, a medical oncologist on the Cleveland Clinic, also weighed in. He said that avoiding too many sugary or artificially sweetened beverages is the very best plan of action, but that other things like smoking, excessive alcohol consumption, sun exposure without adequate sun protection, obesity and lack of exercise “tend to increase the risk of cancer.”