Compared with 3 or fewer servings of sugar-sweetened soft drinks or fruit drinks per month, 1 or more servings of these sugar-sweetened beverages per day was associated with an increased incidence of liver cancer and death from chronic liver disease in postmenopausal women, a study shows. Women who drank artificially sweetened soft drinks or fruit drinks did not have this increased risk. “Future studies should confirm these findings and identify the biological pathways of these associations,” the authors conclude.
A prospective cohort study of 98,786 postmenopausal women aged 50 to 79 in the Women’s Health Initiative from 1993 to 1998 at 40 clinical centers in the US was followed up to Mar. 1, 2020. The consumption of regular soft drinks and fruit drinks (not including fruit juice) was determined using a food frequency questionnaire administered at baseline. Artificially sweetened beverage intake was measured at 3-year follow-up. The primary outcomes were liver cancer incidence and mortality due to chronic liver disease (nonalcoholic fatty liver disease, liver fibrosis, cirrhosis, alcoholic liver diseases, and chronic hepatitis).
“During a median follow-up of 20.9 years, 207 women developed liver cancer and 148 died from chronic liver disease,” the authors report. “At baseline, 6.8% of women consumed 1 or more sugar-sweetened beverage servings per day, and 13.1% consumed 1 or more artificially sweetened beverage servings per day at 3-year follow-up. Compared with intake of 3 or fewer servings of sugar-sweetened beverages per month, those who consumed 1 or more servings per day had a significantly higher risk of liver cancer (18.0 vs 10.3 per 100,000 person-years [P value for trend = .02]; adjusted HR, 1.85 [95% CI, 1.16-2.96]; P = .01) and chronic liver disease mortality (17.7 vs 7.1 per 100,000 person-years [P value for trend <.001]; adjusted HR, 1.68 [95% CI, 1.03-2.75]; P = .04). Compared with intake of 3 or fewer artificially sweetened beverages per month, individuals who consumed 1 or more artificially sweetened beverages per day did not have significantly increased incidence of liver cancer (11.8 vs 10.2 per 100,000 person-years [P value for trend = .70]; adjusted HR, 1.17 [95% CI, 0.70-1.94]; P = .55) or chronic liver disease mortality (7.1 vs 5.3 per 100,000 person-years [P value for trend = .32]; adjusted HR, 0.95 [95% CI, 0.49-1.84]; P = .88).”