Sugary Beverages May Yield Bitter Results in HCC

A significantly higher incidence of liver cancer and death from chronic liver diseases was found among postmenopausal women who consumed 1 or more sugar-sweetened beverages per day, compared with those who drank 3 or fewer sugar-sweetened beverages per month, according to findings reported in JAMA.

In 98,786 postmenopausal women followed up for a median of 20.9 years, compared with consuming 3 servings or less of sugar-sweetened beverages per month, women consuming 1 or more servings per day had significantly higher rates of liver cancer (18.0 vs 10.3 per 100,000 person-years; adjusted hazard ratio [HR], 1.85) and chronic liver disease mortality (17.7 vs 7.1 per 100,000 person-years; adjusted HR, 1.68).

Approximately 65% of adults in the US consume sugar-sweetened beverages daily, the authors pointed out.

The investigators followed a prospective cohort of 98,786 postmenopausal women aged 50 to 79 years enrolled in the Women’s Health Initiative from 1993 to 1998 at 40 clinical centers in the US. The follow-up period was 20.9 years and ended March 1, 2020.

The participants’ intake of sugar-sweetened beverage was defined as the sum of regular soft drinks and fruit drinks, not including fruit juice, and was assessed based on a food frequency questionnaire administered at baseline. Consumption of artificially sweetened beverages was measured at 3-year follow-up.

At baseline, 6.8% of women consumed 1 or more servings of sugar-sweetened beverage per day, while 13.1% of participants consumed 1 or more servings of artificially sweetened beverage per day at 3-year follow-up, the investigators noted.

“The primary outcomes were (1) liver cancer incidence, and (2) mortality due to chronic liver disease, defined as death from nonalcoholic fatty liver disease, liver fibrosis, cirrhosis, alcoholic liver diseases, and chronic hepatitis,” the authors explained. “Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs) and 95% CIs for liver cancer incidence and for chronic liver disease mortality, adjusting for potential confounders including demographics and lifestyle factors.”

During the follow-up period, 207 women developed liver cancer and 148 died from chronic liver disease.

 “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),” the investigators found. “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).”

The authors concluded that among postmenopausal women, those who consumed 1 or more sugar-sweetened beverages per day had a higher incidence of liver cancer and death from chronic liver disease than those who consumed 3 or fewer servings of sugar-sweetened beverages per month.

Reference:
Zhao L, Zhang X, Coday M, et al. Sugar-sweetened and artificially sweetened beverages and risk of liver cancer and chronic liver disease mortality. JAMA. 2023;330(6):537-546. doi:10.1001/jama.2023.12618