In the study, researchers examined the association of SSBs and artificially-sweetened beverages (ASBs) with mortality from all types of cancer among men and women in the Cancer Prevention Study-II (CPS-II) prospective cohort.
In 1982, the cohort of 934,777 cancer-free participants provided information on SSB and ASB consumption. Deaths were identified through 2016. Researchers found that during the study follow-up, 135,093 CPS-II participants died from cancer.
Researchers found that consumption of SSB drinks (2+ servings per day) was not associated with all-cancer mortality, but was associated with increased risk of obesity-related cancers, which became null after adjusting for BMI.
However, SSBs were associated with increased mortality from colorectal and kidney cancers, even after adjusting for BMI.
“These results should inform public policy regarding sweetened beverage consumption to decrease the risk of cancer for men and women in the US,” said Dr. Marjorie McCullough, senior scientific director, epidemiology research at the American Cancer Society and lead author of the study.
The issue of added sugar intake
The 2020-2025 FDA Dietary Guidelines recommend limiting calories from added sugar to less than 10% of total calories per day (200 calories or 50g for those following a 2,000-calorie diet). However, most Americans exceed this recommended amount, with SSBs accounting for a significant portion (24%) of Americans' added sugar intake, according to the FDA.
The study reaffirms what’s been well researched: high consumption of sugary beverages lead to several negative health outcomes, noted McCullough.
“Unfortunately, Americans exceed recommended limits on sugar consumption in the US Dietary Guidelines, and sugar-sweetened beverages are known risk factors for weight gain, being overweight, and obesity,” said McCullough.
“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.”
What about artificially sweetened beverages?
Often seen as the lesser of two evils, the long-term health impact of regular consumption of artificially sweetened beverages such as diet soda remains to be seen and merits further study, said McCullough, who said a positive association of artificially sweetened beverage consumption with obesity-related cancers was null after controlling for BMI; although an increased risk of pancreatic cancer remained post BMI adjustment.
McCullough added that while most artificial sweeteners are generally thought to be safe, artificial sweetener use in the US is increasing and whether these exposures are associated with cancer risk in humans remains of interest.
In July 2022, the World Health Organization (WHO) issued a draft guideline suggesting that non-sugar sweeteners should not be used as a means to weight control or reducing the risk of non-communicable diseases. Another recent study found a link between artificial sweetener intake (i.e. aspartame) and CVD risk, while new research challenges the notion that non-nutritive sweeteners such as sucralose and saccharin are not inert and may impact glycemic tolerance.
“Future research should consider the role of BMI in studies of sweetened beverages and cancer risk,” McCullough added.
Sugar- and Artificially-Sweetened Beverages and Cancer Mortality in a Large U.S. Prospective Cohort
Authors: Marjorie L. McCullough, et al.