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According to the CDC, 63% of adults report drinking one or more sugar-sweetened beverages per day. Nednapa/Getty Images
  • New research has observed a possible link between the regular consumption of sweetened drinks and death because of liver cancer and chronic liver disease.
  • The analysis included almost 100,000 people, all of them postmenopausal women.
  • Experts say that more research needs to be done in order to identify root the root causes of this possible connection.

New research published by JAMA has observed a possible link between postmenopausal women, in this case, those aged 50-79, and the health risks associated with drinking sugar-added beverages. Using data from the Women’s Health Initiative, the researchers were able to assess this link in 98,786 people.

The data was originally collected from 1993 to 1998, with a follow-up happening in 2020. Those who reported having sugar-sweetened drinks every day were found to have a chronic liver disease mortality rate of 17.7 per 100,000 person-years. That number dropped to 7.1 for those who reported drinking three or fewer per month, and there was no notable connection between this type of risk when it came to artificially sweetened drinks.

On the other hand, rates for liver cancer diagnosis were 18 per 100,000 in those consuming sugar-sweetened drinks every day compared to 10.3 in the group who reported drinking three or less per month.

Two of the study’s many authors Dr. Longgang Zhao, Ph.D., a postdoctoral fellow at Brigham and Women’s Hospital; and Xuehong Zhang, ScD, associate professor at Harvard Medical School and Brigham and Women’s Hospital, see the value of the study in its ability to fill a significant gap in a country like the US where 63% of adults drink sugar-sweetened beverages every day.

“Epidemiological studies on dietary factors and liver cancer and chronic liver disease mortality are limited. Identification of new dietary factors may inform disease etiology and primary prevention strategies for liver cancer and chronic liver disease mortality.”

Dr. Raj Dasgupta, MD, a clinical associate professor at the University of Southern California, says that his view of the study is that it is exciting in part because it examines a group of people we don’t usually connect to the regular consumption of sugar-sweetened drinks.

“You tend to think of the adolescents, you know, the college students studying for the all-nighter, or someone who plays video games, would be the stereotypical things to think about. But it’s important to realize that you may not realize that you’re drinking more than you need on a daily basis.”

All of those interviewed in this story are quick to point out that this is in an observational study, meaning that this link requires more investment in terms of time and research in order to establish what is known as “biological pathways.” In other words, we have observed that this increase in liver-related risk is there in this population, but now we need to both confirm these results and determine why this connection exists.

In the process of gathering this data, participants were repeatedly given a questionnaire that asked how often they drank soft drinks, fruit drinks, and artificially sweetened ones (often marketed as diet variations of popular offerings). At certain points, they were also asked what their serving sizes were.

Zhao and Zhang had a direct answer when asked if any of the results they found surprised them.

“No. Intake of sugar-sweetened beverage[s], a postulated risk factor for obesity, diabetes, and cardiovascular disease, may drive insulin resistance and inflammation which are strongly implicated in liver carcinogenesis and liver health. The findings from this large cohort, the Women’s Health Initiative, support our hypothesis that sugar-sweetened beverage is a risk factor for liver [disease].”

The study could help inform future research that would seek to answer why this increase in risk is happening physiologically. They also concluded that research into topics like the gut microbiome could further explore our body’s connection to liver health.

Every study has limitations, and this one was no exception. The authors note in the article that the questionnaire given to the participants, which happened more than twenty years ago, was limited to just three questions and that it was impossible, because it wasn’t collected, to figure out what specific beverages participants were consuming.

However, this research is still valuable. The almost 21 years of follow-up and the ability of the researchers to confirm death data were both listed as strengths of the final product. Zhao and Zhang say that this research gives strong evidence that more research should be done in this age bracket as well as those who are younger.

“Given that the study focused on postmenopausal women, studies involving men and younger women are needed to examine the associations more comprehensively. Furthermore, more research is needed to elucidate the potential mechanisms by integrating genetics, animal/experimental studies … If our findings [are] confirmed, reducing sugar-sweetened beverage consumption might serve as a public health strategy to reduce liver cancer burden.

As for Dasgupta, he’s also keen to see how much additional research in this area can uncover.

“It’s just an eye-opener type of research to let everyone be aware of you what you put in your body no matter what age you are.”