Association Between Sugar-Sweetened and Artificially-Sweetened Beverages and Gastric Cancer

This study of older white adults, aged 30-75, followed for 45 years, demonstrated an association between the intake of sugar-sweetened beverages and gastric cancer. Hopefully, more people are recognizing excess sugars as having multiple connections to chronic diseases.

These include type 2 diabetes, obesity, cardiovascular disease-hypertension, coronary artery disease and stroke, fatty liver, gout, dental disease, and kidney stones.

This article references gastric cancer as the fourth leading cause of cancer mortality in the world. Risk factors include smoking, infection with H. pylori, alcohol and tobacco use. Dietary factors discussed as causing increased risk include salted fish, pickled vegetables, charcoaled meats, and low intake of fruit and vegetables.

Ingestion of sugar-sweetened beverages (SSBs) includes high-fructose corn syrup, juices with added sugar, energy drinks, and regular soda. Existing reference studies show an association between high intake of SSBs and colorectal, liver, and breast cancers.

The International Agency for Research on Cancer also reported that the artificial sweetener aspartame, as an alternative to sugar, is a possible carcinogen.

This study, based on employees of the UK National Health Service, investigated whether SSBs or artificially sweetened beverages (ASBs) were associated with gastric cancer. It included 121,700 female registered nurses, aged 30-55 in 1976, and 51,000 male health care professionals, aged 40-75. Starting with a baseline questionnaire, their beverage intake was assessed ten years later and followed up every two years thereafter, along with a health history.

The types of drinks for SSBs included carbonated beverages, punch, lemonade, and sports drinks; ASBs included low-calorie carbonated beverages. The amounts were measured in 8-ounce servings, and the total number per month was calculated.

The data examined gastric cancer incidence from 1976 until 2021, when the study concluded. Of 112,000+ participants, gastric cancer was documented in 278 people.

Long-term follow-up revealed that higher intake of SSBs, but not ASBs, was associated with a higher risk of gastric cancer. In other studies, SSBs were also associated with esophageal cancer.

Some limitations of the study were uncertainty about whether participants had H. pylori, another risk factor for gastric cancer; the predominantly white study population; and the ages at enrollment, 30-75. The mechanism for the development of gastric cancer is currently unknown, but there are recommendations for further studies to include other known risk factors for cancer, such as obesity, insulin resistance, inflammation, steroid hormone balance, and dysbiosis. Also, information on the consumption of SSBs in young people should be included, recognizing their increased use in this demographic.