Sugary Drinks Associated with Endometrial Cancer in Women

A recent study of more than 20,000 postmenopausal women showed that those who drank sugar-sweetened beverages were more likely to develop endometrial cancer than those who did not. The findings appear in the online edition of Cancer Epidemiology, Biomarkers & Prevention. Researchers evaluated the association between dietary intake of sugar-sweetened beverages, other sugar-rich food groups, and sugars, and the risk of type I and type II endometrial cancer among postmenopausal women. Participants who reported the highest intake of sugar-sweetened beverages showed a 78% increase in risk for estrogen-dependent type I endometrial cancer, the most common type of this disease. The researchers identified a linear association between risk and consumption—the more sugar-sweetened beverages a woman drank, the higher her risk. “We are the first to show the association between sugar-sweetened beverage consumption and the risk of endometrial cancer,” says lead study author Maki Inoue-Choi, PhD, MS, RD, a research associate in the Division of Epidemiology and Community Health of the University of Minnesota’s School of Public Health in Minneapolis. Inoue-Choi and her colleagues analyzed data from 23,039 postmenopausal women in the Iowa Women’s Health Study, who reported dietary intake, demographic information, and medical history in 1986, prior to cancer diagnosis. Their dietary intake was assessed at baseline by the Harvard Food Frequency Questionnaire. Four items asked the participant about the usual frequency of her sugar-sweetened beverage consumption, including: • Coke, Pepsi, or other colas with sugar; • Caffeine-free Coke, Pepsi, or other colas with sugar; • Other carbonated beverages with sugar (e.g., 7-Up); • Hawaiian Punch, lemonade, or other noncarbonated fruit drinks. It also included questions about how often participants consumed sugar-free soft drinks, low-calorie carbonated beverages, and sweets and baked goods. Among the women studied, 506 type I and 89 type II cases of endometrial cancer were recorded between 1986 and 2010. Inoue-Choi and her colleagues did not find any association between type I or type II endometrial cancers and consumption of sugar-free soft drinks, sweets and baked goods, and starch. None of the dietary items in the analysis were associated with type II endometrial cancer risk. “Too much added sugar from any source can elevate a person’s overall calorie intake and may increase the risk of a number of health conditions, such as obesity, diabetes, and heart disease, as well as cancer,” Inoue-Choi says. “Individuals should follow current dietary guidelines to avoid sugar-sweetened beverages.” While identifying the mechanisms for the link between sugar-sweetened beverage consumption and endometrial cancer was outside the scope of their study, Inoue-Choi says there are multiple possible mechanisms. “One possibility is that sugar-sweetened beverage consumption can elevate a woman’s overall calorie intake and may increase her risk of becoming obese. Obese women are likely to have increased levels of estrogens and insulin, which are risk factors for type I endometrial cancer,” she says. Because this was an observational study, it was not possible to prove a causal link between sugar-sweetened beverages and endometrial cancer. Therefore, Inoue-Choi stresses that the findings need replication in other studies. —Colleen Mullarkey Reference Inoue-Choi M, Robien K, Mariani A, Cerhan JR, Anderson KE. Sugar-sweetened beverage intake and the risk of type I and type II endometrial cancer among postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2013 Nov 22. [Online ahead of print].