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The Correlation Between Sugary Beverage Intake and An Increased Risk of Early-Onset Colorectal Cancer in Female Patients

Bottles of assorted global soft drinks

Over the last twenty years, early-onset colorectal cancer has been a growing problem in many first-world countries. Patients born in the 1990s have double the risk of colon cancer and quadruple the risk of rectal cancer when compared to patients born in the 1950s. The exact cause of this increased risk remains mostly unknown.

The increased incidence of early-onset colorectal cancer occurred simultaneously with considerably increased consumption of sugar-sweetened beverages (drinks with added sugar) in the US from 1977 – 2001. In fact, sugar-sweetened beverage consumption increased by more than double in Americans between two and 39 years old. Drinks that are artificially sweetened are the leading cause (39%) of added sugar in American diets. Furthermore, 12% of the US population consumes over three servings of sugar-sweetened beverages a day.

Each daily serving of sugar-sweetened beverages was associated with a 12% increased risk of obesity and 18% increased risk of type 2 diabetes in adults. Sugar-sweetened beverage intake is also considered a major contributor to obesity and insulin resistance in children. Childhood obesity can lead to life-long, adverse metabolic consequences, however further research must be done to understand the relationship between sugar-sweetened beverage consumption, childhood obesity, type 2 diabetes, and early-onset colorectal cancer.

The Nurses’ Health Study II is a continuing study of about 100,000 female registered nurses in the United States. Every two years, participants are asked to self-report detailed information on their demographics, lifestyle and medical history. The participants are also monitored for early-onset colorectal cancer and sugar-sweetened, as well as unsweetened, beverage intake. Among the women studied, 0.001% reported having early-onset colorectal cancer up to 24 years after the study began.

The study also found that respondents with higher sugary beverage intake are more likely to:

      ●    Use NSAIDs

      ●    Not take multivitamins

      ●    Be less physically active

      ●    Have a poorer quality diet

      ●    Consume red and processed meat

      ●    Have a lower endoscopy history due to indications

      ●    Have a lower intake of alcohol, fiber, folate, and calcium

Similarly, women who had a higher sugary beverage intake during their teenage years were also more likely to have an unhealthy diet and lifestyle during those same years. Furthermore, higher sugar-sweetened beverage intake in adulthood is associated with a high risk of early-onset colorectal cancer. Among adolescent participants, each daily serving of sugar-sweetened beverages was associated with a 32% higher risk of developing early-onset colorectal cancer.

Women who consumed two or more servings of sugar-sweetened beverages, when compared to individuals who consumed less than a serving a week of sugary drinks, had a 2.2x higher risk of early-onset colorectal cancer with an additional 16% higher risk per each additional daily serving. When participants replaced one daily serving of sugar-sweetened beverages with an unsweetened beverage, they lowered their risk of early-onset colorectal cancer by 17-36%. 

The study also found that individuals who drank more artificially sweetened beverages were more likely to be overweight, and the individuals who had higher fruit juice consumption were less likely to be overweight. In contrast to sugar-sweetened beverages, artificially sweetened beverages and fruit juice consumption was not associated with an increased risk of early-onset colorectal cancer. 

In this study, higher sugar-sweetened beverage consumption in adulthood and adolescence was associated with a substantially higher risk of early-onset colorectal cancer; no associations were observed for artificially sweetened beverages or fruit juice consumption in adulthood. Replacing sugar-sweetened beverage intake in adulthood with an unsweetened beverage was associated with a lower risk of early-onset colorectal cancer. 

Research and studies on the relationship between sugar-sweetened beverage intake and increased cancer risk have been contradictory and inclusive. Therefore, more research is needed to concretely determine the relationship between the two.

Recent research from the United States and France reported no correlation between sugar-sweetened beverage intake and colorectal cancer. However, this research had a limited number of participants consuming more than a serving a day of sugar-sweetened beverages, and some of these studies only used baseline sugar-sweetened beverage intake.

On the other hand, a recent Australian study with over 100 participants consuming one or more sodas a day showed a 28% higher colorectal cancer risk compared to participants who consumed less than one soda a month.

Between 1950 and 2000, soft drink consumption in the United States increased by around 500%. Furthermore, those born after 1950 started to drink sugar-sweetened beverages earlier in life and had higher intake, compared to those born earlier. This coincides with the rising incidence of early-onset colorectal cancer which supports the correlation between sugar-sweetened beverages and an increased risk of early-onset colorectal cancer.

Although research is limited and further research is still needed, the Nurses’ Health Study II reported a 32% increased risk of early-onset colorectal cancer per daily serving of sugar-sweetened beverages in teenagers. It’s important to remember that 30% of American kids and teens consume more than 1.5 daily servings of sugar-sweetened beverages. This study provides initial research linking prolonged daily sugar-sweetened beverage intake with an increased risk of early-onset colorectal cancer but more research is needed to confirm this correlation.

Fruit juice and artificially sweetened beverages have not been associated with an increased risk of early-onset colorectal cancer. Nonetheless, taking into consideration the surfacing link between these drinks and diabetes/ obesity-related cancers, further research is needed. 

Compared to solid foods, beverages that lack proper nutrition can promote excessive caloric intake and therefore, weight gain. Sugar-sweetened beverages are quickly digested and absorbed, which causes a rapid rise in blood sugar. Specifically, a primary sugar-sweetened beverage sweetener, fructose (a major component of sucrose and high fructose corn syrup), long term consumption can cause metabolic conditions linked to an increased risk of colorectal cancer like insulin resistance, inflammation, obesity, and type 2 diabetes.

In conclusion, over time a higher sugar-sweetened beverage intake is associated with a substantially higher risk of early-onset colorectal cancer, as well as other conditions. Considering the health consequences of sugar-sweetened beverages, it’s essential to reinforce the importance of limiting sugar-sweetened beverage intake. 

Summary

Sugar-sweetened beverage intake in the United States substantially increased from 1950 – 2000, with teenagers and adults under 50 reporting the highest level of consumption. However, the link between early-onset colorectal cancer remains mostly inconclusive due to lack of research.

The Nurses’ Health Study II investigated the correlation between sugar-sweetened beverage intake and early-onset colorectal cancer risk in around 100,000 female nurses. This study documented 109 cases of early-onset colorectal cancer and found that compared to adults who consumed less than a serving a week of sugar-sweetened beverages, adults who consumed two or more daily servings had a doubled risk of early-onset colorectal cancer, with a 16% higher risk per additional daily serving. Furthermore, each daily serving of sugar-sweetened beverages teenagers consumed was associated with a 32% increased risk of early-onset colorectal cancer.

When adult participants swapped each daily serving of sugar-sweetened beverages with unsweetened or artificially sweetened beverages, they lowered their risk of early-onset colorectal cancer by 17 – 36%. These statistics are why it’s essential to reinforce the importance of limiting sugar-sweetened beverage intake. 

Female cancer survivors needing additional resources can always schedule an appointment with Dr. Davis, leading women’s health specialist, in Chico, CA. Call the Mangrove Women’s Health office at (530) 345-0064, Ext 281.

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