Postmenopausal women who consumed sugar-sweetened beverages were more likely to develop the most common type of endometrial cancer compared with women who did not drink sugar-sweetened beverages, according to a new study from the Division of Epidemiology and Community Health of the University of Minnesota School of Public Health in Minneapolis.
Postmenopausal women who reported the highest intake of sugar-sweetened beverages had a 78 percent increased risk for estrogen-dependent type I endometrial cancer (the most common type of this disease). This association was found in a dose-dependent manner: the more sugar-sweetened beverages a woman drank, the higher her risk.
This is the first study to show the association between high sugar-sweetened beverage consumption and endometrial cancer, but the results aren’t surprising. Previous studies have shown increasing consumption of sugar-sweetened beverages has paralleled the increase in obesity. Obese women tend to have higher levels of estrogens, which can stimulate the growth of endometrial cells.
Researchers also believe sugary drinks can increase the risk independent of their effect on body weight. Sugary drinks like pop have a high glycemic index – they spike blood sugar and insulin quickly and then drop quickly. These fluctuations in blood sugar and insulin may also play a role.
The study used data from 23,039 postmenopausal women who reported dietary intake, demographic information, and medical history in 1986, prior to the cancer diagnosis, as part of the Iowa Women's Health Study.
Dietary intake was assessed using the Harvard Food Frequency Questionnaire (FFQ), which asked study participants to report intake frequency of 127 food items in the previous 12 months. A typical portion size for each food item was provided to give study participants a sense of scale.
The dietary questionnaire included four questions asking usual intake frequency of sugar-sweetened beverages, including 1) Coke®, Pepsi®, or other colas with sugar; 2) caffeine-free Coke®, Pepsi®, or other colas with sugar; 3) other carbonated beverages with sugar (e.g., 7-Up®); and 4) Hawaiian Punch®, lemonade, or other noncarbonated fruit drinks.
"Sugar-free soft drinks" included low-calorie caffeinated and caffeine-free cola (e.g., Pepsi-Free®), and other low-calorie carbonated beverages (e.g., Fresca®, Diet 7-Up®, and Diet Ginger Ale®).
The "sweets and baked goods" category comprised 13 items in the FFQ, including chocolate, candy bars, candy without chocolate, cookies (home-baked and ready-made), brownies, doughnuts, cakes (home-baked and ready-made), sweet rolls, coffeecakes or other pastries (home-baked and ready-made), and pies (home-baked and ready-made).
The researchers categorized the sugar-sweetened beverage consumption patterns of these women into quintiles, ranging from no intake (the lowest quintile) to between 1.7 and 60.5 servings a week/average 3.5 servings per week (the highest quintile).
The research team did not find any association between type I or type II endometrial cancers and consumption of sugar-free soft drinks, sweets/baked goods, and starch.
Source: Cancer Epidemiology, Biomarkers & Prevention, November 2013.
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