Liver cancer and liver disease: Sugary drinks may increase risk

Evan Walker
Evan Walker TheMediTary.Com |
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Sugary drinks may increase the risk of liver problems — at least in older women. Image credit: Tatjana Zlatkovic/Stocksy.
  • T​he liver is a vital organ of the body, helping with metabolism and removing dangerous substances from the blood. Damage to the liver can be detrimental to the body’s health.
  • Researchers are still seeking to understand what factors can increase people’s risk for liver problems, such as chronic liver conditions and liver cancer.
  • Data from a recent study found that higher consumption of sugar-sweetened beverages was associated with an increased risk of liver cancer and death from chronic liver disease in women at the postmenopausal stage.

Lifestyle factors can influence the function of the liver. Certain people can be at a higher risk for liver disorders or liver damage.

A recent study published in JAMA examined how drinking sugar-sweetened beverages contributes to liver problems.

The study found that women at the postmenopausal stage who consumed one or more sugar-sweetened drinks daily were at an increased risk for liver cancer and death from chronic liver disease.

This study looked at the relationship between consuming sugar-sweetened beverages and how it relates to liver cancer and chronic liver disease mortality.

The study included almost 99,000 women at the postmenopausal stage, and researchers were able to look at long-term data, following up with participants an average of a little over 20 years later. Researchers used data from a large prospective study called the Women’s Health Initiative.

Participants provided information on their intake of sugary soft drinks and fruit drinks, excluding fruit juice. Their intake of artificially sweetened drinks was recorded at a 3-year follow-up.

Based on their answers, researchers divided participants into one of three groups:

  • 3 or fewer servings per month, including no consumption
  • between 1 and 6 servings a week
  • 1 or more servings a day.

Over the follow-up, researchers looked at the incidence of liver cancer and death from chronic liver disease. They accounted for several covariates, including smoking status, body mass index (BMI), and level of physical activity.

The study found that participants who consumed one or more sugar-sweetened beverages daily were at a higher risk for developing liver cancer and death from chronic liver disease compared to participants who consumed three or fewer sugar-sweetened beverages a month.

However, they found that participants who consumed artificially-sweetened beverages were not at an increased risk for liver cancer or death from chronic liver disease.

Study authors Dr. Longgang Zhao, a postdoctoral research fellow in the Channing Division of Network Medicine at Brigham and Women’s Hospital, Harvard Medical School, and Dr. Xuehong Zhang, associate professor of Medicine at Harvard Medical School and Associate Epidemiologist at the Channing Division of Network Medicine, Brigham and Women’s Hospital explained to Medical News Today:

“Our results support positive associations between sugar-sweetened beverage and adverse liver outcomes among postmenopausal women. Replacing sugar-sweetened beverage with coffee or tea might lower risk of liver cancer and chronic liver disease mortality. We were not surprised by our findings. Intake of sugar-sweetened beverage, 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.”

Dr. David A Gerber, a surgeon and Chief of Abdominal Transplant Surgery at UNC School of Medicine, not involved in the recent study, commented on the findings for MNT.

“My takeaway is that our diet plays a major role in our overall health, just most people don’t think about sugary intake and liver disease, they focus on obesity, diabetes, hypertension, etc,” he told us. “That is probably because we haven’t done a good job educating the public about the role of metabolic liver disease.”

T​his study does have critical limitations. First, it only included women at the postmenopausal stage, meaning we cannot generalize the results. It also indicates the need to explore these findings in other populations.

Second, the study cannot prove that consuming sugar-sweetened beverages is the cause of liver cancer or deaths from chronic liver disease.

Participants only answered a limited number of questions about sugar-sweetened and artificially sweetened beverages. Researchers were unable to gather greater detail about beverages like sugar content or the type of sweetener used. Self-reporting presents certain limitations on accuracy.

There is also the risk of confounding, and researchers were unable to look at the influence of changes in participants’ beverage intake over time. Finally, only a small number of liver cancer cases and death from chronic liver disease occurred, limiting statistical power.

The study sheds light on a potential risk factor that some people can modify to improve health and potentially reduce risk for certain liver problems. Dr. Zhao and Dr. Zhang explained:

“Our findings suggest sugar-sweetened beverage as a potential modifiable risk factor for liver cancer and chronic liver disease mortality. If our findings [are] confirmed, reducing sugar- sweetened beverage consumption might serve as a public health strategy to reduce liver disease burden. The positive association between sugar-sweetened beverage and adverse liver outcomes in [the] current study should not be hastily assumed to imply causation. Further research is necessary before contemplating any alterations to clinical recommendations.”

The Health">liver helps to process substances that come into the body. It helps the body keep what is useful and helps remove substances that are toxic. It also helps metabolize nutrients like fat, carbohydrates, and proteins.

Because of the liver’s central role, damage to the liver can lead to poor health outcomes. Damage to the liver can take on many forms and vary in severity.

“Chronic liver disease is a very serious disease, and it is broken down into subcategories of fibrosis — early scarring of the liver — to the advanced stage of chronic liver disease called cirrhosis,” Dr. Gerber told MNT.

“Cirrhosis is the leading cause of mortality and morbidity across the world, which many people including physicians don’t realize. Roughly 1.3 million people die annually secondary to cirrhosis,” he noted.

Similarly, liver cancer can also be highly detrimental. Certain risk factors increase someone’s chances of developing liver cancer, such as high use of alcohol, obesity, or having type 2 diabetes.

D​r. Gerber further explained that “[w]hen the medical community talks about liver cancer in the setting of chronic liver disease they are referring to primary liver cancer (cancer that arises in the liver) rather than metastatic cancer (cancer in some other organ that spreads to the liver).”

“Primary liver cancer occurs because of the chronic injury of the liver and its incidence goes up with every year that someone has chronic liver disease,” he added.

Research about how people can decrease their risk for liver problems is ongoing.

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