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Nutritional Pearl

Sugar-Sweetened Sodas May Contribute to Colon Cancer

Timothy S. Harlan, MD
12/04/2023

  • Drinking sugar-sweetened beverages may do more than harm your waistline: they may contribute to your risk of colon cancer.

    An analysis of data gathered from the Nurses' Health Study (1984-2014) and the Health Professionals Follow-up Study (1985-2014)—both long-term, large-scale prospective studies—suggests that when compared to those who never drank sugar-sweetened beverages, those who drank at least one serving per day were 38% more likely to develop colorectal cancer—and more than twice as likely to die from it.

    The Research

    An international team of researchers, including scientists affiliated with Harvard University, two universities in Korea, and Washington University, in St. Louis, Missouri, published a paper in the American Journal of Clinical Nutrition describing their analysis of the dietary and health data gathered over close to 50 years from more than 121,000 men and women.1

    Their research was prompted by in vitro and mouse studies, which showed that fructose may enhance tumor growth in colon cancers. For there to be tumor growth,  fructose would have to be present in the colon.

    To (somewhat) oversimplify: normally fructose is metabolized in the liver after it is absorbed in the small intestine. Unfortunately, consuming sugar-sweetened beverages can overwhelm the ability of the small intestine to absorb that fructose, meaning the fructose is not absorbed in the small intestine and is passed to the large intestine.

    The theory is that this excess fructose present in the colon may affect the growth of cancerous tumors, causing them to grow more quickly or become more dangerous in other ways.

    The Results

    The authors analyzed the participants' intake of total fructose as well as their intake of sugar-sweetened beverages containing high fructose corn syrup and looked at the relationship between intake and colon cancers in various locations in the large intestine. They found that sugar-sweetened beverage consumption was strongly associated with cancers in the proximal colon but was far less associated with cancers in the distal colon or rectum.

    Using data modeling, the authors also found that substituting just one serving of an artificially-sweetened (diet) beverage for one serving of a sugar-sweetened beverage "was associated with reductions of 18.7% ... and 25.3% in the incidence and mortality of proximal colon cancer.”

    What’s the Take Home?

    The outcome remains the same: diet sodas are better for you than sugar-sweetened beverages, but water, coffee, or tea are your best choices for regular consumption. The study by Yuan and colleagues is an additional reason to remove soda and other sugar-sweetened beverages from your daily consumption.

    Reference:

    1. Yuan C, Joh HK, Wang QL, et al. Sugar-sweetened beverage and sugar consumption and colorectal cancer incidence and mortality according to anatomic subsite. Am J Clin Nutr. 2022;115(6):1481-1489. doi:10.1093/ajcn/nqac040

    Dr. Gourmet is the definitive health and nutrition web resource for both physicians and patients with evidence-based resources including special diets for coumadin users, patients with GERD/acid reflux, celiac disease, type 2 diabetes, low sodium diets (1500 mg/d), and lactose intolerance. 

    Timothy S. Harlan, MD, FACP, CCMS, is a practicing, board-certified Internist. He is currently an Associate Professor of Medicine at George Washington University and Director of the GW Culinary Medicine Program.

    Health meets Food: the Culinary Medicine Curriculum, is an innovative program teaching medical students about diet and lifestyle that bridges the gap between the basic sciences, clinical medicine, the community, and culinary education. Medical students work side-by-side in the kitchen with culinary students to teach each other, and most importantly, teach the community and patients how to return to their kitchens and transform their health. 

    He served as Associate Dean for Clinical Services at Tulane University School of Medicine and is the founder and Senior Advisor of the Goldring Center for Culinary Medicine, the first-of-its-kind teaching kitchen operated by a medical school.

    Dr Harlan attended medical school at Emory University School of Medicine in Atlanta, Georgia, and pursued his residency at Emory University School of Medicine Affiliated Hospitals in Atlanta, GA.