Consumption of sugar‐sweetened and artificially sweetened beverages and breast cancer survival

Abstract

Background The activation of insulin pathways is hypothesized to promote tumor growth and worsen breast cancer survival. Sugar‐sweetened beverages (SSBs) can lead to a higher risk of insulin resistance and may affect survival. The authors prospectively evaluated the relation of postdiagnostic SSB and artificially sweetened beverage (ASB) consumption with mortality among women with breast cancer. Methods In total, 8863 women with stage I through III breast cancer were identified during follow‐up of the Nurses' Health Study (NHS; 1980‐2010) and Nurses' Health Study II (NHSII; 1991‐2011). Women completed a validated food frequency questionnaire every 4 years after diagnosis and were followed until death or the end of follow‐up (2014 for the NHS and 2015 for the NHSII). Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer‐specific and all‐cause mortality after adjusting for measures of adiposity and other potential predictors of cancer survival. Results With a median follow‐up of 11.5 years, 2482 deaths were prospectively documented, including 1050 deaths from breast cancer. Compared with women who had no consumption, women who had SSB consumption after diagnosis had higher breast cancer‐specific mortality (>1 to 3 servings per week: HR, 1.31 [95% CI, 1.09‐1.58]; >3 servings per week: HR, 1.35 [95% CI, 1.12‐1.62]; Ptrend = .001) and all‐cause mortality (>1 to 3 servings per week: HR, 1.21 [95% CI, 1.07‐1.37]; >3 servings per week: HR, 1.28 [95% CI, 1.13‐1.45]; Ptrend = .0001). In contrast, ASB consumption was not associated with higher breast cancer‐specific or all‐cause mortality. Furthermore, replacing 1 serving per day of SSB consumption with 1 serving per day of ASB consumption was not associated with a lower risk of mortality. Conclusions Higher postdiagnostic SSB consumption among breast cancer survivors was associated with higher breast cancer‐specific mortality and death from all causes.

Diabetes Risk Reduction Diet and Survival after Breast Cancer Diagnosis

“…In Nurses' Health Study (NHS) and NHSII, we previously observed that four components of the DRRD [dietary glycemic index (14), red and processed meat (15), coffee (16), and sugar-sweetened beverages (SSB; ref. 17)] were associated with risk of mortality following breast cancer, while no association was found for whole fruit intake (18). However, no studies to date have evaluated the association between adherence to the whole DRRD [as measured by the DRRD score (13)] and survival outcomes after breast cancer.…”

Associations of low‐carbohydrate diets with breast cancer survival

“…higher risk of breast cancer-specific and all-cause mortality in relation to high consumption of fruit juice and sugar-sweetened beverages as well as total carbohydrate after breast cancer diagnosis. [2][3][4] According to our findings, dietary carbohydrate intake influenced the risk of mortality in women with breast cancer disproportionately depending on the source and type of carbohydrate; whereas carbohydrate from vegetables was associated with a lower risk of all-cause mortality, carbohydrate from fruit juice was linked with a higher risk of breast cancer-specific and all-cause mortality. 5 However, it is unclear what role protein and fat intake plays in breast cancer survival in relation to carbohydrate consumption.…”

Understanding the Link between Sugar and Cancer: An Examination of the Preclinical and Clinical Evidence

“…Numerous epidemiologic studies have shown an association between sugar and breast cancer ( Table 1 ) [ 46 , 47 ]. Additionally, sucrose intake during adolescence [ 48 ] was significantly correlated with higher percentage of dense breast volume [ 49 ], a known risk factor for breast cancer [ 50 ].…”

“…Similarly, Farvid at al. [ 46 ] examined 8863 women with stage I to III breast cancer who were part of the Nurses’ Health Study and found that women who had SSB consumption after diagnosis greater than zero to one serving per week had higher breast-cancer-specific mortality (>1 to 3 servings per week: HR = 1.31 [95% CI, 1.09–1.58]; >3 servings per week: HR = 1.35 [95% CI, 1.12–1.62]; P trend = 0.001) and all-cause mortality (>1 to 3 servings per week: HR = 1.21 [95% CI, 1.07–1.37]; >3 servings per week: HR = 1.28 [95% CI, 1.13–1.45]; P trend = 0.0001). In addition, replacing SSBs with coffee (18%) or tea (15%) reduced breast-cancer-specific mortality, and coffee (19%), tea (17%), or water (9%) lowered all-cause mortality risk [ 46 ].…”