A recently released study published in The Journal of Nutrition reported that overall, consumption of sugar-sweetened beverages was associated with a slightly higher risk of breast cancer among lean women.

Extensive research has demonstrated an association between excessive consumption of sugar-sweetened beverages and cardiometabolic health. Consumption of artificially sweetened beverages, which are marketed as healthier alternatives to sugar-sweetened beverages, has dramatically increased in the last 40 years. Yet, the long-term health implications of artificially sweetened beverages remain largely unknown.  To address these knowledge gaps, Andrea Romanos-Nanclares (Postdoctoral Fellow, Brigham and Women’s Hospital) and colleagues conducted a study to evaluate associations between consumption of sugar-sweetened beverages and artificially sweetened beverages and risks of total and subtype-specific breast cancer.

Data from Nurses’ Health Study and Nurses’ Health Study II, which are based at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, were utilized for this study. The Nurses’ Health study followed 121,700 female nurses aged 30 to 55 years at enrollment in 1976, and the Nurses’ Health Study II followed 116,429 female nurses 25 to 42 years of age at recruitment in 1989.  Both large, prospective ongoing studies collected information on health-related factors and medical history every 2 years. Diets were assessed with a validated food frequency questionnaire and administered in the Nurses’ Health Study in 1980, 1984, 1986, and every 4 years thereafter and the Nurses’ Health Study II in 1991 and every 4 years thereafter. Invasive breast cancer cases were identified through self-report questionnaires or the National Death Index and confirmed by medical records.  Archived records enabled the research team to evaluate tumor characteristics.

After 36 years of follow-up (median, 11 years), 11,379 invasive breast cancer cases were documented. No significant associations of sugar-sweetened beverage or artificially sweetened beverage intake with breast cancer were observed overall. However, a positive association was observed between intake of sugar-sweetened beverages and the risk of breast cancer among lean women that was independent of weight changes and other established dietary and non-dietary breast cancer risk factors. The research team also reported a modest inverse association between artificially sweetened beverage intake and the risk of subtype-specific breast tumors, particularly in obese women. The researchers concluded that although no significant associations were observed overall, consumption of sugar-sweetened beverages was associated with a slightly higher risk of breast cancer among lean women, although this needs further confirmation. Research findings also suggested no substantial increase in the risk of breast cancer with the consumption of artificially sweetened beverages.

In a companion editorial, researchers Amber Kleckner and Amber Kautz (University of Rochester) applaud this study and reinforce the importance of minimizing the intake of sugar-sweetened beverages.  A better understanding of the effects of artificial sweeteners on health outcomes such as breast cancer has not yet been fully established and warrants further investigation.


Romanos-Nanclares A, Collins LC, Hu FB, Willett WC, Rosner Ba, Toledo E, Eliassen AH. Sugar-sweetened beverages, artificially sweetened beverages, and breast cancer risk: Results from 2 prospective US cohorts. J Nutr, Volume 151, Issue 9, September 2021, Pages 2768–2779, https://doi.org/10.1093/jn/nxab172.

Kleckner AS and Kautz A. The importance of continued epidemiological research on sugar-sweetened and artificially sweetened beverages. J Nutr., Volume 151, Issue 9, September 2021, Pages 2511–2512, https://doi.org/10.1093/jn/nxab256.

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