US Pharm. 2023;48(9):4.

Approximately 65% of adults in the United States consume sugar-sweetened beverages daily. Chronic liver disease is a major cause of morbidity and mortality worldwide and can result in liver cancer and liver disease–related mortality. Researchers from Brigham and Women’s Hospital led one of the first studies to look at the association between intake of sugar-sweetened beverages, artificially sweetened beverages, and incidence of liver cancer and chronic liver disease mortality. The results were published recently in the Journal of the American Medical Association.

“To our knowledge, this is the first study to report an association between sugar-sweetened beverage intake and chronic liver disease mortality,” said first author Longgang Zhao, PhD, of the Brigham’s Channing Division of Network Medicine. Dr. Zhao is a postdoctoral researcher who works with senior author Xuehong Zhang, MBBS, ScD, in the Channing Division. “Our findings, if confirmed, may pave the way to a public health strategy to reduce risk of liver disease based on data from a large and geographically diverse cohort.”

This observational study included nearly 100,000 postmenopausal women from the large, prospective Women’s Health Initiative study. Participants reported their usual soft drink and fruit drink (not including fruit juice) consumption, and then reported artificially sweetened beverage consumption after 3 years. Participants were followed for a median of more than 20 years. Researchers looked at self-reported liver cancer incidence and death due to chronic liver disease such as fibrosis, cirrhosis, or chronic hepatitis, which were further verified by medical records or the National Death Index.

A total of 98,786 postmenopausal women were included in the final analyses. The 6.8% of women who consumed one or more sugar-sweetened beverages daily had an 85% higher risk of liver cancer and a 68% higher risk of chronic liver disease mortality compared with those who had fewer than three sugar-sweetened beverages per month.

The authors noted that the study was observational, causality cannot be inferred, and it relied on self-reported responses about intake, sugar content, and outcomes. More studies are needed to validate this risk association and determine why the sugary drinks appeared to increase risk of liver cancer and disease.

In other news impacting women, researchers from Michigan State University found that patients with a history of endometriosis had higher concentrations of cadmium in their urine compared to those without that diagnosis, which suggests that the toxic metal could be linked to the development of this disease.

For more about endometriosis, see the continuing education article in this issue titled “The Role of Pharmacotherapy in Endometriosis,” by Katherine Hale, PharmD, BCPS, MFA.

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