Consumption of Sugar Sweetened Beverages (SSBs) and Breast Cancer: A Narrative Review
-
Sehar Iqbal
,
Zoha Imtiaz Malik
,
Umar Farooq
,
Juweria Abid
,
Hassan Bin Usman Shah
,
Abdul Momin Rizwan Ahmad
Abstract
Sugar sweetened beverages (SSBs) have become a cause of concern because of their growing consumption levels across age groups and associated chronic diseases such as diabetes mellitus, cardiovascular diseases and cancers. The aim of this review was to provide a detailed profile of the SSBs trends and associated health risk, with special focus on its role in breast cancer development. A review of current literature has depicted increased intakes of SSBs across the globe with servings ranging from 3 to 11 per day in different countries, while children, adolescents and young adults report the highest intake levels. These increased intakes further contribute to different metabolic diseases via increased body adiposity, blood glucose and insulin levels, and increased post-menopausal estrogen levels, all of which contribute to chronic diseases, including cancers. Nutrition interventions including ones that target SSBs reduction seem to have a positive impact on reducing the development of these non-communicable diseases and are also associated with better prognosis and survival chances in cancer patients. However, the implementation of SSBs taxation and mass awareness campaign interventions remains poor due to lack of policy development and regulation for these beverages. The control of SSBs intake across the world requires rigorous research to construct efficient and practical policies to reduce the accessibility and marketing of SSBs while simultaneously increasing awareness in the public regarding the health risks of these beverages. To achieve this, a coordinated approach involving different public and private sectors is needed.
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8. Hur J, Otegbeye E, Joh H-K, et al (2021). Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women. Gut, 70:2330–2336.
9. de Ruyter JC, Olthof MR, Seidell JC, et al (2012). A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med, 367:1397–1406.
10. Deshpande G, Mapanga RF, Faadiel Essop M (2017). Frequent sugar-sweetened beverage consumption and the onset of cardiometabolic diseases: Cause for concern? J Endocr Soc, 1:1372–1385.
11. Dai J, Soto MJ, Dunn CG, Bleich SN (2021). Trends and patterns in sugar-sweetened beverage consumption among children and adults by race and/or ethnicity, 2003–2018. Public Health Nutr, 24:2405–2410.
12. Ooi JY, Wolfenden L, Sutherland R, et al (2022.) A systematic review of the recent consumption levels of sugar-sweetened beverages in children and adolescents from the World Health Organization regions with high dietary–related burden of disease. Asia Pac J Public Heal, 34:11–24.
13. Hu H, Song J, MacGregor GA, He FJ (2023). Consumption of soft drinks and overweight and obesity among adolescents in 107 countries and regions. JAMA Netw Open, 6:e2325158.
14. Meng Y, Li S, Khan J, et al (2021). Sugar-and artificially sweetened beverages consumption linked to type 2 diabetes, cardiovascular diseases, and all-cause mortality: A systematic review and dose-response meta-analysis of prospective cohort studies. Nutrients, 13:2636.
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17. Brand-Miller JC, Barclay AW (2017) .Declining consumption of added sugars and sugar-sweetened beverages in Australia: a challenge for obesity prevention. Am J Clin Nutr, 105:854–863.
18. Gibson SA, Francis LE, Newens KJ, et al (2017). Changes in children’s intakes and sources of free sugars since 1997. Proc Nutr Soc, 76:E22.
19. Corte K Della, Fife J, Gardner A, et al (2021). World trends in sugar-sweetened beverage and dietary sugar intakes in children and adolescents: a systematic review. Nutr Rev, 79:274–288.
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21. Geidl-Flueck B, Hochuli M, Németh Á, et al(2021). Fructose- and sucrose- but not glucose-sweetened beverages promote hepatic de novo lipogenesis: A randomized controlled trial. J Hepatol, 75:46–54.
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27. Palmer JR, Boggs DA, Krishnan S, et al (2008). Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Arch Intern Med, 168:1487–1492.
28. De Koning L, Malik VS, Rimm EB, et al (2011). Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr, 93:1321–1327.
29. Santos LP, Gigante DP, Maciel AP (2022). Sugar sweetened beverages intake and risk of non-communicable chronic diseases in longitudinal studies: A systematic review and meta-analysis with 1.5 million individuals. Clin Nutr ESPEN, 51:128-142.
30. Malik VS (2017). Sugar sweetened beverages and cardiometabolic health. Curr Opin Cardiol, 32:572–579.
31. Malik VS, Popkin BM, Bray GA, et al (2010). Sugar sweetened beverages, obesity, type 2 diabetes and cardiovascular disease risk. Circulation, 121:1356-64.
32. Nguyen M, Jarvis SE, Tinajero MG, et al (2023). Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr, 117:160–174.
33. Sigala DM, Stanhope KL (2021). An exploration of the role of sugar-sweetened beverage in promoting obesity and health disparities. Curr Obes Rep, 10:39–52.
34. Deshpande G, Mapanga RF, Faadiel Essop M (2017). Frequent sugar-sweetened beverage consumption and the onset of cardiometabolic diseases: cause for concern? J Endocr Soc, 1:1372–1385.
35. Sedeta ET, Jobre B, Avezbakiyev B (2023). Breast cancer: Global patterns of incidence, mortality, and trends. J Clin Oncol, 41(16_suppl):10528-10528.
36. James FR, Wootton S, Jackson A, et al (2015). Obesity in breast cancer – What is the risk factor? Eur J Cancer, 51:705–720.
37. Argolo DF, Hudis CA, Iyengar NM (2018). The impact of obesity on breast cancer. Curr Oncol Rep, 20:47.
38. Lee K, Kruper L, Dieli-Conwright CM, et al (2019). The Impact of Obesity on Breast Cancer Diagnosis and Treatment. Curr Oncol Rep, 21(5):41.
39. García-Estévez L, Cortés J, Pérez S, et al (2021). Obesity and breast cancer: A paradoxical and controversial relationship influenced by menopausal status. Front Oncol, 11:705911.
40. Romanos-Nanclares A, Toledo E, Gardeazabal I, et al (2019). Sugar-sweetened beverage consumption and incidence of breast cancer: the Seguimiento Universidad de Navarra (SUN) Project. Eur J Nutr, 58:2875–2886.
41. Koyratty N, McCann SE, Millen AE, et al (2021). Sugar-sweetened soda consumption and total and breast cancer mortality: The western new york exposures and breast cancer (WEB) study. Cancer Epidemiol Biomarkers Prev, 30:945–952.
42. Romanos-Nanclares A, Collins LC, Hu FB, et al (2021). Sugar-sweetened beverages, artificially sweetened beverages, and breast cancer risk: Results from 2 prospective US cohorts. J Nutr, 151:2768–2779.
43. Atoum MF, Alzoughool F, Al-Hourani H (2020). Linkage between obesity leptin and breast cancer. Breast Cancer (Auckl), 14:1178223419898458.
44. Chazelas E, Srour B, Desmetz E, et al (2019). Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort. BMJ, 366:l2408.
45. Yoon L, Corvalán C, Pereira A, et al (2022). Sugar-sweetened beverage consumption and breast composition in a longitudinal study of Chilean girls. Breast Cancer Res, 24(1):3.
46. Makarem N, Bandera E V, Nicholson JM, et al (2018). Consumption of sugars, sugary foods, and sugary beverages in relation to cancer risk: A systematic review of longitudinal studies. Annu Rev Nutr, 38:17–39.
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48. Arends J, Bachmann P, Baracos V, et al (2017). ESPEN guidelines on nutrition in cancer patients. Clin Nutr, 36:11–48.
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50. Pérez-Bilbao T, Alonso-Dueñas M, Peinado AB, et al (2023). Effects of combined interventions of exercise and diet or exercise and supplementation on breast cancer patients: A systematic review. Nutrients,15(4):1013.
51. Lo JJ, Park YMM, Sinha R, et al (2020). Association between meat consumption and risk of breast cancer: Findings from the Sister Study. Int J Cancer, 146:2156–2165.
52. Sieri S, Chiodini P, Agnoli C, et al (2014). Dietary fat intake and development of specific breast cancer subtypes. J Natl Cancer Inst, 106(5):dju068.
53. Shahril MR, Zakarai NS, Appannah G, et al (2021). “Energy-dense, high-sfa and low-fiber” dietary pattern lowered adiponectin but not leptin concentration of breast cancer survivors. Nutrients, 13(10):3339.
54. Trestini I, Sperduti I, Caldart A, et al (2021). Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines, anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study. Breast, 60:6–14.
55. Farvid MS, Stern MC, Norat T, et al (2018). Consumption of red and processed meat and breast cancer incidence: A systematic review and meta-analysis of prospective studies. Int J Cancer, 143:2787–2799.
56. Wu J, Zeng R, Huang J, Li X, et al (2016). Dietary protein sources and incidence of breast cancer: A dose-response meta-analysis of prospective studies. Nutrients, 8:730.
57. Kazemi A, Barati-Boldaji R, Soltani S, et al (2021). Intake of various food groups and risk of breast cancer: A systematic review and dose-response meta-analysis of prospective studies. Adv Nutr, 12:809–849.
58. Dong JY, Qin LQ (2011). Soy isoflavones consumption and risk of breast cancer incidence or recurrence: A meta-analysis of prospective studies. Breast Cancer Res Treat, 125:315–323.
59. Wu YC, Zheng D, Sun JJ, et al (2015). Meta-analysis of studies on breast cancer risk and diet in Chinese women. Int J Clin Exp Med, 8:73-85.
60. Mourouti N, Panagiotakos DB (2013). Soy food consumption and breast cancer. Maturitas, 76:118–122.
61. Buja A, Pierbon M, Lago L, et al (2020). Breast Cancer Primary Prevention and Diet: An Umbrella Review. Int J Environ Res Public Heal, 17:4731.
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2. Sousa A, Sych J, Rohrmann S, Faeh D (2020). The importance of sweet beverage definitions when targeting health policies—The case of Switzerland. Nutrients, 12:1976.
3. Malik VS, Hu FB (2022). The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nat Rev Endocrinol, 18(4):205–218.
4. Azad AK, Huque R (2023). The crowding-out effect of sugar-sweetened beverages (SSBs) on household expenditure patterns in Bangladesh. BMC Public Health, 23:1411.
5. Lara-Castor L, Micha R, Cudhea F, et al (2023). Sugar-sweetened beverage intakes among adults between 1990 and 2018 in 185 countries. Nat Commun,14(1): 5957.
6. WHO (2016). Report of the commission on ending childhood obesity.
7. Teng AM, Jones AC, Mizdrak A, et al (2019). Impact of sugar‐sweetened beverage taxes on purchases and dietary intake: Systematic review and meta‐analysis. Obes Rev, 20(9):1187-1204.
8. Hur J, Otegbeye E, Joh H-K, et al (2021). Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women. Gut, 70:2330–2336.
9. de Ruyter JC, Olthof MR, Seidell JC, et al (2012). A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med, 367:1397–1406.
10. Deshpande G, Mapanga RF, Faadiel Essop M (2017). Frequent sugar-sweetened beverage consumption and the onset of cardiometabolic diseases: Cause for concern? J Endocr Soc, 1:1372–1385.
11. Dai J, Soto MJ, Dunn CG, Bleich SN (2021). Trends and patterns in sugar-sweetened beverage consumption among children and adults by race and/or ethnicity, 2003–2018. Public Health Nutr, 24:2405–2410.
12. Ooi JY, Wolfenden L, Sutherland R, et al (2022.) A systematic review of the recent consumption levels of sugar-sweetened beverages in children and adolescents from the World Health Organization regions with high dietary–related burden of disease. Asia Pac J Public Heal, 34:11–24.
13. Hu H, Song J, MacGregor GA, He FJ (2023). Consumption of soft drinks and overweight and obesity among adolescents in 107 countries and regions. JAMA Netw Open, 6:e2325158.
14. Meng Y, Li S, Khan J, et al (2021). Sugar-and artificially sweetened beverages consumption linked to type 2 diabetes, cardiovascular diseases, and all-cause mortality: A systematic review and dose-response meta-analysis of prospective cohort studies. Nutrients, 13:2636.
15. Singh GM, Micha R, Khatibzadeh S, et al (2015). Global, regional, and national consumption of sugar-sweetened beverages, fruit juices, and milk: A systematic assessment of beverage intake in 187 countries. PLoS One, 10(8):e0124845.
16. Welsh JA, Sharma AJ, Grellinger L, et al (2011). Consumption of added sugars is decreasing in the United States. Am J Clin Nutr, 94:726–734.
17. Brand-Miller JC, Barclay AW (2017) .Declining consumption of added sugars and sugar-sweetened beverages in Australia: a challenge for obesity prevention. Am J Clin Nutr, 105:854–863.
18. Gibson SA, Francis LE, Newens KJ, et al (2017). Changes in children’s intakes and sources of free sugars since 1997. Proc Nutr Soc, 76:E22.
19. Corte K Della, Fife J, Gardner A, et al (2021). World trends in sugar-sweetened beverage and dietary sugar intakes in children and adolescents: a systematic review. Nutr Rev, 79:274–288.
20. Ertuglu LA, Afsar B, Yildiz AB, et al (2021). Substitution of sugar-sweetened beverages for other beverages: Can it be the next step towards healthy aging? Curr Nutr Rep, 10:399–412.
21. Geidl-Flueck B, Hochuli M, Németh Á, et al(2021). Fructose- and sucrose- but not glucose-sweetened beverages promote hepatic de novo lipogenesis: A randomized controlled trial. J Hepatol, 75:46–54.
22. Alcaraz A, Pichon-Riviere A, Palacios A, et al (2021). Sugar sweetened beverages attributable disease burden and the potential impact of policy interventions: a systematic review of epidemiological and decision models. BMC Public Health, 21(1):1460.
23. Larsson SC, Åkesson A, Wolk A (2014). Sweetened beverage consumption is associated with increased risk of stroke in women and men. J Nutr, 144:856–860.
24. Bernstein AM, De Koning L, Flint AJ, et al (2012). Soda consumption and the risk of stroke in men and women. Am J Clin Nutr, 95:1190–1199.
25. Pacheco LS, Lacey J V, Martinez ME, et al (2020). Sugar-sweetened beverage intake and cardiovascular disease risk in the california teachers study. J Am Heart Assoc, 9(10):e014883.
26. Schulze MB, Manson JAE, Ludwig DS, et al (2004). Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA, 292:927–934.
27. Palmer JR, Boggs DA, Krishnan S, et al (2008). Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Arch Intern Med, 168:1487–1492.
28. De Koning L, Malik VS, Rimm EB, et al (2011). Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr, 93:1321–1327.
29. Santos LP, Gigante DP, Maciel AP (2022). Sugar sweetened beverages intake and risk of non-communicable chronic diseases in longitudinal studies: A systematic review and meta-analysis with 1.5 million individuals. Clin Nutr ESPEN, 51:128-142.
30. Malik VS (2017). Sugar sweetened beverages and cardiometabolic health. Curr Opin Cardiol, 32:572–579.
31. Malik VS, Popkin BM, Bray GA, et al (2010). Sugar sweetened beverages, obesity, type 2 diabetes and cardiovascular disease risk. Circulation, 121:1356-64.
32. Nguyen M, Jarvis SE, Tinajero MG, et al (2023). Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr, 117:160–174.
33. Sigala DM, Stanhope KL (2021). An exploration of the role of sugar-sweetened beverage in promoting obesity and health disparities. Curr Obes Rep, 10:39–52.
34. Deshpande G, Mapanga RF, Faadiel Essop M (2017). Frequent sugar-sweetened beverage consumption and the onset of cardiometabolic diseases: cause for concern? J Endocr Soc, 1:1372–1385.
35. Sedeta ET, Jobre B, Avezbakiyev B (2023). Breast cancer: Global patterns of incidence, mortality, and trends. J Clin Oncol, 41(16_suppl):10528-10528.
36. James FR, Wootton S, Jackson A, et al (2015). Obesity in breast cancer – What is the risk factor? Eur J Cancer, 51:705–720.
37. Argolo DF, Hudis CA, Iyengar NM (2018). The impact of obesity on breast cancer. Curr Oncol Rep, 20:47.
38. Lee K, Kruper L, Dieli-Conwright CM, et al (2019). The Impact of Obesity on Breast Cancer Diagnosis and Treatment. Curr Oncol Rep, 21(5):41.
39. García-Estévez L, Cortés J, Pérez S, et al (2021). Obesity and breast cancer: A paradoxical and controversial relationship influenced by menopausal status. Front Oncol, 11:705911.
40. Romanos-Nanclares A, Toledo E, Gardeazabal I, et al (2019). Sugar-sweetened beverage consumption and incidence of breast cancer: the Seguimiento Universidad de Navarra (SUN) Project. Eur J Nutr, 58:2875–2886.
41. Koyratty N, McCann SE, Millen AE, et al (2021). Sugar-sweetened soda consumption and total and breast cancer mortality: The western new york exposures and breast cancer (WEB) study. Cancer Epidemiol Biomarkers Prev, 30:945–952.
42. Romanos-Nanclares A, Collins LC, Hu FB, et al (2021). Sugar-sweetened beverages, artificially sweetened beverages, and breast cancer risk: Results from 2 prospective US cohorts. J Nutr, 151:2768–2779.
43. Atoum MF, Alzoughool F, Al-Hourani H (2020). Linkage between obesity leptin and breast cancer. Breast Cancer (Auckl), 14:1178223419898458.
44. Chazelas E, Srour B, Desmetz E, et al (2019). Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort. BMJ, 366:l2408.
45. Yoon L, Corvalán C, Pereira A, et al (2022). Sugar-sweetened beverage consumption and breast composition in a longitudinal study of Chilean girls. Breast Cancer Res, 24(1):3.
46. Makarem N, Bandera E V, Nicholson JM, et al (2018). Consumption of sugars, sugary foods, and sugary beverages in relation to cancer risk: A systematic review of longitudinal studies. Annu Rev Nutr, 38:17–39.
47. Mourouti N, Kontogianni MD, Papavagelis C, et al (2015). Diet and breast cancer: a systematic review. Int J Food Sci Nutr, 66:1–42.
48. Arends J, Bachmann P, Baracos V, et al (2017). ESPEN guidelines on nutrition in cancer patients. Clin Nutr, 36:11–48.
49. De Cicco P, Catani MV, Gasperi V, et al (2019). Nutrition and breast cancer: A literature review on prevention, treatment and recurrence. Nutrients, 11:1514.
50. Pérez-Bilbao T, Alonso-Dueñas M, Peinado AB, et al (2023). Effects of combined interventions of exercise and diet or exercise and supplementation on breast cancer patients: A systematic review. Nutrients,15(4):1013.
51. Lo JJ, Park YMM, Sinha R, et al (2020). Association between meat consumption and risk of breast cancer: Findings from the Sister Study. Int J Cancer, 146:2156–2165.
52. Sieri S, Chiodini P, Agnoli C, et al (2014). Dietary fat intake and development of specific breast cancer subtypes. J Natl Cancer Inst, 106(5):dju068.
53. Shahril MR, Zakarai NS, Appannah G, et al (2021). “Energy-dense, high-sfa and low-fiber” dietary pattern lowered adiponectin but not leptin concentration of breast cancer survivors. Nutrients, 13(10):3339.
54. Trestini I, Sperduti I, Caldart A, et al (2021). Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines, anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study. Breast, 60:6–14.
55. Farvid MS, Stern MC, Norat T, et al (2018). Consumption of red and processed meat and breast cancer incidence: A systematic review and meta-analysis of prospective studies. Int J Cancer, 143:2787–2799.
56. Wu J, Zeng R, Huang J, Li X, et al (2016). Dietary protein sources and incidence of breast cancer: A dose-response meta-analysis of prospective studies. Nutrients, 8:730.
57. Kazemi A, Barati-Boldaji R, Soltani S, et al (2021). Intake of various food groups and risk of breast cancer: A systematic review and dose-response meta-analysis of prospective studies. Adv Nutr, 12:809–849.
58. Dong JY, Qin LQ (2011). Soy isoflavones consumption and risk of breast cancer incidence or recurrence: A meta-analysis of prospective studies. Breast Cancer Res Treat, 125:315–323.
59. Wu YC, Zheng D, Sun JJ, et al (2015). Meta-analysis of studies on breast cancer risk and diet in Chinese women. Int J Clin Exp Med, 8:73-85.
60. Mourouti N, Panagiotakos DB (2013). Soy food consumption and breast cancer. Maturitas, 76:118–122.
61. Buja A, Pierbon M, Lago L, et al (2020). Breast Cancer Primary Prevention and Diet: An Umbrella Review. Int J Environ Res Public Heal, 17:4731.
62. Augustin LSA, Libra M, Crispo A, et al (2017). Low glycemic index diet, exercise and vitamin D to reduce breast cancer recurrence (DediCa): Design of a clinical trial. BMC Cancer, 17:69.
63. Vanhevel J, Verlinden L, Doms S, et al (2022). The role of vitamin D in breast cancer risk and progression. Endocr Relat Cancer, 29:R33–R55.
64. Bradshaw PT, Sagiv SK, Kabat GC, et al (2009). Consumption of sweet foods and breast cancer risk: a case-control study of women on Long Island, New York. Cancer Causes Control, 20:1509-15.
65. Garduño-Alanis A, Ángeles-Llerenas A, Sánchez-Zamorano LM, et al (2024). Sugar-sweetened beverages consumption and breast cancer in premenopausal and postmenopausal women. Cancer Epidemiol Biomarkers Prev, 33:325–332.
66. Clemente-Suárez VJ, Mielgo-Ayuso J, Martín-Rodríguez A, et al (2022). The burden of carbohydrates in health and disease. Nutrients, 14(18):3809.
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| Files | ||
| Issue | Vol 54 No 3 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Sugar sweetened beverages Chronic diseases Breast cancer Nutrition Health policy | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Iqbal S, Malik ZI, Farooq U, Abid J, Usman Shah HB, Ahmad AMR. Consumption of Sugar Sweetened Beverages (SSBs) and Breast Cancer: A Narrative Review. Iran J Public Health. 2025;54(3):489-498.
