
Sugary drinks and cancer risk: results from NutriNet-Santé prospective cohort - bookofjoe
https://www.bmj.com/content/366/bmj.l2408
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Someone1234
Soda is poison. It might sound dramatic, but I think we'll come to see it as
similar to smoking or heavy alcohol drinking (assuming we aren't there
already).

I've been trying to quit for years. I'll likely get mocked, but it is quite
addictive once you're hooked (particularly as it makes you tired, which makes
you want to drink more to feel "normal").

I'm trying to move to sweetened Iced Tea (40% less sugar) and eventually
unsweetened Iced Tea/water. But getting used to less caffeine/sugar actually
causes legitimate withdrawal, plus kicking a habit is always tricky.

It has been linked to cancer (stomach, throat, mouth, the whole digestive
system), diabetes, heart disease, and beyond.

~~~
docker_up
Soda is addictive. At my worst, I drank 6 Cokes a day. I've been a heavy Coke
drinker for a long, long time. I have a psychological dependence on it, so
when I'm particularly stressed, I need to guzzle it down.

I'm down to about 1-2 Cokes every week. I will crumble and drink a 20 oz Coke
about once a week and drink water or ice tea (either unsweetened or low-
sweetened (90 calories)).

The irony is that an equivalent glass of milk has 2x the number of calories as
Coke, but I'll drink a glass of milk a day for the calcium, etc.

~~~
Someone1234
Congrats on the impressive progress.

How did you get started/what steps did you take? Was it a straight switch to
water (with occasional back-slide), or did you just slowly progress away from
the soda one drink at a time?

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docker_up
Thanks but it's far from impressive. It's been years. I've gone back and forth
and did no-carb a few times (lost 30 lbs once and then fell off the wagon)
which helped me break the habit. But then someone stressful would occur and I
was back to 1-2 Cokes a day for a while.

Finally I scared myself enough that sugar drinks cause pancreatic cancer (no
evidence but I'm still scared) and high fructose corn syrup causes fatty liver
disease, which I actually do have, which in turn can lead to cirrhosis and/or
liver cancer.

From that I basically scared myself straight. I started drinking a lot of
unsweetened tea actually, and then substituted a little sweet tea for Coke.
Eventually I've just broken the habit of drinking Coke every day and drinking
tea instead and these days a lot of water as well.

~~~
Jnr
Since I don't drink tea or coffee (I dislike warm drinks, especially in
summer) I was left with soft drinks, juices or plain water. And since most
places don't offer tasty water and each place has different juices I went with
soft drinks - Cola is universal!

You could say that I used a lot of it but then one day I decided to see if I
would be able to quit and so I just did it. It wasn't hard at all and it did
not change the way I feel. I started drinking mostly water instead (it is
still hard to get tasty water so I ask for a slice of lemon in it whenever it
is available). Now I sometimes go for freshly squeezed juice and from time to
time I drink some soft drinks but I do not depend on them like I did before.

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illnewsthat
Does anyone know the answer to this question?

If I am going to drink a soda, which soda am I better off drinking? Coke or
Diet Coke/Coke Zero?

I know that neither option is _good_ for me, but which would be comparatively
better or is the science still out on that?

~~~
cardine
This study seems to very clearly indicate Diet Coke/Coke Zero is much
healthier than Coke.

There are tons of studies like this that concretely show how bad sugar is for
you, while most studies show that artificial sweeteners have no (or minimal
relative to sugar) adverse health effects.

~~~
asveikau
Some years back there were press articles citing studies (of course you can't
believe what you see in the headlines) that claimed artificial sweeteners
don't have the same affect on satiety as real sugar, causing you to eat more.

That matches my one-person anecdotal observations, but perhaps that isn't much
to go by. Find what works for you. I had much better luck with health and
personal fitness by that vs. getting overly worried about what other people
say works.

~~~
djsumdog
This doesn't invalid that hypothesis. A lot of people drink a mix of both.
Artificial sweeteners can confuse your brain/hormone systems and you may
consume more other calories (studies show this in mice).

We are more aware than mice though. Sugar is really bad for you .. really bad.
Read up on keto diets (staying under 30g or sometimes under 10g of carbs per
day .. limiting carb consumption to fruits with high fiber when you do eat
them). I had a good friend who got on Ketro while he had cancer .. didn't tell
his doctor, but within a few week a tumor shrunk by nearly a cm .. enough they
could now operate.

Sugar is a powerful fuel source and modern humans don't need very much of it
at all. The findings of this study don't really surprise me. All that extra
unneeded sugar can totally feed young cancer cells.

~~~
asveikau
> Read up on keto diets

I politely decline. In 2017 and 2018 I lost 100 lbs in 18 months and the
primary staple of my diet was pasta dishes. The low-carb thing is not for me.

Like I said, find what works for you and ignore what people say is supposed to
work. Today it is quite trendy to demonize carbs, tomorrow it may be something
else, meanwhile plenty of healthy people eat lots of demonized items, but a
narrow focus and overemphasis on good/bad may cause you to lose the big
picture.

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umvi
Now that's surprising.

I would have guessed artificial sweeteners would have had more cancerous
effects than "natural" sugars, but I guess that's just a logical fallicy where
I assume lab synthesized chemicals are automatically worse for your body than
plant synthesized chemicals.

~~~
QuickToBan
Artificially sweetened drinks are extremely bad. Refer to
[https://www.ncbi.nlm.nih.gov/pubmed/30802187](https://www.ncbi.nlm.nih.gov/pubmed/30802187)

~~~
w0utert
I quickly scanned the study you linked and its conclusions, but it doesn't
seem to draw any reliable conclusions at all. It specifically mentions the
results need to be reproduced, are purely observational, depended on self-
reported intake quantities, and did not correct for possible factors that
correlate with intake of artificial sweeteners (such as obesity). Last but not
least the test group was purely women in a relatively narrow age range above
50.

I always get somewhat triggered by people claiming artificial sweeteners are
provably bad, because so far I have not seen a single study that conclusively
claims this without a long list of reservations. All while the health effects
of artificial sweeteners are one of the most researched topics in nutritional
science.

I don't have a stake in this game at all (I rarely eat/drink things that have
artificial sweeteners, or actual sugar, for that matter), but the fact that
after decades of research there still is no smoking gun tells me the supposed
adverse health effects of artificial sweeteners are way overblown.

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apo
For those who think this study says "all clear" for artificial sweeteners:

> Null results observed in this study regarding the association between
> artificially sweetened beverages and the risk of cancer does not support the
> hypothesis of an adverse effect of artificial sweeteners. However, caution
> is needed in interpreting this finding because statistical power might have
> been limited to investigate this association owing to the relatively low
> level of consumption in this population study (median=6.9 mL/d). Some
> experimental studies suggest a possible carcinogenic effect for some
> artificial sweeteners, but this point is debated.767778 In order to evaluate
> accurately these associations in humans, it will be necessary to distinguish
> the different types of artificial sweeteners (eg, aspartame, sucralose,
> acesulfam K), and also to take into account all dietary sources for these
> additives (eg, yogurts, candies) and not only artificially sweetened
> beverages.

It should be pointed out that the label "artificial sweetener" encompasses a
wide variety of chemical entities, each of which can be expected to have its
own risk profile.

For comparison:

> Median daily consumption of sugary drinks was greater in men than in women
> (90.3 mL v 74.6 mL, respectively; P<0.001, not tabulated).

And later (although the numbers seem to have been reversed):

> However, the median consumption of sugary drinks was lower in menopausal
> (88.2 mL/d) compared with premenopausal (43.2 mL/d) women.

So, the median volume of consumption was about 10:1 favoring sugar in this
study.

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stochastimus
This is the kind of study you would have thought would have been done decades
ago. Super relevant. I wonder why it’s taken so long.

~~~
manmal
Obviosuly nobody with the necessary money was interested in funding such a
study.

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blakesterz
Interesting results... so sugary drinks AND 100% fruit juices are associated
with an increase in cancer risks. I guess I'm not surprised at all about the
sugary drinks, but fruit juices... maybe.

Artificially sweetened beverages showed no increase.

I guess now we watch for headlines like "Soda Causes Cancer" which is not what
this really says.

~~~
bgentry
Fruit juice and soda are effectively the same to your body. They’re both high-
fructose liquids which spike blood sugar and lead to insulin resistance. The
only meaningful difference is that a fruit juice probably also includes some
vitamins that the soda doesn’t.

Sources: anything published by Dr. Robert Lustig @ UCSF

~~~
ZeroFries
Most fruit juices have a GI of ~50, which is moderate (about the same as a
sweet potato). They don't really spike blood-sugar. Fructose is low-GI. They
also contain other phytonutrients and flavenoids which may aid health in
appropriate doses (e.g. hesperetin and naringenin in citrus juices).

~~~
maxharris
Fructose interferes with satiety, mediated by leptin, ghrelin, etc.

This is well-documented in the literature. High-fructose, low-fiber diets make
people overeat.

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AstralStorm
Eat sugar (glucose), get glycation endproducts impairing immune system,
ultimately increase cancer risk and age yourself.

I'd like to see if this is the exact mechanism or there's still more. Perhaps
oxidative damage? I suppose they controlled for weight and fat percentage
right?

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salex89
I don't understand, maybe due to a language difference. Does 100% fruit juice
mean the store bought 100% fruit guice (the premium brands?) or literally
freshly squeezed orange, immediately drank? Wouldn't also eating fresh fruits
be linked?

~~~
mehrdadn
Out of curiosity what do you see as the difference? Is it just how long the
juice sat there? Or are you suggesting they add something to (not-from-
concentrate) "100% fruit juice" that isn't listed in the ingredients?

~~~
salex89
I'm no food technologist but squeeze an orange and put it in a glass, which is
pure orange guice (100%?) and leave it on a table, and do the same with the
100% store bought one. The one from a bottle or cardboard box, not the
"squeezed today" ones which are refrigerated. There will certainly be a
difference, the freshly squeezed one will be stale, possibly ransid within a
day. The bought one, not so sure... So there is obviously "something" else.
Either preservative or some process done to the fruite.

Not to mention the taste.

~~~
mehrdadn
Have you actually tried this? What did you find? Because I actually conducted
something very similar to this experiment with someone else once, because they
said the same thing as you just did and I was skeptical. We left the one we
squeezed in the fridge for several days (I want to say almost a week, but it's
been a few years so I don't remember exactly) and it was fine when we drank it
after. We did cover the whole glass to avoid constant air exchange etc. (I
didn't try doing it without that) but it was a fairly decent debunking as far
as I was concerned.

~~~
salex89
Not intentionally, but generally yes, just by forgetting a glass. However, it
also has not happened recently, I don't drink any kind of bought juice any
more. I squeeze it myself.

~~~
mehrdadn
Well next time you squeeze one, try this yourself intentionally. Fill a glass
with orange juice, put some plastic wrap tightly over it, leave it in the
fridge for a week (or however long you think is the average selling period for
your local store), then try drinking it and seeing if it tastes rancid like
you expect. Then ask yourself honestly if what you observed is significant
support for the notion that the store-bought ones have preservatives or
something.

~~~
krageon
I have done this repeatedly over the last few years (I drank a lot of freshly
squeezed orange juice for a while and squeezed it in bulk) and I can therefore
say with certainty that orange juice that is fresh will start tasting weird
after 1-2 days in the fridge (kind of tingly, like it's fermented). This
doesn't happen with fruit juice of any kind from a carton, to say nothing of
the fact that orange juice from a carton is fairly disgusting.

~~~
mehrdadn
How much air contact do you let your squeezed juice have while it's in the
fridge? Also, what do the labels on your carton say? (Like ingredients, "from
concentrate", "pasteurized", anything else potentially relevant?)

~~~
krageon
I've tried pasteurized and from concentrate. It should surprise nobody that
those don't really grow things, but then I store both types in whatever carton
they come in or that I decant them into (I had bottles for the squeezed orange
juice). I kept neither completely open in the fridge, as that makes everything
smell like orange juice and the orange juice itself taste like fridge.

~~~
mehrdadn
If your question is merely why yours only lasts a couple days when mine lasted
a week, it might've just been due to a difference in air contact or something,
since in my case I think I pretty much filled a glass to the brim, put plastic
wrap over it, and left it like that in the fridge for a week. I think my goal
in that particular experiment was just to show orange juice doesn't inherently
need special treatment to last that long.

But I thought the whole debate here is whether they're doing something to
commercial juice that's different from what you get when you squeeze your own.
In which case... shouldn't you be comparing home-squeezed vs. the store-bought
ones that are _not_ pasteurized or from concentrate? The ones that are
claiming they're absolutely nothing but just squeezed orange juice? If the
label already says it's been treated differently then there's nothing to
investigate...

~~~
krageon
I will readily admit that I don't believe such a juice exists in any shops
close to me. Anything that claims to be fresh is from concentrate, pasteurized
or barely the juice that it claims to be (eg 90% apple juice, 7% the juice
that you want, 3% unaccounted for).

~~~
mehrdadn
Ah I see. It depends on where/which country you are I guess. As a couple
examples, if you're somewhere with a Target, Simply Orange [1] claims to be
pasteurized, whereas Tropicana does not [2], and neither is from concentrate.
Although it's possible they both are pasteurized and the labeling isn't
required... I don't know if it is.

However, if your next-best option is pasteurized juice, that sounds... just
fine, if not even better? I mean I hope you're not finding pasteurization a
horrifying Big Ag conspiracy of some sort. And pasteurization seems like a
pretty plausible explanation of the difference you see compared to what you
squeeze yourself... so then what's the huge worry?

[1] [https://www.target.com/p/simply-orange-pulp-free-
juice-52-fl...](https://www.target.com/p/simply-orange-pulp-free-juice-52-fl-
oz/-/A-13183052)

[2] [https://www.target.com/p/tropicana-pure-premium-no-pulp-
oran...](https://www.target.com/p/tropicana-pure-premium-no-pulp-orange-
juice-52-fl-oz/-/A-13587184)

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azhenley
Does it ever say how much the participants were drinking?

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galkk
When I've been in Bangalore, I was surprised that there's no sugar-free sodas
at all.

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pkaye
So people who drink coffee are doubly impacted due to the acrylamide and the
sugar.

~~~
QuickToBan
Not quite. They're supposed to be drinking coffee without sugar.

~~~
pkaye
But the acrylamide in coffee is a cancer risk also.

~~~
QuickToBan
There is no evidence that the content of acrylamide in coffee is concerning.
Nevertheless I agree that acrylamide is a general concern, and its levels in
foods and drinks including coffee needs to be regulated better.

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purplezooey
I switched to Galliano and Diet Dr. Pepper and never looked back.

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sleepysysadmin
Sorry

Warburg Effect on wikipedia if anyone is curious.

~~~
DrAwdeOccarim
[citations needed]

