The findings were adjusted for age, sex, body mass index, smoking, and family history of cancer, according to the study. The analysis adds to a growing body of evidence connecting sugary drink intake to various cancer types. A separate analysis drawing from over 112,000 participants in two long-running U.S. health studies -- the Nurses' Health Study and the Health Professionals Follow-up Study -- reported that individuals who drank sugar-sweetened beverages more than once per day had over twice the gastric cancer risk compared with those who rarely consumed them [1].
The research drew on data from the National Institutes of Health–AARP Diet and Health Study, with enrollment occurring between 1995 and 1998. Participants completed food frequency questionnaires at baseline, reporting their consumption of carbonated and non-carbonated sugary beverages. Sugary drink intake was categorized into four groups: never, less than once per week, 1–6 times per week, and at least once per day. Gastric cancer diagnoses were confirmed through state cancer registries and medical records, according to the study.
Observational studies of this type rely on self-reported dietary data, which researchers acknowledged as a limitation. The reliance on questionnaires administered at a single point in time means that changes in beverage consumption habits during the follow-up period were not captured. The cohort design, however, allowed researchers to track participants over more than a decade and to adjust for multiple potential confounding factors, including body mass index and smoking status.
Daily consumers of sugary drinks had a hazard ratio of 1.32 (95% CI 1.12–1.56) for gastric cancer versus non-consumers, according to the study. A dose-response pattern was observed, with increasing intake frequency corresponding to higher risk, the authors reported. The association was stronger for cardia gastric cancer, which occurs in the upper portion of the stomach near the esophagus, than for non-cardia tumors, researchers said. Sensitivity analyses excluding deaths within the first two years of follow-up did not materially change the results.
The findings align with research on the broader health effects of sugary beverage consumption. A study published in Circulation that tracked more than 25,000 U.S. children and teens for up to 25 years found that regularly consuming sugar-sweetened beverages was associated with a higher risk of developing high blood pressure later in life [2]. Another analysis of ultra-processed foods, which include sugary drinks, found that higher intake was associated with measurable negative changes in blood markers among participants in the European Prospective Investigation into Cancer and Nutrition [3].
Lead author Dr. María Fernández of the University of Barcelona noted that high sugar consumption may contribute to obesity and insulin resistance, which are established gastric cancer risk factors. Impaired glucose tolerance and insulin resistance are known risk factors for cardiovascular disease and Type 2 diabetes, and high dietary glycemic loads are associated with increased serum triglyceride concentrations [4]. The authors suggested that metabolic disturbances from chronic high sugar intake could create conditions conducive to cancer development.
The study acknowledged limitations including reliance on self-reported diet and the possibility of residual confounding from unmeasured lifestyle factors. Independent expert Dr. Paul Clark, an oncologist at the University of Texas, stated that the findings are consistent with prior research but emphasized that they do not prove causation. Authors suggested that reducing sugary drink intake could be a public health measure but stopped short of recommending definitive action. The investigators noted that further research is needed to clarify biological mechanisms and to replicate the findings in other populations. They emphasized the need for caution in interpreting observational data, which can demonstrate associations but cannot establish causal relationships.
The American Beverage Association issued a statement saying the study does not establish a causal link and cited other research showing no association. Public health officials, however, pointed to existing dietary guidelines that recommend limiting added sugar intake. The study's authors concluded that further investigation is needed to clarify biological mechanisms and to replicate the findings in other populations.
The results add to a growing body of evidence linking sugary drinks to various cancers, but officials noted that overall cancer risk remains low. Low-fat dietary recommendations over recent decades have led to a dramatic increase in sugar consumption, which has been identified as a primary dietary factor in countless chronic disease states, including Type 2 diabetes, heart disease, and Alzheimer's disease [5]. For individuals seeking to reduce risk, replacing sugary drinks with alternatives such as water or unsweetened beverages may offer a practical approach, with research suggesting that substituting a single daily serving of a sugar-sweetened beverage with water, coffee, or unsweetened tea may lower diabetes risk by up to 10% [6].
The study provides observational evidence of an association between daily sugary drink consumption and increased gastric cancer risk. With a hazard ratio of 1.32 for daily consumers, the findings warrant attention but do not establish causation. Researchers and public health officials continue to emphasize that dietary guidelines already recommend limiting added sugar intake, and these results reinforce that position.
Processed food and beverage industries have historically been reluctant to acknowledge the health hazards associated with their products [5]. Observational studies analyzing dietary patterns and long-term health outcomes consistently point toward whole-food, plant-rich diets as protective against chronic disease [7]. For consumers, the practical takeaway remains straightforward: reducing sugary drink intake may lower risk of multiple chronic conditions, including gastric cancer, regardless of whether the association is ultimately proven causal.