(P17-083-25) Associations Between Low-Calorie Sweetener Consumption and Risk of Overall and Obesity-Related Cancer in a Cohort of U.S. Adults

Objectives: The role of low-calorie sweeteners (LCSs) in chronic diseases, such as cancer, is inconclusive. Using data from the American Cancer Society’s (ACS) Cancer Prevention Study-II (CPS-II) Nutrition Cohort, we examined the association of LCS-containing (any type) carbonated beverage (LCSB) intake with risk of overall and obesity-related cancer. We also separately examined total aspartame intake from LCSBs and aspartame-containing packets (i.e., NutraSweet or Equal) in relation to cancer risk.

Methods: Among 100,004 adults who provided dietary data in 1999, cancer cases were verified through June 30, 2017. LCSB and aspartame intake over the past year was assessed using a modified Willett FFQ in 1999 and 2003, and intakes were cumulatively updated: pre-2003 intake was based on 1999 FFQ, while 2003-2017 intake was estimated as the mean of 1999 and 2003 FFQs. LCSB intake was categorized in 12-ounce can equivalents as non-consumers, >0-≤ 3 cans/mo, 1-6 cans/wk, and ≥1 can/d. Aspartame intake (mg) was categorized into quartiles among consumers, with non-consumers as the reference group. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: Over a median follow-up of 12.8 years, 21,069 participants developed cancer, including 8,087 obesity-related cancers. At baseline, 70% of participants reported consuming LCSBs, with 10% consuming ≥1 can/d. Adjusted models accounting for sociodemographic and lifestyle factors, including BMI, showed no association between LCSB consumption and overall cancer risk. However, men who consumed ≥1 can/day had 19% higher risk of obesity-related cancers (95% CI 1.00-1.40, p-trend=0.01) compared to non-consumers. The highest category of aspartame intake was associated with 7% higher risk of any cancer (95% CI 1.02-1.12, p-trend=0.02) in men and women combined and 19% higher risk of obesity-related cancers (95% CI 1.02-1.39, p-trend=0.01) among men only.

Conclusions: High aspartame intake was positively linked to cancer risk among U.S. men and women. Among men, high intake of both aspartame and LCSBs were associated with higher obesity-related cancer risk.

Funding Sources: The ACS funds the creation, maintenance, and updating of the CPS-II cohort. Support for this project was funded by the ACS.