Abstract 6420: Association between added sugar, glycemic index, glycemic load, soda consumption, and fiber intake with breast cancer risk
Authors: Liliana Gomez-Flores-Ramos, Leticia Palma, Dalia Stern, Marion Brochier, Adrian Cortes-Valencia, Pabel Miranda-Aguirre, Patricia Pérez-Escobedo, Mauricio Hernandez-Avila, Martin Lajous
Journal: Cancer Research (2025)

Abstract Background: Mexico has a high prevalence of dietary patterns rich in added sugars, low in fiber, and with frequent soda consumption. These factors are emerging contributors to chronic diseases, including breast cancer (BC). This study aimed to evaluate the associations of added sugar, glycemic index (GI), glycemic load (GL), soda consumption, and dietary fiber intake with BC incidence in Mexican women from the Mexican Teachers’ Cohort (MTC). Methods: This prospective cohort included 89, 879 women from 12 Mexican states, cancer-free at baseline, with dietary data collected via a validated food frequency questionnaire (2006-2008). Added sugar intake was categorized into four groups (≤26, 27-52, 53-78, ≥79 g/day), fiber intake into four categories (&amp;lt;25, 25-30, 30-35, ≥35 g/day), and soda consumption into five categories (≤0.5, 0.6-1.5, 1.6-2.5, 2.6-4.0, ≥4.1 servings/week). GI and GL were divided into quintiles. Multivariable Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for BC incidence, adjusting for socioeconomic status, reproductive history, physical activity, and dietary covariates. BC cases were identified through medical records and cancer registries until December 2019. Results: Over a median follow-up of 10.9 years, 1, 313 BC cases were identified. Median added sugar intake was 52 g/day (IQR: 36-77). Higher added sugar intake (53-78 g/day) was associated with a 27% increased BC risk (HR=1.27, 95% CI: 1.01-1.59), rising to 39% in premenopausal women (HR=1.39, 95% CI: 0.96-2.02). High GI was associated with increased BC risk in postmenopausal women (third quintile HR=1.57, 95% CI: 1.14-2.16), and high GL was linked to a 41% increased risk in premenopausal women (highest quintile HR=1.41, 95% CI: 1.01-1.96). Soda consumption emerged as a significant contributor to BC risk. Women consuming ≥4 servings/week had a 25% increased BC risk compared to ≤0.5 servings/week (HR=1.25, 95% CI: 1.00-1.56). Soda was the primary source of added sugars in the cohort. Fiber intake showed a protective trend. Compared to &amp;lt;25 g/day, women consuming ≥35 g/day had a 21% reduced BC risk (HR=0.79, 95% CI: 0.63-1.01). Multivariable adjustments consistently supported this association. Conclusions: High added sugar and soda consumption, alongside dietary patterns with high GI and GL, increase BC risk in Mexican women, particularly in premenopausal and postmenopausal subgroups. Increased fiber intake appears protective. Public health strategies should prioritize reducing soda and added sugar consumption and promoting dietary fiber to lower BC incidence in the Mexican population. Citation Format: Liliana Gomez-Flores-Ramos, Leticia Palma, Dalia Stern, Marion Brochier, Adrian Cortes-Valencia, Pabel Miranda-Aguirre, Patricia Pérez-Escobedo, Mauricio Hernandez-Avila, Martin Lajous. Association between added sugar, glycemic index, glycemic load, soda consumption, and fiber intake with breast cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6420.