Mary Gleason Mills

Sugar-sweetened beverage (SSB) consumption is linked to increased metabolic syndrome (MetS) and breast cancer risk. This cross-sectional study examined associations between SSB intake and MetS by family history of breast cancer among postmenopausal Black women with obesity. Baseline data of 210 participants from the Focused Intervention on Exercise to Reduce CancEr (FIERCE) clinical trial were used. SSB intake was assessed with the Block 2005 Food Frequency Questionnaire, and family history of breast cancer was collected via a self-report questionnaire. Women with a family history of breast cancer who had high (vs. low) SSB intake had higher triglycerides (29.69 mg/dL higher, P = 0.011), lower high-density lipoprotein cholesterol (7.94 mg/dL lower, P = 0.027), and a higher MetS z-score (1.89 U higher, P < 0.001). Adjusting for relevant covariates, greater SSB intake predicted a higher MetS z-score (b = 0.01, Pinteraction = 0.031) and fasting glucose (b = 0.02, Pinteraction = 0.013) compared with lower SSB intake, only in women with a family history of breast cancer. Greater consumption of SSB subtypes (sugary juices, iced tea, and others) were associated with higher triglycerides, fasting glucose, and/or MetS z-score compared with lower consumption, only in women with a family history of breast cancer (Pinteractions < 0.05). Higher SSB consumption is linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer. Targeted multilevel interventions to reduce SSB consumption and improve metabolic health in this population are warranted.Significance:Higher SSB consumption was linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer, but not in women without this family history. Findings highlight important heterogeneity in metabolic vulnerability and the need for culturally informed multilevel interventions, such as those targeting healthcare providers and individual decision making, to reduce SSB intake in vulnerable populations with a family history of breast cancer.

Prevalence of any daily SSB intake, stratified by family history of breast cancer, in the FIERCE study population of postmenopausal Black women.

Baseline characteristics by family history of breast cancer in the FIERCE study population of postmenopausal Black women.

Interaction between total energy-adjusted SSB intake and family history of breast cancer on MetS z-score in the FIERCE study population of postmenopausal Black women. Total energy-adjusted SSB intake was standardized using the following formula: (average daily intake of SSB in grams/average total daily food energy intake in kilocalories) × 1,000. The model was adjusted for age, smoking status, income, and dietary factors (alcohol, red meat, and saturated fat intake).

Participant flow diagram for the FIERCE trial and present study analytic sample.

Multivariable-adjusted associations of SSB intake and SSB subtypes with continuous MetS outcomes by family history of breast cancer in the FIERCE study population of postmenopausal Black women.

Differences in MetS z-score and continuous MetS components by high vs. low SSB intake, stratified by family history of breast cancer in the FIERCE study population of postmenopausal Black women.

Sugar-sweetened beverage (SSB) consumption is linked to increased metabolic syndrome (MetS) and breast cancer risk. This cross-sectional study examined associations between SSB intake and MetS by family history of breast cancer among postmenopausal Black women with obesity. Baseline data of 210 participants from the Focused Intervention on Exercise to Reduce CancEr (FIERCE) clinical trial were used. SSB intake was assessed with the Block 2005 Food Frequency Questionnaire, and family history of breast cancer was collected via a self-report questionnaire. Women with a family history of breast cancer who had high (vs. low) SSB intake had higher triglycerides (29.69 mg/dL higher, P = 0.011), lower high-density lipoprotein cholesterol (7.94 mg/dL lower, P = 0.027), and a higher MetS z-score (1.89 U higher, P < 0.001). Adjusting for relevant covariates, greater SSB intake predicted a higher MetS z-score (b = 0.01, Pinteraction = 0.031) and fasting glucose (b = 0.02, Pinteraction = 0.013) compared with lower SSB intake, only in women with a family history of breast cancer. Greater consumption of SSB subtypes (sugary juices, iced tea, and others) were associated with higher triglycerides, fasting glucose, and/or MetS z-score compared with lower consumption, only in women with a family history of breast cancer (Pinteractions < 0.05). Higher SSB consumption is linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer. Targeted multilevel interventions to reduce SSB consumption and improve metabolic health in this population are warranted. Significance: Higher SSB consumption was linked to higher fasting glucose, triglycerides, and overall MetS risk in postmenopausal Black women with a family history of breast cancer, but not in women without this family history. Findings highlight important heterogeneity in metabolic vulnerability and the need for culturally informed multilevel interventions, such as those targeting healthcare providers and individual decision making, to reduce SSB intake in vulnerable populations with a family history of breast cancer.