It seems as though every day another product is linked to a higher risk of cancer. Growing evidence suggests deli meats, alcohol, sugar-sweetened beverages and ultra-processed snacks may contribute to colorectal cancer.
In recent months, people have become increasingly concerned that canned sparkling water could increase your risk, too. On Instagram and TikTok, influencers claim the beverages, which are often marketed as a healthy alternative to soda, contain undisclosed chemicals and high levels of forever chemicals that cause cancer.
HuffPost reached out to two colorectal cancer specialists and asked them for their take on the sparkling water debate. Here’s what they said:
How exactly could sparkling water be linked to colorectal cancer?
The concern about sparkling water and cancer is not about the carbonated drink itself but the containers they are typically packaged in. Many cans are coated with protective linings or are exposed to contaminants — including per- and polyfluoroalkyl substances (PFAS), or forever chemicals — during the manufacturing and packaging processes. Other packaging includes plastic bottles, which are also more heavily linked to PFAS.
“They are often referred to as ‘forever chemicals’ because they persist in the environment and accumulate in the human body,” said Dr. Maen Abdelrahim, section chief of Gastrointestinal Medical Oncology at Houston Methodist.
Research has linked PFAS to a higher risk of several types of cancer, including kidney and testicular cancer, along with impaired immunity, liver damage, infertility, and thyroid disease.
Some studies have found PFAS in popular sparkling water brands, but the levels often fall well below the current federal advisory limits, according to Dr. Steven Lee-Kong, division chief of colorectal surgery at Hackensack Meridian Health’s Hackensack University Medical Center.
According to Abdelrahim, the amount, or dosage, of PFAS is key, and the amount leached from beverage cans specifically is far below those shown to cause cancer is experimental studies.
That said, even low levels do not necessarily guarantee the drinks are safe. “The science is evolving, and some health organizations argue that even very low levels of exposure could pose a risk,” Lee-Kong said.
How might PFAS exposure, in general, lead to cancer?
Abdelrahim said PFAS can “act as endocrine disruptors, promote oxidative stress, alter gene expression, or interfere with DNA repair, which in theory, could contribute to carcinogenesis over long-term exposure.”
In addition, evidence suggests PFAS may disrupt the intestinal barrier. Over time, these disruptions can cause gut inflammation, damage to the intestinal lining and changes to the gut microbiome ― the community of microorganisms that live within the intestines, Lee-Kong explained.
There is a well-established link between chronic inflammation and colorectal cancer. And some PFAS may alter intestinal cells in a way that may promote tumor growth.
“While research is ongoing and some findings are inconsistent, the potential for PFAS to promote gut inflammation and cellular changes is the primary mechanism of concern for colorectal cancer risk,” Lee-Kong said.
So, should you be concerned sparkling water could increase your risk of colorectal cancer?
The truth: It’s unclear as the science is still in its infancy. Abdelrahim noted there’s currently no direct evidence concluding that canned sparkling water or seltzer can give you colon cancer.
“Based on current evidence, canned sparkling water is not considered a significant source of PFAS exposure,” he explained.
More long-term studies are needed to better understand the relationship between canned beverages and cancer risk. Until then, it’s best to be a mindful consumer, according to Lee-Kong. His advice? Drink sparkling water in moderation, and diversify your beverage choices.
In general, the safest and most effective way to stay hydrated is through water that’s ideally been filtered. “When you do choose canned beverages, do so as part of a balanced and varied diet,” Lee-Kong said.
Other than that, Abdelrahim recommended focusing on the well-established modifiable colorectal cancer risk factors. This includes “maintaining a healthy weight, limiting processed and red meat, avoiding tobacco, moderating alcohol, staying physically active, and following age-appropriate screening guidelines,” he said.
Finally, know that regulatory organizations, such as the U.S. Environmental Protection Agency (EPA), should be taking this issue seriously and are continuously investigating the risk.
“Staying informed through reliable sources like the EPA and being mindful of your consumption habits are practical steps everyone can take for their long-term health,” Lee-Kong said.
This article originally appeared on HuffPost.
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