Up to 60% Increased Risk of Liver Disease
Recent research has shed light on the potential health risks associated with popular beverages, revealing that both sugary and diet sodas may significantly elevate the chances of developing a common liver condition. A new study presented at the United European Gastroenterology (UEG) Week in Berlin indicates that consuming just one can (approximately 330 mL) of diet soda daily could increase the risk of metabolic dysfunction-associated steatotic liver disease (MASLD) by up to 60%, while the same amount of sugary soda raises it by 50%. This challenges the notion that diet alternatives are always a safer choice, prompting experts to urge a reevaluation of daily drinking habits.
The findings, based on a large-scale analysis of over 123,000 participants, highlight how even modest intake levels of these drinks can contribute to liver fat accumulation over time. Lead author Lihe Liu, a graduate student in gastroenterology at the First Affiliated Hospital of Soochow University in Suzhou, China, emphasized that low- or non-sugar-sweetened beverages (LNSSBs), often marketed as healthier, were actually associated with a higher risk than their sugary counterparts in some cases. This unpublished study, which tracked participants for an average of 10.2 years, also found that frequent consumers of LNSSBs faced a 44% overall increased risk of MASLD, while sugar-sweetened beverages (SSBs) were linked to a 34% rise. Additionally, diet beverage consumption was tied to a higher likelihood of mortality from liver disease.
Understanding MASLD: What Is This Liver Condition?
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a condition where excess fat builds up in the liver cells of individuals who consume little to no alcohol. This fat accumulation can lead to inflammation, scarring (fibrosis), and in severe cases, progress to cirrhosis—a stage of advanced liver damage—or even liver cancer. The liver plays a crucial role in metabolism, detoxification, and nutrient processing, so any impairment can have widespread health effects, including increased risks for type 2 diabetes, heart disease, and metabolic syndrome.
MASLD is often asymptomatic in its early stages, but symptoms may include fatigue, abdominal discomfort, or elevated liver enzymes detected through blood tests. Diagnosis typically involves imaging like ultrasounds, blood work, or biopsies. The condition is reversible if caught early, primarily through lifestyle changes.
Prevalence and Rising Concerns
MASLD has become a global health epidemic, affecting an estimated 25-33% of the world’s adult population. In the United States, prevalence has surged by about 50% over the past three decades, now impacting around 38% of adults—roughly 100 million people. It’s the leading cause of chronic liver disease and a major contributor to liver cancer worldwide. Factors like obesity, poor diet, and sedentary lifestyles drive this increase, with projections suggesting it could become the primary reason for liver transplants in the coming years.
The Study: Key Findings and Methodology
The research utilized data from the UK Biobank, a long-term biomedical database tracking health outcomes in the United Kingdom. Researchers followed 123,139 participants without pre-existing liver disease for over a decade, assessing beverage consumption via repeated 24-hour dietary questionnaires. During this period, 4,388 individuals developed MASLD, confirmed through validated diagnostic tests.
| Beverage Type | Overall Risk Increase | Risk at 1 Can/Day | Substitution Benefit with Water |
|---|---|---|---|
| Sugary Beverages (SSBs) | 34% | 50% | 13-14.5% risk reduction |
| Diet Beverages (LNSSBs) | 44% | 60% | 13.4-15% risk reduction |
Switching from sugary to diet drinks (or vice versa) offered no protective effect, underscoring that neither is a harmless alternative. However, replacing either with water significantly lowered risks, positioning water as the optimal choice for liver health. Sajid Jalil, a clinical associate professor of gastroenterology and hepatology at Stanford University School of Medicine (not involved in the study), praised its prospective design, large sample size, and long follow-up, noting it provides stronger evidence than prior analyses.
Discussions on platforms like X (formerly Twitter) echo these concerns, with users sharing older studies showing sugary sodas double liver fat even without weight gain.
Why Do These Drinks Harm the Liver?
Sugary beverages contribute to liver issues through high fructose content, which causes rapid blood sugar and insulin spikes, promoting weight gain and direct fat storage in the liver. Diet drinks, despite being low-calorie, may disrupt liver health via artificial sweeteners like aspartame and sucralose. These can alter the gut microbiome, reduce feelings of fullness, heighten sweet cravings, stimulate insulin release, and interfere with liver detoxification processes. Studies suggest they may even promote liver fibrosis and, in animal models, increase cancer risk.
Supporting research, such as a 2023 NHANES analysis, found excessive diet soft drink intake linked to MASLD, partly mediated by body mass index (BMI). Randomized trials have shown that daily sugary soda consumption for months can increase liver fat by 10-140%, independent of overall calorie intake.
Prevention and Lifestyle Recommendations
Preventing MASLD focuses on addressing root causes like obesity and poor diet. Key strategies include:
- Weight Management: Losing 5-10% of body weight can reduce liver fat significantly.
- Dietary Changes: Emphasize whole foods, fruits, vegetables, lean proteins, and healthy fats. Avoid processed sugars and limit sweetened beverages.
- Exercise: Aim for 150 minutes of moderate activity weekly to improve insulin sensitivity.
- Beverage Choices: Opt for water, unsweetened tea, or coffee. The study shows substituting sweetened drinks with water cuts risk by 13-15%.
- Monitoring: Regular check-ups for at-risk individuals (e.g., those with obesity or diabetes) via liver function tests.
Broader lifestyle factors, such as reducing unhealthy habits like sedentary behavior, also play a role.
This study and supporting evidence underscore the need to rethink sweetened beverages’ role in daily diets. As MASLD continues to rise globally, simple swaps like choosing water could make a substantial difference in protecting liver health. Consult a healthcare provider for personalized advice, especially if you have risk factors.