Do you opt for no-sugar or zero-sugar beverages instead of regular ones? Well, you are not alone. Most people assume that zero sugar means no trouble for their health, especially the liver.
A major new study examined the impact of artificially sweetened and sugary drinks on the liver. The study was presented at the UEG Week 2025 earlier this week.
How do artificially sweetened and low or no-sugar beverages affect the liver?
Liver diseases are on the rise. Non-alcoholic fatty liver disease, now known as metabolic dysfunction-associated steatotic liver disease (MASLD), is a major contributor. This disease is becoming increasingly common in young people, and lifestyle factors, including diet, play a crucial role.
The recent study found that both artificially sweetened and sugary drinks are associated with an increased risk of liver disease. The research showed that sugar-sweetened beverages (SSBs) and low- or non-sugar-sweetened beverages (LNSSBs) are significantly associated with a higher risk of developing metabolic dysfunction-associated steatotic liver disease.
What is MASLD
Formerly known as non-alcoholic fatty liver disease (NAFLD), this is a condition where fat accumulates in the liver. This, over time, can cause inflammation (hepatitis) and symptoms such as pain, fatigue, and loss of appetite. The disease has emerged as a global health burden since being recognised as the most common chronic liver disease, with experts estimating that it affects over 30% of people worldwide and is a rapidly increasing cause of liver-related deaths.
The study
To understand the effects of artificially sweetened and low or no-sugar drinks on the liver, the researchers followed 123,788 people from the UK Biobank without liver disease at baseline. Their beverage consumption was assessed using repeated 24-hour dietary questionnaires. The researchers then examined the associations between SSB and LNSSB intake and the risks of developing MASLD, liver fat accumulation, and liver-related mortality.
They found that a higher intake of both LNSSBs and SSBs (>250g per day) was associated with a 60% (HR: 1.599) and 50% (HR: 1.469) elevated risk of developing MASLD, respectively.
After a median 10.3-year follow-up, they found that 1,178 participants developed MASLD and 108 died from liver-related causes. They also found something that’s more striking. There was no significant association for SSBs, however, LNSSB consumption was additionally linked to a higher risk of liver-related mortality. Both beverage types were also positively associated with higher liver fat content.
What are the experts saying?
“SSBs have long been under scrutiny, while their ‘diet’ alternatives are often seen as the healthier choice. Both, however, are widely consumed and their effects on liver health have not been well understood,” lead author of the study, Lihe Liu, said in a statement.
“Our study shows that LNSSBs were actually linked to a higher risk of MASLD, even at modest intake levels such as a single can per day. These findings challenge the common perception that these drinks are harmless and highlight the need to reconsider their role in diet and liver health, especially as MASLD emerges as a global health concern,” Liu added.
Liu also emphasized that the potential biological mechanisms that may underlie the observed risks, “The higher sugar content in SSBs can cause rapid spikes in blood glucose and insulin, promote weight gain and increase uric acid levels, all of which contribute to liver fat accumulation. LNSSBs, on the other hand, may affect liver health by altering the gut microbiome, disrupting the feeling of fullness, driving sweet cravings and even stimulating insulin secretion.”
The researchers added that replacing either beverage with water significantly reduced MASLD risk - by 12.8% for SSBs and 15.2% for LNSSBs, while substitution between the two types of beverages offered no risk reduction.
“The safest approach is to limit both sugar-sweetened and artificially sweetened drinks. Water remains the best choice as it removes the metabolic burden and prevents fat accumulation in the liver, whilst hydrating the body,” Liu added.
A major new study examined the impact of artificially sweetened and sugary drinks on the liver. The study was presented at the UEG Week 2025 earlier this week.
How do artificially sweetened and low or no-sugar beverages affect the liver?
Liver diseases are on the rise. Non-alcoholic fatty liver disease, now known as metabolic dysfunction-associated steatotic liver disease (MASLD), is a major contributor. This disease is becoming increasingly common in young people, and lifestyle factors, including diet, play a crucial role.
The recent study found that both artificially sweetened and sugary drinks are associated with an increased risk of liver disease. The research showed that sugar-sweetened beverages (SSBs) and low- or non-sugar-sweetened beverages (LNSSBs) are significantly associated with a higher risk of developing metabolic dysfunction-associated steatotic liver disease.
What is MASLD
Formerly known as non-alcoholic fatty liver disease (NAFLD), this is a condition where fat accumulates in the liver. This, over time, can cause inflammation (hepatitis) and symptoms such as pain, fatigue, and loss of appetite. The disease has emerged as a global health burden since being recognised as the most common chronic liver disease, with experts estimating that it affects over 30% of people worldwide and is a rapidly increasing cause of liver-related deaths.
The study
To understand the effects of artificially sweetened and low or no-sugar drinks on the liver, the researchers followed 123,788 people from the UK Biobank without liver disease at baseline. Their beverage consumption was assessed using repeated 24-hour dietary questionnaires. The researchers then examined the associations between SSB and LNSSB intake and the risks of developing MASLD, liver fat accumulation, and liver-related mortality.
They found that a higher intake of both LNSSBs and SSBs (>250g per day) was associated with a 60% (HR: 1.599) and 50% (HR: 1.469) elevated risk of developing MASLD, respectively.
After a median 10.3-year follow-up, they found that 1,178 participants developed MASLD and 108 died from liver-related causes. They also found something that’s more striking. There was no significant association for SSBs, however, LNSSB consumption was additionally linked to a higher risk of liver-related mortality. Both beverage types were also positively associated with higher liver fat content.
What are the experts saying?
“SSBs have long been under scrutiny, while their ‘diet’ alternatives are often seen as the healthier choice. Both, however, are widely consumed and their effects on liver health have not been well understood,” lead author of the study, Lihe Liu, said in a statement.
“Our study shows that LNSSBs were actually linked to a higher risk of MASLD, even at modest intake levels such as a single can per day. These findings challenge the common perception that these drinks are harmless and highlight the need to reconsider their role in diet and liver health, especially as MASLD emerges as a global health concern,” Liu added.
Liu also emphasized that the potential biological mechanisms that may underlie the observed risks, “The higher sugar content in SSBs can cause rapid spikes in blood glucose and insulin, promote weight gain and increase uric acid levels, all of which contribute to liver fat accumulation. LNSSBs, on the other hand, may affect liver health by altering the gut microbiome, disrupting the feeling of fullness, driving sweet cravings and even stimulating insulin secretion.”
The researchers added that replacing either beverage with water significantly reduced MASLD risk - by 12.8% for SSBs and 15.2% for LNSSBs, while substitution between the two types of beverages offered no risk reduction.
“The safest approach is to limit both sugar-sweetened and artificially sweetened drinks. Water remains the best choice as it removes the metabolic burden and prevents fat accumulation in the liver, whilst hydrating the body,” Liu added.
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