Diet Drinks Linked to Increased Risk of Liver Disease

A recent large-scale study presented at UEG Week 2025 has revealed concerning associations between both sugary and low-calorie beverages and the risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD). The research analyzed data from 123,788 participants in the UK Biobank who reported their beverage intake through multiple 24-hour dietary questionnaires. The findings indicate that individuals consuming more than 250 grams of either sugary drinks (sugar-sweetened beverages, SSBs) or low- or non-sugar-sweetened beverages (LNSSBs) daily faced significantly higher risks of MASLD—60% for LNSSBs and 50% for SSBs—over a median follow-up period of 10.3 years.

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MASLD, previously known as non-alcoholic fatty liver disease (NAFLD), is characterized by excess fat accumulation in the liver, which can lead to inflammation and various symptoms, including fatigue and abdominal pain. The condition has emerged as a major public health issue, affecting over 30% of the global population and becoming a leading cause of liver-related deaths. Lead author Lihe Liu emphasized that both SSBs and LNSSBs have been widely consumed without a clear understanding of their effects on liver health.

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The study suggests potential biological mechanisms for the observed risks. Liu noted that the high sugar content in SSBs can lead to spikes in blood glucose and insulin levels, promoting weight gain and liver fat accumulation. Conversely, LNSSBs may disrupt gut microbiome balance, alter feelings of fullness, and stimulate insulin secretion, contributing to liver health deterioration.

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The researchers advocate for limiting both SSBs and LNSSBs as part of a comprehensive strategy to prevent liver disease and promote overall metabolic health. They found that replacing these beverages with water significantly reduced the risk of MASLD—by 12.8% for SSBs and 15.2% for LNSSBs. Liu stated, “The safest approach is to limit both sugar-sweetened and artificially sweetened drinks. Water remains the best choice.”

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Critics of soda consumption have long highlighted the health risks associated with both sugary and diet sodas. Studies have linked regular consumption of sugary beverages to increased risks of chronic diseases, including type 2 diabetes and heart disease. Additionally, diet sodas have been associated with insulin resistance and potential negative impacts on gut health. The findings of the recent study further challenge the perception that diet sodas are a safe alternative to sugary drinks.

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While the study presents compelling evidence linking both types of beverages to liver disease, some sources suggest that the risks associated with diet sodas may not be as pronounced as those for sugary sodas. Further research is needed to clarify these discrepancies and explore the causal mechanisms involved.

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• “ “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.” — Lihe Liu, Lead Author

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• “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.” — Lihe Liu, Lead Author

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The study underscores the importance of reevaluating beverage choices and their implications for liver health, urging consumers to consider water as the optimal alternative.

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