A new study presented at the UEG Week 2025 has found that both sugar-sweetened beverages (SSBs) and low- or no-sugar-sweetened beverages (LNSSBs) may significantly increase the risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). Contrary to the common belief that diet drinks are safer, the findings suggest that even modest intake of low- or no-sugar-sweetened beverages, such as a single can per day, may pose health risks.
To investigate how different beverages influence liver health, researchers from the UK Biobank study followed 123,788 participants without liver disease at baseline. Participants’ beverage intake was assessed through repeated 24-hour dietary questionnaires. Over a median 10.3-year follow-up, the researchers tracked the development of MASLD, liver fat accumulation, and liver-related mortality.
The study found that people consuming more than 250g per day of sugar-sweetened beverages and low- or no-sugar-sweetened beverages had a 50% (HR: 1.469) and 60% (HR: 1.599) increased risk of MASLD, respectively. In total, 1,178 participants developed MASLD, and 108 died from liver-related causes. Surprisingly, while sugar-sweetened beverages were not significantly associated with liver-related death, low- or no-sugar-sweetened beverages were linked to an elevated mortality risk. Both beverage types were also correlated with increased liver fat content.
Lead author Lihe Liu explained, “Our study shows that low- or no-sugar-sweetened beverages 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.” Liu also pointed out that low- or no-sugar-sweetened beverages may harm liver health by disrupting gut microbiota, affecting satiety, and increasing sweet cravings.
Importantly, substituting either sugar-sweetened beverages or low- or no-sugar-sweetened beverages with water significantly reduced MASLD risk by 12.8% and 15.2%, respectively.
Reference: https://ueg.eu/
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