Both sugary and low-calorie drinks were linked to higher liver disease risk. Replacing them with water lowered that risk.
A large-scale study has found that both sugar-sweetened beverages (SSBs) and low- or non-sugar-sweetened beverages (LNSSBs) are linked to an increased risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD).
Presented at UEG Week 2025, the study analyzed data from 123,788 UK Biobank participants who had no pre-existing liver disease. Participants reported their beverage intake through multiple 24-hour dietary questionnaires, allowing researchers to investigate how consumption of SSBs and LNSSBs related to the likelihood of developing MASLD, liver fat buildup, and liver-related deaths.
Results showed that individuals consuming more than 250 grams of either beverage per day faced higher risks of developing MASLD, by 60% for LNSSBs (HR: 1.599) and 50% for SSBs (HR: 1.469). Over a median follow-up of 10.3 years, 1,178 participants were diagnosed with MASLD and 108 died from liver-related causes. Although SSBs were not significantly linked to liver-related mortality, LNSSB consumption showed a notable association. Both drink types were also correlated with higher levels of liver fat.
Understanding MASLD and its growing impact
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously called non-alcoholic fatty liver disease (NAFLD), occurs when excess fat builds up in the liver. Over time, this can lead to inflammation (hepatitis) and symptoms including fatigue, abdominal pain, and loss of appetite. The condition has become a major public health issue and is now recognized as the most widespread chronic liver disease. Experts estimate that more than 30% of the global population is affected, and the disease is rapidly emerging as a leading cause of liver-related deaths.
Lead author of the study, Lihe Liu, commented, “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.”
“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 noted 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.”
Why water is the safest choice
The authors emphasized that these findings support limiting both SSBs and LNSSBs as part of a comprehensive prevention strategy, targeting not only liver disease but also cardio-renal-metabolic health. 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.
Liu added, “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.”
The researchers now aim to explore causal mechanisms more deeply through long-term, randomized, and genetic trials with a focus on how sugar and its substitutes interact with the gut microbiome and influence liver disease.
Meeting: UEG Week 2025
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4 Comments
Despite the best of intentions and the greatest of diligence, most if not all large cohort studies are inherently fatally-flawed due to global mainstream medicine still failing to recognize, research, practice and teach nearly subclinical (sub-acute) non-IgE-mediated food allergies (https://www.foodallergy.org/fare-blog/why-we-need-stop-referring-ige-mediated-allergies-true-food-allergies) as an underlying cause, officially (FDA approved in the US) approved food poisoning: soy (late 1960s); the cooking oil preservative TBHQ (1972) and added MSG (1980), minimally, as aggravating factors and excessive related/resultant medical errors in their findings. No disrespect intended to the author/team but the study is questionable (at best) or invalid (at worst).
Link to the paper???
Eye-opening article. I always thought diet drinks were safe but it’s clear water is still the healthiest choice. I also use SheMed’s blogs sometimes for simple, practical health tips and it’s been really helpful for making better daily choices.
Correlation does not mean causation, so why are ppl treating this article as though it somehow “proves” soda consumption leads to liver problems? Again, epidemiological studies are correlative and extremely weak in terms of scientific evidence and they definitely don’t show a causal relationship!