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The liver disease Fatty liver disease associated with metabolic dysfunction (MASLD), formally known as nonalcoholic fatty liver disease (NAFLD), is a condition in which fat builds up in the liver, which over time can cause inflammation (hepatitis) and symptoms such as pain, fatigue, and loss of appetite.
This disease has become a global health burden since it was recognized as the most common chronic liver disease, and experts estimate that it affects more than 30% of people worldwide and is a rapidly increasing cause of liver-related deaths.
Diet and sugary drinks and MASLD
A new study of the Soochow University in China reveals that both sugar-sweetened beverages (SSBs) and low- or no-sugar beverages (LNSSBs) are significantly associated with an increased risk of developing steatotic liver disease associated with metabolic dysfunction (MASLD).
The study is presented in the UEG Week 2025held in Berlin (Germany). The team of researchers followed 123,788 UK Biobank participants without liver disease at the start of the study. Beverage consumption was assessed by dietary questionnaires repeated over 24 hours.
The researchers examined the association between low birth weight and sugar-sweetened beverage (LNSSB) intake and the risk of developing MASLD, liver fat accumulation, and liver-related mortality.
Greater consumption of sugary and low-calorie beverages (>250 g per day) was associated with a 60% (HR: 1.599) and 50% (HR: 1.469) increase in the risk of developing MASLD, respectively. During a median follow-up of 10.3 years, 1,178 participants developed MASLD and 108 died of liver causes.
No association was observed with sugary drinks
Although no significant association was observed with sugar-sweetened beverages, consumption of sugar-sweetened and low-calorie beverages was also associated with an increased risk of liver mortality. Both types of beverages were also positively associated with higher liver fat content.
The lead author of the study, Lihe Liu, comments: “Sugary drinks have long been under scrutiny, while their dietary alternatives are often considered the healthier option. However, both are widely consumed and their effects on liver health have not been well understood.”
The study shows that the alcoholic beverages Low-alcohol drinks were associated with an increased risk of MASLD, even with moderate consumption, such as just one can per day. These findings challenge the common perception that these drinks are safe and highlight the need to reconsider their role in diet and health. liver healthespecially now that MASLD is becoming a global health problem.
Liu points out possible biological mechanisms that could underlie the observed risks: “The higher sugar content in sugary drinks can cause rapid spikes in blood glucose and insulin, promote weight gain, and increase uric acid levels, all of which contribute to fat accumulation in the liver.
Do even ‘light’ soft drinks damage your liver?
On the other hand, the Unsweetened sugary drinks can affect liver health by altering the gut microbiome, altering feelings of satiety, triggering sweet cravings, and even stimulating insulin secretion.”
The authors emphasize that these findings support limiting the consumption of sugar-sweetened beverages and low-sugar beverages as part of a comprehensive prevention strategy, focused not only on liver disease, but also on cardiorenal and metabolic health. Substituting either drink for water significantly reduced the risk of MASLD (12.8% for sugary drinks and 15.2% for low-sugar drinks), while substituting between both types of drinks did not reduce the risk.
Liu adds: “The safest thing to do is to limit sugary and artificial drinks. Water is still the best option, as it eliminates metabolic load and prevents the accumulation of fat in the liver, while hydrating the body.”
Researchers now aim to explore causal mechanisms more deeply through long-term, randomized, genetic trials, focusing on how sugar and its substitutes interact with the gut microbiome and influence liver disease.
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