Artificially sweetened, low-sugar beverages associated with higher risk of fatty liver disease: study

Drinking those zero-calorie and artificially sweetened beverages may not be as harmless for your body as once thought. A new study has revealed a connection between the artificially sweetened drinks and metabolic dysfunction associated with liver disease.

The study, authored by Lihe Liu, a graduate student in the Department of Gastroenterology at the First Affiliated Hospital of Soochow University, Suzhou, China, was presented at the UEG Week 2025 (United European Gastroenterology).

The UEG stated, “A major new study reveals that both 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 (MASLD).”

According to UEG, the study followed 1,23,788 UK participants without liver disease at baseline. They were given a dietary questionnaire, assessing repeated beverage consumption of participants during 24-hours. 

“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. Over the median 10.3-year follow-up, 1,178 participants developed MASLD and 108 died from liver-related causes,” it stated.

Moreover, the study also derived that both beverage types are positively associated with higher liver fat content.

Citing experts, the UEG statement noted that MASLD affects over 30% of people worldwide and is a rapidly increasing cause of liver-related deaths.

Liu noted that 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, according to Liu, may affect liver health by altering the gut microbiome, disrupting the feeling of fullness, driving sweet cravings and even stimulating insulin secretion.

On the other hand, replacing these beverages with water significantly reduced MASLD risk – by 12.8% for SSBs and 15.2% for LNSSBs, according to the study.

Moreover, substitution between the two types of beverages offered no risk reduction.